Premature Ponderings



Sometimes things just creep up on you and suddenly you realize, this is a huge deal.
Why did it take me so long to notice this particular thing going on all around me?

So you pitch a fit (whether audible or just in your mind) and get all puffy.
Break out the chopstix STAT!

In this instance, it suddenly truly sinks in how prematurely born infants are handled here on a global scale.
In general, most parents who give birth to a preemie cannot see them in person, touch them or hold them until they are discharged.
Often a mother’s breastmilk is not deemed acceptable for various reasons and the babies have no chance to get the best stuff even if the mom really wants it.
Etc, etc.
Shocking, right?

And then just as you start to operate in your high-and-mighty expat mentality–“how on earth can this stone age approach be acceptable in this modern world, I’ll tell them what’s what”– you catch yourself.
Hopefully before you’ve done too much damage.

You open your eyes, ask a lot of questions, and read.
You listen, read and ask more questions.

You learn that this was exactly the case in the good ol’ United States not so long ago–well within your, ahem, young lifespan, and to some extent, your own (even younger) career.
The same fears, concerns, issues.
Fear of infection, concerns that parents will get in the way of the staff.
Incentives by formula companies to promote certain unmentionables to new moms.

And you dig a little more, and realize that while the US was building new NICUs that had parent beds and private rooms, this country was just recovering from political chaos of decades++ and there was not even portable oxygen available 20 years ago.

A preemie had no chance at all.

In the interim, babies who had no shot at life at all and were deemed “stillbirths” at 28-30 weeks, are now surviving and their odds are improving from year to year.

Wow then. Curb the rabid mutterings of a wild-eyed child advocate.
Fresh perspective here.

So thankfully, by the time you walk into your lecture with about 25 young doctors at a Women’s and Children’s hospital, you’re a little less judgmental, less critical and a lot more ready to have a real dialogue with your audience.

[switch to first person]
And we truly had some good dialogue going.
I buttered them up with a lot of factual slides, loaded with statistics (which any self-respecting Chinese student expects) and peanut butter chocolate chip cookies.
Thanks to social media, I had received photos from many moms with their infants in the NICU in other countries, touching, holding and feeding them.
I ended my lecture early, and surprised the class with having them break up into small groups to discuss a few questions in depth.
There was a lot of mutual learning taking place as I heard their perspectives, and they wrestled with new ideas in this context, perhaps for the first time.

Now then.

This was really not about preemies (although it is) as much as it was a reminder to me of how reflexively I slip back into “west is best” mode, even when I think I am being openminded and receptive.
How do I keep that kind of attitude from coloring my interactions with people I want to truly connect with?
Even if my words are ok, my attitude speaks so much louder, especially in a culture where everybody is trained from infancy to recognize nuances of body language that are invisible to most westerners.

One of my mentors, Dr. Karen Olness, always says effective cross-cultural communication demands that we enter any new situation as a learner, regardless of hierarchy.
If we forget we are learners, we risk losing the opportunity to understand what is going on.

China has in many ways astounded the world with rapid progress in many areas.
I believe the story has not yet been completely told regarding preemies in this context.
I’m just privileged to be stepping into the middle of it as it unfolds here.


One response »

  1. Well said. Something I have struggled with often in my career….for example, when I have recommended chemo to a patient with a potentially curable lymphoma, but all they could think of was how horrible chemo was for another family member. It can be exasperating, to see someone decline potentially life-saving treatment. But we have to meet them where they are. Glad you have the memories of a mentor like Karen Olness. Now maybe you’re the mentor!?!

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