Or, hugs and kisses. I can’t begin to tell you the times I have been embarrassed to the point of wanting to wrap up in a giant tortilla and become a human burrito because I have committed some horrible breach of cultural protocol.

Culture can be extremely frustrating and mysteriously impossible to penetrate at times. You can either be frustrated or simply embrace it with the understanding that you will be indeed make a fool of yourself no matter how sophisticated you imagine yourself to be. I have personally chosen the option to be fascinated with culture and be its student. There are risks involved.

Pastor Luis’ assistant and another lady from the church office staff were waiting for us as we came down to the front desk this morning to begin our trip home. They had come to ensure we had no problem with check out and to wait with us until our arranged transportation to the airport arrived. We walked out the front doors of the hotel and, in a typically Latino manner, we said goodbye to the ladies with an appropriate kiss to the cheek.

Thinking back on the events of the week, I reflected on the subtleties of culture. Yesterday I commented on the buildup of powder and makeup on my right shoulder due to hugs and kisses. When we arrived at the airport last Wednesday, I heard my name called and turned around to see Francisco and Martita, having just arrived on a different flight from Romania where they have served for the past ten years. I had not seen Francisco for years, but immediately gave him a full Latino abrazo complete with some back patting. I then turned to Martita and gave her an appropriate male/female abrazo complete with a kiss to the cheek. Most kisses to the cheek in this part of Latin America are really “air kisses, “just to give you an idea. But, as I drew back from my strategically-placed air kiss and pleasant words, I saw that Martita was poised to give another kiss to the other cheek.

OK, what do I do? Not that I was seriously worried. These are former seminary students of mine and we go back years. I didn’t want to say anything or do anything to re-initiate the process so as not to embarrass her (or me). Almost instantly I knew the problem. They had just gotten off the plane from Romania, officially a two-kiss country. These habits are very strong. We rode the same van to the hotel and when it came time for the goodbye kisses, I noted the same inward momentum geared toward a second kiss. Man! Can I ever identify with these cultural inner urges that push us to repeat patterns we have learned.

I thought back to the first few months that Cheryl and I lived in Kansas City. We were constantly pushed by this inward urge to kiss and hug everyone. Some people didn’t mind, but there were some backwoods Missouri types that I’m sure thought we must be some sort of perverts. To this day, in our multicultural church, I have this inward struggle about whetherto hug and kiss or not to hug and kiss. This is especially hard coming out of the third service in full English mode and running into the chorro (flow) of Hispanics emerging from their adult Sunday school class.

Later, Francisco and I had a laugh about how hard it is to adjust our inner habits as we change cultures. He confirmed Martita’s initial urge and the reason is obvious to anyone who has learned the ways of other cultures. The first day or two, I noticed that Francisco struggled at times to find the right word in Spanish. Again, I can identify. It’s hard to explain, but I often feel that I am perfectly influent in two or three languages, never knowing in which I will be most confused.

What makes this cultural kiss thing even more complicate is that in Romania they start on the opposite cheek. In Romania men never offer to shake a woman’s hand unless she makes the first move. Men and greet men with kisses. In France kisses proliferate to three. Some cultures involve men greeting men with a kiss on the lips. (I try to avoid those cultures. I have limits). Further into South America, men kissing men on the cheek is very common – not air kisses but wet, sloppy ones. In some cultures you see women walking hand and hand and there is nothing going on there. In other cultures you see men walking hand in hand with men and they are NORMAL! Well, except for the hand-holding bit. See how complicated this gets?

The situation in Latin America is enriched by the fact that different countries start the kiss on alternate sides. In some countries there are unspoken social lines above and below which kissing and hugging rules change. I’m just scratching the surface here. It can really become somewhat overwhelming and bewildering. My recent trip to Thailand via Hong Kong reminded me of the East Asian penchant for giving and receiving objects (like a business card) in both hands with just a tinge of ceremonial flourish.

So, people like me that travel a bit through different cultures, or live in a mosaic like KCBT, are constantly on guard for cultural blunders. Most people are wonderfully gracious with people from outside their culture and very forgiving. Still, I have memories of burning on the inside when I have moved to kiss or hug from the wrong side and caused a nose collision, or kissed when I should have offered a hand, or not. Or kissed a hand instead of a cheek. Or, …

Both Peter and Paul mention that we should greet the brethren with a holy kiss. I wonder sometimes if there were varying cheek sides in the first century, or what other oddities may have existed. Yeah, wouldn’t that be interesting to know.

