And another NYTimes articles

From their Health Blog

Fat bias worse for women

Life as a tall Girl

After reading Claire's post on Talk..

I remembered the activity we did in class where we went over various advantages we get as every-day, able-bodied, privileged people. Honestly, it scares me to think about all those things because I don't want to think of what I would be without it; my life would be much harder and I definitely wouldn't be an Emory student today. For what my parents came from, my mother a refugee from Myanmar (formerly Burma, if any of you know about the civil wars and military struggle there), and my father a descendant of sugar slaves in Barbados, life must have been very difficult. I always hear from my dad about how he worked through college because his parents couldn't afford to put him through, and my mother took the housewife role, giving up any idea of college when my older brother was born. My father worked his ass off to support my family for so long, and he gave all that he had up until he hit bankruptcy a few years back. I don't think my parents had it easy when starting in America; my mother worked at a Chinese restaurant and her dad was an alcoholic at the time, always taking her money; my father struggled to stay independent from his parents. For me to think about what they went through in their home countries... my mother tells me about how hard it was in Burma, how her youngest brother almost died at age 5 of a terrible fever, how hard it was to get by, how her mother moved her husband and six children to Massachusetts with only a few hundred dollars. I take advantage of so much in this lifetime, that it's hard for me to understand not having what I do, but the when my family went bankrupt, I started to understand hardship. For the first time in my life, I was financially unstable and had to work for myself and give up all the extra things like birthday gifts and summer vacations to Barbados; my family couldn't afford those things. My mother had to go back to work for the first time in almost 20 years, and she struggled to keep a job, only because she's very people-oriented and can't get along with rude people. My parents went through a lot for me.

I wonder if I have it in me to do the same, heaven forbid it happens to me in the future. I have to learn from my parents and understand all they've gone through in order to make myself who I am, and I try to absorb all I can from them. I am very afraid to think about whether or not my future is secure, hell I'm worried about finding a job by the time I graduate, because that affects my life after Emory. I'm so sheltered in this life that I'm worried, and the privilege has become too much. My life is comfortable, and my boyfriend's life is even more comfortable than mine, and to think that it won't always be like this, it's a wake-up call. We all have to do everything we can and stop taking things for granted, because it won't be here forever.

It also makes me think of "rich", well-to-do parents who don't spoil their children, let alone give them an allowance in order to teach their children to make money and work for what you have. My family is far from wealthy, but we're no longer so close to bankrupt, but I've learned the meaning of a dollar, I know what hard work is, I know how to earn my way and give everything I can, and I know not to step on the feet of the people I pass along the way, or even those with whom I share the path.

I hope we all took something meaningful out of the discussion from Thursday, and I hope we all understand how blesses and privileged we are just as Emory students. Just as college students, hell, just for making it as far in life as we have, because there are plenty of people who die before making it to 21 like me, 18 like a few of us; being adults is a privilege supported by where we grew up, by how our parents cared for us, by what education we received. It all starts at the beginning. And that brings new light to the Hmong idea of the first beginning of the world; I'm finally beginning to understand.

My favorite chapter of The Spirit Catches You, "The Big One"

One of the things I liked about the chapter on Lia's grand mal seizure is that it showed the medical perspective on something so severe. Neil's biggest fear concerning Lia came true, and I think it was a great example of Karma, how Neil was the doctor on call when he desperately wanted not to be. His doctoring seemed sub-par when it came to Lia, not because of his medical performance, but because of his human performance. He was annoyed by and referred to Lia negatively throughout the book, and he got the pressure of trying to save her.

One negative medical aspect I couldn't forget is that the doctors felt that a brain with no activity represented a body that didn't need medication or medical care; I feel that the right to make decisions for their child was stripped from Foua and Nao Kao, and even though they got some say in what happened, it makes me appreciate medicine of today and the respect given to family members when they go through such a struggle.

