2015 Blog-in-Review

This is kind of cute  –

The WordPress.com stats helper monkeys prepared a 2015 annual report for my blog…

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 8,400 times in 2015. If it were a concert at Sydney Opera House, it would take about 3 sold-out performances for that many people to see it…

Click here to see the complete report.


A Tale of Two Worlds

T.S. Eliot (4)

Over the past two years, our world has seen its fair share of change.

When I boarded a plane out of Boston in September 2013, enrollment in the Affordable Care Act was just weeks from going live. So was the resulting partisan disagreement that led to our government’s two-week shutdown.

That same year, a violent and bloodthirsty sect calling itself the Islamic State was still unheard of to most of us, while civil war in Syria teetered on the edge of a surge in casualties and press coverage. It wasn’t long before an obscure virus named for a tributary in the Congo would dominate international headlines — a disease that, for all we knew then, was limited to the stuff of print thrillers and sci-fi disaster films.

While I was away, America developed an obsession with Candy Crush, cheered on its first Triple Crown winner in thirty-seven years, and entrenched the term “selfie” firmly in its lexicon — even voting it the OED’s 2013 Word of the Year.

On the very day I arrived in Tansen, in fact, South Africa lost its renowned and beloved elder statesman — a man whose message of peace and reconciliation reached far beyond the borders of his own nation. Not long afterward, the cities of Ferguson, Baltimore and Charleston became foci of a nationwide conversation around race relations in America, as long-simmering tensions erupted into new waves of conflict and raised pressing questions without easy answers.

A landmark 5-4 Supreme Court decision was announced in favor of legalizing gay marriage. Pope Francis made his first visit to the States. Scotland courted the idea of independence.

Ukraine-Russian (not to mention Russian-American) tensions escalated with Russia’s invasion of Crimea. Meanwhile, and not a little ironically, American-Cuban diplomatic relations finally began experiencing a post-Cold-War thaw — to the relief of cigar aficionados everywhere.

Nepali Man bearing Flag

Nepal also saw a remarkable number of watershed events during this brief two-year window: the adoption and ratification of a new constitution; free elections for only the third time in its history; the inauguration of its first female president. Two massive earthquakes struck this past spring, of course, leaving a country devastated by natural disaster — only to be hammered a few months later by India’s even more crippling border blockade. It’s a situation that daily grows more desperate even as I write this, and cries out for our prayer and action.

I’ll not venture much speculation on how I may have changed in these two years. There’s plenty of time to reflect on this time of significant, if often uncomfortable, growth. At the very least, though, it’s safe to say I still love traveling to far-flung places! And happily, I’ve also gained many more wonderful friends to visit during this time abroad. Unexpectedly, but as apparently often happens, I seem to have adopted a rather more liberal political bent, and generally find politics more engaging than I did before. (In fairness though, the series West Wing — combined with hype around a new election cycle — may have more to do with that.)

In reflecting on this swirl of change, I’m reminded of a stanza I love from T. S. Eliot’s poem Four Quartets ~

T.S. Eliot (2)

Only time will tell what has changed the most in and around me. That sort of noticing is inescapable during the transition involved in leaving one world to re-enter another. Time will also make clearer the lasting impact of those changes, as I arrive back home where I started — just to find I’m encountering it, in some ways, for the very first time.

T.S. Eliot once made another lyrical observation, that “every moment is a fresh beginning.”

Well, this moment certainly seems to be.

A Joy & Privilege

Tansen Team, Dec 2015 (outside).jpg

Last year, I wrote about the things I’ve learned to appreciate about the two places I have called “home.” The truth is, though, that what any of us enjoy – and miss – most when leaving is the people, dear friends we come to know and love in each.

Shane Claiborne once defined community as surrounding yourself with people who are like the person you want to become. I can think of no better way than this to describe my experience in the Tansen community.

Attic Bible Study (2014)It is true professionally – of colleagues who challenged me with their consistent example of loving, diligent care to patients. They each brought a wealth of experience that they freely shared. They’ve also had to wade through their own share of tough headwaters, emerging on the other side with even greater resilience and beauty.

It is equally true personally, as I shared life day to day alongside these same friends, with their grit and perseverance, their humility, their humor, and above all their utter self-forgetfulness. I’ve learned that the best communities are those that at first may seem rather ordinary – until you scratch the surface to find pure, fire-tested gold.

