Describes a 2-yr study of Tunisian peasants' perceptions of well-being and misfortune. It was found that a large number of peasants were critical of their communcation with Western-trained doctors. It is suggested that one of the reasons is the peasants' ignorance of the doctor's paradigm. When we look at the flow of communication between the local healer and his client, we discover that mutual understanding is based on shared knowledge and assumptions. In the case of the Western-educated physician and the peasant, both parties are ill-informed about each other's model of the world.