The Spirit Catches You And You Fall Down Ch. 17 & 18

 In chapter 17, life keeps moving for the Lees’ children as they all grow older and pursue their interests, all except for Lia. Foua and Nao Kao lose any faith they had left in Western medicine, but Foua becomes closer to Neil and Peggy. Fadiman discovers Lia became brain dead due to septic shock, not her final seizure. It seems to me the tragedy is that Lia had so thoroughly become viewed only as her seizure disorder, that no one thought to identify a different cause. Fadiman also mentions asking Neil if he wished he had done something different after discovering this, but his response focused on medication and not his interactions with the Lees, which was disappointing. It would have been interesting to see his perspective shift, even if just  a little. Arthur Kleinman’s eight questions designed for cross-cultural medicine practice were interesting in their simplicity, allowing for medical practitioners to understand their patients more. His suggestions after learning about Lia’s case were insightful. He mentioned the importance of removing the term compliance from the conversation because of its implied moral hegemony, which reminded me of our discussion about terminology in regards to race, ethnicity, and migrant status. His other points on compromise and the cultural aspects of biomedicine were also intriguing.

    Chapter 18 was more broadly focused on cases similar to Lia’s and it was nice to see some cases with good outcomes. The case that involved Frances Carr was particularly important because it showed the importance of treating a cultural broker as an equal, not a subordinate, in order to succeed with cultural compromise. Fadiman’s story about the Minnesota epidemiologist was a good reminder about the importance of Western medicine. I fear I might have fallen into the trap of romanticizing the Hmongs in previous posts. Although I find a lot of faults with the methods used to practice Western medicine, I value the actual medicine and only wish for the culture surrounding it to change.

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