This diverse Tansen community, a body that images the beauty of Christ among the nations, draws out because of its diversity the many facets of God. How I will miss hearing the beautiful sound of Scriptures read and prayers prayed in accents from around the globe – French and German, British, Australian and Irish, Dutch, Afrikaans, Tamil, Korean and Canadian – and yes of course, Nepali too!

Tansen Team, Dec 2015I’ve now finally arrived home in the States, after a wonderful week in the UK with two other Tansen friends – a sort of “pre-re-entry,” as it were. Today’s blog is reserved as a tribute to each of you in my dear, and dearly missed Tansen community. I write with prayers for your continued unity, strength, and encouragement in our Lord.

And in the sure hope that it’s not goodbye but rather, for now, “See ya…”  

Farewell from Tansen

Coming Home

We are so little reconciled to time that we are even astonished at it. “How he’s grown!” we exclaim, “How time flies!” It’s as strange as if a fish were repeatedly surprised at the wetness of water. And that would be strange indeed; unless of course, the fish were destined to become, one day, a land animal.”

C.S. Lewis, Reflections on the Psalms

Perhaps it’s an element of denial, or maybe just the busy crush of life at its transition points, but incredibly, I haven’t yet posted anything about my
Fish Out of Waterimminent return home!

As I write this, I’m waiting for my flight out of Nepal – 3 hours delayed, not surprisingly – using only the second one-way ticket I’ve ever bought. Early yesterday morning I said goodbye to Tansen, as a dear group of friends bid me farewell on the path behind our homes. It was a weekend of heartfelt, bittersweet goodbyes, a time in which to reflect on beautiful friendships formed, and to look forward to those friendships growing in the coming years. On the way home, I’ll spend a week with a few other Tansen friends in the UK before arriving in JFK Airport on the evening of December 13th.

Time is a funny thing. We never quite get used to it’s pace – sometimes racing breathlessly by, at other times plodding along with interminable
languor. C.S. Lewis saw this strangeness of time, and our being “so little reconciled” to it, as evidence that we are made for eternity, for a world that transcends time. This definitely resonates. Time also seems to speed up at transition points, especially those bigger ones in life. Maybe it’s something about time at the margins – in much the same way that the surface of a pool appears immobile, until you see it cascade over an edge. It’s evident in the more mundane time warp of that last half-hour before going to work, too – Where do those minutes go?

But pause, one must – to share one last cup of chiya with a dear friend, laughing together over something silly because we both want to avert our eyes from parting’s inevitable heartache. Or on the way home fromKTM Traffic Cow (1) work, as I walk the now-familiar hospital paths one last time, knowing that although I’ll certainly return one day, it will never again be as one trying to make her home here. Or one final pause as I head to the airport, taking in the stream of trucks, cars and rickshaws weaving languidly back and forth – the unforgettable, casual chaos that is quintessentially South Asian.

There is still more to say (and soon!) about my upcoming transition to life back home, and what it feels like at the margins of this life-shaping experience. So stay tuned; I won’t bring this blog to a close quite yet…

Tansen Forest (detail)

On the advent of Advent

John 1-14 (palms)

A brief meditation to begin this season of Advent, and welcome the Word made Flesh  ~

Man’s Maker was made man,
that He, Ruler of the stars, might nurse at His mother’s breast;
that the Bread might hunger,
the Fountain thirst,
the Light sleep,
the Way be tired on its journey;

that the Truth might be accused of false witness,
the Teacher be beaten with whips,
the Foundation be suspended on wood;
that Strength might grow weak;
that the Healer might be wounded;
that Life might die.

– St. Augustine of Hippo


The “Not-Horse” Chipper

“Finally, he put his finger on the crack, looked at me, and said softly, “This is where the light comes through.” ~ Rachel Naomi Remen, The Container

But we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us… Therefore we do not lose heart. ~ II Corinthians 4


Featured artwork: Expansion – a sculpture in bronze by Paige Bradley

I almost titled this post “Coming To The End,” which would have been appropriate on more than one level. It also could have read “The Great Unraveling,” or simply just “Self Deconstruction.”

Yet somehow, this awkwardly-phrased title seemed to fit best.  It references a quote, perhaps apocryphal, attributed to Michaelangelo. In response to one bystander’s curious inquiry about how he would bring forth such noble equine glory from the block of marble before him, the great Horse Sculpture detailartist replied, “I just chip away all the parts that aren’t horse.”