I also constantly think about Neil'n'Peggy and the way they were personally as opposed to professionally. True, they held each half well, but in transition arose their flaws. Neil especially, seems to be a man who loves his family and gets along with people, and medically he is a great man, but when transitioning between personal and professional, he looks like he can't do both at the same time. His attitude toward treating Lia shocked me, and I was displeased to read about him reacting the ways he did when he was on call for Lia, it was always a negative emotion because he had to go in, and I imagine many doctors get like that because though the job is what they wanted, the time allotted for personal life is very short. Looking back on it, I know I felt very negative toward Niel, especially when presenting over this chapter, but now I understand how his stress must have been hard to deal with because he needed the time to get over everything that was happening, but he spent so much time with Lia that it was getting to him. For our future doctors, a few of which are in this class, I wish you the best when it comes to handling your patients, because sometimes the emotional care you show means more than the medical care you can give.

By the way, to all graduates, congratulations!!

Toxic Bodies

This article brought up a lot of good points that really pertains to our society today, especially in terms of the environment. I think the fact that we have grown up in a sort of "throw away" society really shows how we treat the environment. The fact that we drink water out of disposable water bottles and use oil like there is no tomorrow shows that we expect these things to come from some infinite source, and that where they go afterward is not really our problem. In terms of economics, this lifestyle is embedded into our way of thinking--our capitalistic economy praises the aggressive attitudes and actions of massive corporations and the individual's pursuit of conspicuous consumption. The "American way of life" is not healthy to the environment or society as a whole, at least in the long run.

Another point that the author brought up was the unexpected correlation of toxic bodies and the purity of the nation. I liked how Berila related the environmental issue with AIDS. I hadn't really thought of them going together, but thinking about it shows how they are closely related in issues. When I think of the idea of nation's "purity," I have to ask, what needs to be kept pure? What population's lifestyle has to be kept safe? We have issues of race, gender, sexual orientation, etc. come up with this question. The whole AIDS issue that Berila brings up parallels the readings we read in class about the Puerto Rican women, Native Americans, and the eugenics movement. Somehow, these marginalized members of society must be restrained and/or kept under control in order to maintain the health of the nation. It's scary to think that unfounded beliefs, such as the prejudices against people with AIDS, can form from the idea that there is some sort of a health of the nation--especially the belief that only the homosexual population gets AIDS, and this population must be contained in order to save the heterogeneous, contained population (130). This sort of pervasive way of thinking is embedded into our culture on a very subtle, basic level. Groups like ACT UP are integral in changing this way of thinking. I like how Berila deconstructed basic attitudes and beliefs in order to question their faultiness.

Poverty fuels medical crisis

Until few months ago, I didn't know what all those political hypes about health care, HMO, Medicare and Medicaid was about. When I moved to U.S. I had to get medical insurance. I was under my uncle's policy for a while as a dependent, while I lived with them during high school, but when I came to college, I had to get student health plan. Some of my friends who are international student have complained that the cost for the plan was expensive. I knew that seeing dentist is not included in the plan, and therefore it would be expensive to get checkups and necessary treatments. One of my friend, couple years ago waited to go to hospital to get antibiotics for her sickness, so she got worse. When she had to go to ER, she was ended up with over one thousand dollars of hospital bills. The wall of high health care cost was right around me, but I didn't realize that so many people in this richest country on earth, do not have health insurance.

In the article "Poverty fuels medical crisis," a woman named Deborah Maple died during her asthma attacks because she couldn't pay an inhaler. Tomorrow during class, I will be showing some parts of Michael Moore's documentary "SiCKO". In that documentary, Moore go over to Cuba with couple dozens of people including three of 9/11 rescue workers who are suffering from illnesses they got during their rescue works, but not getting sufficient health care. After being deny to enter detention camp at Guantanamo Bay where prisoners like the 9/11 terrorists receives top class medical attention, they go over to a Cuban Pharmacy and hospital. There, one of the rescue worker with lung problem finds that a inhaler she pays $120 dollars in U.S. costs 5 cents in Cuba. How ridiculous is this that a person has to die because she cannot afford to pay something that costs 5 cents in some part of the world?

