Gaman

Gaman, Gaman

Sturdy and sure, keep faith and endure

Gaman, Gaman

Hold your head high and carry on, Gaman

Jay Kuo

Allegiance The Musical

One of the fringe benefits of medical practice is connecting with patients personally as people. Chatting with them after the “bullet points” of a visit are addressed is a joy that I cherish and treasure. My elderly patient with severe COPD told me that his breathing is the best when fishing in the ocean breeze. “Catch anything” I ask? Proudly he replies “Yesterday I got two papio. Big Ones!” I asked, “What you use for bait.” He whispers, “It’s a secret… but I’ll tell you.”

Our kupuna have so much wisdom. I have a senior Japanese patient who told me that she was embarking on a meditation retreat. I remarked that I viewed this as an unusual activity for someone of her age and culture. She said that she had experienced a lot of trauma and suffering in her life that she had kept suppressed. In her older years, the pain began showing itself. Mindfulness and meditation was her way of restoring peace. I asked her “But isn’t that the Japanese way; to repress, forbear and endure?” She said “That’s right. Gaman.”

Gaman is a feature of traditional Japanese culture. As a youth, I was taught to keep family issues private. We do not share our troubles with others. Gaman has been translated to mean perseverance, patience, tolerance and endurance.

Gaman has been credited as a mechanism for Japan to maintain tranquility and cooperation within a crowded and interdependent community. Getting along took priority over individual preferences and needs. Gaman has also been credited as a coping mechanism during times of adversity. Interned Japanese Americans were said to have survived WWII with the attitude of Gaman.

But, while good for the group, is it good for the individual? And, while it may be useful for the short-term, are there long-term consequences? Times have changed and people, attitudes and cultures have changed. Without cultural support, practicing Gaman is more difficult and may have more adverse effects. Then, there is the question of honesty. Are we being honest to others when we don’t speak our minds? More importantly, are we being honest to ourselves?

Like everything in life, there is a balance. There is a Yin and a Yang. The serenity prayer reads God, grant me the serenity to accept the things I cannot change and the courage to change the things I can. There are times when we need to speak up and there are times when Gaman may be more appropriate. What we need to pray for is “the wisdom to know the difference.”