In the Chinese and Japanese cultures the number 4 is pronounced the same way as the character for the word “death.” A number that is considered bad luck. Hence if the number 4 is used either communicated or used in a health care room number. Even the most sensitive health care provider could not be expected to know the significance of the number 4 without some knowledge of these 2 Asian cultures (or their languages).
Lack of eye contact in American culture may indicate many things, most of which are negative. A physician may interpret a patient's refusal to make eye contact as a lack of interest, embarrassment, or even depression. However, a Chinese patient may be showing the physician respect.4 If the patient is female and from a Muslim