So, I bid you goodbye with a hug or kiss of your choice. I warn you, though; there are cultures like those in Latin America where you must greet each and every person upon entering or leaving. And, in my beloved Latin America, we are famous for saying goodbye over and over, up to ten times, each with hugs and kisses. No judgment intended, but I guess that why I feel a little cold visiting cultures like England with a formal handshake and equally formal “how do you do?”

Site of great tradition

How’s THAT for a title? Well, since this was a “down” day before the group arrives tomorrow, I thought I would post something a bit different.

First, let me report on a wonderful tradition. It has been our custom for the past several years to take advantage of the day before the group arrives from Kansas City, to meet with the team from Zolder 50. Many of you know Linda Kitchen who has been through Kansas City. A good number of you met her when you have come on this trip with me. Many of you have also meet Eric and Marci Asp. Eric is the pastor of Zolder 50.

Our tradition is to meet at noon at the Aran Irish Pub on the Max Euweplein. Today was great because Linda, Eric and Marci were all able to come. This is such an amazing story of God’s grace and power and I am encouraged every time I am around these people. It was fun catching up and hearing about the continued growth and progress of the church.

OK, back to the title. You have undoubtedly heard the many horror stories of European socialized medicine as our own country has been debating medical care and all that goes with it. Multitudes die trying to get in to see a doctor and all the rest. You also remember me asking you to pray for my swollen elbow. My elbow has not gotten a lot worse, but neither has it gotten a lot better. I don’t care that it is uncomfortable,  but I sure don’t want to play around if it is infected.That could be dangerous.

This morning I spoke with friends here at the hotel. At lunch I asked the Asps and Linda what they would recommend. The consensus was to boldly walk into an ER.

Now, against the backdrop of the many horror stories and my own personal experiences in ER’s in the USA and those of others, I wasn’t really looking forward to this. But, neither was I looking forward to suddenly dropping dead in Europe from an arm infection.

“Wow! You say Jeff just dropped over dead right after his blackened arm detached from his shoulder?”

“Yeah, he was too stubborn to ask for help. Tragic, huh?”

No, I didn’t want to leave that legacy. So, mustering up courage and strength, I led Donna, Mikaela and Brenda to a famous flea market here and set off to the hospital. I knew exactly where it was. I’ve been by it many times.  Bravely telling them I would see them for dinner, but advisingthem to go ahead without me if I didn’t make, I disappeared into the bowels  of a nearby metro station and began my journey to what would likely be a painful, frustrating death. Yeah, I know you probably think that pastor/missionary types are fearless, confident always, nerves of steel. Right?

“Dear Jesus! Watch over my soul as I walk through the Valley of the Shadow of Death. Here I deliver myself into the hands of the great Antichrist of the European socialized medical system. Lord, I’m coming home.”

Departing the subway I was in the middle of the enormous Amsterdam Free University campus. I walked by the equally enormous medical center.

“Where do I go?” I wondered to myself as I walked across the street to the hospital-looking Polyclinic. A lady at a reception desk spoke little English, but directed me back across the street to “First Aid.”

“First Aid, Yah?”

“Yah, and probably also the last”, I thought.

Crossing the street, an ambulance with full lights and sirens pulled up to the ER dock.

They sure won’t care much about my fluid-filled elbow.

Well, I had come this far. I couldn’t turn back now. Deep breath! OK, there’s the door and I’m walking through it.

The automatic glass doors peeled back Red-Sea-like in front of me. Good start. Right on the other side, within 4 paces of having entered the sanctity of the ER, a friendly, but very professional lady dressed in white asked if she could help me. So, I went through my litany of being concerned about my fluid-filled elbow, and …

“So, you would like to speak to a doctor?”

“Well,  ….. yeah, ….. I ……. ” I thought I’d have to explain more, or be a bit more insistent, or maybe even do something drastic like look sick or something! But, before I could even argue she said,

“Please, sit down here and let me help you.”

She quickly went to the other side of the counter and handed me a form to fill out. “It’s in English so you shouldn’t have much trouble.” I gave her my driver’s license as ID and looked at the one-sheet-form with only the most basic of information on it, as she made a copy of my license. Thirty seconds later or so the form was filled out and she pointed to the waiting room behind me.