As the article mentions no one escapes effects of health crisis. Sooner or later, we all will have to feel the effect of long term cost of inaccessibility of health care. In a society that is so driven by profit, private profit, how do we fix this? Presidential candidates talk and talk about changing health care system. Would it change in next four or five years once new president is elected and his or her term begins?

Toxic Bodies? Race? Gender?

I really enjoyed this week's reading by Beth Berila, Toxic Bodies? for many varying reasons. She starts off talking about the tainting of the "purity" of this country through "marginalized" communities, a concept I cannot seem to comprehend, simply because of its outlandishness. She outlined a few examples, mostly through the organization ACT UP of how there seems to be an uncomfortable coherence between heteronormativity and nation. She even mentioned a study done by ACT UP in regards to dressing up for Wall Street and Burroughs Welcome, and how people were mortified and uncomfortable that they were "fooled" and couldn't "read" them, letting them "pass" as being "normal," all of which directly show that interpretations of homosexuality are politically connected to our heteronormative society.
One of the main points I thought was most interesting was how to help solve this problem, not just because it exists in the LGBTQ community, but also with women, people of color, poverty, and even fatness, in my opinion. She described how important it is to "unsettle" the ability to decipher between citizens and "aliens," thus directly confronting the issue of the insider/outsider opposition.
This idea can EASILY be applied to ALL of the other categories of social struggle we've talked about thus far in class, including the ones listed above.

Closing Thoughts...

Although our final discussion on The Spirit Catches You and You Fall Down was a week ago, I wanted to share my thoughts on the book. The lack of communication is the key problem that is mentioned throughout each chapter, whether that was from not being able to understand because of a language barrier or a cultural barrier. As was demonstrated in various situations, no one was particularly at fault for the lack of understanding; frustration could be seen from both sides. However, I feel that if everyone took the time to appreciate the other culture and traditions, many of the issues that were raised would not have necessarily occurred. Regardless, it is difficult to find a balance between two such distinct ways of thinking; the Hmong people will uphold the values they have lived by, as will Americans will continue to follow their fast-paced way of life. In order for communication to truly happen, a compromise must be reached. Compromising, however, is a difficult task for many people of all cultures and backgrounds.

I am not sure what could be done to "fix" a problem like this. Although cultural brokers are a great idea, I am not sure if it the most practical. Not only would it be expensive, I feel like with the strict rules and regulations that are already in effect in our medical system today, being able to facilitate the understanding between two groups of people would be restricted in some aspects. Furthermore, when looking at the broader picture, having a cultural broker for one distinct culture is not enough. The United States is termed the "melting pot" for a reason. Is it reasonable to have a cultural broker for every culture? I am not sure how this plan, although great in idea, would be put into practice.

I felt as if this book represented how much improvement our medical system can make. Aside from all the technological advances and breakthroughs in disease, it is more important to understand and appreciate each individual person rather than the problem that is being fixed. I honestly feel as if we should go back to the basics, or at the very least, try to incorporate them into what has already been set.

A New York Times Article

There is a very short video interview about people who are multi-racial, talking about their experiences, and since we talked about this a bit in class while ago, I thought I'd post the link here.

