Avoiding Caput Medusa - or - Try and Keep Your Cross-Cultural Teaching Simple

(from Eric)

We are in the throes of clinical teaching here at Kibuye.  In French.  To a group of Burundians.  Who are on their first hospital rotation.  And we're still learning how to do it.  So we try out some new things.

I asked my students what some topics were that they wanted to learn about.  Perhaps that was the first mistake, because it is certainly possible to be too early in your education to know what you need to know.  They said psychiatric disease, liver failure, kidney disease, and hypertension.  I would have only picked one of those things.

But, I did ask, so I tried to follow through.  The next day, I sat down to try and do a little extemporaneous talk on liver failure.  Every time I try and do this, I discover that I don't know significant amounts of vocabulary necessary for the topic.  And I discover that when it is too late to turn back.  So you just try pronouncing the word with a French accent.  If they repeat it back, you're good.  If they don't, you give it a second try for good measure.  Third blank looks gets an attempt to explain it.  Fourth blank looks abandons the topic.

We started with a list of symptoms of chronic liver disease.  They got a few of them.  Ascites.  Jaundice.  But they weren't getting anything associated with portal hypertension.  So I asked them:

(in a French accent) "Hypertension Portal?" (it's also good to try and reverse the orders of words)

Flash of recognition.  Good.  Success.  "OK, can you name any signs of portal hypertension?"  Blank stares.  OK, I should explain it to them.  "So, when the blood going to your liver gets backed up, the blood gets sent on alternative pathways in various parts of the body, and that leads to varicose veins there and possible bleeding problems."

If you are impressed that I could explain that in French, then you shouldn't be, since, though I got an "E" for effort, they obviously didn't really understand me.  OK, moving on:

"Esophageal varices?"  OK, good, they've heard of that one.  "The same problem in another place?"

No response.

"Hemorrhoids?"  I think they get the word, but they seem more confused.

"Caput medusa?"  Very confused.  "Medusa, do you know her, from Greek mythology?"  Nothing yet.  "A lady with snakes instead of hair."  Mouths agape with astonished stares.  "Uh, yeah, I guess it does sound a bit frightening..."  

This is where I realized I had certainly gone too far, but now, with the totality of their interest directed towards me, what am I to do?

"Well, picture a face with a bunch of snakes coming out, and then picture the belly button with dilated veins sort of coming... out... instead..."

One of them ventures boldly:  "You can see that, just by looking?!"

Uh, yeah, but I don't think it's as dramatic as you are thinking...

Medusa

Caput medusa

Another day in our lives.

 Wikipedia France has informed me that "la tête de Medusa" is, in fact, the French term.