The Spirit Catches You and You Call Down Essay

Being a Hmong-American in the United States was hard. Growing up in a community that was full of Americans, and being in a private school in my early years, (consisting mostly of Americans and little diversity) was difficult. In that kind of environment, I never saw each person differently. The characteristics that I saw were our skin color, and another distinction that I saw was our religious and cultural backgrounds. I started to lose touch of my own culture and identity as a Hmong-American girl. My family told me that in the stages of my toddler years, I used to be good at speaking my native tongue until I started school.

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

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

     The Hmong had trouble adapting to American life. With no driver’s license or bank account, they had to make a living doing whatever they could. Not knowing the language in a foreign land doesn’t help either. The Hmong women adapted much more quickly than the men did because of the fact that they interacted more with English-speaking people. While the men were at work, the women were spending time interacting. The Hmong men also refused to change more that the women did. This shift of power caused a lot of changes in Hmong households. What even caused more of a power shift was the fact that the Hmong children learned about the culture easier than the women did. Instead of the father having control over the family like it was back in Southeast Asia, the children now had the upper edge. The children could communicate, interact and even drive with Americans. You could see a 16-year-old Hmong

The doctors assuming the Lee were giving their daughter her medications, were surprised to not see levels of the medications in her blood. Dan Murphy who was one of Lia’s doctor questioned the parents and he learned that due to their cultural beliefs, Lia’s parents have not been administering her with the proper medicine. Where Lia’s mother believes she is doing the right thing for her daughter, Murphy has sympathy for the mother and told Fadiman “I remember having a little bit of awe of how differently we looked at the world”. A key feature of the Hmong is that they have no interest in being rule, do not like to be told what to do, and are rarely persuaded by the customs of other culture. The mistrust and open hostility between the medical staff and the Lee family seemed to overshadow Lia’s disease. Both side obviously loves Lia and wants her healthy but neither was willing to compromised and meet half way.

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.

4. There were many people affected by the Lia’s seizures and the cultural clashes that ensued. I will focus on the two that seemed most significant. The first people who were affected were her family, namely her parents. Nao Kao and Foua were obviously distressed that their youngest daughter was having these seizures. The Hmong in general are excellent parents, providing their children with an extraordinary amount of love and attention (Fadiman, 1997, p. 22) and I can’t even imagine the amount of grief the Lees dealt with as they watched Lia’s soul slip away during those several tumultuous years of her life. Because the Lees blamed the medical system for the end result of Lia’s vegetative state, they became increasingly angry people, Nao Kao in particular. Fadiman tells us how angry he was several times in the book, angry enough to try to steal Lia away from the hospital (p. 213). While Foua more evenly tempered than her husband, she did show severe signs of depression and even suicide when Lia was first taken away from them and placed in

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.

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.

As with playing the “What If” game (asking “what if” incessantly to explore each aspect of a situation), so did a chain of events occur that caused this relationship to form.

All communication is cultural. It draws on ways we have learned to speak and give nonverbal messages. We do not always communicate the same way from day to day, since factors like individual personality, mood, and the context of the situation interact with the variety of cultural influences we have internalized that influence our choices. Communication is interactive, so an important influence on its effectiveness is our relationship with others. Do they hear and understand what we are trying to say? Are they listening well? Are we listening well in response? Do their responses show that they understand the words and the meanings behind the words we have chosen? Is the mood positive and receptive? Is there trust between them and us? Are there differences that relate to ineffective communication, divergent goals or interests, or fundamentally different ways of seeing the world? The answers to these questions will give us some clues about the effectiveness of our communication and the ease with which we may be able to move through conflict. The challenge is that even with all the good will in the world, miscommunication is likely to happen, especially when there are significant cultural differences between communicators. Miscommunication may lead to conflict, or aggravate conflict that already exists, or in the sad of case of girl developing epilepsy and both her parent’s Hmong culturally clashing with her Western medicine

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?

The biggest thing I've noted, not only about the Hmong, but also concerning other ethnicities and cultures is that there is a lack of substantial research focused on specific health concerns, and treatment on seemingly anyone that isn't a straight white male. Many factors can of course contribute to this for instance in the Hmong's case, and in the Lee's case, the clash between cultures and health practices can often make it hard for research to be done if an illness is only found and treated by Western medicine as a last stop and only once it has progressed.I was surprised to learn in the article "Health Issues for the Hmong Population in the US" that the "Hmong populations present signs and symptoms of cancer at an earlier age than the general

If I were a Western caregiver, first, I would probably listen to Hmong people and try to understand what they believe and what they want. If they cannot understand English, I would hire an interpreter to understand each other. Moreover, since I read that Hmong people care about what they eat and said that the food at the western hospital