Chapter 17 & 18

Chapters 17 and 18 start to wrap up Lia’s story. Chapter 17 discusses what could have been done differently to help Lia and prevent her brain death. The most revealing part of the chapter was the insight from Dr. Hutchinson, who said that Lia’s seizure disorder was incidental to her septic shock and only made the shock a little more difficult to catch. In fact, the seizure medication Lia was given may have compromised her immune system and actually could have put her at more of a risk. After reading account after account of doctor’s blaming Lia’s parents throughout the novel, this doctor says the parents were right—the meds did make her more sick. The catch twenty-two of this is that if the doctors hadn’t given Lia the medicine, her seizure disorder might have killed her before the septic shock did. Fadiman says “American medicine had both preserved her life and compromised it” (pg. 258).

I thought Chapter 18 was really interesting because it talked a lot about Paul Farmer and his focus on illness narratives, psychosocial and cultural factors, and the culture of biomedicine. I actually read Paul Farmer’s book “The Illness Narratives” last semester in Biopolitics in Medical Anthropology. The book completely changed my view on Western medicine and showed me how one-sided it can be. I specifically remember a narrative that was described in the book about a black woman who went to see her doctor for high blood pressure. She shared with the doctor her own explanatory model, one that was different than typical Western medicine, that explained her behavior and “noncompliance”. However, the doctor reduced her to her illness, did not take into account her everyday stressors, and got frustrated with her when she didn’t stick to the doctor’s treatment plan. This specific case showed how important it is to take into account the patient’s explanatory models and their psychosocial/cultural factors in order to provide them with treatment options that fit their beliefs and needs, hence Paul Farmer’s Eight Questions. We see this importance in the Lee’s case too. The chapters stated that it wasn’t because the Lee’s were noncompliant or because the doctor’s provided subpar treatment; it was because of the lack of cultural understanding.

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