Chapters 5 & 6

These two chapters go into the misunderstandings and frustrations associated with Hmong treatment in a Western hospital. Chapter 5 focuses a lot on the doctor’s frustrations with the Lee family, and how their expertise was rarely ever taken seriously or applied accurately. The doctors seem to be doing everything they can for the family, but a combination of noncompliance and misunderstanding keeps Lia from getting better. Chapter 6 switches the focus a little more to the Hmong culture and perceptions of Western medicine. It talks about the mistrust of doctors, the Hmong holistic view of medicine, the lack of cultural relativism from Western doctors, and the strong beliefs held by Hmong people about their medical care. Both chapters gave really interesting insight into the thoughts of both sides.

Even as just a reader, I was so frustrated by the experience doctors had with the Lee family and other Hmong patients. The chapter “Take As Directed” was mind-boggling. While the chapter was biased towards telling the doctors’ perceptions, it still showed that these doctors in particular were working extremely hard to help this family and tried so many different things to improve Lia’s health. It seemed impossible to help. It was also really hard for me to keep cultural relativism in mind and try to understand the Hmong culture when it was so clear to me that if the Lee family did not start listening to the doctors, Lia could die.

On the other hand, the next chapter talks about how Western doctors are not trained at all in cross cultural medicine or cultural relativism. This is a huge problem in medical education. This type of training, or at least some knowledge in these ideas, is so important- and not just for treating cultures as drastically different as the Hmong. There is something to be said about the Hmong view of health care- that medicine is intertwined with religion, society, culture, history, politics, economy and essentially all aspects of life (pg. 60-61). These factors affect the type of care a person receives, how that person views illness, and how the person interacts with doctors. The mistrust of doctors that the Hmong experience comes from history, society, culture, etc. and does affect their care. This mistrust is common with black people in America as well, because of the same factors. For example, the history of the Tuskegee syphilis experiments. In turn, this affects their care. The unwavering views that the Hmong hold, like the pregnant woman who refused surgery despite knowing she would die, reflect the Hmong history with the Chinese, refusing to change through years and years of conflict. With more emphasis on cross cultural medicine, these cultural misunderstandings could be understood and avoided, leading to better care.

 

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