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What would it be like to come to a country and not understand anything about its health care system? To many this would be a very daunting task. Unfortunately, this is the scenario that the Lee family has to deal with in the book The Spirit Catches You and You Fall Down by Anne Fadiman. The Lee family, and the other thousands of Hmong immigrants, try to understand and navigate the complex and sometimes confusing health care system of the United States. As the book points out, the values and ideals of the Hmong culture and the United States health care system are not always the same and sometimes come into great conflict with each other. Lia Lee was unfortunately the person stuck in the middle of this great conflict. The two Hmong cultural values that were demonstrated by the Lee family are portrayed by their belief and view about the cause and method of cure for an illness. The Lee family comes from a culture that believes in holistic healing. They have an animalistic view about health and medicine. For instance an epileptic is seen as someone who has been chosen to be a healer. Most Hmong epileptic are shamans, therefore even though the Lee’s wish that their daughter’s illness will be cured, they also have a mixture of pride because “although shamanism is an arduous calling that require years of training with a master in order to learn the ritual techniques and chants, it confers an enormous amount of social status in the community and publicly marks the triv neeh as a person of high moral character since a healing spirit will never choose a no account host” (Fadiman,1997, p.21). It is not surprising that their view about health is reflected mostly in their traditional belief in the causes and the cure of an illness. For i... ... middle of paper ... ..., p.261) With this knowledge of the culture that one works in, the health care worker can better see the differences with the cultures of the patients that they are taking care of. Hopefully this understanding will lead to less conflict and better healing. In this book Anne Fadiman portrayed the ethnocentricity of the American culture, in which people of other cultures are judged based on the standard of American customs and tradition. This means that people are very skeptical about the things that they do not understand. A lot can be learned from the interactions that took place between the Western United States health care system and the more traditional Hmong culture. This book proved that in the end neither way of thinking was completely wrong or completely right. Compromise and understanding is the key to both cultures getting the outcome that they desire.
The Spirit Catches You and You Fall Down tells the story of a young Hmong girl stricken with epilepsy, her family, her doctors, and how misunderstandings between cultures can lead to tragedy. The title comes from the Hmong term for epilepsy, which translated, is “the spirit catches you and you fall down”. Anne Fadiman alternates between chapters on Hmong history or culture and chapters on the Lees, and specifically Lia. The condensed history of the Hmong portrayed here starts at their beginning, and traces their heritage, their movements, and why they do what they do as they flee from enemies to country to country. This record allows the reader to better understand the Lees and their situation without bogging him down with details that may
The Spirit Catches You and You Fall Down by Anne Fadiman is about the cross-cultural ethics in medicine. The book is about a small Hmong child named Lia Lee, who had epilepsy. Epilepsy is called, quag dab peg1 in the Hmong culture that translates to the spirit catches you and you fall down. In the Hmong culture this illness is sign of distinction and divinity, because most Hmong epileptics become shaman, or as the Hmong call them, txiv neeb2. These shamans are special people imbued with healing spirits, and are held to those having high morale character, so to Lia's parents, Foua Yang and Nao Kao Lee, the disease was both a gift and a curse. The main question in this case was could Lia have survived if her parent's and the doctors overcame the miscommunication, cultural racism, and the western way of medicine.
...ation could have been improved between doctors and patients in simple ways. Interpreters were used and children went to school and helped translate for family members. These helped communication somewhat, but it wasn’t enough. There may not have been any other way to help, but some people tried to and doctors tried to be patient with the Hmong to understand what they wanted and to make them understand what was going on.
Traditional Hmong’s believe in their Shaman rather than western doctors, they choose to detain their treatment by hosting their rituals to save them. A shaman is “a person who acts as intermediary between the natural and supernatural worlds, using magic to cure illness, foretell the future, control spiritual forces, etc” (dictionary.com). Hmong individual’s have a belief that ancestral spirits, including the spirits of shamans, are reincarnated into the same family tree. Hmong consider being a shaman an honor because they carry the duty of helping mankind according to Hmong mythology. Differences between Hmong traditional beliefs and Western biomedical beliefs create a lack of understanding. Negative health care experiences result in Hmong community members’ mistrust and fear of Western medicine. However, when there’s mistrust between a doctor and a patient there could be lack of treatment because of the differences between our ...
Within this critical analysis, I hope to show that the lack of communication and compromise between the Hmong family and the American doctors, was the defining blow to Lia’s ill health. I hope to do this by addressing the following three main points of interest in relation to this miscommunication; the views held by the American healthcare professions on the causes of Lia’s illness, contrasted with the opinions of Lia’s parents. I will then discuss the health-seeking strategies of Lia’s parents and how they were influenced by different resou...
