Anyone who has ever been told by a mother or grandmother that they must lie still while vapo-rub is swabbed over their chest or that the ancient recipe of tea with brandy, lemon and honey will cure their cough, must be aware that we all have certain beliefs about health and sickness that have not been, to put it mildly, subjected to evidence-based medicine. Costa Ricans are no exception. I learned this first from a handout given to me in Spanish class that explained words like quebranto (“a mysterious elevation of the body’s temperature that is not enough to cause a fever but serious enough to warrant missing work”) and empacho (“indigestion brought about by ‘heavy food’ especially of the sort that comes in a can, rather than being homemade, and including such diverse comestibles as tuna, fruit, and pigs’ feet”). Now, as a nurse with a certain anthropological interest and an at times self-satisfied sense of open-mindedness, I thought, “How interesting! How different!” and maybe even, I must admit, “How cute!”
Seeing the handout come to life did not take long. During training, my host family provided first-hand experience. Thus, Doña V, a motherly and gregarious woman in her 60’s, was convinced that I had contracted a cold with sore throat due to the fact that I had been drinking too much cold water. With every intention of being helpful, cold water was denied to me for the next two months. This same venerable señora was also convinced that if she did not wear a hat outside on nights when temperatures dipped to, say 68 degrees Fahrenheit, she would catch the serena, which my handout helpfully identified as “a mysterious substance that comes down at night as a cold breeze and affects children and the elderly who do not use well-wrapped scarves.” I was also encouraged to wear either a scarf or sweater to avoid this night air, although, luckily, as a 33-year-old, my life was not considered to be at risk. Later, when made miserable for a day or two by an inevitable but light bout of travel’s diarrhea, I was told it could not possibly be food poisoning, but rather must be the “heavy food” I had to eat on the days I went to class and missed a regular home-cooked meal.
My initial reaction to all these events was to take the position of an amused foreigner willing to dialogue about cultural differences. The Peace Corps would have been proud. In fact, I imagine there is another handout somewhere about this, with such helpful advice as: “Use the new perspective presented to you as an opportunity to learn. Do not make rash, judgmental remarks. Ask questions about your new friend’s viewpoint with curiosity, but also with respect. Perhaps this is a chance for you to share your culture, too, as you open up a new way of thinking and begin a cultural dialogue, etc. etc.” But, as the months passed, I found myself in the lot of all long-term travelers, getting less patient with this idea and less interested in the attractions of a cultural dialogue I’d already had countless times. One can only be warned away from the open fridge after exercising so many times before something snaps.
It is thus with embarrassment that I relate the following:
I was not feeling particularly patient, and I did not have a Peace Corps handout available when I ran into D the other day on the road to the school. It was about a million degrees out and I had just arrived by bike and I looked like a hot, sweaty gringa. In contrast, D, as most women here are mysteriously able to manage, looked as fresh and clean as a flower. She gave me a sympathetic nod, which nonetheless said, “You look terrible.” Here is the subsequent dialogue about health that we ought to have had, as it could have appeared in the Peace Corps handout:
D: What a hot day. Did you bike from Matapalo?
Me: Yes, it’s so hot. But I just stopped by the river to stick my feet in, so I feel refreshed.
D (with concerned look): Oh, you shouldn’t do that, it’s very dangerous.
Me: What? Why?
D: Because if you are very hot and then you cool down too quickly with very cold water you will get sick.
Me: How interesting. I do not share this cultural belief. Please tell me more… Have you always believed this?
D: Oh yes, it is quite commonly known to be true.
Me: I am respectfully intrigued by this information… Perhaps someday we can have a coffee together and I will tell you about my grandmother Julianna’s cure for the common cold.
D: Lovely.
Unfortunately, no, no, this is not what happened. Instead, a shameful combination of a nursing education that had been lying dormant for seven months, a slow-onset ire at the Costa Rican need to tell me, against all common and empirical sense, that cold water can kill, and the irritation of being hot and sweaty led to the following:
D: What a hot day. Did you bike from Matapalo?
Me: Yes, it’s so hot. But I just stopped by the river to stick my feet in, so I feel refreshed.
D (with concerned look): Oh, you shouldn’t do that, it’s very dangerous.
Me: What? Why?
D: Because if you are very hot and then you cool down too quickly with very cold water you will get sick.
Me (annoyed): No. No, that is not true.
D: But everyone knows this.
M: No, I don’t believe you. That’s just not true. (Barely stifled derisive laughter) Listen, I went to nursing school, and they never taught us anything about this. I just don’t believe in what you’re saying. I’m telling you, it’s not true.
D: …
Me: And what’s more, where I’m from the water in rivers is really cold, not like this water here. You call this cold? (Unstifled derisive laughter) I’m talking about Colorado, where the river water is from melted snow. That is cold water. This water here, this 3 inches of water I stepped in for 10 seconds, that doesn’t count. It isn’t even cold and it certainly can’t get me sick. It just can’t be so.
D: (uncomfortably looking at feet)
Me: I’m telling you there is no evidence for this to be the case. No, no sir, nope, I don’t buy it. It just can’t be. I know about these things and I’m telling you this theory of yours is not true. Let me tell you about a little something called evidence-based medicine….
D (stunned, but polite): Well, ok … see you later.
Alright, so maybe I didn’t go on quite that long, but I’m pretty sure that D is now convinced I am either an egomaniac or touched in the head (tocado). But, really, why I couldn’t just forge a middle path and thank D for the information and politely return to discussing the weather, I will never know. Either way, I’m thinking of bringing D some cookies tomorrow and, by way of apologizing, asking her how her mother is doing after that bout of empacho she had last week.
At least in your bout of heat-induced annoyance, you didn't shoot her like Albert Camus' protagonist from The Stanger. All I'm saying is that it could have been worse.
ReplyDeleteDoes this "quebranto" tend to affect people on Fridays?
ReplyDeleteLOL! My nurse wife has had similar encounters here. Good luck and keep those feet dry!
ReplyDeletesay what you will but heavy foods are totally a legitimate concern! but i wouldnt define them as only foods eaten outside the house but rather any food that when you step outside into the heat too quickly after eating makes you feel nauseas. for instance if i eat anything besides bread and coffee before 8am, my body is no longer able to deal w/ the stress of any kind of exercise. or at least thats what i tell myself.
ReplyDelete