Chapters 5 & 6

Though immigration is a large part of American history, many immigrants struggle to adapt to life in the west. Chapter five of Fadiman’s The Spirit Catches You and You Fall Down captures one prominent struggle for many non-English speaking immigrants: the inability to communicate effectively with others in a given community. Given Lia’s condition, she was prescribed a plethora of medication. However, it was often unclear to doctors whether or not these treatments were working. This was because they were under the assumption that the prescription they assigned to Lia was being properly rendered to her by her parents. This was not the case as the Lee family not only did not like some of the medication, and thus refused to administer them, but due to the sheer amount of medication, they also were unclear and often confused about what medication to give and when. This caused grievances on both sides as the doctors were unhappy about the lack of compliance on the parents’ end, citing that the Hmong were amongst the most difficult of patients, and the parents were unhappy that despite being professionals, they did not believe the doctors were doing a good job. To a lesser extent, my parents also faced difficulties when it came to health care upon their arrival. Due to the language barrier, they often were unable to clearly articulate their problems to doctors and in turn, doctors would have to “dumb down” their language with my parents in order to most effectively communicate with them given their limited knowledge. While some overcome this issue through the use of a translator or just going to see a doctor who speaks the same language as them, as my parents’ began to do later on, the Hmong are more limited in their options given their heritage is not as widespread in the United States as the Spanish or Chinese for instance. These frustrations are clearly outlined in the huge, distinct disagreements between the Lees and their doctors which ultimately ended in Lia’s parents losing custody of their daughter.

As I alluded to in the discussion of chapter five, chapter six emphasises western doctors’ social and cultural difficulties with the Hmong. They describe the Hmong as hard to reason with and exhausting to take care of. The Hmong were known to adhere to their beliefs and practices as much as possible, often refusing traditional western methods of treating illness or giving birth. They remain stoic through great pain and reject the orders of doctors unless absolutely forced to. The cultural differences are greatly palatable in the stories told by doctors and it is in this rigid divide between cultures that I see a lack of understanding and a lack of acceptance. American doctors were not trained to be prepared to know every culture’s medical nuances and likewise, the Hmong were not sufficiently exposed to the various American methods. As a result, there is a tension that comes from not knowing. While in a perfect world, everyone would be enlightened about everyone else’s culture, but it is often not feasible to expect this.

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