And so, it seems, it is with God – however painful that chipping may be, however much still remains to be done. In light of this, I would be remiss if I’d spent two years blogging about life and work abroad, and not at least brushed the surface of this profound and painful reality – the reality of our being smoothed and shaped, of having our rough edges knocked off. It’s an inescapable reality for each of us, of course, regardless of where we receive our mail. Yet it’s also one I feel I’ve encountered more acutely during these years away. There’s a sort of profoundly disorienting, unbalancing gravitational force that seems to exert its strongest pull in displacement.

Or, as my friend Ansie put it, “Eventually, Nepal brings us to the end of ourselves.”

How true.

I’ve found that for me personally, much of the pummeling and chipping stems from the loss of certain daily, stable, orienting relationships – what’s known in the literature as one’s “reference group.” Whether or not you’re familiar with research out there on this concept, the following excerpt will resonate with anyone who has been through this kind of tumultuous cross-cultural journey:

A central factor in the change in identity is the loss of one’s reference group… Those familiar people who provide both subtle and overt feedback about who we are and how we are perceived suddenly disappear. The people who become new sources of feedback, especially those not from our own culture and language, may give us very different messages about the self. In the early stages of our adaptation, they will likely let us know that we are inadequate in our new cultural setting, our new role…

We had to start fresh in being known to a degree that we could again receive positive feedback about ourselves. This took time. In the meantime, we starved for the kind of affirmation which keeps one emotionally nurtured…


Over time, if one is successfully adapting…one achieves an altered sense of self, a new identity, incorporating some of the old and some of new. This is not easy or quick, as it means letting go of parts of the former self. This is in fact a painful process as we seek to determine which aspects of the self are negotiable and which aspects we cannot change if we are to keep our sense of integrity…

~ excerpt, Stressed From Core to Cosmos

In short, I’m discovering an obvious (but unexpectedly difficult) truth: that to move abroad is to suffer a particular loss of identity, to experience an unraveling of one’s sense of self. You find yourself suddenly plucked from one world and transplanted into another, very different one, a world where even your closest friends start out as strangers with foreign cultures of their own. Add to that a brand new language and set of customs in the dominant new culture of your adoption, and you find yourself starting from Square One in every possible sense – “much like a small child,” as one fellow traveler described it. It is an experience fraught with humiliation, insecurity, defensive self-doubt, questioning every turn.


The same publication excerpted above suggests several ways to support those facing the cross-cultural identity crisis I’ve described:

  1. Affirm the uniqueness and inherent worth of the person, especially from a Biblical perspective of our identity being in Christ – being His workmanship, being His beloved children, being His chosen. Nurture the wounded person, because experiencing God’s love and acceptance through the counselor becomes a key source of energy and motivation for regaining equilibrium.
  2. Help the person identify key aspects of the self, to sort out what is negotiable for change and what must remain relatively stable in order to maintain integrity of the self. This involves traits, qualities, values, habits, ways of relating.
  3. Affirm the adaptive ability the person already manifests, as evidenced by the levels of stress already endured and the amount of change already achieved.
  4. Educate regarding the energy demanded for adaptation and affirm the reality and difficulty of maintaining a good sense of self given all the layers of change required by cross-cultural ministry.
  5. Normalize the stress experienced. Anyone having to adapt to so much would experience a shaking of their foundations.

These tips are helpful, to be sure. But honestly, at the end of the day I have no easy answers. Far from it, in fact; I’m still very much in the throes of this struggle myself, with barely even the words to express it.


Yet there remains one anchor – a strong Hand holding me fast even when my own grasp threatens to loosen. It is the hand of another, greater Artist, the powerful, constant, tender hand of One who binds all things together, even as He continues to relentlessly chip away at all the parts “that aren’t horse.”

Whoe’er I am, You know me
O God; You know I am Yours.

Bonhoeffer put it beautifully in “Wer Bin Ich,” his famous poem that wrestles with similar questions – though under far greater stresses than any I’ve ever had to face:

How To Make Cheese — in Ten (Easy?) Steps

Cheese Board (rustic)My flatmate Becky and I met a small cadre of friends (and fellow cheese-lovers) in Kathmandu last weekend with the express purpose of making cheese.  It’s part of my fascination with the “back-to-basics” lifestyle I’ve referenced previously, and it’s also been on our To-Do list for months.

