The family would certainly have been more comfortable if the hospital made more of an effort to understand their culture and beliefs. The Lees were treated as if they were indignant and unresponsive to the needs of their child which was not the case at all. The hospital could have enlisted the help of affluent Hmong natives who have become more accustomed to American traditions. This person could have helped both parties, the Lees to understand medical necessities and the hospital staff to understand the importance of cultural traditions. Both parties could have used a trusted intermediary, Fadiman (1997) refers to this as a "cultural broker" (p. 265).
Another factor that would have made this experience easier for the Lees would have been if the medical professionals had an understanding of some of the important religious rituals and beliefs of their culture. Of particular importance to the Hmong is the concept of death. The doctor's told the Lees several times during Lia's last hospitalization that she was going to die in a few hours. For the Hmong, predicting a death is unthinkable, they believe that it makes the dab come closer to the dying person. The Hmong believe that it means that one is accepting of the person's death (Fadiman, 1997).
The Lee family is completely illiterate. They are unable to read either English or Hmong but they can write their names, a skill they had to learn in order to immigrate to the United States. The family can speak Hmong but that is the extent of their ability to communicate with others. Therefore, when attempting to communicate with the Lees hospital staff could benefit from an understanding of Hmong culture and language. Medical information would be more easily communicated to the Lees if the conditions that they were attempting to describe existed in Hmong language. The reality that there were often not Hmong equivalents made communication...
Spirit Catches You and You Fall Down by Anne Fadiman is a groundbreaking book about cross-cultural communication in health care. The book is about Lia Lee, who was the first in her Hmong family to be born in the United States. Her parents spoke no English. When Lia Lee was three months old, she had her first seizure. Due to misdiagnosis, a string of unfortunate events prevented Lia Lee from
Within this clash of cultures, the Lee family did not know how to cope with the medical system in place to help Lia and her epilepsy. When they refused to give her the medications, Lia was removed from the home and placed in foster care. When the foster care parents gave her the prescribed medication, her condition worsened in several important ways. The foster parents believe that Lia's parents realized
Spirit Faidman, Anne. (1998) The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giroux. The title of Anne Fadiman's book on the implications of multiculturalism in modern nursing sounds more like a religious testimony than a textual asset to the modern nursing profession. However, Faidman tells a tale of Biblical proportions, and the emotional nature of The Spirit Catches You and You Fall Down is epic in its
Yet the nightmare continued, because the communication problems were not resolved. During the next four years, her anticonvulsant medicines were changed about 25 times, which would have been hell for any family. The Lees questioned the value of so many prescriptions, especially with their Hmong mindset, and did not follow directions. Of course, this was exacerbated by the fact that they did not understand the dosages. The doctors inaccurately concluded
Then, if the parents did not listen to the doctors, they assumed more of the responsibility of what happened. How could the doctors expect the medicine to be taken correctly when the parents did not read, did not know mathematical symbols and were given change after change. They were blindsided by their own diagnosis and the arrogance that everyone would follow their treatment exactly. Nor can the doctors be
They cannot ignore the socioeconomic issues of adversity so often present and, where necessary, need to act as advocates, mediators and social brokers (Compton, Galaway, & Curnoyer, 2005). The concern is that the issue of healthcare for culturally diverse individuals is so complex, there are no exact rights and wrongs. For example, in Fadiman's book, no person(s) can be said to be ultimately correct or incorrect in his/her behavior or
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