Article Link

Poverty and Medical Crises

Laura Ungar's article on the relationship between poverty and medical crises is very similar to several scholarly pieces that I have read in the past. In the article she distinctly defines this very devastating relationship through several different avenues. She discusses the rising health problem in relation to education, class, geographic location, belief systems, and several other factors. Much of her discussion reminded me of a concept often used to describe how inequalities affect health outcomes. This concept is commonly known as structural violence, which specifically has to do with the ways that social structures affect inequalities in health by limiting people abilities. Structural violence is often times normalized by a population and hidden within a society's organization and historical context. Many of Ungar's points relate to this idea.
First, Ungar discusses that lack of educational opportunities that rural Kentuckians have. Because of the development and progress in our country, little resources have been distributed to areas outside large metropolitan bases, and Kentucky is unfortunately one of the places that has been overlooked. Many studies have suggested, as Ungar notes, the direct relationship between education and overall health- the more educated a person is, the better his or her health. In addition, I related the idea of structural violence to the jobs available to those working in rural Kentucky. Many people living in this area have low-paying jobs that often did not include health insurance benefits. Simply put, Ungar says, "good paying jobs are scarce."
Although Ungar does focus on people suffering in rural areas, I appreciate her effort to describe how similar situations exist among the poor living in urban areas. Despite the development focused around urban centers, the poor are subjected to highly competitive environments that often prevent them from getting themselves out of the poverty trap. This is many times the case for minorities. Ungar describes the negative health outcomes that minorities face and reasons that allow for this to happen. This is unfortunately another form of structural violence.
Many of Ungar's stories reminded me of our discussions surrounding The Spirit Catches You and You Fall Down along with the readings that describe our hegemonic and bureaucratic society. In the book that we have just discussed, we continually see how minorities encounter many problems with our health system and often have a difficult time navigating their way through it. In addition to this, Lia and her family demonstrate how those who are worst off, financially, often make use of the most expensive care by going to the emergency room. People who don't have health insurance have no choice but to wait until an emergency arises to receive help and treatment for their problems. Ungar describes many important points in her article that describe several of the flaws that exist within the US biomedical system, which are perpetuated by the organization of our society.

Talk, Talk, Talk

I think that “Talk” is a brilliant video. Not only does it show the difficulties that disabled people face, but it also emphasizes their ability to do. Yes, the video is aimed at abled people, encouraging them to do something, but the video also shows disabled people doing something. In other words, it shows them in action. It shows their capabilities to dance, work, have sex, or do anything at all if they are given adequate means by which to do these things. These means include the elevator to the building of the job interview, the bus for people with wheelchairs, and the brail documents. All of these things allow disabled people to be active.
Thus, the meaning of the emphasis on doing rather than talking becomes a twofold urging for us to take action: to ensure that we make these helpful means a part of our society so that “disabled” people will be able to do. And when disabled people are doing, as they are in the video, they are no longer disabled people but just people.
This divide between disable and abled people is evident throughout the video. In the work meeting, disabled people are talked about as a sort of “other.” There are no “others” who work in this building, or my cousin is one of those. These others are looked at like another species. The boss asks the main guy to do research on these people and present his findings like he is researching animals at the zoo.

“Toxic Bodies” thoughts: Getting rid of "natural"

In Toxic Bodies, Beth Berila addresses America’s distaste for anything considered “toxic,” “unnatural,” or “impure.” As American citizens, how do we determine the identity of these poisons? Our upbringings, the media, government, and popular culture all inform us those unlike ourselves, those who cannot or will not fit into traditional American categories are “unnatural.” As patriotic Americans, we are taught to push away the “unnatural” at all costs— such people threaten our “natural” conventionality and the American dream. This sentiment is expressed perfectly through former President Bush announcement: “the American way of life is not negotiable.”

Instead of embracing difference, America discriminates against race, cultural background, sexual orientation, religious practices, and physical and mental abilities—these are the anomalies we deem “unnatural.” I am outraged, however, that society not only instructs us to disown certain bodies and beliefs, but also that it can label them “unnatural” at all. It is difficult for me to grasp how anything born or produced of the earth—whether genes, skin colors, defects, or ideologies—can be “unnatural” to begin with. Did not mothers and fathers give birth to homosexuals, people with missing limbs, autistic children, minority religions, and everything else “unnatural” considered toxic to America’s otherwise unadulterated society? Meanwhile, artificial chemicals, genetically-engineered and fake food, grown organs, and cloned animals created in test tubes are embraced as meaningful, and therefore “natural,” elements of America. I cannot imagine a society without some tinge of prejudice. However, I believe that working toward a country more accepting of differences requires ridding ourselves of the notions of “natural” and “unnatural” in relation to people or beliefs. We must remember that Americans come in every shade of color, size, and creed. Nobody is not “unnatural,” we just might not be in the majority.

