This entire book has shown the struggle between different cultures, medicine and the Hmong people. The difficulties the two groups have had dealing with each other has become apparent. I feel deeply saddened by Lia's case and thinking of how some of this could have been avoided or dealt with differently (by medical staff, Lia's parents, the Hmong community, etc.) doesn't help. If she was diagnosed sooner, if she took the proper medications, if she stayed with her parents. These are all what-if questions that honestly no longer matter. These things weren't done and it was because of the significant cultural differences between the medical staff and the Lees. It's important to know that the Lees made a great leap of faith by even coming to the hospital so many times. It is not part of their culture and they did it anyways. Their thoughts were that their healing treatments were more important than the doctors' medical treatments, but they saw compromise. It was great that they allowed any sort of treatment at all. I think the medical staff didn't make it easy for them either. They did not understand what was happening and the medicine was simply too complicated. I do not think they can be blamed for that. They can be blamed for changing her dosages, however, because they were well aware that they were doing it.
These kinds of differences exist. All across the country there are medical staff and foreigners coming into conflict because they just don't understand one another. I mentioned in my presentation that efforts have been made to sort of "bridge the gap" between these differences. I mentioned the CME conferences that are training doctors in dealing with people of other cultures and the book mentioned how recently medical schools and residencies are requiring students to train at refugee clinics in order to get exposure to these types of situations. These are great strides, but they are recent. Previously, and up until recently, doctors were not trained to handle cultural emergencies, only medical ones. Therefore, situations like Lia's were and are bound to happen. Doctors were not trained to deal with other cultures, only other bodies. Medicine is medicine and deals with peoples bodies, not their cultures. That is how it has been taught. I think this makes for great doctors that are able to handle medical and physical emergencies, but they are not able to handle people. The efforts that have been made to allow doctors to become more familiar with dealing with cultural differences is great and necessary. I think this is a beginning, but takes open-mindedness and willingness to compromise on everyone's part. Like the book stated, doctors have to prioritize the important aspects of their patients, find out what they are not willing to budge on, and realize that everything else can be compromised.
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I remember reading the last page of book and thinking that the publisher had accidentally forgotten to include the final chapter in my copy. I wanted to know what happened to Lia. If all of the "What if's" as you mention caused her to die or if she was still living as that perfect vegetable as she had been described in class. I then realized that I was missing the entire point of the book. All of these "What if's" were as you say a result of cultural differences. Maybe Lia could have been diagnosed earlier, or maybe she could have been given her medications properly from the beginning, but this is all nothing more that speculation. I agree with your post and I enjoyed the aspect of the your presentation that explained that we needed to bridge the gap between our cultures.
I think it is great that CME conferences are training doctors on how to deal with people of other cultures; however, I think the greatest advancement in bridging our cultures is the fact that medical schools and residencies are requiring students to train at refugee clinics. You can read a book about a group of people, and maybe work with a few in a hospitals, but you can never truly understand a culture until you divulge into it and live as one with those you are trying to understand. If we are able to improve modern medicine so that people of all races, religions, cultures, etc. are not afraid to seek medical treatment and we are able to work together to incorporate their traditional practices to have them better accept our practices, then modern medicine can only be improved.
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