Yes. He made a referral to a Mormon bishop, who was able to apply the theology of Mormonism to heal this woman’s intense fear. She was very fearful because she had realized that in her first marriage, she had been married for this world and the next, an eternal marriage to this man who had died just a few months after their marriage. She had subsequently remarried and spent her whole life up to that point (she was in her middle years) with that man. They had four children, and she considered him to be her real husband.

It had occurred to her one day, like a bolt out of the blue, that she was married to a stranger for eternity. She became terrified and even horrified, because she wanted to spend eternity with her current husband and their children. So that threw her into an emotional tailspin and sent her to the psychiatrist. And he, not being Mormon, could not fully comprehend the issue though he could see it was serious. So he referred her to someone who could fully comprehend the issue and could resolve it.

Someone who could work with her within the framework that she lived in, so to speak.

That’s a great way to put it. To work within her reality structure, so as to relieve her fear and her distress and allow her to go back comfortably to living her life as it presently was.

It seems to me that in a country such as our own, and increasingly a world such as our own, with such diversity and such an increasing degree of interaction among different cultures and peoples with different beliefs, that this kind of thoughtful, respectful perspective is incredibly valuable.

I think so, yes. There are some excellent books on this subject. There’s a psychiatrist named Arthur Kleinman who has written a lot about cross-cultural medicine and how to deal with it. Then there’s this fascinating book, Medicine and Culture, by Lynn Payer, which talks about cultural differences within the practice of biomedicine. People have a tendency to think that biomedicine is scientific and culture-free. Well, science is not culture-free and biomedicine is emphatically not culture-free, or objective, or any of those other words that people like to use. This is a really fascinating book, because she compares biomedicine as it’s practiced in the United States, England, Germany and France.

What are some of the most dramatic examples, or most meaningful examples, that she describes?

One that I particularly enjoy involves the question of what issue particularly concerns both the MDs and the patients in any given country. The Germans are very worried about their hearts, and some remarkable proportion of prescriptions in Germany are written for heart medications.

More so than here?

Far more so than here. The French are worried about their livers. The British are concerned about their guts, particularly their large intestines and whether they are constipated or not. Americans are worried about whether their immune systems are working properly. Now, every human being in the world has all these parts and every medical system deals with them in one way or another. And yet, culturally, the medicines—and this is all biomedicine we’re talking about—have been biased toward these cultural concerns. And Lynn Payer’s discussion of this is very, very interesting. And very funny, too.

Is it that the doctors are meeting the desires of their patients or are the patients being influenced by their doctors? Or is there some kind of circular feedback loop here?

Each society has a cultural issue. In Germany it happens to be the heart, in France it’s the liver. In Britain, it’s the intestines and in the U.S. it’s the immune system.

I want to ask why, but I’m not sure that “why” is even an appropriate question.

I have no idea why. That would be a difficult historical issue and I’m not a historian. Here’s another example—suppositories versus injections versus pills. The way you’re going to deliver the medicine. There are biases toward preferring one or another.