Monday, April 21, 2014

Cultural Equivalents in Standard Greetings

After taking yoga for more than a year and hearing the word "Namaste" multiple times, it reminded me of the Hebrew word "Shalom, the Arabic word "Assalamu alaykum, and the Hawaiian word "Aloha". 

Namaste is a customary greeting when  individuals meet and a farewell when they part.  It is a form of greeting commonly found among people of South Asia, in some Southeast Asian countries, and diaspora from these regions.  Namaste is spoken with a slight bow and hands pressed together, palms touching and fingers pointing upwards, thumbs close to the chest.  This gesture in Hinduism means "I bow to the divine in you".

Shalom is a Hebrew word meaning peace, completeness, prosperity, and welfare and can be used idiomatically to mean both hello and goodbye.  As it does in English, it can refer to either peace between two entities, or to the well-being, welfare or safety of an individual or a group of individuals. 

Assalamu alaykum is an Arabic greeting widely used in the Muslim world even by non-Muslims.  It nearly translates to "peace be upon you", but is often considered the equivalent to "hello", "hi", or "good day" in English.


Aloha in the Hawaiian language means affection, peace, compassion and mercy.  Since the middle of the 19th century, it also has come to be used as an English greeting to say hello and goodbye.


One could go to every culture and find a similar sentiment.  The bottom line is that fundamentally everyone is the same.  When it comes to the preliminaries of human contact, at least at a fundamental level underneath the difference within language. 

However, in the ED, the key challenge is putting the patient/family at ease in a matter of seconds.  There is really not much time to accomplish this, and following a few basic principles goes a long way.  Here are some:
  1. Eye Contact-Confidence: Put the patient at ease by looking them in the eye, and having a bearing that reflects confidence.  This gets the patient over the initial anxiety hurdle of winding up with a less-than-fully-competent physician by allowing them to say to themselves "this doctor knows what they are doing".
  2. Advance Knowledge: Put the patient at ease by knowing something about the case before you walk into the room, and showing that in your initial words.  Asking "why are you here" is a loser... because the common answer or thought is "I've already told five people why I am here!"  How much better to walk in and say "I understand you are here, because you are having XYZ (chest pain, weakness, shortness of breath, etc.) .
  3. Common ground: Put the patient at ease by establishing common ground from the get-go.  An initial "I understand you are here because..." starts that ball rolling, and following that with some reflection on their discomfort or anxiety, will enhance the encounter tremendously.  You might say, for example..."you must be feeling pretty bad to come here to the ED, it is hard to come into any medical facility, and I'd understand if you felt anxious or worried".
  4. Outline of Plan: Put the patient at ease by giving a quick summary of what you are going to do to help.  EG: "Well, we are going to help you feel better...first we'll relieve pain, alleviate distressing symptoms...then we will run some tests to find out why this is happening...and then we will do whatever we can to help you.
  5. Questions: Put the patient at ease by now...starting your actual...interview..."So...let me ask you a few questions..."


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