Cultural diversity: American style.

A lot of attention has recently been placed on cultural diversity. There have been numerous conferences, meetings and presentations on this subject; all in an attempt to have practitioners become more sensitive and open to the "inner workings" of what makes us different from our neighbor. Many respiratory care programs and hospital respiratory departments have taken closer looks at the cultural diversity in their classrooms and workplaces. In our society, there is a mixture of heritages and backgrounds from all over the world. However, something we often overlook is the cultural differences that vary from region to region in our country.

By cultural differences I mean dress, language, customs and attitudes. Although, at times not quite so evident, cultural diversity within these United States has to be dealt with when a person moves from one state to another or from one region to another. Regional diversity, as I like to call it, can be as simple as someone preferring Manhattan clam chowder over New England, rooting for a particular professional team, having that "unique" accent or "twang", or wearing cowboy boots and those little rope ties.

When therapists move, they often are confronted with changes in speech, dress, customs, food, attitudes and beliefs. Just as someone from India, China, Eastern Europe or Africa has to deal with acceptance, so does the practitioner moving from Delaware to Oregon. There will be new ways of doing something, different attitudes and different perspectives. When you think of it, difference is an interesting phenomenon. They say differences attract and yet, we tend to seek those who are more like us, those who have interests similar to ours and who want to do what we like to do.

Diversity, however, is good and healthy. What woman goes to an event knowingly wearing what her friend will wear? Imagine if we all wore the same style clothes or if we ate pasta everyday? The world would become a very boring place. Each of us, deep inside, really craves the exciting and the different. In some ways, we are still pioneers; seeking out what is new and different. Then why are we suspicious or afraid of anyone different? Why don't we readily accept those not like us? I guess that is the reason for all of those seminars and conferences on cultural diversity. We still don't have the answer, because if we did, this country and this world would be far different places.

Getting back to regional diversity. My husband and I recently moved from New Jersey to Lake George, New York, a distance of about 200 miles. This is not a move from East Coast to West Coast, and yet, we have encountered significant regional diversity. Some were surprised that we did not have the "Joisey" accent or did not do everything in a New York City minute. We have come to find that life in the "North Country" is quite relaxed and that "talk don't shuck an ear of corn." Up here, it is permissible to visit a home care patient wearing a simple pair of pants and a clean shirt. In fact, if you wore a dress or a shirt and tie, you might make some people nervous and/or leery of you.

Up here, they laugh if you lock your doors at night or put the "club" on your car. The attitude is "we trust and help each other," including strangers. There isn't much difference in the type of respiratory care delivered but there seems to be a difference in the way it is delivered, at least in the home. Up here in the North Country, you are expected to sit down and converse first. By the way, that is after you have found the house. In urban areas, you go to First Street, apartment 3B. Here you go to the house with the red roof, wagon wheel up against the oak and with the mountain pinks under the mailbox. Don't rely on street names or house numbers, they change like the Adirondack weather.

In general, health care in this rural area is a local affair. Small health centers with G.P.'s or nurse practitioners are the first line of defense but the nearest hospital might be more than a hundred miles away. People think nothing of driving two hours to receive their health care, are more than willing to take time off for your visit and will actually volunteer to meet you at your office. Maybe, it's because you can drive longer distances in less time. There isn't the congestion of traffic to contend with.

I'm sure therapists who have relocated from one area of the country to another have encountered somewhat the same experiences in terms of language, dress and customs. Cultural or regional diversity is not an issue when there is understanding and acceptance. It only becomes problematic when there isn't. Fortunately, we were accepted with open arms in New York. I'm sure it would have been the same if we moved to Tennessee, Texas, Oregon or Michigan. A lot of it depends on what you bring to the table ... your expectations, attitudes and openness. Diversity is a two way street.

Before any one accuses me of bashing New Jersey or urban areas, I have a lot of close friends and patient contacts there. People, for the most part, are good in their hearts, their desires and attitudes. Many times I have been invited for dinner at a patient's home or expected to spend time simply conversing with a patient, family member or caregiver. When it comes down to it, we human beings are a pretty decent lot. We help when asked, care when needed and love when we can. We just need to get over the suspicions that arise from our differences. Remember, in nature, opposites attract. It's the natural way. We should listen to Mother Nature and embrace both what separates us and what brings us together.

So, the next time you have a new person work with you in your department, whether they are from India, Poland, New Jersey or Minnesota, make sure you open your mind and heart and make them feel welcome. By the way, special thanks to the wonderful people in the North Country of New York State who have made us feel so welcomed.