"Talk"

I thought the short movie we watched today was well-done in the way that it got a very clear message across without being too cliche. From the opening scene, the tone is set. It is clear that the people in the meeting do not really care about the disability act which they are meant to enforce. In addition to this, they show that the only reasons they have for enforcing it are completely the wrong reasons. They bring up the issues of money, business competition, and good public relations, however, they never stop to think why changing their practices towards the disabled is simply the right thing to do.
However unbelievable the fantasy world which the main character enters is, where everyone is disabled and he (being "able-bodied") is unusual, it serves as a good example for how you can not really understand the situation of another person until you've seen the world from their perspective. I would never expect anyone to truly understand my feelings at all times; they are so tied up in my personal history and way of thinking. It is therefore almost insulting for someone to assume that they "know what's best" for someone else, especially in the case of disability. Until you make a true personal connection with someone, you cannot understand what their daily experience is like.
The movie showed how people with disabilities cannot escape their situation, it is simply a part of their life at all times. Small things which "able-bodied" people take for granted are sometimes impossible tasks. The movie makes the point that it is one thing to talk about change (like I am doing now). Talking about change is really easy. However, the real challenge is creating change. The movie makes the point that we (society) need to do more and talk less.

Comments on Chapter 14: “The Melting Pot”

In class today we addressed the question of America’s Hmong population in relation to its welfare status. We know from Fadiman that an incredibly large portion, if not the majority, of first-generation Hmong families in America rely on welfare for most of their income. Are they unethically taking advantage of the federal system? It is easy to look at the situation only through cold “facts”: America has taken in hundreds of Hmong families, given them shelter, clothing, and free medical care (hundreds of thousands of dollars worth in Lia’s case). Yet these people make little to no effect to learn our language, therefore holding very few, mostly menial jobs. The Hmong are clearly an undesirable economic burden on the United States welfare system, taking rather than contributing to our economic well-being.

From this standpoint it not difficult to see how the US government, as well as natural citizens, may hold the Hmong abusive of the system, lazy, or stubborn. How many people know, however, the enormous debt that America owes Hmong society? I am willing to guess that even fewer know the horrendous conditions the Hmong tolerated in Laos, and later in refuge camps as a result of their involvement with America’s conflicts. The Hmong were essentially cheated into fighting for America since we have done very little to uphold our end of the bargain—airlifting only the captains out of danger in Laos, relegating the Hmong to disease-ridden refuge camps, scattering tribes and families across the States in assimilation efforts. In my opinion, the least that the federal government can do is provide unquestioned welfare to the first generation of Hmong refugees without judging or questioning their ethics.

“Veterinary Medicine”

The theme of “miscommunication” is so vital to “The Spirit Catches You…” that Fadiman wastes no time addressing the strained American-Hmong interactions in Merced. From the first chapter she emphasizes and reiterates that Hmong patients rarely, if ever, understood the language and medical logic of their caretakers. Likewise, healthcare providers most often could not explain their decisions and interventions to the Hmong. In community interactions, such as at grocery stores, parks, and DMVs, the language and cultural barriers were likely frustrating and time-consuming. In the medical arena, however, miscommunication was life-threatening.
Fadiman explains that at the Merced County Hospital, the best translator a doctor could usually muster was a janitor or perhaps a young English-speaking Hmong child. Not only did these characters lack general training—which teaches cultural sensitivity, broaching difficult conversations, and mediation between parties—but also lacked the specific training of medical translators. Medical translating involves an extensive medical vocabulary and the ability to explain pathologies to a party which may have no native words for “brain,” “infection,” or “cancer.” When one cannot rely on trained translators grounded in both cultures, or in Fadiman’s words “cultural brokers,” patients may leave not only insulted or annoyed, but also with sub-par treatment, and perhaps even in mortal danger.
One Merced doctor mentioned the cultural and lingual barrier was so thick that he was forced to practice “veterinary medicine.” After I got over the initial shock of his word choice, I realized that this statement was not merely insulting. While “veterinary medicine” does somewhat imply bestiality in Hmong patients, it also implies care. Doctors must not allow patients, human or otherwise, to suffer simply because they cannot communicate their pains or will not cooperate in treatment. Rather, doctors must gain the patients’ trust, acknowledge that their knowledge and status is not revered by every patient, and provide them with the best treatment possible given the barriers while seeking cultural brokers to breach them.

