...culture comes more boundaries for biomedicine to face. Instead of trying to cross these boundaries, biomedicine strictly believes that their knowledge of medicine is far superior to other cultures. The problems that occur due to these barriers could be overcome if the doctors were able to understand their patients’ culture better. This could be done if medical schools were to expand their course curriculum, incorporating cultural classes. In order for a doctor to be successful, he must be able to understand his patients. Without this understanding, the doctor cannot adequately assess the medical problem. Not being able to assess the problem leads to a wrong diagnosis. Understanding their patients involves knowing their cultural beliefs. Doctors will not know about every single culture, but they can still research them. Not knowing enough information about other cultural groups can be detrimental from the start. The Hmong society is a group of people that the doctors do not particularly understand. This is constantly seen throughout Anne Fadiman’s book “The Spirit Catches You and You Fall Down”. The Hmong people are terrified to go to the hospital and only go when they feel that they have no other choice. Stone 2 The Hmong are not use to the differences between how a doctor and Shaman go about their work. For instance they are not use to the aggressive questioning that takes place when they go...
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...provides direction to decision and actions. All culture has systems of health beliefs to explain what causes illness, how it can be cured or treated and who should be involved in the care process. Cultural awareness can be defines as : “an in-depth self-examination of one’s own background, recognizing bias, prejudices, and assumption about other people”. To provide an effective care, health care provider should be of cultural competence and practice. Cultural sensitive care in nursing is important to provide meaningful and supportive care for clients. Beyond the concept that language can often present a barrier to proper understanding and decision making, every client has a unique background and life story that influences what he or she considers appropriate care. Age, race ethnicity, gender, race, religion, economic status, and other factors such as prior healthcare encounter and recent family event can all affect how an individual sees the world. To discover client’s culture care, values, meaning, beliefs and practices, nurses need to be able to assess social, cultural, and biophysical factors influencing treatment and care of client; nurses also need to show the motivation and commitment to care for others and learn from them, be open and accepting of cultural difference and build on cultural similarities; obtaining sufficient comparative knowledge of diverse group, including their indigenous values health beliefs, care practice, worldview and bicultural ecology. To provide an effective...
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...The Spirit Catches You and You Fall Down (1997) is an ethnography written by Anne Faidman. It tells the story of Lia Lee, a Hmong girl with severe epilepsy, and her family’s journey with managing the condition and the cultural barriers that posed great challenges in Lia’s care. Lia was diagnosed with epilepsy during infancy. Her family’s opinion was that the condition was a spiritual gift. Lia’s parents, Nao Kao and Foua, were wary of the American medical system, preferring to care for Lia in the Hmong way. Throughout the considerable conflict surrounding her care, Lia continued to have seizures; at the age of 4 ½, after a particularly devastating episode of status epilepticus, she slipped into a persistent vegetative state that would last...
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...The most ideal situation is cultural integration, where both cultures can coexist with respect and acceptance of the other one. On the other hand, cultural assimilation can occur where the minority group/culture comes to adopt and resemble the dominant group. The worst case is a cultural clash. Conflicts can arise from the different cultural values and a lack of effort by either one to truly understand the platform of the other group. A similar cultural collision between a Hmong family and their American doctors is demonstrated in Anne Fadiman’s book called The Spirit Catches You and You Fall Down. This book examines how this culture clash impacts the...
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...09/09/2013 Assignment 1 1. What do you think of traditional Hmong birth practices (pp. 3-5)? Compare them to the techniques used when Lia was born (p. 7). How do Hmong and American birth practices differ? I find the traditional birth practices peculiar and very unsafe. The conceiving of a child should be done in a sterile environment by professionals, so that the risks of negative effects like infections, wounds, etc. is minimized. Nevertheless I think the tradition, that the placenta is buried by the father, so that the soul can return to it’s first jacket, in order to continue it’s after death journey, is a wonderful way of believing what comes after death. Professional doctors handled Lia’s birth the American way, with her mother lying on a metal table with sterile drapes and no anaesthetics. This is a big difference to the Hmon customs, where Foua would have squatted on the dirty floor and pulled the baby out by herself, while trying not to touch the floor and not waking her other kids, until the new-born starts to cry. Another difference is that the Hmong bury the baby’s placenta and the Americans incinerate it. After birth a soul calling ceremony officially in order to confirm the quality of Lia’s name and pleasing the soul to reside in Lia’s body to protect her from illness and evil spirits. 2. Over many centuries the Hmong fought against a number of different peoples who claimed sovereignty over their lands; they were also forced to emigrate from China. How...
