Lori Arviso Alvord's Analysis

“In the Spirit Catches You and You Fall Down”, Anne Fadiman explores the subject of cross cultural misunderstanding. This she effectively portrays using Lia, a Hmong, her medical history, the misunderstandings created by obstacles of communication, the religious background, the battle with modernized medical science and cultural anachronisms. Handling an epileptic child, in a strange land in a manner very unlike the shamanistic animism they were accustomed to, generated many problems for her parents. The author dwells on the radically different cultures to highlight the necessity for medical communities to have an understanding of the immigrants when treating them.

Alvord uses her personal experiences of working as a Navajo surgeon to teach her readers the philosophies her people follow to heal. Her philosophy is that instead of looking at each patient as a mechanical system with each part separate, look at their mind, body and spirit as being connected. If one can do this, patient care will improve. She also touches upon being culturally competent in the work place by knowing your patient population’s beliefs on healing and health care. After reading her story, I believe that in order to be the best health care provider one must look into the spiritual aspects of their patients’ lives. As providers we must provide care using the biopsychosocial model of care and become knowledgeable on our patients beliefs. Like Alvord states within her story, we must walk in beauty, become harmoniously connected to those around us, and care for our patients in a positive

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

According to the Hmong culture a shaman helps to cure the soul. A doctor cures biological problems. As we learn throughout this class there is a difference between an illness and a disease. An illness or a disease may have the absence of the other. In most cases an illness can be present without a disease. In the case of Lia there was a presence of both Illness and disease. If txiv neb and the American doctor would have balanced their practices and learned from each other this would have affected the way the Lees thought about medicine. I believe that faith plays an important role in Lia’s case if the doctors would have understood the way that txiv neeb thought and vice versa the lees would have trusted American doctors and medicine more. Learning from txiv neeb would have also helped the American doctors in other cases when treating Hmong by understanding their culture. It is important for the doctors to understand the Hmong culture and specifically the way that a txiv neeb works because in Merced a third of the population were Hmong and used a tixv neeb as their main source of healing.

Anne Fadiman’s novel, The Spirit Catches You and You Fall Down, addresses key concerns regarding health and medicinal relationships with cultural beliefs. She challenges readers to consider what is known about western medicinal practices and beliefs, based on science, and recognize its effectiveness when paired with cultural understanding. This novel portrays some of the greatest medicinal and health challenges and cultural failures of western societies. There were several cultural competency themes integrated throughout the book, however, it surprised me at how distant western practices and the Hmong’s healing methods were at the beginning. It seemed as if it would be a stretch to form a connection between these two extremities,

Medicine, to the modern day world, is a way of healing the sick and helping people experience life to their full potential. It is an ingredient of a culture that allows the culture to survive through decades and centuries at a time. But what if the medicine that we know as helpful is actually harmful? When a child cuts their knee the first thing an adult would do is check the scrape and then assess the damage. After assessing the damage, the adult would normally plan a course of treatment to ensure the child would not lose a limb in the near future. After treating the child with a mixture of antibacterial wipes, bandages and ice cream, what if the child is not better, but actually worse? That is what happens when you compare the medical practices of the Hmong to the medical practices of the Americans, both cultures believe that the others will cause more damage than good in respect to healing the soul and body.

Though American Indians are enjoying an independent public health system with above $3 billion funds provided by Congress annually for delivering healthcare services to them, still figure and facts on health status of American Indians reveal that they are facing many difficulties and have to suffer from diverse type of illness and disease at a misappropriate level. Since long it was identified by medical communities that there are wide spread diseases diabetes, alcoholism, tuberculosis, suicide, unintentional injuries, and other health conditions among American Indian and they are dying of these diseases at shocking rates (American Heart Association [AHA], 2010). Through this essay I want to discuss the healthcare status of American Indians in the perspective of their culture as how it impacted and lead to develop mistrust between amongst the medical community and American Indians.

