Choque, Lucha, and Cariño
After spending four years living and working as a pediatrician in Bolivia (2005-2009), I realized there were some words I used in Spanish that just couldn’t be translated into English and convey the same meaning. The three most common words which fell into this category were: “choque”, “lucha”, and “cariño”. As I look these words up in a Spanish/English dictionary, there are 10 English synonyms for each of them and none convey the meaning as well as the Spanish versions.
These three words describe the experiences I witnessed last week as I returned to Bolivia, accompanying a group of doctors volunteering our time to improve neuro-trauma management in this low-income country.
A “choque” is an experience of impasse when 2 or more objects unexpectedly crash into each other, necessitating some maneuvering to continue functioning. Our week was filled with cultural and operational choques; from not having the right instruments needed in the O.R., to disagreements with our Bolivian colleagues regarding how to manage certain patients, to confusion about our daily schedule. Even though choques can be extremely frustrating when they occur, they always provide opportunities to learn more about ourselves and those with whom we wish to be in relationship. We all realized that many of the choques we experience in our work back home can be overcome with renewed commitment to a common mission and better communication.
A “lucha” is a fight or mission of commitment that is integrated into someone’s being to the point that it cannot be extracted or ignored. All week long, we encountered people whose commitment to a cause inspired us to serve in whatever way we could. We worked alongside of Bolivian physicians who work long hours for very little pay to care for patients who could not afford medical treatment and patients who waited for years to get the surgery or treatment that would change their lives. Each of us was inspired in a particular way to invest in our own “lucha” to bring meaning and commitment back into our medical practices as we returned home to the US.
“Cariño” is that special gift of deep kindness and affection which one person gives to another like a warm blanket, creating a relationship which is ever enduring. We were constantly overwhelmed with cariño everywhere we turned. The sense of deep appreciation for our time and service was conveyed in tears of joy from patients’ families, embraces from our Bolivian colleagues, and special small gifts at the time of our departure. True cariño is contagious and mutual. It is also something which is, unfortunately, not as present as it used to be in our daily lives as doctors back in the U.S. However, we each left inspired to help create a new culture of cariño within our medical teams by investing in each other’s well-being.
As the members of our team returned to their “normal” lives back in the US, I reminded each of them to use their experiences of choque, lucha, and cariño as inspiration to help create a culture of common mission and mutual appreciation within their own clinical teams. It won’t be easy, given the current challenges we face in medicine. But we must start influencing what is within our control if we hope to make a difference.