RT Journal Article SR Electronic T1 Indication JF The Annals of Family Medicine JO Ann Fam Med FD American Academy of Family Physicians SP 75 OP 78 DO 10.1370/afm.1318 VO 10 IS 1 A1 Ronald E. Pust YR 2012 UL http://www.annfammed.org/content/10/1/75.abstract AB Should the indications for therapies differ from one nation to the next? What are the reasons behind controversial therapeutic variations? What roles do cultural history and authoritarian conflict among clinicians play in the adoption of therapies? When I worked at a rural hospital in Kenya, a woman experiencing obstructed labor made me ponder many questions—but only after our emergency ended in the death of her newborn son. In recounting and learning from this episode, I listened to the disparate Kenyan voices of the patient, the hospital’s director, the consultant obstetrician, and to the even more controversial voices of evidence-based medicine. In reflecting on this process, I have learned at least 3 lessons—about the transmissibility of arrogance, the role of guests in other countries, and the nature of science.