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...Anne Fadiman explores the delicate nature of cross-cultural medical care in her book “The Spirit Catches You and You Fall down,” a title taken from the Hmong phrase “qaug dab peg,” an interpretation for epilepsy and its spiritual connections with the evil spirit (“dab”). Through her deep dive into the world of the Hmong people and their interactions with American medicine, her research combined with the personal story of the Lee family and their experience navigating the complicated system of eastern medicine, exposes the difficulties that so often occur when two very different cultures approach healthcare. Fadiman follows the Lees, an immigrant family who relocated to Merced, CA after conflict in Laos forced them out of their home. The book...
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...Hmong Culture vs Western Medicine: A Social Constructionist Analysis Throughout Lia Lee’s medical journey, both her doctors and her family struggled to understand one another’s behavior resulting in misunderstandings, alienation, and distrust between the two parties. The social constructionist perspective and related theories on human behavior, such as symbolic interactionism, can be used to analyze the complicated and confusing relationship between the Lee family and the Merced County Medical Center doctors. The social constructionist perspective, as defined in the book Human Behavior and the Social Environment, states that “people construct meaning, sense of self, and a social world through their interactions with each other,” Hustchison, 2019, p 52....
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...course website. 1. What do you think of traditional Hmong birth practices (pp. 3-5)? Compare them to the techniques used when Lia was born (p. 7). How do Hmong and American birth practices differ? 2. Over many centuries the Hmong fought against a number of different peoples who claimed sovereignty over their lands; they were also forced to emigrate from China. How do you think these up-heavals have affected their culture? What role has history played in the formation of Hmong culture? 3. Dr. Dan Murphy said, "The language barrier was the most obvious problem, but not the most important. The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference" (p. 91). What does he mean by this? 4. The author says, "I was struck...by the staggering toll of stress that the Hmong exacted from the people who took care of them, particularly the ones who were young, idealistic, and meticulous" (p. 75). Why do you think the doctors felt such great stress? 5. Dr. Neil Ernst said, "I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids' lives. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior" (p. 79). Do you think the Hmong understood this message? Why or why not? What do you think...
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...1. Compare and contrast traditional Hmong birthing practices with those in the United States. Because the Hmong culture varies so differently from that of American practices, significant traits can be compared from each way of life. One of these differing practices is childbirth. Typically, Hmong women do not go for regular checkups, let alone see any medical professionals, for the duration of their pregnancy. Once it comes time to deliver the child, the mother gives birth in her own home, by herself, without making a sound as to not “thwart the birth” (Fadiman 1997, 3). No epidurals, medication, housewives, or nurses are utilized and the mother tends to take care of everything on her own. The only assistance the woman receives is a cup of hot water, upon request, from her husband who must avert his eyes. The woman would stand as she delivers, pushing the newborn into her arms. Her husband would then cut the umbilical cord with a pair of heated scissors. Because the spiritual side of life is so important to the Hmong, the placenta would be buried in the family’s hut so that “when the [child dies] his or her soul [can] travel back from place to place, retracing the path of its life geography, until it reaches the burial place of its placental ‘jacket’ and [puts] it on” (Faiman 1997, 5). After birth, women were to eat and drink warm liquids and follow a strict diet of steamed rice and chicken boiled in water with five special herbs (Fadiman 1997, 9). The child’s body would be...
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...about the Hmong culture, they originally dominated the country of China; however, they were overtaken by other Asian groups (Split Horn). Some Hmong people were enslaved, while majority of the Hmong individuals scattered throughout the world. Hmong families and relatives strayed away from populated areas, and decided to escape to Thailand. With the separation of the Hmong population, Hmong relatives mainly mobilized to Laos or deep into the mountains in Thailand. The estimated Hmong population during that time was 300,000 to 400,000 people (Split Horn). When the Vietnam War began, several Hmong people decided to find different locations to live in, while other Hmong individuals contributed to fight along with the United...
