In The Book “The Spirit Catches You And You Fall Down”, The Author Anne Fadiman Tells A True Story Of Lia And Her Family.
Ms Fadiman a journalist eloquently documents the anguish of the worst epilepsy disorder in childhood. In early 1980, a large number of Hmong families fled oppression and war in Southeast Asia and came to settle in the United States. Lee family settled in an apartment complex in central California (Fadiman 3). Their settlement signaled an immersion in a cultural and social setting entirely different from theirs. Lia Lee was born to this family in 1982. At three months, the kid suffered from her first epileptic seizure. Her physicians eventually conclude that she suffered from an electronic storm in her brain. However, her family attributed their child’s symptoms to qaug dab peg that means “the spirit catches you and you fall down”. According to Lia’s family, her condition was attributed to her elder sister when she accidentally slammed the door in their house. Lia’s sister action is believed to have frightened her spirit for happiness and health away (Fadiman 5).
In the Hmong’s culture spiritual and medical practices are tied to animism. That is the spirits are ascribed to objects and beings and when frightened away death and diseases occur. Hmong’s belief is that the lost soul and the body can be linked by shamans. Since 1970s, Merced County Medical Centre in California had treated several Hmong patients in accordance with their unusual medical requests. However, in California such cultural beliefs were insignificant in effecting a cure. Lia Lee was severely affected by epileptic seizures and the medical centre despite the continual consternation presented by her family, legitimized its narrative and prescribed the appropriate drugs. The diversity of healthcare provision in California did not reflect the diversity of her people. From this scenario, it can be argued that the health works did not have the skills and attitude necessary for the provision of effective medical care in such a culturally diverse community (Fadiman 17).
Several authors promote acronyms to help people in the society and students to combine elements of cultural competencies into their practice. The current researchers have found a need for a model that emphasizes the core values of cultural competencies in healthcare provision. These values include Self-awareness, cultural consideration, assessing differences, showing respect and sensitivity, and practicing it all with humility (Fadiman 89). Fadiman’s in her representation of Lia’s case shows how the Merced Medical Centre as colonizing. However, she does not blame the kid’s vegetative state to either the medical staff or her family but she blames cross-cultural misunderstanding. According to the California Endowment, culture is an integrated pattern of learned beliefs, behaviors, customs and core values that are shared by a particular group of people. However, the expression and influence of the culture will differ among individuals even within a culture defined by these principles (Fadiman 117).
Medical and colonial powers are the divining force behind Lia’s critical condition. If the model of the current authors is something to go by in her case, the model was not followed at all. For instance, the model advocate for respect of each according to their personality, socio-historical, and family perspective. However, the arena of Hmong medical care in America since the late 1970s undermines this respect. Lia’s parents had a frequent consternation over their daughter’s declining conditions and their frustration by the Merced Medical Staff. But they were coaxed to accept the routine operations in California because they did not have a way of communicating with the medical establishment. In addition, the medical staff did not assess carefully cultural and family history. Using such a broad understanding of her medical history Lia’s physicians in their diagnosis, they would have located her medication with her background (Mcintyre 118).
In the larger community, the clash was about money and the well fare cost that strangled the community services. However, in the medical community the clash was about contradicting beliefs. The Lees were concerned in saving soul of their daughter while the physicians were concerned with saving her life. Medical practices such as surgery, anesthesia and blood tests trespass Hmong sacred taboos. Disrespect of these taboos is both dangerous and offensive for Hmong people. Consequently, most Hmong seek medical care only as a last resort. Lia was diagnosed with epilepsy when she was young as three months old, and in ensuring four years the child was seen in the emergency room severally. Her medical records documented that her parent were not cooperative with healthcare efforts. They were also relying on traditional cure. The emergency care physicians were frustrated with her parents that the called the Child Protective Services to intervene. Lia was taken away from her family for ten months. However, that did not help since she eventually suffered an acute brain damage (Mcintyre 178).
Cultural sensitivity requires a deep awareness of particular beliefs, values and perceptions of cultures especially those that might influence the patient’s decisions in terms of healthcare. Sensitivity is critical to gestures and expressions that might result in an offense or mistrust between the healthcare providers and the patients. A deep sensitivity is paramount in conducting health education (Mcintyre 356). Educational materials can be matched to observable superficial characteristics such as historical, psychological, social, environmental, and cultural forces that affect the health behaviors in a particular culture. Lia case caused the Hmongs settlers to be at odds with medical establishment. As a result, severe public hazard emerged those endangered lives and at the same time it was very expensive. When these cross-cultural divisions received proper attention, it was realized that there was entirely no medical intervention among the Hmong. In all their meeting with Lia’s family, the emergency room physicians never sought to establish the reasons for their uncooperativeness. They were completely unaware of the uses of a tvix neeb as the Lia’s family was with the values of laboratory tests (Mcintyre 378).
In conclusion, understanding cultures is difficult. No one is fully aware of the possible encounters faced by physicians caring for a diverse community. However, there are specific skills and core values that can help the healthcare providers to become effective in healthcare provision in a multi-cultural community. Cultural competency may require several years to understand. But a realistic goal for healthcare workers is to learn certain habits and behaviours that can allow them to become culturally essential. Healthcare providers must learn to avoid missteps that might be culturally offensive. The medical establishment must be quick to apologies for any cultural missteps that arise and commit to learning a variety of cultures that constitute the popular American culture. Such a step will enable everyone including the people of Hmong, who are in no hurry, to adapt to the majority’s ways.
Mcintyre, lisa. The practical skeptic:core concepts in sociology. 2010 6th edition boston: Mcgraw hill. Pp. 1-400
Mcintyre, lisa. The practical skeptic: reading in sociology. 2010 6th edition boston pp. 1-415
Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. , 2012. Internet resource. Pp. 1-352