Goodnight.

The culture of medicine almost seems to be an oxymoron the first time you hear it. Medicine is thought to be a purely physical area of study and practice that is based on universal biological principles. But the practice of medicine can actually be considered to have a large psychological component. People tend to forget that the practitioners of medicine are people, too. People who are susceptible to opinion, bias, and different views (even though all those qualities sound pretty much the same). The way a doctor practices medicine, what he advises his patients, and what his training entailed is culturally-based. You see an interesting interaction of medicine and culture right here in Nova Scotia. Many doctors in the region are immigrants who often grew up in vastly different cultures from own and may have received their medical training here in Canada or in their home countries. For example, my mother has a had more psychiatrists over the years than you can shake a stick at, yet she only ever really got along with one of them, who was a true Maritimer who understands the people of the region and what their needs and concerns are. One of her more recent psychiatrists was from Germany, and she had the quite stern, no non-sense attitude that is often ascribed to the Germanic people, along with the obvious accent and poor people skills. Sometimes I stop and wonder why people with the personalities of a cactus and no people skills ever get involved in psychology, where making a connection and good rapport with your patients is as important as the treatment itself. Continuing in the discussion, I remember a story my mother once told me about my grandfather. In his (relative) youth, my grandfather was the kind of person who knew what he wanted and had no problem telling anyone off if he figured he was right. So my grandfather was having chest pains many years ago and went to his family doctor to talk about. His doctor was an African immigrant who said during his office visit that where he comes from, you don't complain about something as trivial as some small pains and that my grandfather was going to be fine and that he should go home. Well, my grandfather  being the mouthpiece he was at that age, said to him that he didn't come to listen to his BS diagnosis, listen to stupid stories, or cared what he had to say. He knew something was wrong and he wanted a referral to a real doctor, as in a heart specialist. So he got it, took a trip to Halifax and met with the cardiologist. The doctor told him that he had a rupture in his aorta and that if he was any later getting in to see him, he probably would have died. So he got immediate surgery then was one his way. My grandfather was a wise man.

It's stories like this that make me think about the clashes of culture in medicine. Everyone is certainly entitled to their own opinion, but if you ask me, if you're going to work within the realm of a certain culture, you need to adapt and change how you conduct yourself to match the values of that culture. Of course, with that African doctor, I think it might have been a combination of being blinded by culture and perhaps a bit of incompetence. Nova Scotia isn't exactly well known for its excellent medical care, given my family's experiences within the system *coughmisdiagnosesandmedicalmalpracticecough*.

On the other hand, I think it's important to consider what other cultures find important as well, as long as it makes sense. That African doctor's cultural values, not so much. But it's all relative and subject to how you look at it, I guess. I like the idea that France has with their medical care. As opposed to North American medicine, French medicine puts an emphasis on the body as terrain and that balance is important. Long rests and days at the spa are prescribed more often then actual medicine. Constant bathing is also discouraged. It may seem gross to a lot of people, but I think it makes sense. Dirt and germs are part of our terrain and are seen as beneficial. Even though many bacteria and viruses make us sick, it's rarely ever the case that it's really debilitating. They are beneficial in that they allow our bodies to build up immunity and train them to protect themselves better. We are one with our germs, in a way. I think I can attest to that. I only shower once every two or three days and I never go to the doctor when I get a cold, flu, or whatever. I even avoid going to the doctor when I probably should, like when I got a slight inner ear infection a number of weeks back. But I hardly ever get sick. Everyone I know goes to the doctor for pretty much anything and they all get sick from time to time during regular and cold and flu seasons. But not me. The worst I ever really get is a bit of phlegm and a slightly sore throat, and that typically only lasts a day. In my third year of university, I shared an apartment with three people who all developed whatever that nasty flu was that went around campus, swine flu I think. Three sick people with me all confined to close quarters, one of which was sort of quarantined in the apartment for a while. I never got sick. I went happily on my way doing my thing while everyone else suffered! I'm always bragging about my kick-ass immune system, and the only thing that makes sense to me as to why it is great is that I've built up a great defense system by not really partaking in North American medicinal culture. I don't drown myself in pills or antibiotics, never get flu shots (though I'm constantly told by the school, news, and family to get one every year), and so on. My diet isn't exactly full of body-enhancing nutrients, it's mostly just junk food, yet my immune system is great. I'm also pretty laid back most of the time, so my body can always focus on its internal upkeep. It seems a French style of personal care is working for me.

