Cultural Humility

What? Freire and Horton explain the relationship between practice, theory, and knowledge as one of reliance. Knowledge depends on practice — “without practice there’s no knowledge.” (98) You can’t know something if you don’t practice it, examples of which can be seen in people’s everyday lives. You won’t know the materials that will be on a test if you don’t study and practice with the information. You can’t prepare a dish if you haven’t previously looked at the ingredients. You can’t write a reflective paper on something you haven’t read. They also explain that practice isn’t the same thing as theory: “it creates knowledge, but it is not its own theory.” (98) While practice may be what makes knowledge, it doesn’t make something as complex as a theory. People themselves make theories from the knowledge that comes from practice. This relationship is significant in terms of the way I understand education and knowledge because it allows me to know where the theories I make come from, and change what leads to them if necessary. If the theories I make come from the knowledge I get from practice, it means my practices need to be that much better. Keeping better practices leads to better knowledge and theories and overall better thinking, something extremely important in terms of education.

In “Close Encounters of the Human Kind,” practice, theory, and knowledge have their own place. As a medically trained doctor, Abraham Verghese had so much practice in healing and helping patients, even in similar situations to those he was seeing now as it reminded him of clinics he had worked at in India and Ethiopia where “with so few medical resources at hand, the careful listening, the thorough exam, the laying of hands was the therapy.” The destruction caused by Hurricane Katrina was obvious in looking at the areas affected, but many people failed to realize the extent of the destruction. People lost their homes, yes, but people also lost their lives, sometimes immediately and sometimes slow due to the fact that they lost the medicines keeping them going in their homes. Due to the practice Verghese had from past experience in similar situations the way he thought and the knowledge he had was probably different than most other doctors who had never been in situations like this. The theories Verghese created allowed him to be a quick thinker on his feet. While some doctors may have fallen into stress in times like Hurricane Katrina, Verghese helped his patients get the correct medicine they needed by looking through the Physicians’ Desk Reference with them until they found one that looked familiar. It was the best thing he could do in that situation so that’s exactly what he did for these people.

From his patients, Verghese learned an important lesson. In the beginning of the article, he talked of how when he was first starting his career in medicine, he felt as if he had to put “armor” on himself so he could be able to see the suffering of people and not be affected. At the end of the article, he learns from one of his patients that was the opposite of what he should have been doing. “The years have shown that there is no armor. There never was. The willingness to be wounded may be all we have to offer.” In situations like the aftermath of Hurricane Katrina, sometimes there isn’t really anything we can do but have empathy for people going through these situations. Sometimes the only help we can give is emotional help and that has to be and is enough.

So What? During the time the founders created and implemented the Principles of Cultural Humility, America was in a time of distress. Families and people of color didn’t feel comfortable coming to hospitals in fear that their concerns would be brushed under the rug, like the Hispanic patient in the video who was told their race was known for showing their concerns too much and too out of proportion. Also during this time, the Children’s Hospital Oakland community was “compelled to meet in a series of highly charged sessions” to look at their own “patterns of institutionalized racism, injustice and inequality” according to the Cultural Humility video. It became so crucial for them to identify and address unjust power structures as part of their job as healthcare providers because they had people coming to them with serious issues and ailments and some medical professionals weren’t taking these issues and ailments seriously. That’s an extremely dangerous game to play considering these people of color are real people with real issues who could potentially be seriously injured or even die without the necessary help.

Patricia Cataneda-Davis, a pediatrician working for Kaiser, said something at the group’s reunion in the Cultural Humility video that connected to Freire and Horton’s views. In speaking of cultural humility and how she just genuinely wasn’t taught about it, she said “There’s no way to know something unless you learn about it.” I thought this was well-said and while it may be obvious, as stated before, Freire and Horton found the connection between practice, knowledge, and theory as one of reliance. To gain the knowledge needed to create theories, it’s essential to actually learn something.

In “Close Encounters of the Human Kind,” I don’t believe Verghese is “neutral” about the suffering of his patients. As a doctor in these intense situations, sometimes you do have to put an “armor” up, like he stated in the beginning of the article, but that doesn’t mean he just turned his feelings off. As a medical professional, it is required to keep it just that — professional, but when you have people coming in by the busload with terrible injuries and terrible stories to go along with it, it is impossible to not feel something. So while Verghese does have to keep it somewhat professional so as not to upset his patients further, I don’t believe he is neutral as he definitely feels for his suffering patients, even telling one, “I’m so sorry. So sorry.” I see he is practicing lifelong learning and critical self-reflection because at the beginning of the article, Verghese believes the best thing for him to do as a medical professional is to put his metaphorical armor up in front of his patients, but after going through all he goes through and seeing all he is seen, he realizes “The years have shown that there is no armor. There never was. The willingness to be wounded may be all we have to offer.”

Now What? To practice cultural humility in my community partner experience, there are a couple different action steps I can take. Working with Canal Alliance, I learned most of the people I will be working with are Guatemalan. I can take my past experiences with the cultures I will be with and use them for reference, but I won’t base how I see these people on my past experiences, because everyone is a complicated, multidimensional human being, so it would be unfair to base views of people on the culture and not they themselves. I can take my past experiences and learn from them to practice lifelong learning and critical self-reflection. As a volunteer for middle school aged students, I obviously do have more of the power in the situation, which is a power imbalance, while not necessarily a bad one. As the older one in the situation, I have more responsibilities for the children, but I don’t ever want them to feel like I’m treating them as younger, less smart, or anything lesser than who they really are, and show them I respect them to give them some of their own power. Lastly, I can take action steps toward institutional accountability and modeling the principles by taking everything I’ve learned and practiced about cultural humility, turn it into knowledge, and theories, and be and make the difference between cultural competence and cultural humility.