more dirt

In response to Hannele's comment on dirt, I was reminded of something that happened to me in the line of my paying job.

Several years ago, I had a very nice older gentleman as a patient who looked far, far younger than his years. Very quiet, well-groomed and well-mannered, he had had what we in the business tend to consider a relatively minor procedure and he was recovering beautifully. In fact, I expected he'd be going home when his family cornered me in the hallway .

Apparently their concern was that he was actually a bit of a hermit, lived in the far north in a cabin with a dirt floor with no indoor plumbing, and, to top off the list of what they obviously considered to be almost crimes against humanity, he shared his living quarters with a horse, in the same one-room cabin -- at least that is how I understood it. Their expressed fear was that he was at risk for infection having just had surgery and everything. They also implied that the man was perhaps missing a few marbles...And I suppose that they wanted us to detain the man somehow and place him -- where? -- they probably hadn't thought that far of course. If the family had not brought up the man's lifestyle, there was nothing about his appearance or behavior to suggest that his was anything out of the norm (whatever that is).

Well, I didn't bother to explain the technicalities of a wound healing to them, nor the legalities of holding somebody against their will, but in the interest of respecting my patient's privacy and independence, I decided to remain neutral and check things out for myself after the family had left.

Well, the man was most certainly in his right mind, eccentric as hell, but only wanted to return to the peace and quiet of his cabin in the woods. He was able to clearly and coherently explain to me how he would comply with our suggestions for caring for his wound, etc. at home. And just from observing him for two days in the hospital, I was quite sure that even if he shared the cabin with a horse, the cabin was probably neat as a pin.

The family pushed enough to get Discharge Planning involved. D.P. was puzzled, perhaps at first, when it was confirmed that, yes indeed, the man lived in a cabin with a dirt floor with a horse. But anybody could see for themselves that the man was not nuts, was clean, was healthy and quite ready to go home. He was discharged that very day.

I still wonder sometimes what the family thought, that we, the supposed health professionals, were nuts as well? Or were they just worried if the truth about their family member's unique lifestyle came out, how that might soil their own reputations?

In most Third World Countries, I wonder how this might play out?

On a completely different tangent, it reminds me of how furious I was when I learned that a certain baby-formula manufacturer had successfully convinced somebody that it was a good idea to encourage mothers in Africa to feed their infants formula vs breast-feeding them. Never mind that bottles and formula are expensive and sources of clean water nearly impossible in many places and that finding fuel and/or money to buy fuel to sterilize the equipment is very problematic...etc.etc.etc. That struck me as the most cynical exploitation of desperation possible and still makes my blood boil. God forbid you should try to empower the women in any way so that they are not weak and starving and can feed their babies themselves in the way God intended. What is worse is that although this scandal occurred many years ago, you can still find remnants of that thinking in some of the literature and protocols of ngo's etc that provide aid and health care in Africa.