The Spirit Catches You and You Fall Down and the class discussions made me wonder about the expectations that individuals have from doctors and the margin for error in their work. As a society, I feel that we tend to hold the viewpoint that it is necessary that doctors make no mistakes. This is clearly evident in our legal system as healthcare systems are often punished for any errors they make. In addition, there is a clear double standard present with doctors. Our society views them as experts in their field, and as a result, it is expected that doctors know how to solve every ailment and that they are successful when they attempt to do so. Since medicine is a service and drugs are products that are paid for, there is also the expectation that if there is any type of monetary investment into these services, then these drugs and health treatments should always help and work as the doctors say they will. It is not too unlike purchasing a product from a store. If you buy a TV and it doesn't work, you would want to return it to get your money back. The combinations of expectations and the evolution of medical services as a service creates a difficult situation for doctors even within their own society. Also, the fact that individuals are often times putting their lives into the hands of these doctors, they expect their doctors to perform flawlessly.
The situation is compounded when individuals from other cultures are brought into the equation. For example, Lia's parents expectations, of western medicine is, like with everyone else, shaped by their past experiences with the doctors. This represents their standpoint on how they view western medicine. Lia's parents have had limited experiences with western doctors, and as a result their perception and expectations would be different than those that have had different more positive experiences with doctors. But, like society as a whole, they still feel that doctors would be able to help, and that is why they come to the hospital to seek treatment.
Although they do not pay for their medical services, they initially expect the doctors to be able to cure Lia because of all the time they are investing in the doctors. They, like everyone else, expect western doctors to be able to cure Lia's ailments due to the high standard that they measure doctors against. Lia's persistent seizures and her subsequent vegetative state causes Lia's parents to lose faith in western medicine since by the end of the whole saga, Lia's condition has worsened. They are disappointed in western medicine for its failure to fulfill their expectations. I feel that incidents like Lia's may have even occurred with individuals that are not immigrants and have fully assimilated into American culture. Doctors, by nature are human. The human element means that ailments are sometimes misdiagnosed and bad judgements may be used in making life-altering decisions. Treatments and drugs are never 100% effective and always have potential side-effects. How a patient reacts to a treatment is unique in every case. Going into a given situation while holding doctors to such a high standard creates a most optimistic outlook on the situation, setting the patient up for disappointment. Although cultural differences may have played a role in the misunderstandings which caused Lia to end up in a vegetative state, the failure of doctors to fulfill our expectations and help Lia is what makes the situation even more tragic.
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It is interesting to note how different the Hmongs’ expectations are for the Txiv neebs compared with their expectations of Western doctors. Fadiman compares the two types of healers on page 33. Like you mentioned, society has high expectations for medicine and doctors since we believe that they should know all the answers and not make mistakes. Fadiman points out when a doctor cannot heal the patient the doctor feels responsible and considers it his or her own fault. The guilt occurs not only because the doctor has his or her own expectations for their abilities but also results from the high expectations of society. However, if a Txiv neeb is unable to heal his or her patient, then it is the fault of bad spirits like the dab interfering with the healing process and not the shaman’s methods. What I thought was really surprising was that a shaman who did not succeed in healing their patient may be held in even higher regard if they had to fight a dangerous spirit. We definitely don’t consider a doctor a better doctor for not saving a patient’s life from cancer even if it were a very difficult type of cancer to treat.
Why then did the Hmong have different expectations for the Txiv neebs and for Western doctors or even accept Western society’s expectations for doctors? I know the general reason is cultural differences, but I’m confused as to what specifically caused the Hmongs’ high expectations for doctors to fix problems yet at the same time be mistrustful of their methods. Could the difference go back to the idea that doctors are concerned with saving the life of the patient while the Txiv neeb focuses his powers on saving patient’s soul? I could understand the Hmong being more lenient in their expectations of a shaman than a doctor since the Txiv neebs are considered the only ones who can go into the unseen realm of the spirits and thus one must place his or her faith in the shaman.
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