Medical misinformation: communication between outport Newfoundland women and their physicians

A middle-aged woman in a Newfoundland outport fishing village visits the doctor at a local medical clinic and complains of a case of bad nerves. Because he neither adequately understands the subtleties of the village concept of nerves nor the local etiquette of disease disclosure, the physician misinterprets the women's complaint and treats her for an ailment she does not have. The incident discourages the woman and other villagers from seeking medical care in the future. Any outport doctor should be familiar with the character of nerves as effectors of temperament, as conversation capital, and as female status enhancers and also with the role that 'women the worrier' plays in the local fishery. Features of village life which the physician, in this case study, fails to understand include: the complex patterns of social interaction behind the woman's decision to seek medical aid, the outporter's reluctance to ask for help or become obligated to others, and the local fear of persons in positions of authority. Most importantly the doctor is ignorant of the local view of the physician as a kind of moral adjudicator with the power to undermine the patient's reputation as a good woman in the community.