Harold, an elderly gentleman, has gone with his wife to the medical center for a checkup a few days after gall bladder surgery. The surgeon, Dr. Manoukian, is pleased with Harold's condition.
As they part company, Harold offers a flowery thanks, puts his arm around the young physician and gives him a kiss on the forehead. The doctor kisses Harold in return, then puts his arm around Harold's wife and kisses her on the cheek.
Astonished, Harold's wife freezes.
What went wrong? Harold's wife was caught off-guard. She had never before been hugged or kissed by a doctor. Especially nowadays with heightened sensitivity about sexual harassment, professionals rarely express physical affection to the opposite sex. However, Dr. Manoukian was only demonstrating that he cared for Harold and his family.
Dr. Manoukian's behavior reflected his Armenian roots. In most business transactions with persons of Armenian and other Middle Eastern heritage, a more personal interest may be displayed and affection naturally given.
Although the surgeon's behavior was unusual, Harold's wife felt remiss that she hadn't responded positively. However, the doctor took his cues from his patients' behavior. On subsequent visits he still hugged Harold, but only shook hands with Harold's wife.
Rule: Even in a formal doctor/patient relationship, communication styles may follow cultural traditions.