The profession of nursing is more than caring for the physiological health of an individual. It also includes caring for their spiritual, mental, and overall wellbeing. Nurses, and all health care workers, need to take into consideration a patient’s cultural preference in order to maintain their spiritual well-being. This paper will address Native American cultural considerations relating to end of life using the Giger and Davidhizar assessment model as explained in chapter 4 of Sagar (2012) Transcultural Nursing Theory and Models: Application in Nursing Education Practice, and Administration. It will overview the assessment model, then apply it to death in the Native American culture as well as present nursing implications.

Healthcare is an ever changing entity with an ever changing population of clients. In current day 2016, the United Sates has become a melting pot of many different cultural backgrounds, which has led to changes within the system to accommodate the patient base. Unfortunately, not all changes have been able to effectively reach any and all persons from every background. We still see language and cultural barriers that have direct correlation to the inability to seek healthcare and or the ability to change cultural perspectives to ensure healthy lifestyles. Within this paper, the health of American Indian and Alaskan Native populations will be discussed along with the barriers to care and the

Native American traditional medicine and spiritual healing rituals go back for thousands of years, these traditions often focus on different variations of alternative medicine. This knowledge is passed on throughout generations, many of the tribes learn that by mixing natural plants such as herbs and roots they can make remedies with healing properties. It is believed that being healthy is when people reach a state of harmony not only spiritually, mentally but physically. To be able to overcome the forces that cause illness people must “operate in the context of relationship to four constructs —namely, spirituality (Creator, Mother Earth, Great Father); community (family, clan, tribe/nation); environment (daily life, nature, balance); and self (inner passions and peace, thoughts, and values)” (Portman & Garret, 2006, p.453). In this research paper I am going to show evidence of the tremendous influence that Native American medicine and spiritual healing have over modern medicine in the course of healing

"Native American medicine is based on widely held beliefs about healthy living, the repercussions of disease-producing behavior, and the spiritual principles that restore balance." -Ken "Bear Hawk" Cohen (Chrisman 1).

After completing the “cultural competence checklist: personal reflection designed by T.D. Goode” for the first time, I was not surprised by my results. The results were a reflection of my personal understanding how culture impacts holistic care and my continuous need to improve my care. I have strived to become non-judgmental. I work to not let my personal beliefs and values influence my nursing care on decisions. When I practice this philosophy it provides better patient outcomes and promotes an improved understanding of cultural differences. This also enhances a safe and caring environment. “It is important for health care providers to recognize that care must be individualized and considerate of the cultural. Racial, and ethnic identity of the patients and their families” (Broome, 2006, p. 486) .There is much diversity in the beliefs and practices of the Indian culture and we should grant these individuals complete freedom to practice their personal cultural variations and the religion they choose.

Every culture has its own views of health care, diseases, and medical interventions. The way people of a given culture view health care affects how they handle themselves when they fall ill. For instance, the Asian culture believes that illnesses are caused by supernatural phenomena, which should be diagnosed and treated by means of spiritual healing or traditional herbs. Physicians and other medical practitioners should try to understand the cultural beliefs of their patients to handle them appropriately.

Townsend and Davidson (1988) also suggested that the term health is derived from the word “whole”, which is a recipient of the healing process. Therefore, an attempt to heal or cure in medical field literally means, to make whole or restore health. It is this idea that influences medicine to adopt a mechanistic approach towards disease management thereby obscuring the understanding of health in human context of well-being, which advocates for alternative or complementary approaches. This viewpoint also reflects in some definitions and the medical model discussed above. The criticisms of the medical by Illich (1974) is that the medical view only deals with the cause of disease or illness rather than the external factors affecting the person’s health. Within different sections of medicine, for example the mental health department, there are marked differences when explaining the origin of illness, disease and treatments.

There are many cultures out in the world today that practice beliefs different than those in the United States. America is based off Western Culture and traditional medicine practices which focus on preventative and curative medicine. Most cultures around the world practice folk medicine, which focus more on the person as a whole with remedies and ceremonies rather than medicine and treatment. Even though each one believes in a different practice, all medical professionals should have the knowledge and awareness of each culture’s health beliefs to properly treat their patients in a respectful and kind