What about our poor?

I would like to raise some questions, partially as a devil’s advocate. And I hope some of you will read and answer because I really am interested in what others think on the matter. I am wondering, with so many philanthropists, health scientists, doctors, and so much government funding aimed at problems oversees, are we overlooking the problems in our own backyard?

As an Anthropology and Global Health student, I have always been taught about the miserable, disadvantaged, poverty-stricken “Other” of South Africa, Haiti, Vietnam, Romania, etc. My attention has nearly always been directed abroad to places I have only seen photographs of and read about. As a result, I feel extremely sympathetic toward people who I have never met, and passionate about bettering their lives, protecting their rights, and curing their diseases. Yet I feel significantly less connected with people suffering in my own backyard. I simply have not been exposed to their plights on an intellectual level or even in a personal context. (I admit that most of my volunteering/social improvement efforts have been with organizations providing international aid.) Finding myself in such a situation—caring more for and knowing more about Kenyan AIDS orphans than the Kentuckian poor—makes me wonder if others are in a similar place? Shouldn’t government officials, human rights lobbyists, and charity programs focus on America’s own problems before tackling some distant countries’? (And yes, I do understand that we are all interconnected, and that Africa’s problems affect our own. But how much more do Kentucky’s problems influence our lives than another continent’s?) And finally, shouldn’t university professors address our AIDS, poverty, sanitation, and women’s rights concerns before someone else’s? How did I find myself knowing about the “types of advanced diseases” (p.2) plaguing Filipinos, but nothing about how they similarly threaten my neighbors?

Communication

Communication is imperative in the environment of a hospital. When you are dealing with the health care of people, you cannot afford to have any misunderstandings. Yet, in Lia Lee's situation we notice the harmful effect poor communication can create. The cultural and language barriers made the relationship between the Lee's and the hospital tough, but not impossible. Regardless of the language barrier, there were ways the problem could have been addressed. Fadiman discusses some of these solutions, and I was pleased to know that the hospital was respecting the Hmong differences. Yet, I believe there should have been more of an effort to monitor Lia's medicine intake due to the lack of understanding on her parent's behalf. I respect the Hmong beliefs and values, but if you bring your child to a hospital, you should comply with the doctors and nurses' requests when it comes to dosage and other health-related topics. I felt like the Lee's were not understanding or compromising with the hospital, which did heavily influence the fall of their daughter's life.

This issue is prevalent at many hospitals across the country since America consists of a variety of people and cultures. Hospitals need to prepare for these situations to accommodate their patients in the best manner. Also, patients should come to hospitals with an open mind and acknowledge all of their options. Thus, the communication between patients and hospital workers can be easier.