Fortunately, we had the seasoned expertise of our friend Simon, a British farmer who managed the Denhay dairy farm in Dorset, UK for twenty-five years, before moving to Nepal to help with quality standards in the dairy industry here.  (Incidentally, this award-winning farm won the “World’s Best Cheddar” gold medal in 2012.  It’s cheese-making at a whole other level…)

If nothing else, it promised to be a fascinating day with an eclectic bunch of widely-traveled people, listening as they spoke of the sorts of challenges that arise in a world entirely different from my own.

Did you know, for instance, that a dairy cow needs to calve annually (literally, delivering on schedule every 365 days) in order to maintain optimal milk production?  Or that there’s something called a “Maiden Milker” — the phenomenon of a cow that produces milk even having never calved?  (If you grew up on a farm, this is probably not earth-shattering news, but for this life-long city dweller it was a real jaw-dropper.)

We then covered a Jersey Cowspectrum of
factors — types of rennet, starter cultures, acidifying techniques, and molds or gas-forming bacteria — that conspire to produce the many varietals of cheese available worldwide, each with their own particular taste and character — swiss, camembert, cheddar and chevre; roquefort, gruyere, gorgonzola and stilton; brie, bleu and boerenkaas gouda…

But best of all, over the next ten-plus hours we learned how to MAKE cheese (specifically, a kind of generic “hard cheese” that we hope turns out something like cheddar…)  Until last weekend, this was a process entirely shrouded in mystery for me.

I will now reveal the secret of this not-so-intuitive process, in ten not-so-easy steps, should you wish to try this at home:

STEP 1:  Bring milk (we used 40 liters, but less is also fine) to exactly 72°C for 25 seconds to pasteurize, stirring constantly.  [Skip this part if starting with already-pasteurized milk.]  Then cool to 34°C and add cheese starter culture (100 mL per ten liters, or as directed).

STEP 2:  Let sit for one hour, then add rennet — approximately one drop per liter for soft cheese, three or more drops per liter for hard cheese.  But it also depends on your rennet; I’m told that “You’ve GOT to know your rennet.”  (That may be, but you probably do NOT wish to know from whence your rennet cometh…) Stir for two minutes and let sit undisturbed for another hour, keeping at around 34°C.

STEP 3:  “Test the set” by sliding a knife blade (or your hand) down along the inside of the pot, watching to see if it splits as you lift it up. If so, then you’re ready to “cut the curd” into blocks, using a sharp, long bladed knife (lengthwise & widthwise).  Be careful not to mash up the curd too much, as this lowers the yield of cheese.

STEP 4:  SLOWLY heat back up to 40°C over ONE HOUR (best done in strict bursts of two degrees every 15-20 minutes), then keep it between 39-40°C for yet another hour, stirring gently the whole time.  You’ll notice the curds (solid part) and whey (liquid part) separating. (You’ll also notice that we’ve accumulated quite a few hours by now…)

STEP 5:  “Pitch the curd” by straining the whole mixture through fine cheesecloth, then return the solid curds to one side of the pot and place it at a slight incline to allow the rest of the whey to drain out. (NOTE: Whey is high in protein, and can be used to make ricotta cheese, baked into bread, or mixed into your morning smoothie.)  Let sit for around 30 minutes, constantly cutting and turning it over to dry, and prevent it from congealing into a single lump. (This also gives time for bacteria in the culture to ferment and acidify the curd.)

STEP 6:  After removing all excess whey, add non-iodinized salt — 2% of the curd-weight, or 20 grams per kilo of curd.  (Assuming a 10% yield, you should get about a kilo of curd for every 10 liters of milk.)  Stir vigorously, mixing the salt thoroughly throughout the curd.

STEP 7:  Tilt the pot to the side once more for another few minutes to drain any extra whey produced by the salt’s drying effect, then pack the dry curd into cheesecloth-lined cheese moulds (plastic sieve-like containers with little holes for draining out the rest of the liquid) and place weights on top of the moulds (100-120 PSI, if you care about things like that).  After 20 minutes, remove and re-pack as before (in order to get out all the cheesecloth-wrinkles).  Then leave under the weights at room temperature overnight, or 10-12 hours.

STEP 8:  In the morning, gently remove the pressed curds from the mould and pack in cling-wrap, then double-bagging in zip-loc (or vacuum) bags to form an airtight seal.  Alternatively, you can try the old fashioned way: wrapping the curd in ghee-soaked cheesecloth scraps cut to size (and then no zip-loc or vacuum bags).

