Chapter 19 and Book Overview

The last chapter of the novel described what happens in a Hmong healing ceremony. The incredible value that the Hmong ascribe to these sacrifices is clear- the Lees spend their welfare savings to buy a pig. I thought it was so interesting that Fadiman mentioned the flying horse, an important figure in the Hmong belief system, and emphasized that to them it actually was a flying horse. She compared it to Catholics believing that the bread and wine is literally the body and blood of Jesus Christ. I think this was such an important comparison to make. It flips the “strangeness” of other cultures right back on us. Thinking about typical religious practices in the US, these could also be seen as bizarre and nonsensical, but we are so quick to judge other cultures as being the strange ones. The author making this statement framed the rest of the chapter in a more open-minded light.

I was so glad there was an Afterword. It was almost like the happy ending we were looking for, reading that the MCMC instituted the first formal shaman policy in the country. The hospital, and hospitals all across the nation, are focusing on patient-centered care and cultural competence, just as we read about in class. Fadiman makes the distinction between cultural competence and cultural humility, as well as cultural responsiveness. Again, we read about these differences in class. Fadiman worries that making these distinctions and making an effort to be “politically correct” will only appeal to more liberal doctors. Then, she makes an extremely important (and relevant) point: “the ability to deal with patients from unfamiliar cultures shouldn’t be a political stance but a human stance” (p. 296). This is an argument that unfortunately has to made again and again. Whether it is tear-gassing immigrants at the border, putting children in cages, travel bans, LGBTQ rights, or many other issues, we somehow still have to remind people that certain things go beyond political stance, but are about taking a human stance.

I think Fadiman really showed the importance of what we are studying in this class. Discussing things like cultural humility vs. cultural competence may seem like a “scramble for the slippery pinnacle of political correctness” (p. 295) but these are the things that make a difference in people’s lives, especially those who do not that the privileges that we do. Overall, this book did an amazing job showing the struggle of both sides and emphasized how important it is to learn from this story. We have to constantly be self-evaluating and be critically aware of the realities of inequality and cultural difference.

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