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The importance of understanding cultural differences in the medical environment
The importance of understanding cultural differences in the medical environment
Cultural Differences Among Patients in the Medical Field
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Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.) As part of my Culture, Health and Illness class, I undertook a critical analysis of the book “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures” by Anne Fadiman. This book was published in 1997, and documents the struggle of a Hmong family from Laos in communicating with and understanding the American health system. The Vietnam War caused great destruction in Laos, and so the Lee family migrated to America, after spending a short time in refugee camps in Thailand. After settling in America, Foua gives birth to Lia, who unbeknownst to them will suffer from epilepsy soon after she is born. For four years, little Lia is admitted to hospital seventeen times, after suffering both grand and petit mal seizures. Through miscommunication and a failure to understand each other’s cultural differences, both the parents of Lia, and her American doctors, are ultimately at fault for Lia’s tragic fate, when she is left in a vegetative state. 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... ... middle of paper ... ... Lia Lee will never be repeated. “The soul-caller in Lia’s healing ceremony, began to chant, “Where are you? Where have you gone? . . . Come home to your house. Come home to your mother . . . Come home. Come home. Come home.” Ironically and tragically, Lia would never come home, because her brain had been lost forever. References: Balzer Riley, J. 2012. Communication in Nursing. 7th Ed. United States: Elsevier Fadiman, A. 1997. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Straus, and Giroux. Kleinman, A. 1980. Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. University of California Press. Kohn, L. et al. 2000. To err is human: building a safer health system. Washington D.C. National Academies Press.
In their pursuit of assimilating and calling the US home, they had forged a new identity of Hmong Americans. (Yang, 203) Being Hmong American meant striving to move up the economic ladder and determining one’s own future. They understood that for them to realize their American dream and their “possibilities”, it could only be done so through “school”. (Yang, 139) Yang realized her dream by attaining a Master’s of Fine Arts from Columbia University and publishing books about the Hmong story.
To conclude, with the Lees being Hmong and not wanting to conform to society and abide by the way things works, I feel Lia’s fate was inevitable. The doctors did as much as they could, but in the end, it still wasn’t enough to prevent Lia from going brain dead. Language and communication may have been the one thing that caused Lia to suffer because the doctors couldn’t understand the Hmong and the Hmong couldn’t or refused to understand the doctors.
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.
Though Lia’s parents and her doctors wanted the best for her, the above barriers were creating a hindrance to her treatment. They both were not understanding each other and the interpreter was also not there, doctors wanted to transfer her to another best hospital because they were not getting with her disease but her parents misunderstood the situation and thought they were shifting her for their own benefit. In expansion to these convictions, Hmong likewise have numerous traditions and folks that are negotiated by those of the American standard and therapeutic groups; for instance, some Hmong customarily perform custom creature sacrifice and in view of extremely particular entombment customs and the alarm of every human's numerous souls potentially getting away from, the accepted Hmong convictions don't consider anybody experiencing obtrusive restorative surgery. The Hmong medicinal framework is dependent upon nature-based hypothesis that lets life stream as it may be, while the western restorative framework is dependent upon the modernized humanism-based medicinal science. So when Lia was dealt with by the American specialist with western pharmaceutical, Lia's guardians don't concur with them....
Aimee Phan’s book We Should Never Meet, follows the lives of four Amerasian children brought to the US because of the Vietnam War. The book highlights their struggles, achievements, and efforts to become in touch with their Vietnamese background. The book goes shifts from present to past and allows the audience to experience every side of the struggle. From a mother’s point of view, a nun’s point of view, even an adoption helper’s point of view. Kim, Mai, Huan and Vinh all faced everyday struggles of being biracial in the United States. They also struggled eternally with the unknown of their placements in life and how fair or unfair life had done them. Huan and Vinh came to America in different ways but they had one thing in common, the struggle
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
In The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, author Anne Fadiman explores the complexity of a cultural clash through communication and interaction between the Hmong minority and biomedical culture in the United States. In broad terms, her book classifies as a modern-day case of cultural anthropology that depicts the complications of unprepared cross-cultural communication and lack of assimilation. Fadiman documented the saga of the Lees, a Hmong family who immigrated to Merced, California after nation-wide problems in their homeland of Laos and China (Fadiman 5). Their story exemplifies the struggle with biomedicine in the United States by detailing the story of the Lee’s severely epileptic daughter Lia and reflecting on the factors and outcomes of her life and death.
“Whenever she had to warn us about life, my mother told stories that ran like this one, a story to grow up on. She tested our strengths to establish realities”(5). In the book “The Woman Warrior,” Maxine Kingston is most interested in finding out about Chinese culture and history and relating them to her emerging American sense of self. One of the main ways she does so is listening to her mother’s talk-stories about the family’s Chinese past and applying them to her life.