“Please be seated and someone will get you as quickly as possible.”

“OK, this is it. This is where all those people die waiting to see a doctor.” I took a seat expecting the worst.

Maybe five minutes later, but more like 4, a casually dressed young man called out my name. “Mr. Adams?” He was the triage nurse that took me back to a small room, questioned me about my symptoms, took my temperature, asked about any current medications, etc. He was extremely courteous, actually seemed interested and very professionally explained what a triage nurse is and does. “My job is to determine which doctor will see you and how quickly.” He placed the obligatory wristband ID on my arm. “Now, Mr. Adams, if I could ask you to please take a seat once again in the waiting room and a doctor will be with you shortly.”

“Aha, this is it! To this point has merely been to play with my mind, get my hopes up. Now, I will become mummified sitting in this waiting room.” I took a book out of my day pack and settled in for a long wait.

I actually jumped with shock, having barely opened my book when my name again filled the air. I looked up and saw a smiling young doctor who greeted me by his first name and a handshake, inviting me to follow him to a little ER cubicle leading me by a few folks who were really sick and in pain. You’d never know from his demeanor that my condition was any less serious or important.

He very carefully examined every bit of my right arm, pressing on every bone, asking me if it hurt, asking questions about when and how it possibly started, how was my health in general, what medications I was taking,what sports I engaged in, and what was the name of my first dog. Well, maybe not the dog, but he asked just about every other question and even seemed to listen to my answers. He didn’t seem in the least to be in a hurry as if the insurance company quota had not yet been reached for patient/doctor consultations between 3 and 4:00pm on Wednesdays. I was beginning to fall under the spell and believe this was really happening.

He explained that he did not think there was infection and patiently explained why. His English was impeccable, even though he couldn’t come up with the name “sweatshirt” that he asked me to remove. “This has all the signs of bursitis”, he said, “but first I want to consult with my supervisor. We don’t see this type of thing every day. Would you please mind waiting just a moment.”

Perhaps three or four minutes later he appeared through the drawn curtain, this time accompanied by a classic, young Dutch blond face who announced that she was one of the ER doctors. First, they both asked apologies for keeping me waiting. Can you even imagine!!!

She also examined my arm very carefully, asked a few more questions, then went into some amount of detail explaining why they were both convinced this was bursitis. She explained clearly the reasons for that. She said that they were going to get me some medication and that they wanted to see me back in the Out Patient clinic on Monday. Then, she went through the list of things that should bring me immediately back to the ER. She made me feel like I had made the right decision to have this checked out.  Then she said that before letting me go she wanted to consult with one more doctor. Her opinion was that there was not quite enough fluid to merit draining the fluid from my arm.

“Your body will eventually absorb the liquid. If we open your arm up to drain it, that’s just one more opportunity to expose you to possible infection. We don’t want to do that unless absolutely necessary. First, let me consult with my colleague. We’ll be right back.”

Maybe four or five minutes later, the first two doctors were both back in my cubicle. Yes, you read that right. The first thing they did was again apologize for making me wait. No, seriously. They really did! I’m not making this up. She then  explained that she had spoken with the ER trauma surgeon and he concurred with what they had done.

“There’s only one minor modification, Mr. Adams, that we want to make to your treatment. We are still giving you pain medication, but we are also including something to reduce the inflammation. And, here is a pill to counteract the possible stomach discomfort that might arise.”

Then, the young intern, the first doctor, escorted me to the checkout counter and worked with the person there to make an appointment for Monday, give me an English letter for my insurance company, and take my US credit card for payment.

Payment? In less than an hour’s time I had been greeted, registered, triaged, and my case considered by THREE doctors, with un-rushed face time by two of them who actually made me feel human and confident, and been personally escorted by a doctor who assisted in the check out – Payment? $415.83. Been to an ER in the US lately?

Daniel enjoys a good laugh

Tonight, we had dinner with our two Dutch graduates of Shepherd School of Ministry, Hosper and Daniel. Over a great Indonesian dinner they arranged for us, I told them of my ER experience. I told them some of the stuff that is often said by El Rush Bo Hannity O’Riley McBeck Whatever. My Dutch friends smiled in unbelief. “People really say things like that? You’re kidding, right?”

This is just one person’s experience on a Tuesday in October, 2010, a random visitor to a Dutch ER. Moral to the story – don’t believe everything you hear from a politician or talk radio/TV.