Lia Lee Could Be The Hallmark

In addition, relying on a doctor who does not share the same beliefs as one does can become fearful. Trusting the doctor for full treatment is necessary but when from a different cultural background it can prevent them on trusting them. According to a research article, Cross- Cultural Medicine a Decade Later, clearly states “when the basic belief structure of biomedicine and another set of health beliefs differs radically, problems and frustrations almost inevitably arise” (Barker, 1992, p.249). The central purpose of the research was to show whether or not health beliefs between patient and doctor differs will they find it difficult to interpret the symptoms and treatment variations to accommodate their beliefs. However, the doctor having faith in one’s health beliefs can sometimes be beneficial for the patients because they’ll be fully understood and not misjudged as being crazy. As stated by the author, for the article Chinese Health Beliefs of Older Chinese in Canada, “the findings support the previous prescriptive knowledge about Chinese health beliefs and illustrate the intergroup socio-cultural diversity that health practitioners should acknowledge in their practice” (Lai, 2009, 38). Like the Chinese, Hmong’s too first go to their shaman for traditional treatment rather than going to the doctor; to them an illness and their healing is more of a spiritual thing that

What happens when two very different or even mutually exclusive cultural perspective are forced into contact with one another? In Anne Fadiman’s The Spirit Catches You and You Fall Down, there is a division between the shamanistic insubordinate cultural of Hmong refugees in Merced, California and the cold analytical approach of western medicine. In the early 1980s, the child of a Hmong refugee family in Merced, California is born with epilepsy, her name is Lia Lee. Anne Fadiman traces the interaction between these two cultures and Lia’s disease, she reviews that misunderstanding and miscommunication can have calamitous consequences for all involved. The author introduces many characters throughout the book and they all

While the language barrier became very obvious to them as the Hmong language has very long descriptions for even the simplest words, the cultural barrier lead to a cultural bias in regards of western medicine. Hmong patients expected to be released of the ER with any kind of medicine they wouldn’t need. In addition to that the Hmong had a negative attitude towards surgery or any other invasive treatments, as it was frowned upon in their culture. One aspect that made it even harder was that pregnant Hmong women preferred to stay at home till the really last moment, so that often Hmong children were born in the parking lot or the elevator. They distrusted the western medicine so much that they preferred not getting better by gratefully accepting the medicine and diagnosis to save their pride and dignity. Just as history showed, they would rather die than give up their pride.

This prejudice is another strong concept, as the American doctors continued to underestimate, disrespect, and undermine Foua Yang (mother) and Nao Kao Lee (father) and their Hmong way of life. Vice versa, the Lees would refuse doctors’ orders in administering medicines. Ruane and Cerulo hit it right on the nail when describing prejudice,(20) which is a prejudgment directed towards members of certain social groups, as a feeling associated with immigrant groups, those that contain individuals who have left their homelands in pursuit of a new life in a new country. There is a clear indication of an in-group vs. an out-group, as it is noted from Second Thoughts, “an in-group carry unrealistically positive views of their group. At the same time…share unrealistically negative views of the out-group.” The cultural barriers are built due to “the one-sided relationship,” of knowledge only found in the unyielding West, with the prominent racial discrimination found among the white, English-speaking doctors and their intimidate dismissal of the existence of any Hmong medical practices/knowledge. The application of assimilation (20) is important to the in-group, as they simply believe that the immigrants will come to embrace the same values and customs of their new ‘homeland.’

Many years ago, an epileptic Hmong girl named Lia Lee entered a permanent vegetative state due to cross-cultural misunderstanding between her parents and her doctors. An author named Anne Fadiman documented this case and tried to untangle what exactly went wrong with the situation. Two key players in her narrative were Neil Ernst and Peggy Philp, the main doctors on Lia’s case. As Fadiman describes, “Neil and Peggy liked the Hmong, too, but they did not love them… [W]henever a patient crossed the compliance line, thus sabotaging their ability to be optimally effective doctors, cultural diversity ceased being a delicious spice and became a disagreeable obstacle.” (Fadiman 265) At first glance, this statement seems to implicate Neil and Peggy as morally blameworthy for a failure to be culturally sensitive enough. However, upon further inspection of the rest of the book, it becomes clear that Neil and Peggy’s failure to be more culturally sensitive to their Hmong patients was caused by structural issues in the American biomedical system. To prove this point, this paper will first present a background to Lia’s case, then discuss possibilities for assigning blame to Neil and Peggy, then show evidence for the structural issues in American biomedicine, before finally concluding.