This book addresses one of the common characteristics, and challenges, of health care today: the need to achieve a working knowledge of as many cultures as possible in health care. The Hmong population of Merced, California addresses the collision between Western medicine and holistic healing traditions of the Hmong immigrants, which plays out a common dilemma in western medical centers: the need to integrate modern western medicinal remedies with aspects of cultural that are good for the well-being of the patient, and the belief of the patient’s ability to recuperate. What we see is a clash, or lack of integration in the example of the story thereof. Lia, a Hmong child with a rare form of epilepsy, must enter the western hospital instead of the Laotian forest. In the forest she would seek out herbs to remedy the problems that beset her, but in the west she is forced to enter the western medical hospital without access to those remedies, which provided not only physical but spiritual comfort to those members of the Hmong culture. The herbs that are supposed to fix her spirit in the forest are not available in the western hospital. The Merced County hospital system clashes with Hmong animist traditions.
The book I read to examine multicultural issues and cultural biases was The Spirit Catches You and You Fall Down, by Anne Faldiman. I found it helpful to use Google maps to get a visual of the location Hmong refugees came from in Laos and mentally trace their journey across the Pacific to settle in Merced, CA. There are two main cultures discussed in this book which includes the subordinate Hmong Lee family and the dominant White American doctors who tried to help Lia with her medical or spirit issues depending on which culture you asked. Faldiman stated in the preface, “I have always felt that the action most worth watching is not at the center of things but where the edges meet.” This statement would hold so much relevance because Lia’s treatments could have been less stressful if the two cultures reached a point of intersectionality. This is also congruent with what Tatum mentioned in Why are All the Black Kids Sitting Together in the Cafeteria concerning, “Changes in immigration policy in 1965 dramatically increased Asian immigration, significantly altering the demographic makeup of the Asian Pacific American community.” In order to have a full
The Hmong people, an Asian ethnic group from the mountainous regions of China, Vietnam and Laos, greatly value their culture and traditions. The film “The Split Horn: Life of a Hmong Shaman in America” documents the seventeen year journey of the Hmong Shaman, Paja Thao and his family from the mountains of Laos to the heartland of America. This film shows the struggle of Paja Thao to maintain their 5000 year-old shamanic traditions as his children embrace the American culture. Moreover, the film shows that one of the major problems refugees like Paja Thao and his family face upon their arrival to the United States is conflict with the American medical system. Despite the dominant biomedical model of health, the film “The Split Horn” shows that
Cobb, Torry Grantham, DHSc, MPH,M.H.S., P.A.-C. (2010). STRATEGIES FOR PROVIDING CULTURAL COMPETENT HEALTH CARE FOR HMONG AMERICANS. Journal of Cultural Diversity, 17(3), 79-83. Retrieved from http://search.proquest.com.ezp-01.lirn.net/docview/750318474?accountid=158556
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Cultural Competence is important for many reasons. First, it can help develop culturally sensitive practices which can in turn help reduce barriers that affect treatment in health care settings. Second, it can help build understanding, which is critical in competence, in order wards knowing whom the person recognizes as a health care professional and whom they views as traditional healer, can aid the development of trust and improve the individual’s investment and participation in treatment. Third, our population in the United States is not only growing quickly but also changing, cultural competence will allow us as educators and healthcare workers keep up wi...
Jean Giddens (2013) defines culture as “a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language, or live in a defined geographical region.” (Giddens, 2013). A person’s culture influences every aspect that person’s life. Beliefs affected by culture include how someone interacts within the family, how to raise children, the types of foods eaten, the style of clothes chosen, which religion is practiced, and the style of communication (including verbal, and body language, slang used etc.) (Giddens, 2013). In addition to these beliefs, health care practices are also affected by culture. The cause
By every individual accepting and acknowledging that we are all different then there will be mutual respect for each other’s cultural difference. When these differences are explored in a safe, positive, and nurturing environment, they are more than simply tolerating others but that through these differences are instead commended and embraced. People become aware of each other’s difference and uniqueness such as religion, sexual orientation, race, gender, age and beliefs. When this is embraced by the health care providers then there will be improved care.
As nurses entering the medical field understanding the culture of our patients is crucial to proper care. Each culture has their own set of beliefs and values that are shared among groups of people which influences personality, language, lifestyles, house hold, level modesty, social standings, foods, health treatment and identity. Culture affects how people view health and illness; dictating when, where and what type of medical treatment they will receive and who will be their care provider.
Understanding cultural differences not only improves the effectiveness of the treatment the patient receives, it is also help the nurse to prevent negliency of care. It is impostant to maintain a curiosity about each patient no matter how much we know abouth that person's culture.