My Grandpa Was A Man

Cultural implications were evaluated from the Hmong perspective, using the book “The Spirit Catches You and You Fall Down.” The assessment was based on the Hmong people and followed the Geiger and Davidhizar’s transcultural assessment model. Five areas were focused on in particular from their model: Environmental Control, Social Organization, Communication, Space, and Time Orientation. The result reaffirmed that there is a huge cultural divide that caused many errors in the care of young Lia Lee, including many miscommunications that could have been prevented. I briefly touch on the importance of cultural awareness in the health care industry and why it is important to be sensitive to the culture of others.

The two ethical dilemmas that stick out to me in the case are patient autonomy, and distributive justice. Patient autonomy is the patient’s right to make decisions about their care, including whether to accept or decline treatment (Taylor, 2014). Because the patient did not fully understand the information relayed in the consent form or the procedure, her patient autonomy may have been violated. This also may mean the consent form may not be valid. A signed consent form from a patient affords the hospital with an assumed duty to care for that patient (as cited Taylor, 2014). And the patient has given the medical professional permission to provide treatment. Therefore, it is important that the patient fully understands and can communicate that understanding when consenting to

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,

Language barrier was a major factor that served to extend the boundary existing between the two cultures. Some of the utterances made by the doctors were interpreted right but were understood wrongly (Swartz 2). This resulted in a worsened discernment of the American doctors by the Lees and Hmong as an entity alike. In the case of an emergency, the Lees needed to contact an ambulance, but could not communicate with the hospital. This necessitated the involvement of their learned nephew, who would call an ambulance. The interpretation process would at times limit the effectiveness of the message intended by either party. For instance, when Lia was undergoing critical care in MCMC, the Lees needed to be comforted, a process which had to be done by an interpreter. Before the final discharge, miscommunication between Lia’s mother and the doctors had her think that the nurses disconnected medicine tubes off Lia in order to give it to some other patient; a mean act. In the same incident, Lia’s father was made to sign a letter of discharge for Lia, which would happen in two hours. However, he understood this as a letter to guarantee death in two

On account of the conflicts between the family and doctors, the psychosocial complications of Lia's care overwhelmed dramatically not just for Lia but also for everyone who was surrounded her. First of all, the severity level of epilepsy in Lia's case had increased dramatically over the years. The treatment was such a hindrance to Lia. The Lees family and healthcare staff both were prejudiced, and that made it worst. From the family view, distrusting the American medical system contributed to did not cure well. on the other hand, American doctors, thought they had advanced education and training system, they are the best and they only know what is the better for

It is not always easy to decide about the care of a patient, because the patient’s cultural beliefs do not always coincide with the beliefs of the nurse. Ephesians 4:2 in “Be completely humble and gentle; be patient, bearing with one another in love” (English Standard Version). God has loved us unconditionally from the beginning of time, and has always been patient with us. It is time that humans show the love that God has for us onto others and respect one another no matter the differences. This paper will discuss the importance of respecting another person’s culture, what stigma is and whether if Lia’s family viewed her that way, brief history of the Hmong, the preventions that could have taken place, and how to incorporate

Lia Lee born and raised in America, but brought up as a Hmong, faced health issues specifically epilepsy. Her parents who practice the Hmong culture had a different view on how to handle Lia critical condition. Hmong did not believe in traditional medicine but believed in Txiv neeb, person with a healing spirit. Not only do they believe in a person with healing spirit to help cure their illness but also consider epilepsy as power; “Their seizures are thought to be evidence that they have the power to perceive things other people cannot see, as well as facilitating their entry into trances, a prerequisite for their journeys into the realm of the unseen” (Fadiman, 1998, p.21). Right at this moment is where you can tell conflict is going to occur.

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.

One of the huge mistakes was that the medical profession did not value the family’s beliefs and knowledge. Her family was aware of her condition, and they had alternative healing methods for Lia, however, the U.S. medical profession did not value these wishes. Instead, they performed multiple procedures on her that went against her family’s beliefs (Fadiman 1997).

The case study of Lia Lee is interesting and serves as a cautionary tale as it explores the consequences of cultural misunderstanding. In this case both the parents and medical staff sought the same thing; they both wanted Lia to have a positive outcome. Unfortunately, both groups had distinct ideas regarding how to achieve the common objective. This division was rooted in each sides individual cultural beliefs.

Consent should be obtained before carrying out any form of care or activity with any individual; if consent cannot be obtained then any form of care etc should not be carried out. If consent cannot be readily established and patient presents in an emergency situation, is unconscious, mentally incapable, and with no family available, and no advanced directive in place, it is considered reasonable to treat the patient. It is assumed that under these conditions, the patient would consent to treat. If there is a language barrier, and the patient is otherwise capable of giving consent, a reasonable effort must be made to find an interpreter, which includes using the ones through the phone companies. If the patient's life is in danger, and there is nobody who can communicate with them, then with careful documentation, treatment can be delivered.

“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.

Anne Fadiman wrote this book to document the conflict between cultural barriers and how they affect medical issues. In this book, Lia Lee is a Hmong child was has epilepsy and battles cultural medical differences. The main struggle in this story is the conflict between the doctors and parents because they cannot seem to get on the same page. While writing the book, Fadiman stated that there was a “clash of cultures”. (Fadiman, preface) Meaning, there are two different sides to the story and the problem has not be solved.

“The Spirit Catches You and You Fall Down” by Anne Fadiman presents the story of a Hmong child and her family and the obstacles that they face through her battles with epilepsy. The story takes place in Merced, California and centered around the Merced Community Medical Center. The Hmong child is Lia Lee and her parents are Nao Kao and Foua Lee. The parents of Lia did not understand English nor do they speak it which caused a lot of confusion and commotion among the staffs as they tried their best to explain what the situation is and procedure that they should follow to treat Lia. Throughout the course of the book, the author also dedicated a few chapters to the history and culture of the Hmong people.

Throughtout the later chapters of When The Spirit Catches You and You Fall Down, Fadiman describes how the Homong play a large role in the population of Merced, but are not considered in the city’s day to day life. This brings to light the strong ties of their own community of the Homong. During this time of the book Lia has become more stable from when she had her major sezirue but the brain damage from her grand mal becomes more apparent. Lia’s father, Nao Kao, continuously uses the Homong medicine just as he has in the past which shows that he wants her health to return to a somewhat normal state. In his view he sees a contradicting image that occurs between the Western medicine preformed by the medical doctors versus the Homong traditional medicine practices.