Dengue and the Case of Dr. Google & Dr. DR
“Do not try and learn this disease. Just listen to me. Let me guide you.” This was the doctor’s response after I asked him several questions about my son’s dengue fever. We’ve been in the hospital for several days. It may be hard to believe, but the doctor said this with good reason. And come to find out, his response had everything to do with guava and red pepper juice.
For as long I have known the people of the Dominican Republic, they have always considered themselves “unique” (sui generis). One of the most unique things they do is “chercha.” Even if you don’t speak Spanish, you’ll find chercha interesting to watch. Dominican friends and family gather together in intimate places and engage in animated conversation. During chercha, mostly everyone participating thinks he or she knows more than the next person. Mostly everyone engaged in the conversation steps on each other’s words. You wonder if anyone is really listening to each other. During chercha, conversing really means talking. There is not much listening.
You can find chercha happening at a private party in the home or even in a circle at a public place. But, for some reason, Dominicans think the time for social congregation and chercha is during a funeral or when someone is sick in the hospital.
Quick side note here: I remember when I lived in the Dominican Republic for 12 years; we would go to the small rural town of Miches on Samaná Bay. I saw a funeral being held in the town. Everyone came out to pay his or her respects. But the funeral, held in the street, in front of the deceased’s meager home, under a small tent like structure, looked more like a party than a funeral. A local neighborhood person told me that all the town’s people come out for a funeral, no matter if they know the person who has died or not. The funeral becomes a social event. Miches is a little town. Miches had a small funeral, but with a lot of people. You can find the same social atmosphere if you pass by the largest funeral parlor in the country, Blandino Funeral Home, in the middle of Santo Domingo.
It’s been a while since I witnessed “la chercha,” but I found myself right in the middle of one that began around 8 o’clock at night in the hospital bedroom of my son who suffers from his second episode of dengue fever. The chercha continued for a second consecutive night with the same group, but now the chercha was ever larger and with more participants. If you ask, “who is everyone?” Everyone is a “Tia” (Aunt). Everyone is a “primo” (cousin). It’s easy to wonder if these people are really tias and primos, or are they just longtime friends looking for a good Friday night chercha.
I know that family is important in the Dominican Republic. I know that family and friends try to be supportive, especially in times of crisis. But, this time, my son needed his rest. He needed his room for himself. He needed the phone calls to stop. And he needed the chercha to take place somewhere else besides his small hospital room. I was growing impatient with the chercha, but I respect the culture. I began to give signals to my son’s mother. “Time is up. Let’s go. End the chercha.” But, I received no response from her and the chercha continued until the hospital security posed its limit on visiting hours.
Although “family” in the Dominican Republic tries to be supportive, they really are not. They are often their own worst enemy. And my conversation with the doctor today proved that to me. All of the family left, including my son’s mother who took off on a trip to South America. Therefore, I had the doctor’s ear and attention to myself.
As I said above, I began to ask him several questions about dengue fever. He got more nervous and anxious, the more that I asked. But, after the doctor realized that I was merely “curious,” he began to explain that Dominicans, while they suffer from an epidemic of dengue fever in the country, try to learn the disease and apply ancient folk medicine. He said, and I am paraphrasing, that old wives’ tales and folklore drive Dominicans to prescribe remedies and natural juice mixtures that only complicate the medical situation. He said that patients and their families should just listen to professional medical advice and not invent their own solutions.
The doctor told me that I will not be able to learn what he had learned studying medicine and dengue for over 10 years at Saint-Louis Hospital in Paris, France (as part of his studies at the renowned Sorbonne University.) I responded, “Doctor you will forever be my professor, but I must educate myself as much as possible about dengue.” He said, “but what is happening here is not a question of Doctor Google, it’s a question of Doctor Dominican Republic.”
At this point in our conversation, I began to understand the doctor and empathize with his anxiety and concern. He wanted patients and their families to trust him. Trust was the key word. There is a trust deficit in the Dominican Republic, in general — ever since I have come to know this beautiful Caribbean country.
My conversation with the doctor began to change. He began to trust me. He began to explain to me the basic fundamental vital signs of dengue fever. He began to explain the trends that we will see over the next few days. We discussed the normal composition of blood and what happens to it when a patient has dengue. I learned a lot. The doctor felt more comfortable. Our trust for each other increased.
But, as we carried on our deep conversation, the hospital room phone rang. (It has been ringing constantly.) He looked at me, acknowledging for me to “answer the phone”. I responded, “No, doctor. I am listening to you. It is probably another tia, tio, abuelo, abuela, primo, prima, etc. calling. I am focused on you right now.” Our trust levels grew. And he said to me, “They are part of the problem. They think there is a mixed juice concoction to remedy every disease.”
The main problem for a person with dengue is that their blood loses water (hydration), and the blood becomes thicker and more viscous. “Here (Dominican Republic) they make a guava and red pepper juice concoction that they think raises blood platelets for dengue patients, but this is not true. Blood platelets drop and rise in patients with dengue, with or without the juice,” the doctor said.
“Guava and red pepper juice is actually the worst combination, because it sits in the patient’s stomach, making the patient’s liver swell even worse — even more so than it normally swells when one has dengue; and often causes vomiting — all while the patient needs to stop vomiting and retain hydration so that the blood returns to its normal state,” explained the doctor. He said, “Guava and red pepper juice is actually the worst thing you can give a patient with dengue.”
This begged my question, “Then why would the ‘tias’ (aunts) mix up this guava and red pepper concoction?” His response, “Doctor Dominican Republic.” I asked the doctor to follow me around the corner to our small hospital room-sized refrigerator. I pulled out a silver container of homemade juice delivered to us by some of the same tias who had enjoyed two consecutive days of late night chercha in my son’s hospital.
The doctor said, “I can’t even bring myself to smell that!” It was guava and red pepper juice. The doctor’s orders were: “pour it out, tell the family ‘thank you’, make them think the juice worked, make them think this juice concoction contributed to raising your son’s blood platelets; and never let them know you didn’t want their juice, because they will blame you — ‘the stupid American’ for anything that goes wrong.”
John R. Gagain Jr. is Managing Partner at Infinity Media USA LLC — an award winning media company helping business & organizations tell their story & engage audiences online [infinitymedia.im]. He is author of the book “Visions for the Global Economy.” John serves as a Certified Business Mentor for young entrepreneurs and Start-Ups at SCORE Association. John can be found on LinkedIn at linkedin.com/in/Gagain.
