Cultural encounters and family medicine: six lessons from South America.

Our lives are filled with lessons. Each of us takes from our encounters with family and friends and patients deeper understandings with which we can make sense of the complexities of our personal and professional lives. These understandings enrich us all. I present here six lessons I learned during my tenure in 1994 as a visiting professor and senior Fulbright Scholar in the Family Medicine Residency Program at the National Experimental University of Tach ira in San Cristobal, Venezuela (Figure 1). My work there was focused on teaching residents, including directly supervising their ambulatory practices, developing Balint groups, and teaching about qualitative and quantitative research methods. I spent most of my time, however, exposed to new sights, smells, sounds, and distinct ways of handling daily life, making personal discoveries all along the way. I was a gringo in San Cristobal, a city of 500,000 people in the low Andes Mountains. It is a commercial center located near the Colombian border, a tortuous IS-hour bus ride from Caracas, the nation's capital. As are many Latin American hubs, San Cristobal is home to wealth and poverty, to big business and household industry. Founded early during the Spanish conquest, regionally isolated, now ever-growing in size, it has one foot in the past and one in the future. For the medical connoisseur of pathology, the city offers a wide variety of readily observed diagnoses, from anxiety to pertussis to scleroderma, and more. In San Cristobal I was learning a new Spanish