Chapter 3 & 4

Chapters 3 & 4 discuss how Western medicine and Hmong culture work in opposition to each other. They differ in what they believe is the cause of illness, how to cure illness, and how a healer and patient should interact. Not only do all of these factors contribute to a fundamental misunderstanding between the two parties, but these chapters also show that the severe language barrier makes matters even worse.

These chapters show how Western medicine has an “all-knowing” mindset, believing that their ideas and practices are the only correct way to treat patients. Any other views on illness are considered uneducated and that the people just don’t understand disease and science the way the Western world does. The Hmong people believe that a person with epilepsy has spirits inside of them, blessing them with insights and visions other people do not have. Jeanine Hilt, who worked with the Lee family, said that other doctors and nurses knew vaguely about “spirits”, but Jeanine was the only person who actually asked the family what they thought of the illness. Dwight Conquergood tells how nurses cut off spirit-strings and would not work with shamans to provide care tailored to Hmong needs. This ethnocentrism causes health professionals to not even try to understand other culture’s beliefs, but rather “enlighten” them with Western ideas.

While hospitals often disregarded Hmong culture and beliefs, believing in the superiority of Western thought, Conquergood actually tried to learn about the culture, and adapt his care in a way that would be well-received by the Hmong people. It shows how important it is that the relationship between doctor and patient is a dialogue, not a one-sided relationship where doctors force their expertise on patients. We see this one-sidedness within American patients as well. Patients in low-income areas often have many sociopolitical factors affecting their health (like stress, resources, etc.), not just the condition the doctor diagnoses. Doctors get frustrated with patients, thinking that they do not understand/won’t listen to their diagnoses and follow up instructions, when in reality, their environment does not allow changes like a new diet, time-consuming treatments, etc. Understanding the whole patient, not just the scientific illness they suffer from, proves important for the Hmong and anyone receiving medical care.

Another important piece to mention is language barrier. Not only do the Hmong and doctors misunderstand each other culturally, but they also do not speak the same language. As we saw in the chapter, this lead to misdiagnoses that could be life-threatening. When I studied abroad in Spain, the language barrier made it difficult for me to even buy contact solution, something that would not have been life threatening had I not been able to get it. However, for the Lee family to not be able to tell the doctor their daughter had a seizure, and that was why there was bronchial congestion, could have been detrimental to Lia’s health.

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