STEP 9:  Place in a temperature-controlled fridge at 10°C for 4-6 months (or longer).

STEP 10:  Enjoy your hard-earned cheese!  (FYI, don’t be put off by mold growing on the outside, especially if you tried the “old fashioned ghee-and-cheesecloth” technique, which is practically guaranteed to mold… It adds character!)

As seen on YouTube…

A friend recently told me about this AMAZING video-like photo collage of hundreds of Nepal pictures.  It must have taken a dizzying amount of time & effort to compile!  I love how it weaves these fragments of narrative thread together to form a sort of wordless gestalt of a story.

I’ll write a longer post of my own soon, but in the meantime, be sure to check out this three-minute tour of the complex beauty and chaos that is Nepal…

Beiha Gareko

As I write this, the screen in front of my seat says that we are presently some 39,000 feet above Dublin, en route back to Kathmandu and (eventually) Tansen. I’m returning to Nepal after a whirlwind visit home for my sister’s wedding — SUCH a glorious time! (Of note, I tried to fly a bit under the radar during this trip back, since I knew schedules would be tight and wanted to be 100% available for wedding preparations; apologies if we didn’t get to connect this time around!) In honor of the joyful occasion, I thought it would be fun to share a few Nepali wedding traditions… 

Jess and Matt, this one’s for you.  =)  LOVE YOU GUYS!

J&M (2)

Because of numerous ethnic groups across Nepal, it’s hard to generalize about “Nepali” wedding customs, which can vary widely from region to region and even from village to village. However, as in America and the world over, weddings are times of joyful, extravagantly festive celebration, usually lasting several days.

If you know anything about marriage customs in south Asia, it probably has something to do with the practice of arranged marriage. Indeed, in traditional Hindu societies, marriages were historically arranged by two sets of parents on behalf of the bride and groom, a practice that remains widespread today, although often in modified forms. However, prem beiha, or “love marriage” is also becoming increasingly prevalent, particularly in urban settings with the influx of Western customs and attitudes. Child marriage, also previously common, has fortunately become rare except in very remote villages, with the passing of national laws that set the marriageable age at 18.

Marriage in Nepal tends to be monogamous, and in this highly traditional society, divorce is rare. Marriage arrangements are traditionally patrilocal, meaning women move in with their husband’s kin after marrying. However, this too is changing, as families are often now living on their own, a trend increasingly popular among Nepal’s younger, more urbanized generation. However, when a bride is to live with her in-laws, it’s not uncommon to see her weeping as she is ceremonially led away from her own family and childhood home (or “maita”) and ushered into the groom’s family home. Challenging in-law relationships – including, not infrequently, physical and emotional abuse – can add to the stressful anticipation of the move.

In some castes or ethnic groups, such as the Newari and Magar groups, elopement is more common. Yet even then, specific practices are in place to guide the Nepal Wedding 4young couple’s covert union, and eventual welcome back into their local community.

Hindu wedding ceremonies in Nepal are dictated largely by the astrological determinations of a local village priest, according to the Vedas, or Hindu scriptures. Astrology, for instance, plays a major role in determining whether a match is suitable, which months are appropriately matrimonial (i.e. mid January to mid-March, mid-April to mid-June and mid-November to mid-December), and which date is most auspicious for the couple’s ceremony.

Red is the traditional bridal color in Nepal and India. Brides are adorned with voluminous amounts of gold, jewelry and precious stones – traditionally, part of the dowry given by the bride’s family – and elaborately tattooed with a hemp-based (non-permanent) ink called mahendi.

Nepal Wedding 5When processing to the ceremony, the groom and his family will sometimes make their way with a crowd of guests through their village to the bride’s home, where she has been prepared and is waiting. Alternatively, a band-led procession may leave the groom behind, who waits at home while his family collects the bride and carries her back (literally, in a hammock or basket) the following morning.

When finally introduced, the bride and groom are seated together on a platform sheltered by a three-sided silk tent. Guests then line up to give them a red tikka (rice mixed with vermillion powder and yogurt), a colorful scarf and a gift, wishing them Badhai chha, “Congratulations!” (With anywhere from 500-1000 guests, this part can take hours.) After a day or two of rituals led by the priest, the couple symbolically share a meal from the same plate.