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...between cultures and the importance of cultural competence. The story focuses on a Hmong refugee family from Laos living in Merced, California when one of it’s younger members, Lia, is diagnosed with epilepsy. The Hmong people believe they are protectors of their own souls and that people afflicted with epilepsy have a sacred ability to travel to the spirit realm to protect their spirit from the dab, or malevolent spirits. Because of this, Hmong epileptics are seen as people to be revered fighting a noble battle. This conflicts with western medicine and created a war between Lia’s doctors and family that kept her from receiving the care she needed. At four years old, Lia developed status epilepticus and hit her head. She went into septic shock in the hospital and suffered brain-death. Her parents chose not to remove her from life support. The overarching theme of The Spirit Catches You and You Fall Down was that lack of cultural competence can kill. Fadiman wrote, “I have come to believe that her life was ruined not by septic shock or noncompliant parents but by cross-cultural misunderstanding” (p.262). Lia’s parents almost never followed the doctor’s...
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...Hmong culture practice many traditions that my not have the same rationale in western medicine. In addition, this culture value the opinion of their family and clan, and male elderly is the main decision maker. “As a description of Hmong traditional society, patrilocal means that Hmong people live with their father’s side of the family. When a woman marries, she leaves her father’s household to join her husband’s household and kin group”(Culhane-Pera, Vawter, Xiong, Babbitt, & Solberg, 2003, p. 15). Western medicine and traditional healer such as Hmong medicine man use different healing or health approach, having this differences problem happen. Some of the strategies I will practice in Mrs. Thor case are to establish a rapport, gaining the trust of the patient may gain high compliance. To be able to know her knowledge about pregnancy, I will use explanatory model, by doing this will encourage her to provide insight about her health. “Care providers can capitalize on the Hmong...
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...in her book humanizes the experiences of a Hmong refugee family, the Lees, and their interactions with the health care system in Merced, California. The book mainly focuses on the health care of Lia Lee, one of the youngest daughters. She is diagnosed with epilepsy, nonetheless, that diagnoses went against her family’s cultural beliefs. In her culture, they believed her illness was the result of her sister’s Yer actions, where she had slammed a door and the noise was what caused Lia’s soul to flee. According to Fadiman, “They [family] recognize the resulting symptoms as qaug dad peg, which means, “the spirit catches you and you fall down.” (20), therefore, for them it was a spiritual matter. Nevertheless, as a way to seek treatment, the family took Lia to Merced Community...
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...down Introduction: “The Spirit Catches You and You Fall Down’’ by Anne Fadiman represents true story of the epileptic Hmong girl and her family displaced from China to the USA. She suffers severe grand mal seizures and eventually becomes vegetative for the rest of her life. Lia Lee’s story was a poignant example that emphasizes the cultural barriers between modern and traditional cultures through their approaches to the life, which results in complete destruction of her brain. The Lees favored traditional treatment that conflicted with the doctors’ treatment by medications. Through conscious ignorance of the proper combined treatment and so-called compliance, it becomes the basis of a tug-of-war for Lia’s life between her doctors and her parents resulting in Lia’s vegetative state. Fadiman uses this conflict as the reflection of the conflict between Western and Eastern medicine and inability to find a compromise in general due to the cultural differences. The author succeeded to represent colliding of the cultures through the characters such as Dang Moua and in the same time to represent primitive culture, unable to compromise, through Foua and Nao Kao. Lia’s condition signifies the result of the conflict and inability to fully understand different cultures and their customs and tradition. Topic #1: In this paper I will discuss the acculturation of Hmong people in United States and how this process takes place based on the previous research and investigations. Acculturation...
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...of saving Lia’s life above all. However, later in the book the author is able to present the Lee’s point of view. How they and the Hmong community interpret certain things and the impact that their beliefs have on treating illnesses. Each side with the best of intentions in mind for Lia. Unfortunately, the cultural differences between the Lee’s and the doctors’ were stronger than those well intentions. 2. Identify and discuss three major themes evident in the book 2.1-The importance of cultural understanding and tolerance The most important and obvious theme of this story is the importance of understanding and accepting that there are many different cultures out there. Equally important is learning what these differences are so that both cultures can work together towards one common goal in a respectful manner. In Lia’s case the many misunderstandings due to religious differences and language barrier led to the Lee’s noncompliance of Lia’s medications. At the same time , the doctors’ unwillingness to even consider the Hmong’s beliefs or incorporate any of it in Lia’s treatment and care, also contributed to Lia’s vegetative state in the end. 2.2-Compromise: differences in medical treatment Throughout the story we repeatedly see how the doctors want to treat Lia and how her parents believe she should be treated. Hmongs believe illnesses have more to do with emotions meaning that the soul is the key. In American culture illnesses are physically...
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