Circumstances

It is sad to read that the people who really tried to help Lia had to watch her deteriorate in front of their eyes. The mix of circumstances and confusion between all the factions that really tried to help her just exacerbated her problem. At a certain point, it seems that Peggy and Neil just pretty much gave up on Lia while her parents kept on trying. As Fadiman had mentioned, they had already lost three children and survived numerous catastrophic events. It's both astonishing and not so surprising at the same time to see that they had not given up.
Throughout the book, Fadiman continuously adds different dimensions to the story of the Lee family. The aspect of assimilation was interesting to me, in that Fadiman made distinctions between reasons why the European immigrants left (to assimilate) and why the Hmong left (to escape assimilation). Just to relate this to a current event, this is similar to what is going on now with the Tibetan situation and China. Why would these people want to assimilate if that was what they were being forced to do before and give up their cultural identity? Relating this back to Lia's situation, I think this is partly what led to the overall complicated situation. Accepting Western medicine would mean forgoing their own ideals and beliefs. At the time the book was written, the view was that Western, scientific, medicine and Eastern, mostly esoteric, medicine were exclusive and incompatible with each other.
Later, when the revelation came that Lia's deterioration was the result of the hospital's errors, everything seemed to straighten out in terms of clarity. One quote was especially interesting: "Lia was dead to her physicians...because medicine had once made extravagant claims on her behalf and had had to renounce them" (257). This doesn't seem to please her parents, as Foua just seems sad at how things have turned out. I really consider the story of Lia a sort of tragedy in that she was a victim of unusual and uncontrollable circumstances. In retrospect, it seems clear in how the situations should have been handled. Still, the complexities and obstacles that come along with two clashing cultures like the American and Hmong seemed to be mired in many things. Fadiman points out the issues with American bureaucracy, politics, history, medicine, etc., and then Hmong mindset, culture, and various practices. Maybe Lia's situation could have been avoided if a different approach had been taken respect to the consequences. Her case can only be looked at as an example for future generations who meet the same circumstances.

Lia Lee

I found that I was most upset and sad while reading the last part of Fadiman's book. The author provides a further and more detailed description of the Hmong people in light of a historical context, which made me feel particularly emotional. The stories of the Hmong living in our contemporary society are almost heart-wrenching, and their dislike of our culture is even more saddening. Many of the Hmong indicate that they have no home at all, especially now that they live in the United States. The idea of the melting pot for the Hmong people is terribly disorienting and seemingly miserable; Fadiman only reports of few Hmong who have been successful here in the states.

I was additionally upset by chapter 15 titled Gold and Dross. In this chapter Fadiman provides an update of Lia's state and condition, in which the author describes the little girl who is in a "persistent vegetative state". Despite Foua and Nao Kao's love and acceptance for their daughter, along with others in the Hmong community (who accepted her without reservation), I can't help but think what the doctors could have done to prevent Lia from becoming so incapable of living her life. It was only at this point in Lia's story that the medical professionals saw the Lees as acceptable parents. While reading this chapter I immediately thought of a concept - medical pluralism - that could have possibly led to a very different outcome.

Medical pluralism seems absolutely necessary in our contemporary society, and Fadiman clearly demonstrates this point; the concept is defined by the co-existence and synthesis of a variety of medical systems. Although biomedicine creates some sort of biopsychosocial causation, it does not always satisfy patient needs. As we see in this book, biomedicine seems almost too reductionist in the fact that the doctors completely disregard the belief and faith of the Lee's throughout the entire story. Few of the medical professionals understand Hmong culture, let alone incorporate it into a healing system that could have been more beneficial for Lia. I have previously read how medical pluralism can be extremely beneficial in the the book The Scalpel and the Silver Bear in which a female Navajo doctor combines her beliefs with the contemporary practice of medicine.

Similarly to other things that we have read, Fadiman demonstrates in the last chapters how many people are discouraged by the medical system that we employ in the US. We see this same idea in the movie that we watched with the mother who gave birth to the intersexed child. Her doctors did not give her much choice; we see this exact same thing in Fadiman's book. I also noted the control and power that the medical professionals had over Lia and her family. This idea relates to many of the articles that we have read discussing how both race and ethnicity affect health outcomes in America. Fadiman's work in this book is tremendous, and I applaud her effort to reveal how people encounter several problems with our hegemonic medical system.

Who is at Fault?

After the discussion we held in class on Thursday, it is becoming more and more apparent that communication has a major influence on the relationship between the Hmong and the doctors. This barrier can ultimately be considered a major factor in Lia's treatment or lack thereof. For instance, as is seen in the book, the "best" translators as those individuals who are patient. Although there may be many duties of a translator at a given time, those that take a moment to thoroughly explain what the status of the treatment is are the ones who are successful. This problem in communication not only stems from the fact that the two group of people speak different languages, but more so because they have different traditions and backgrounds. What is seem respectful to the Hmong people may not have the same affect for the American doctors.

