tours

More Cultural Reflections

I have spent the last week still sick from whatever bug I picked up in Vietnam.

I began my travel blogs with a post from the Korean airport about cultural differences. I don’t think anything could have better highlighted such differences than seeking medical help in Vietnam and Korea before returning home to the U.S.

On my last day in Vietnam, the concierge of my hotel in Hanoi directed me to a clinic down the street. When I got there, the door was locked, even though the sign in the window said “open” and I could clearly see someone sitting behind a desk inside. I knocked a few times and was about to give up when the figure inside stirred, then slowly made its way to the door to let me in. The door opened, and I stepped into a shabby but clean room with a desk piled with books, two chairs, and a cabinet stacked with drug samples. The doctor was a small woman wearing a labcoat and slippers embroidered with the logo of the Daewoo hotel (where I happened to be staying). She had clearly been sleeping.

She spoke little English, so we had difficulty communicating. But her eyes lit up when I said the word “stomach,” and she said, “Okay, okay, I help.” She opened a paperback volume on her desk and ran her finger down the page until stopping, reading something, and then slamming the book shut. She then dug through the pile of samples on the cabinet and eventually found two bubble packs of pills. I paid about $4 and left with two prescriptions that I had no idea how to take. I realized as I left that she hadn’t taken my temperature.

Later, in my hotel room, I looked up the names of the prescriptions online. Both packages were in French, so it took quite a while to find information on them in English. In the process, I realized one had already expired. Online searching revealed that both were widely regarded as placebos and could cause fairly severe side effects. I decided not to take them.

I hesitate to draw conclusions based on my experience at a single clinic, but I got the overwhelming impression while staying there that we were acting out a scene from a bad American medical drama. The props (labcoat, drugs, manuals), characters (doctor, patient), and language (“stomach”) were all present, but were only symbolic as linguistic and cultural barriers prevented a substantive exchange.

In a cab on the way to the airport several hours later, my Vietnamese host suggested that my illness was caused by an internal imbalance between yin and yang; constant travel, unusual sleep schedules, and being away from my husband had disrupted the harmony of my body and caused illness. He made a sharp, chopping motion on my neck and back to restore balance, recounting times he had used this massage to help other visitors to Vietnam suffering a similar affliction. (Most interestingly, he had given the same massage to Emily Morrison, the daughter of Norman Morrison, the Quaker who famously set himself ablaze beneath McNamara’s window at the Pentagon to protest the Vietnam war. During Emily’s first visit to Vietnam, she became quite ill at Ho Chi Minh’s mausoleum, but her symptoms were eased by the same massage I was receiving.)

This massage seemed no less plausible a treatment than expired French placebos, and I gladly submitted to my host’s almost painful chopping at my back and neck. I suppose I was hopeful not only that my queasiness would subside, but that I would also witness some sort of triumph of traditional Vietnamese medical practices over a Vietnamese attempt to mimic American medicine (as I thought I’d seen in the clinic). I confess I’ve become a little skeptical about American medicine lately, particularly its propensity to medicate every conceivable condition – for example, this weekend I saw a commercial for a drug to help “restless leg syndrome.”

However, by the time I landed in Seoul, I was feeling terrible. The Seoul airport has a hospital in its basement, and an airport employee kindly wrote for me in Korean on a scrap of paper, “I want to go to the hospital.” I showed this paper to every official I encountered on my way to the hospital – which, it turns out, required leaving the airport altogether – and it seemed to convince customs, passport control, and airport security that I required no special scrutiny. Once in the hospital, my experience was remarkably similar to that in Vietnam, despite the significantly more sterile environment. Once again, I was given two prescriptions that I could not read and did not know how to take. This time, frightened by the prospect of feeling sick for an entire 13 hour flight, I took both before boarding my plane to the U.S. and hoped for the best.

As much as I wished to understand Vietnamese medical beliefs, I am American, and I was relieved to finally arrive in Atlanta and visit the airport clinic. There, I could communicate in English; the doctor acted predictably aloof and technical; and the treatment, an IV, was thoroughly communicated and matter-of-factly administered. The experience lacked the novelty and personal nature of my taxicab massage in Vietnam, but it was effective and, for all its sterile detachment, comforting.

It is strange enough to step inside another culture’s concept of health and medicine, stranger still to do so without any means to communicate about that concept. So I left Vietnam much the way I entered it: reflecting on cultural assumptions and differences, this time made much more immediate and personal as my physical well-being depended on successfully negotiating those differences.

(If you are at all interested in this topic, please read Ann Fadiman’s wonderful book The Spirit Catches You and You Fall Down, about a family of Lao Hmong refugees seeking medical attention in the U.S.)

Lying in bed all week gave me plenty of time to reflect, and now that I am feeling better (i.e., I can type without feeling nauseated), I have some final thoughts on Vietnam that I hope to type today or tomorrow.