Stress Illness in other cultures

Physical symptoms connected to stress are reported in many cultures.  Abraham Verghese, MD is a professor of medicine at Stanford University in California.  His critically acclaimed novel Cutting for Stone (Vintage Books, 2009) is narrated by Marion Stone, a 50 year old surgeon born in dramatic circumstances at a hospital in Addis Ababa, Ethiopia.  Dr Ghosh practices Internal Medicine at the hospital and early in Chapter 12 there is a description of some of his work.

“It was a sad fact that the commonest complaint in the outpatient department was ‘rasehn…libehn…hodehn,’ literally, ‘My head…my heart… and my stomach,’ with the patient’s hand touching each part as she pronounced the words.  Ghosh called it the RLH syndrome.”   The RLH sufferers were often young women or the elderly.  If pressed to be more specific, the patients might offer that their heads were spinning or burning or their hearts were tired, or they had abdominal discomfort or cramps, but these symptoms were reported as an aside and grudgingly, because rasehn-libehn-hodehn should have been enough for any doctor worth his salt.  It had taken Matron her first year in Addis to understand that this was how stress, anxiety, marital strife and depression were expressed in Ethiopia – somatization was what Ghosh said the experts called this phenomenon.  Psychic distress was projected onto a body part, because culturally it was the way to express that kind of suffering.  Patients might see no connection between the abusive husband, or meddlesome mother-in-law, or the recent death of their infant, and their dizziness or palpitations.  And they all knew just the cure for what ailed them: an injection.”

I haven’t finished reading the book yet but have found it very entertaining so far.

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