The Spirit Catches You and You Fall Down by Anne Fadiman is a nonfiction book that brings to light the clash of Hmong culture and Western medicine in Merced, California. Anne Fadiman tells the story of a Hmong immigrant family, the Lees, and the unfortunate condition of epilepsy that their daughter Lia suffers from. Throughout the book the reader sees great conflict inflicted on medical practitioners due to the Lee’s own cultural beliefs and the frustration suffered by the family due to miscommunication. Anne develops the story by giving a detailed background of the Hmong peoples’ lifestyle in their indigenous land of Lao, how it contributes to their beliefs, and their struggle to understand and accept Western practices.
After the fall of the Saigon in 1975, Heidi’s mother- Mrs. Mai Thi Kim decided to send her to America as fearing for her uncertain future in Vietnam. Twenty two years later years, Heidi eventually found her Vietnamese mother. However, as she was raised in the States, Heidi is now "101%" American and has little knowledge of her Vietnamese heritage. Undoubtedly, this reality reveals potentials for cultural collision.
The book titled “The Spirit Catches You and You Fall Down” is not only an interesting narrative to read just because but it serves as insight into the culture of the Hmong’s and not only how but also a why the Lee’s struggled to adapt and agree with Western medical practices for her daughter’s health.
Through showing the different definitions of health, the authors explain how those different understandings affect patterns of behavior on health depend on different cultures. In addition, an analysis of the models of health demonstrates even western medical approaches to health have different cognitions, same as the Indigenous health beliefs. The most remarkable aspect is a balance, a corresponding core element in most cultures which is an important consideration in Indigenous health as well. From an Indigenous perspective, health is considered as being linked, and keeping the connection is a priority to preserve their health. Consequently, health is a very much culturally determined. Health practitioners should anticipate and respect the cultural differences when they encounter a patient from various cultures. In particular, this article is good to understand why the Indigenous health beliefs are not that different than western medicine views using appropriate examples and comparative composition, even though the implementation the authors indicated is a bit abstract, not
The main coping mechanism, then, became suppressing of the memories and emotions attached to the traumas of the Vietnam Wars. Their home served as the host of these demons, but the demons impacted parenting styles. Thi acknowledges that her parents taught her and her siblings many lessons, some intentional but others, quite the contrary. It was the “unintentional ones [that] came from their unexorcised demons and from the habits they formed over so many years of trying to survive;”(“The Best We Could Do,” 295) these lessons were indeed unintentional because just like the suppressed communication, they derived weak communication between the parents and the children. In Min Zhou’s article “Are Asians Becoming ‘White’?” she concludes by including a picture of a Vietnamese family celebrating the 1998 Lunar Year, looking happy. This happy family in the article is much like the Bui family because on the outside, they appeared happy, but inside their home and their hearts, a darkness
Going to a different country or area of the world can open up anybody’s eyes to see that culture makes a huge impact on the understanding and practices of healthcare that seem to be so common to other areas of the world. When a person lives in one country their whole life, that person may not realize how different the life they live is from someone in a foreign country. If a person is going to receive treatment from someone with a different cultural background, they should be expected to get treatment to respects their own culture. Massachusetts College of Pharmacy and Health Sciences having such a diverse variety of students has their own cultural competency definition that states “effectively and comfortably communicate across cultures with patients of differing backgrounds, taking into account aspects of trust in order to adopt mutually acceptable objectives and measures”. In the book Dancing Skeletons: Life and Death in West Africa by Katherine Dettwyler, the issue of culture and healthcare are greatly prevalent. Katherine Dettwyler herself goes to West Africa as an anthropologist and her horizons are broadened when during her research she comes in contact with how much culture has an impact on healthcare and everyday life.
She clearly portrayed the Hmong beliefs and their origins through her detailed explanation of the Hmong customs and history. She also uses keen details to explain the medications and medical procedures over the course of Lia’s treatment. It was evident that Fadiman entered the case with an open mind and avoided cultural/religious misunderstanding. While her explanation of the Hmong culture using the “fish soup” method laid a foundation for which the novel would build upon, I believe that maintaining aroused on the subject was slightly difficult. Fadiman also uses her knowledge of medical education to explain that blame for the culture clash cannot be assigned to the doctors since they were not educated on that matter (Fadiman, 61). Even though Fadiman attempts maintain an unbiased position on the issue, I believe her claim regarding doctor was biased. The author states, “Medicine, as it is taught in the United States does an excellent job of separating students from their emotions. … Dissociation is part of the job. … Neil Ernst avoided Lia Lee after she returned from Fresno with irreplaceable brain damage(he couldn’t bear it) (Fadiman, 275, 276). In the beginning of the novel the author explained how doctors Neil Ernst and Peggy Philp were some of the only people to provide satisfactory treatment for Lia (Fadiman, 42). With this being said, I believe that