Many live under the assumption that those who come to the United States want to become Americanized and assimilate to the melting pot our culture has formed into. This is the populations ethnocentric belief, which is the belief that the ways of one’s culture are superior to the ways of a different culture, that wants others to melt into the western ways. In Ann Faidman’s The Spirit Catches You and You Fall Down, Faidman fails to completely remain objective when demonstrating how cross-cultural misunderstandings create issues in the healthcare field, specifically between the Hmong and western cultures that created dire consequences between the Lee’s and their American doctors. Faidman uses her connections with the Hmong and the doctors who cared for them in order to disclose the different views, beliefs and practices the Hmong and Western cultures practiced. With her attempt to be culturally relative to the situation, Faidman discusses the series of events and reasons as to why the Lee’s faced the fate that they did and how it parallels to the ethnocentrism in the health care system.

1. The client system, in this case the Lee family, defines Lia’s seizures as both a spiritual and physical ailment. According to Fadiman (1997), “…the noise of the door had been so profoundly frightening that her soul had fled her body and become lost. They recognized the resulting symptoms as qaug dab peg, which means ‘the spirit catches you and you fall down’”(p.20). To the Lee family, Lia’s condition was as revered as it was frightening. While a person with qaug dab peg was traditionally held in high esteem in the Hmong culture, it was also terrifying enough that the Lee’s rushed Lia to the emergency room more than once in the first few months

The Lees, a Hmong family, came to the United States in the 1970s as refugees from Laos, and lived in Merced, California. Unlike most immigrants, the Hmong population was less amenable to assimilation. The traditional health beliefs and practices of the Hmong population were disputed by the practices of Western medicine. This became very event when the Lees took their three-month-old daughter, Lia Lee, to the emergency room in Merced. Lia was diagnosed with epilepsy a disease that had two different meaning among the Hmong population and Western medicine.

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

In a perfect world, race, ethnicity and culture would have no negative effect on the medical care we receive, yet problems do arise and it affects the quality of care the patient receives. Language barrier, poor socioeconomic status, and poor health literacy also contribute to health care disparity. For Lia, it was more than her skin color, it was all of the above, her parents did not speak English and they were illiterate. They had trouble understanding the American healthcare system, had trouble or little interest in adjusting to or understanding the American culture. They didn’t work, which in addition to cross cultural misunderstanding, helped contribute to animosity between the Hmong and the host community, because some in the Merced area did not like or appreciate the fact that some Hmong did not work and relied on welfare to make ends meet. All these factors, contributed to the poor quality of

Lia Lee was a Hmong infant born with epilepsy. Lia’s parents were immigrants to a Western nation. However, the parents held tightly onto traditional beliefs from their native country. The incongruent belief structure of the East and West created difficulty when the two systems collided in an effort to care for Lia Lee. Specifically, when the drug therapy prescribed for Lia Lee was not followed by her parents. Subsequently the child’s medical team contacted child services, which lead to Lia’s removal from her family. The result of the cultural misunderstanding was fragmented family. In addition to fueling the distrust of the western healthcare system by an already marginalized community.

In Hmong culture seizures are not recognized much as a physical illness as it is spiritual in nature and quab dab peg which translates to, the spirit catches you and you fall down, describes the group of symptoms experienced by Lia in the Hmong culture. The Lee’s were both happy and sad about Lia’s seizures. In Hmong culture seizures are considered to have special powers and usually become Shamans, but at the same time the Lees were worried about their child’s health.

We can see that there was a misunderstanding between the Lee’s and the doctor. Both parties explained the view on Lia’s case but from a biased perspective within their own culture. Lia's doctors strongly opinionated to treat her disease with medication, however her parents felt that being given medication would restrict with the spiritual healing given by a Hmong shaman.

1. Do you think the author was evenhanded in her presentation of Hmong culture and medical culture?

Prior to reading chapter six I was incognizant of the Hmong sudden death syndrome. It was interesting to read as well as be educated on such phenomena. Vang the Hmong refugee who survived the syndrome was lucky as his counselor was objectively open to understand his problems without prejudging or discarding his complaints. As the chapter indicated although unusual to the Western Ontology incidents parallel to Mr. Vang Xiong sudden death syndrome is no new phenomena to Southeast Asian refugees. For some reason, the incidents of unexplained death, primarily among Hmong men, would occur within the first 2 years of residence in the United States. Autopsies generated on identifiable reason for the deaths.