The ceremony is held in the open under a canopy known as mandap, with a sacred fire in the center. The venue is vibrantly decorated with colors, flowers and lights. While customs vary, the celebration usually also involves plenty of music (drums, horns and cymbals) played enthusiastically to announce the occasion for all in earshot. (The exuberant sounds can continue from before dawn until well into the night by a seemingly tireless band.) Meanwhile, guests join the couple in a feast of traditional dishes.

Weddings in Nepal are tons of fun, with plenty of dancing, fancy clothes, food and time with friends. It’s sometimes a challenge to attend weddings if long travel is required, especially without a lot of lead-time. (My record for the latest invitation received was the afternoon prior.) However, in true communal style, people are very gracious, and enjoy having guests drop by for as long or short as they are able to join in celebrating the new union.

Privacy Settings

In honor of this weekend’s Fourth of July — a high summer holiday celebrating America, where concern over this issue has become something of a national pastime — I’d like to share a few observations on a topic that is as mundane as it is pervasive. It happens to be one that has fascinated and frustrated me from virtually the first moment I set foot in South Asia.

I’m referring, of course, to the topic of Privacy.

But not in the N.S.A. sense. Think much more basic.

Every culture has its own norms and boundaries when it comes to privacy. What varies, of course, is where those boundaries fall. For instance, take bathing in public. By necessity, this is a normal feature of Bathing in Street #2Nepali village life. Most of my neighbors don’t enjoy the convenience of their own running water at the turn of a tap, and must instead fill enormous jugs each morning and evening to haul their family’s daily water supply from a communal well. So if our neighbor down the road wishes to bathe, she does so in a sort of “bathing sari” — which, I’m told, requires remarkable skill. Even with the astonishing ability to do so modestly, it remains a relatively public act.

The same is true of a man urinating at the side of the road. (Bear in mind, of course, that interstate rest-stop pavilions have not yet found their way to Nepal. Neither, for that matter, have interstates.) By convention, then, it is considered rude in the extreme for another person to so much as glance in his direction at that indiscreet time. The owness is on us, the passing public, to make a separate space for the person who, out of necessity, is doing this generally “private” act in the open.

Interestingly, it’s the opposite in America; by unspoken agreement, we generally consider it the person’s responsibility to hide him/herself as much as possible – inconveniently venturing deep into the roadside brush, for instance, to relieve oneself on the side of the highway. (The combination of poisonous snakes and sheer cliffs, however, make that a decidedly unappealing prospect here.)

The converse holds true, however, for medical results and other matters that, in the West, we would consider highly confidential. Imagine sharing a brief interaction with your patient at a nursing station back home. (I know, I know, a HUGE No-No! But bear with me for a moment…) Even when sharing somethFemale OPDing as innocuous as the result of a thyroid test, everyone in earshot would turn away, making it very clear through their body language that they wish to intentionally protect a private area for us. In other words, others take it upon themselves to provide privacy; it is their burden, by social contract, to create that space.

Think how strange it would be, then, if you noticed a complete stranger nearby obviously eavesdropping on that conversation, even craning their neck to hear more clearly! For us, that kind of behavior is implicitly prohibited by the social order, and therefore considered quite awkward.

Yet in my experience here, on the rare occasion that I forget to share a result with a patient after her visit in our Female OPD [“Out Patient Department”] clinic, and have to chase her down in the corridor to speak with her, we are immediately surrounded by a cadre of twenty other women. They all chime in with helpful suggestions, repeating and clarifying my instructions, even clamoring to relate their own prior experiences:  When I got my thyroid checked…  Oh, I had that kind of ultrasound myself once…  Don’t worry, it’s easy…  First go to counter #3, then down the hall to room #9…  She is being guided by other women who have walked this path before her. It’s as if this kind of sharing is a normalizing experience, a source of comfort for the patient. It represents the secure presence of community surrounding her — in a society that values community above just about anything else.

Yet I know a lot of folks back home (myself included!) for whom this aspect of culture would drive them crazy. For most Americans, it amounts to an extreme — and extremely distressing — breach of privacy. Which simply illustrates a crucial point: “rudeness” in one culture may well be the preferred and socially accepted norm in another. And vice versa. One culture’s “invasion of privacy” may well be another culture’s standard of decency, their expected “requisite help.” Our own specific cultural norms, rather than some universal understanding, are often what dictate “appropriate” behavior for prescribed circumstances.

When trying to navigate the cross-cultural experience, it’s wise to bear that in mind.