How to Cross the Canyon

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The canyons of the Napali coast. 2013.

Picking up the phone, I took a deep breath, then dialed the number.  One of the benefits of being multilingual is that you can communicate and cross barriers  to connect with others.  But one disadvantage is that you might also have to do the very thing that no one else wants to do… deliver bad news.

“Hello?” a woman answered.

“Hello, ?? Bong (older sister)?” [In Khmer it’s polite to call others older brother or sister even if they are not related to you.]

“???? (yes)?” the woman replied, with a gentleness in her voice.

“This is the nurse from your OB’s office. We got your lab results back, and they show your blood pressure is high and affecting your kidneys. You need to go to the hospital now. They might have to deliver your baby today.”

“What do you mean? Why would I go to the hospital now?” she asked.

“Your blood pressure is high and when you’re pregnant, it can be very dangerous and cause you to have seizures.” I explained.

“How is this possible? High blood pressure? But I don’t feel sick,” she replied. “No… I’m not going.”

“If you don’t go, you could hurt both you and your baby,” I pleaded.

“But I feel fine,” she insisted, in an firm tone. “I’m not going.”

In that moment, with her still on the line, I felt like I was clutching onto a life raft between two tall canyons, one representing American culture and the other, my Asian heritage.

Since I was born in the States, I grew up largely with an American mindset, like my Western approach to patient care.  It was very straightforward to me, that she should follow her doctor’s instructions and go to the hospital based on her abnormal labs.  But the more I have worked serving a largely immigrant and refugee population, the more I have been challenged to think differently, and to approach situations from a new perspective.

How do I get off this life raft and cross to the other canyon?

Suddenly I was reminded of a Khmer proverb. “I see what you’re saying.  My dad taught me the saying, ‘if the wound is not bleeding, don’t irritate it…’, is that right? Have you heard that?”

Her voice softened. “Yes. EXACTLY. So why would I go deliver my baby if nothing is wrong? ”

“That’s the thing… high blood pressure is what we call a ‘silent killer.’ You don’t feel anything, but it’s there. And for you, your blood work showed that it’s already hurting your kidneys. And it could not just hurt you, but your baby as well.”

“Oh…”

“Well how about this… pack your bags and go to the hospital. If the doctor there evaluates you and thinks you are safe to go home, they might give you medicine and let you go home. But if not, they will do what they think is the safest…”

She sighed. “Okay. I guess I will go then. Thank you… bye.”

~ ~ ~

A week later, my colleague scooted into her seat in front of her laptop. “Remember that patient? With the high blood pressure?”

“Yeah, what happened to her?”

“She had an emergency Csection.  It was pretty serious.  If you hadn’t talked to her… it would have been even worse. You saved a life,” she answered, while typing away.  She wasn’t even looking at me, like it was no big deal.

Actually, it was the first time…

I didn’t save one life.

I saved two.

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