HEAD IN SAND

I understand why some people would rather keep their head in the sand and not be aware of what is happening around the world. There is only so much we can do. Does it help anyone for me personally to read details of various wars, human trafficking, environmental disasters, political prison systems, and more? Or do I just traumatize myself to the point that I cannot be as helpful in contributing my little bit to society? Does information overload make it all seem so hopeless that I get paralyzed in despair?

I used to feel obligated to know as much as I could, under an idealistic theory that “if they can live through it, I have to handle knowing about it,” and I sought out information, and really tried to understand so many situations that were so far out of my control. It gave me a certain world view that can be painful to me but keeps me more sensitive to the suffering of others, and in that way, I suppose it has served me well. I am much less likely to wound others where they are already most wounded. I have a sense of where vulnerable people’s sensitivities are.

Not everyone has embraced this process, and I do understand why they wouldn’t want to. But I wish those who work in healthcare and others who interface intimately with vulnerable populations would make some effort to have a general understanding of the people they are likely to meet. A few evenings of reading would give them enough insight to avoid reawakening deep wounds in those they are paid to serve, and they don’t need to delve in deeper than the surface if they would rather not. A few simple tips:

TORTURE: People are really tortured. Don’t give a torture example for your pain scale questions (10 is like being tortured!) And please stop joking about torture or using the term with a sarcastic laugh. It is no more appropriate than joking about rape, which is one form of torture among many. I cannot count the times nurses have joked about not being into torture, or how something is torture. It is not torture to have a blood draw. It is not torture to watch a film about transplant. Find another word. Millions of people in war zones and areas of conflict face torture as part of the power struggle. It is very real and leaves permanent scars on the body and in the psyche. Be respectful. Torture is real. Making light of it hurts.

MURDER: Most people in war zones have lost family members. Sometimes whole families are gutted. In my father’s country, they lost 10% of their population and 18% of their land in the last war. No one in that country had a family that was intact. I remember one older man telling me he didn’t dare marry his childhood sweetheart after the war, because her father had been killed, her older brother had been killed, her two uncles had been killed, her cousin was an amputee, and the farm was going to filled with widows, disabled and orphans. This still goes on. So what seems like small talk, casually asking about family members, how many kids someone has (left) can open deep wounds.

FAMILY SEPARATION: It is extremely rare for a refugee or immigrant family to arrive all at the same time, or even to all arrive. One parent or an adult child is sent here to work, or wins an immigration lottery, or makes it over the border while the rest of the family is caught and deported. Again, the small talk that is so common, how many kids do you have, where are they? Oh, dear, you haven’t seen your daughter in 8 years, that must be hard! Your wife is now with someone else after you sent money for 4 years, too bad. Your Mom died a lingering illness but you couldn’t go back and say goodbye? Oh, gee! Folks, these are not the conversations that your refugee patients need to have during blood draw, with a medical assistant, or at any other time during a routine visit. Be sensitive. Don’t pry. You can open a wound simply by asking someone if their children live nearby.

HOW CAN I BE SENSITIVE? Just remembering that the refugees you hope to serve have likely been through terrible and traumatizing situations will make you more sensitive and respectful. Understanding that their family has huge holes in it, missing people, parents they will not be able to comfort on their deathbeds, children they will not be able to raise themselves, wounds that can open at the slightest touch, will make you kinder and more careful in your speech. Focus on what you are doing with the patient, and let them bring up their families, their lives, and their experiences if they wish. If they find you compassionate, and you have the time, they may wish to have these conversations and talk about their lives, but let it be their choice and in their way. It is the least we can do.