North America tries to drive home the idea that germs are bad and must be eliminated, with antibiotics being prescribed like candy at the Bulk Barn. The thing about that is that taking copious amounts of antibiotics causes bacteria to build up an immunity themselves and those super robust bacteria that are leftover reproduce and wreck your body. Germs aren't bad, they help us even if it doesn't seem like it. I wish most people would just sit and think about that for a while. I mean, doctors are supposed to be super smart themselves! It takes a special kind of person with immense cognitive abilities to get through medical school, so you'd think most would be enlightened enough to explore different applications medicine. Then again, they could be funded by big pharma, which is a story for another day. There's just a lot to it, I guess.

Anyway, I guess that's it for tonight. This blog is due tomorrow, so I hope I talked enough across a broad enough spectrum of ideas.

Templeton "Faceman" Peck

Motivation and culture interact with one another in pretty interesting ways. One of these interactions I'm thinking of at the moment is self-improvement. Sure, most (motivated) people want to be the best they can possibly be, but the reasons behind why differ from culture to culture. In our Western culture, the concept of self-improvement is largely motivated by the principle of promotion orientation. That is, we focus on striving toward positive outcomes and advancement. Success is what we find important and that idea is usually drilled into our heads from a very young age. Even today at the age of 24, whenever I talk to my parents about something important like an upcoming exam for a difficult course or an intimidating job interview, they still tell me to do the best I can because they know I can do well and go far; they want to see me succeed in the world. So because of that, I have a promotion orientation, as do my parents, and their parents, and so on. This is true for most people in the West. Whenever I think about promotion orientation, the idea of a corporate bigwig inevitably comes to mind. I suppose this can be seen as an extreme example of promotion orientation. I keep thinking of the average white collar employee who starts working for some random company at one of those menial entry level positions, who, because of his over-the-top motivation to succeed in the corporate world, manages to claw his way up through the ranks of the company to an executive position. To get there, he sells out his fellow employees, betrays those at his level and above, and God knows what else. Eventually, he may even become CEO, sitting atop his Ivory Tower with his millions of dollars buying and selling smaller companies, accruing even more wealth.

It's kind of funny because it seems like the exact opposite of someone with a prevention orientation. That orientation is characterized by a focus of avoiding negative consequences, avoiding future failure, and improving one's weaknesses with the overall goal of maintaining social harmony and esteem with others. As you may have guess, prevention orientation is mostly seen in Eastern cultures. Now, I'm not very knowledgeable of Eastern business practices, but I imagine that the scenario of clawing one's way to the top doesn't really exist in those cultures. I can just imagine the reaction of those around if one were to attempt that. I imagine a firing would be in order. As far as I know, while CEOs in North America change fairly often businesses evolve consistently, while CEOs in Japan tend to be more static and are often family members of those who founded the company. I believe that children of corporate executives and business owners are often raised to follow in their father's footsteps and to take his place once he retires or passes on. Family-owned businesses are kind of a big deal in Japan while they are dwindling ever so quickly in North America. Corporate buy-outs likely happen in Japan as well, but we don't really hear too much about it. Likely not as great as here in North America. Nintendo was a family-owned company from its founding in 1889 until 2002, and that was only because Hiroshi Yamauchi, the company's previous president, had no immediate family to take over once he retired, so Satoru Iwata was chosen to head the company, due to his great leadership skills and track record of top-notch work.

Much of the difference in orientation is due to the concept of "face", as in from the phrase "saving face". Translated directly from Chinese, face is the social value given by other people if you fulfill your social obligations and expectations. Here in the West, we generally don't care about what other think about us. Well, we do, but not in the same way those in the East do. I had pretty low self-esteem was I was a kid and teenage and I was really concerned about what other people thought of me. I hated confrontation because I had an almost obsessive fear of "rocking the boat" as well as a fear of rejection and making other people uncomfortable. Hell, I'm still kinda of bad for that. My parents always used to tell me to not concern myself with what other think thought of me and that the only one's opinion of me that mattered was my own. I imagine it would be the opposite if I were raised in Japan. I would probably be told that others opinions really do matter and that my focus should be on doing what I'm expected to and maintain social balance. Thinking about it now, did I really have low self-esteem and an aversion to confrontation? Or did I just have a prevention orientation? Considering the context of culture, I probably just had low self-esteem. I wasn't raised with intention of maintaining social harmony, I was just afraid of other people and consequences. Still, it's interesting to ponder.

Well, that's it for tonight!