A young African man was interpreting for his grandmother, who came in with right upper quadrant pain of three days' duration.
"When the pain started, did it start gradually or suddenly?" I asked.
"It started when someone sat on her, " he replied.
I waited expectantly.
"We went to a feast," he said simply.
Wanting to respect any tribal customs, I picked my questions carefully. "How big was the person who sat on her?"
"A sixteen-year-old girl. A big girl."
I pictured the banquet table. Maybe her granddaughter had come over to greet her and affectionately sat on her lap. "How long did she sit on her?"
I jettisoned all efforts at cultural sensitivity. "Why?"
"There wasn't enough room in the car."
"You drove one hour to the feast and your grandmother had another adult sitting on her lap?"
Thinking maybe I had misunderstood the time line and this had occurred in Zimbabwe, prior to immigrating, I clarified, "What city was this?"
I examined the patient's abdomen, and filled out the requisitions for some investigations. I decided I couldn't ignore the issue of their transportation methods. "In Canada, you aren't allowed to travel in a vehicle with another adult on your lap."
"You're not?" He was genuinely amazed.
"No. It's an issue of safety. If the police catch you, you'll be fined." He looked alarmed, and I reassured him, "I'm not going to call them. But you need to know that each adult must travel in their own seat, with a seat belt."
He looked like a reprimanded schoolboy. "But we had to do that," he said earnestly. "Or someone would have been left behind."