If you should be in Rome, live in the Roman manner; if you should be elsewhere, live as they do there.

If you should be in Rome, live in the Roman manner; if you should be elsewhere, live as they do there.

The idea of living as an expat, especially on a Caribbean island, is pretty romantic. The reality, though not nearly as rosy, is so much more interesting. I’ve officially been an expat for 9 months now. I’ve been here long enough to experience the underside of the beast, especially in my line of work. Unlike many expats who work in tourism or hospitality, (providing visitors with great food or guiding them to a wonderful dive site), I see mostly locals, many times on their worst day. I certainly care for tourists, it’s rare a day goes by without treating at least one cruise ship passenger, but more than half my calls are for locals. What makes working with and caring for, the local population difficult is although they speak English, our customs and approach to life is different. I’ve had to adopt a “when in Rome” attitude. I remember reading about U.S. Special Forces, when they initially entered Afghanistan following 9/11, becoming frustrated with sitting down and having tea with village elders before getting down to business. The thing is, that’s how the Afghans do business. The soldiers had two choices, fight that custom, appear disrespectful and possibly lose an ally, or adapt to the new reality and gain their trust.
Like the soldiers in Afghanistan, I’ve had to alter my practice slightly to accommodate my new reality. In the U.S., when I greeted a patient I might say hello or I might just start asking why they called 911. Here, it’s important to greet patients by the time of day. So for instance, when I arrive on scene instead of saying, “Hi, I’m Don, why did you call 911?” I instead would greet them by saying, “Good night sir” and wait for their reply before introducing myself and determining their complaint. It’s subtle, but important. Locals find it abrasive if you don’t greet them first with the time of day (good morning, good afternoon, good night…). This is true with local colleagues too. The younger generation isn’t as offended, but the older generation sure will be if you fail to properly greet them. How you refer to patients is important also. Calling someone Mr. or Ms. is customary. So I would refer to a patient named Michael, as Mr. Michael. A patient named Angela, as Ms. Angela. Again, subtle, but it’s respecting those little details that enable me to be more successful at my job. As a paramedic I need to develop rapport and trust quickly. I can say, “well that’s not how I do things where I’m from,” and abandon local customs, but risk coming across as harsh, or I can adjust to a new way of thinking and gain my patients respect, thereby enabling me to do what I came here to do, help the patient. Besides, I didn’t leave the United States because I wanted the same experience; I left and came here to broaden my perspectives.