"Rain Taxi Talks With Anne Fadiman." YouTube video, 4:58. Posted by "Raintaxiinc," May 9, 2012, http://youtu.be/WzRZvF9fXAQ.
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Final Thoughts
The application of critical and clinically applied anthropology throughout The Spirit Catches You and You Fall Down allows us to relate the history of the Hmong people, their difficult resettlement in America and their lack of access to healthcare (unless it was government funded). Furthermore, we learn how the doctor-patient relationship is constantly strained in Lia Lee's case because of language barriers as well as different belief systems about illness and healing between the Hmong people and Lia's American doctors. Most importantly, we learn that effective health interventions often require the blending of two cultural belief systems, and cultural competency enables one to achieve this goal effectively. As Anne Fadiman states in this interview by Lorberer (2012), "Everywhere things have really improved but that doesn't mean that there isn't still room for improvement-- there's still an enormous cross-cultural gulf in medical care right now." We therefore need to continually remind ourselves to set aside ethnocentrism and make room for empathy, learning and understanding. As a sidenote... Regarding Lia Lee's case, I too wonder, like Anne Fadiman, whether or not the cultural dissonance that existed between Lia's parents and her doctors could've been diminished had the medical staff simply asked them what they thought the cause of Lia's illness was. Fadiman (1997) questions in her concluding remarks in The Spirit Catches You and You Fall Down: "Was the gulf unbridgeable? I kept returning, obsessively, to the Lee's earliest encounters with MCMC during Lia's infancy, when no interpreters were present and her epilepsy was misdiagnosed as pneumonia. Instead of practicing 'veterinary medicine,' what is the residents in the emergency room had managed to elicit the Lee's trust at the outset-- or at least managed not to crush it-- by finding out what they believed, feared and hoped? Jeanine Hilt had asked them for their version of the story, but no doctor ever had. Martin Kilgore had tried, but by then it was years too late. Of course the Lees' perspective might have been as unfathomable to the doctors as the doctors' perspective was to the Lees. Hmong culture, as Blia Yao Moua observed to me, is not Cartesian. Nothing could be more Cartesian than Western medicine. Trying to understand Lia and her family by reading her medical chart (something I spent hundreds of hours doing) was like deconstructing a love sonnet by reducing it to a series of syllogisms. Yet to the residents and pediatricians who cared for her since she was three months old, there was no guide to Lia's world except her chart. As each of them struggled to make sense of a set of problems that were not expressible in the language they knew, the chart simply grew longer and longer, until it contained more than 400,000 words. Even one of those words reflected it's authors intelligence, training and good intentions, but not a single one dealt with the Lees' perception of their daughter's illness" (Fadiman 1997: 259-260). Please feel free to comment either about this or about the question below. |
A glimpse into the Hmong culture as well as the Lee family described in The Spirit Catches You and You Fall Down.
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"The Spirit Catches You and You Fall Down." YouTube video, 4:32. Posted by "Jerseygirl989," November 5, 2010, http://youtu.be/LwnPVHvK1wE.