Olive oil – Marilyn R. Gardner

There were 6 of us in a small examining room designed for two people — the doctor and the patient. In this case there were two women from the Sudan, two nurses, one patient navigator, one interpreter, and one baby.

It was crowded.

To say I was invited to come to this community health center was something of a delusion, it was more as if I had been challenged to come – challenged with strong words: “This program isn’t working! You try to use this life-style education tool with culturally diverse patients”

To give context the “challenger” was referring to a health assessment that my office had developed to gauge whether a person is ready to make changes to their lifestyle. It included questions on weight, healthy fats, exercise, fresh fruits, vegetable consumption and more.

I was not a fan of the questionnaire – I had worked with people from different cultural backgrounds my entire professional career and knew that this tool had been developed from a bias of western biomedicine. As such, it had limited use.

But I accepted the invitation knowing that at least they would see I was on their side.

So there we were: health professionals, patients, and a culturally biased assessment. Speaking through an interpreter I began talking. I introduced myself and asked if I could ask them a few questions. They nodded in assent – no problem.

And so I began:

“Are you a healthy weight?” Blank looks.

The interpreter tried again, and then looked at me. “This is not relevant,” she said. “They do not weigh themselves.” Of course, they didn’t. What was I thinking? They were women who had escaped the Sudan, made their way through the arduous process of refugee camps and resettlement and I was asking them about healthy weight. Wow. But determined to continue I pressed on.

“Do you eat healthy fats?” More blank looks. My problem-solving mode switched on and I thought – ok, I’ll ask if they use olive oil – that’s a healthy fat.

“Do you use olive oil?”

Their eyes lit up. They smiled. “Oh yes! We use olive oil all the time”. Good, I thought! We’re making some progress…..

“Yes olive oil. We love olive oil! It is wonderful. We use it every day…..on our hair”

I began to laugh, and they with me. The whole encounter was so absurd. I would have gotten more information on their health and eating habits by having a normal conversation and inserting the right questions at the right time instead of following this biased and culturally illiterate tool.

The story is a great example of some of the challenges presented in working with patients from different countries and cultures. The healthcare professional (whether nurse, doctor, social worker or any other) comes into the clinical encounter with his or her own predetermined biases, values, and beliefs. Added to that is the often inflexible culture of western biomedicine under the umbrella of the institution. All of this mixes into a potentially difficult interaction with the patient. We then wonder why patients won’t come back…or get offended…or don’t do as we want them to.

Culturally responsive care is critical to healthy outcomes.

But changing this dynamic is not easy. It’s a journey and as such takes time, preparation, and mile markers.

One of the first mile markers in learning to communicate across cultural boundaries is to understand one’s own cultural beliefs and values. Only then can we better interact with those from different backgrounds. If we don’t know what we believe and value, what is unique to our cultural backgrounds, we are ill-equipped to forge into relationships with those vastly different from us, even less ready to offer them good health care.

And after that it’s about listening to the stories and constantly being willing to learn and adapt.

It’s interactions like the one I’ve described that help me on this journey of communicating across cultural boundaries. They remind me that I have to be ever flexible and willing to see from the other person’s perspective; recognizing both literally and metaphorically the many uses of olive oil.

Got Olive Oil, Honey, and Sugar? Then You Have a Great Scrub (bellasugar.com)

When we crave hummus or stuffed grape leaves; when our mouths water for lebne and fresh pita bread; when large grocery stores of packaged and processed foods with too many choices and paralyzing cereal aisles begin to weigh us down, we head to the Armenian stores of Watertown.

There within a couple of blocks are five or six stores, all boasting the foods we love and crave. They are small and manageable filled with all the smells, spices, and goods that represent so much of the wonder of the Middle East.

They sit competitively on Mount Auburn Street in Watertown and are known throughout the area. Their names are words like Massis and Arax and Sevan and all hold tastes of familiarity and home, tastes of the middle east.

As soon as we get home we set out our mezzes in the pottery plate we bought in Jerusalem. The separated parts of the plate are perfect for the variety of foods we have purchased. Mouths watering, we put out our food treasures, anxious to sit down and eat.

And in those moments, as we dip fresh pita bread into hummus laced with pungent olive oil and sprinkled with the deep red spice of sumac, we live out our longing for a place through food.