|
||||||||
|
When Phone Calls Make for a Bad Connection
"Who is Marian?" I asked. "She didn't say," my assistant said as she hurried past with a chart. Many Navajo live in scattered outposts across the "Rez." The cost of building telephone lines to isolated clusters of homes is prohibitive, and as a result, nearly 70 percent live without a phone. Instead, some have started to carry cell phones with reception that fades in and out. A patient recently called me from sheep camp. Her crackly voice had intermittent gaps, and I heard distinct bleating in the background as she herded her sheep into the corral. Communication in the Navajo Nation is very different than in the Western world I am accustomed to. The phone only accentuates the differences. In the Navajo culture, each person is considered part deity, and thus the spoken word has the ability to shape the future. Names carry particular power. Most traditional Navajo have a special Navajo name that is used only in ceremonies. Even the English name is used sparingly. "Sister, go get Son!" the mother of one of my patients told her daughter as the youngest toddled out of the examination room. Sometimes patients will identify themselves, but as often as not the voice at the other end of the line will launch directly into the issue: "Dr. Rothman, remember how you saw my son last week? Well, he still gets all hot even though I give him the medicine." Understanding on the LineIf talking to the average Navajo on the phone has its challenges, they were nothing compared to calling a medicine man. I planned to invite several medicine men to speak with local Navajo high school students participating in a mentorship program through the clinic where I work. In addition to teaching them about the Western medicine in the clinic, I wanted to expose them to traditional Navajo beliefs.My staff warned that finding someone willing to come would be difficult. Medicine men have traditionally been selective about whom they teach, each selecting a single disciple to follow in his footsteps. Navajo is primarily a spoken language, and little about their practices has ever been written down. Speaking for an hour or two on a particular topic to a group of students, even Navajo students, was not something they would be accustomed to. One of the medicine men was employed by another Indian Health Service facility and routinely performed ceremonies for clinic patients. I thought this experience would make him more comfortable working with a biligaana (white) doctor. It took several calls before I reached him, and then I left a few messages to confirm the date and time. I also called Samuel, another more traditional medicine man, who was a patient at the clinic and had even undergone a kidney transplant. The phone rang endlessly at Samuel's residence. While phones are uncommon, private answering machines are virtually unheard of. I finally wrote Samuel a letter, assuming that even if he couldn't read it, someone in his family could. I asked him to contact me the next time he came to the clinic to set up a time, if he was interested. Cultural CritiqueOur patient advocate in the clinic is well connected to the community and quick to recognize issues that compromise traditional Navajo values. Unfortunately, she has difficulty helping our patients understand the cultural conflict from a Western perspective. "Rothman, do you have a minute?" she asked me one afternoon. "Samuel's daughter is here." It had been months since I sent the original letter."Samuel wants to come," his daughter said, "but he's been waiting at home for a letter telling him what day and time." "I'm so glad to meet you," I said, extending my right hand in polite Navajo greeting. "I didn't realize that Samuel wanted to come. I expected him to find me in the clinic if he was interested. I understand that this is an unusual request, and some medicine men aren't comfortable. If he's still available and interested, perhaps he could come next week." The daughter smiled at me, and I handed her a slip of paper with the date, time, and place. I hurried back to my waiting patients. By the following week, I still hadn't heard from Samuel. I asked the patient advocate whether she had heard from him. "Samuel's daughter was pretty upset after last week," she said. "She asked if you always do business like that. She said, 'My father wanted to come and was just waiting for a time. And why did she send a letter? She has to understand that even though my dad can speak English, he can't read it so well.'" Furthermore, the Navajo consider it impolite to make eye contact when speaking to someone. I kept trying to look away and instead glance downwards as we were speaking. Apparently, the daughter felt that I was rudely looking her over. At the same time, the patient advocate informed me that the IHS medicine man had called her to complain that I talked too fast on the answering machine. He wasn't sure what I wanted, she said, and he wanted her to find out. Not surprisingly, Samuel didn't arrive for his session. The IHS medicine man was willing to give me a second chance, however. Despite the difficulty we had connecting over the phone, communicating in person was surprisingly comfortable. He was impressed with the program and the kids. By the time his session was over, he had given me suggestions for other medicine men to invite in the future. He chuckled as he issued his last suggestion. "Just talk slower on the answering machine," he said as he shook my hand. "You've got to talk slower." --Ellen Rothman, HMS '98, now practicing in northern Arizona on the Navajo Reservation All patient names in this column are pseudonyms. |
