How Understanding Culture Matters To Healthcare

If you do not take cultural and religious beliefs seriously, you will not fully understand your patient’s concern.

My wife, Mary, and I have what we consider to be our adopted son, Menachem. He worked at the Church Health Center after he graduated from Rhodes College in Memphis, and then he went to University of Tennessee for medical school. Last year he finished his family medicine residency at Beth Israel in New York.

Menachem is an African American kid from Tupelo, Mississippi. How did he get a name like Menachem? Menachem was born during the time of the Camp David Accord. His mother, a social worker’s assistant, was so enamored with the idea of peace in the Middle East that she was going to name her baby Menachem, Anwar or Jimmy. She chose Menachem Begin for the honor.

So this poor black kid from Mississippi was named Menachem. He then went to Tennessee. I made the really big mistake—because my plan was for him to come back to work at the Church Health Center—of taking him to the Big Apple, and he falls in love with New York. He ended up matching with Beth Israel for his residency. Beth Israel has a large population of Hasidic Jews who use their clinic. The doctors who see them are residents. Patients look at a sheet of paper and pick who is going to be their doctor.

Menachem! What Hasidic Jew is not going to say, “I’m picking Menachem!”

When it first happened, patients were very surprised to meet Menachem, and Menachem had no idea what a Hasidic Jew was. Then he was doing his family practice OB rotation, and a woman was in labor. Menachem was doing his thing, and the father was pacing constantly around the room looking at his watch and asking Menachem how long was going to take. Menachem is sort of a laid back guy and he said, “Look, hang on, it’s going to happen.”

Finally, the father said, “So, look, are you going to get the baby out by Shabbat?”

Perhaps you don’t know what Shabbat is. The Jewish Sabbath starts on sundown on Friday. “Are you going to get the baby out by Shabbat?” Menachem had no ability to answer that question. First of all, he didn’t know what Shabbat was, and second, it wasn’t up to him when the baby would come. When Menachem finally figured it out, he had to tell the father, “I can’t do this!”

All of a sudden he was more on the same page. I’m not sure the father was ever on Menachem’s page, but Menachem now had a cultural understanding that the father was anxious that the baby wouldn’t come before the Sabbath began and work should cease.

Today, three years later, Menachem understands the Hasidic culture a whole lot better than he did then. But it took some effort on his part. Patients now choose Menachem not because of his name but because they know the kind of doctor he is. They know he has taken the time and effort to learn what Hasidism is all about. It makes him a better doctor.

It’s pretty powerful.

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