Hello friends,

I recently did a book analysis. The name of the book is ” The spirit catches you and you fall down“. A very beautiful book return by Anne Fadiman in the year 1988. I will attach the link of the book right here for you guys. The book narrates the struggles faced by a Hmong family due to cultural differences.

Short summary of the book: Lia is the child born in this Hmong Family. Hmong family totally had 16 children out of which only 11 survived. Lia is suffering from Grand mal and petit mal seizures and epilepsy. The doctors in the Merced Hospital California are treating this little baby Lia, however, Lia’s parents Nao Kao Lee and Foua Yang are not happy with the treatment provided in the Merced Hospital. This Hmong family believes in a little medicine, a little neeb or a soul. A beautiful story where this poor couple are unable to explain their methodology and customs of their Hmong ancestry medicine and their belief in their rituals. The consequences are Lia is now in a vegetative state where she is unable to move, talk, react or express emotionally. A very touching story.

Here is the book analysis that I did last week. The book analysis include the gray areas and the areas which I liked the most. The cause and effect of this book. My personal opinion on what should have done. The core question ” Why we need to study culture and differences”? Is global health care necessary?

Enjoy the book!

Introduction

Cultural diversities are the rich heritage of human society. Evolution in human society takes place due to wide cultural diversities that brings novelties and enhancements in the cultural environment. It is necessary to understand that cultural differences facilitate the relationship between people of different geographical areas. The society would have been a boring place without the give and take of culture. However, it is necessary for the society to adapt to the present culture and understand the norms and traditions behind the rituals. The following post gives a reflective analysis of the book and addresses various issues where humans falls short and the areas where changes are needed to enhance the path to the global health care system.

The book “The Spirit Catches You and You fall down” by Anne Fadiman (1998) is a powerful explanation where the author explains the lack and inability of the health care professionals to understand the cultural norms of the Hmong family. The book represents the shortcomings faced by the Hmong family and their trust in their family medicine. There are many reasons to like this book which are as follows;

1) The strong trust of the Hmong couple in their belief that Lia will be able to survive no matter what the condition prevails.

2) The strong belief of the Hmong couple in their ancestry herbal medicines. Also the couple firmly believed that a little of neeb would definitely produce effective results in their child’s health.

3) The doctors who realized the mistake done by tracheal tube and published an article accordingly to aware the society.

4) The unfailing approach by the American Doctors to save Lia and providing the service free of cost.

5) The unfailing love of the couple for their daughter although they were aware that she was going to be in the vegetative state forever but still had the trust that she will improve.

There were some of the areas in the book which I personally did not like,

1) The orders of the court to hand over the child to the foster home without going through the family’s cultural background and emotional setbacks.

2) The lack of understanding on the doctor’s side while treating Lia.

3) The worst part of the play is in the end when the doctors tried to declare Lia as almost dead when Lia’s soul was still in her flesh and she was breathing. The doctors are supposed to fight for the individual until she has breadth in her body.

4) I found the medical professionals and court decision as a one sided approach. Neither the doctor nor did the court tried to find out the root cause why Lia’s mother stopped giving her the medications on time.

5) I still found the book partial. The book is unable to firmly decide what helped Lia to live and not die. The book affirmatively challenges the medial health care professionals and their lethargic attitude towards the Hmong culture.

Masin and Tischenko (2007), states that cultural competencies has been recognized as one of the essential skills for working in clinical practice today. Masin and Tischenko (2007), also states that in order to develop cultural competent values and behaviors, one first must understand the concept of cultural differences. The author Masin et al. (2007) also states that the cultural competence was initially described in the year 1989.

The entire incident of the Hmong family happened in California. California, New York, Texas and Florida have the highest amount of foreign immigrants as these states are situated near the border. The incident was indeed an eye opener that although these states have a vast variety of cultural differences still the Hmong family was not treated right. Shouldn’t we expect cultural competencies from these states first?

Implications and learning from the book: The book gives explicit explanations of the core human and cultural values. The fact that one cannot neglect from the book is one must be able to understand the ethical background. Not only one must understand the ethical and cultural background but one must also respect the cultural differences. Disrespecting the cultural differences not only mocks the patient-therapist relationship but also loses its value. Although it is not stated in the book, however, the irritation and frustration of the family and their emotional feelings is easily depicted from the author’s story.

Going back to the Hmong story, in my opinion the US health care system tried diligently to treat Lia’s epilepsy with the help of medical personals and medications. However, the gap didn’t bridge because, although US health care system made all the efforts they were still unable to understand the family’s notions and emotional attachments with their ancestry/family medicine. If the doctors would have tried to know the reason why Lia’s mother did not gave her the medications on time, may be Lia’s condition would have improved. The health care personals neglected the incident why Lia’s father didn’t want to sign the form and his anxiety behind that.

Dupre and Goodgold (2007), states that United States is steadily increasing in racial and ethnic diversity. Consequently, providing quality health care requires practioners to have knowledge and respect for their patient’s cultural point of reference, especially their patient’s beliefs and attitudes towards health and illness. A comprehensive cultural competence program should start with the achievement of cultural awareness (Purnell & Paulanka, 2003a). Lazaro and Umphred (2007), also states that Cultural awareness enables educators to gain information regarding people who are different from themselves. It also allows them to recognize their own values, beliefs, and behaviors as well as to understand how these impact others. It explores issues such as ethnocentricities, stereotypes, biases, and prejudices.

In my opinion, to combat the cultural differences, various comprehensive cultural competence programs have been initiated and the health care personals are made aware about the differences. Cultural workshops, learning languages and casting cultural differences through media has also been performed.

One of my Italian patient started knowing about Indian culture after watching the Big Bang Theory (casted on TBS). I think media is the largest platform from where cultural differences can be propagated and awareness programs can be made respectively. Students in school should also be given subjects regarding the cultural differences and similar workshops should be conducted at the work premises to enrich the patient-client relationship.

Conclusion: Cultural competencies are important to have a successful health care system. Cultural give and take is nothing but a barter system in today’s health care system that should be enhanced, nurtured and respected to meet the dream achievement of global health care. A health care system will remain broken if doctors are unable to understand and respect the patient’s ethical and cultural background.

 

References:

Lazaro, R.T., & Umphred , D. (2007). Improving Cultural Diversity Awareness Of Physical

Therapy Educators. Journal of Cultural Diversity, 14(3), 121-125.

Purnell, L. D., & Paulanka, B. J. (2003a). Transcultural diversity and health care.’ In L. D.

Purnell & B. J. Paulanka (Eds.), Transcultural health care: A culturally competent approach (2″” ed.) (pp. 1-7). Philadelphia: Davis.

Dupre, A., & GoodGold, S. (2007). Development of Physical Therapy Student Cultural

Competency through International Community Service. Journal of Cultural Diversity, 14(3), 126-134.

Masin, H., & Tischenko, A. (2007). Professionalism, attitudes, beliefs and transformation of the

Learning experience: cross-cultural implications for developing a Spanish elective for non-Spanish-speaking physical therapist student. Journal of Physical Therapy Education, 21(3), 40-46.

Fadiman, Anne. (1998). The spirit catches you and you fall down: A Hmon child, her American

doctors, and the collision of two cultures. New York: Noonday Press.