When speaking of translators, how much influence do they really have in the treatment process? For example, in any culture, terming a person as "government property" may be viewed as disrespectful. For the Hmong people, for instance, when Sue the translator uses this term in explaining what is about to happen to Lia, she is seen as a sellout for not sticking to her Hmong beliefs. Is the translator really the traitor in this instance? What about when the life support is pulled out from Lia? I feel as if it is extremely difficult to put the blame on one person in such a situation. More so, I think that the system in general could be at fault; if the communication between the two groups was improved, perhaps this incident would never have occurred. However, I feel like it is difficult to make changes in the system when it already seems to be so standardized and fixed. What do you guys think?

Love and Cultural Understanding

In Chapter 18, Anne Fadiman makes an interesting point about different doctors in MCMC and their relations with their patients. She describes the relations Francesca Farr and Dan Murphy had with the Hmong as love relationships. Francesca Farr, the social worker, went against standard procedure of MCMC to take special care of the Hmong patients, and even put aside her own belief system. Dan Murphy said that "of the ten most admirable people he had met in the last decade, seven or eight were Hmong." Other people included in the list of Hmong "lovers" are Jeanine Hilt, Sukey Waller, Eric Crystal, and Dwight Conquergood. What these people also have in common is their higher success rate in communicating and dealing with the Lees.
In contrast to this, Fadiman states that Neil and Peggy liked Hmong, "but they did not love them." "Love," Fadiman concludes, "cannot be taught. It can only be granted." It is not their fault that they did not, at least in Fadiman's opinion, have this quality. They were still undoubtedly excellent doctors. However, lacking this aspect made them, in Lia's case, "Imperfect Healers." It is amazing to me how this concept really did affect the doctors' interactions with their patients. When I was trying to pinpoint what it was that made some people successful and not others, I thought of many characteristics: patience, understanding, genuine interest in other culture. But I think Fadiman pinpoints the difference between adequate and "imperfect healers" correctly, and the difference involves Love.

Intolerance to "otherness"

As described in ch. 14 "Melting Pot," Hmong people left their mother land to the country of freedom in search of freedom from oppression. They were mistreated as if they were unintelligent because they were not used to social culture and technology in America. In certain cities, Americans mistreated them with violence, with no clear reason to do so, except because they didn't like having foreigners around and having their tax money going to refugees instead of U.S. citizens. Earlier in the class, we had some discussions of otherness. We talked about how people are not comfortable with dealing with unknown and with things that are different from what we are used to. We often do not know how to deal with differences, so we put them into the "other" category and clump together people with disability with people who committed crime.

In the case of Hmong people, they had over two thousands years of rich history. They had tradition and their way of sustaining their heritage. Nations with such old history value their culture very much, it is the case for both Chinese and Korean people as well as Hmong people. Despite being called country of freedom and diversity, America is often intolerant toward immigrants, who posses distinct culture. With economic and technologically power, perhaps Americans makes assumptions that everyone is proud to be an American. In the chapter, the author quoted articles from newspapers and magazines, which used phrases like "Stone Age" or "emerging from the mists of time" to refer to Hmong people. Here, the fact that these people possess rich history and culture does not even come into consideration. Western definition of "cultured" person as technology savvy and up-to-date with U.S. affair cannot be applied these immigrants or refugees who grew up in completely different social setting.

When pilgrims from Western Europe seeking refuge came over to America, they too were foreigners. In the eyes of Native Americans, these immigrants probably looked strange and at times barbaric. In one of my English class, we talked about cultural salad bowl versus melting pot. In the early history of migration to America, U.S. was a cultural salad bowl, where different national and ethnic culture was preserved. However, at some point, those who move to this country are silently forced to join the melting pot in order not to be excluded from the society.

Reactions to Chapter 11, "The Big One"

As I have been reading this book, I have become more and more shocked over the collisions of cultures depicted in Fadiman's book.  This is not a new thought; all of our discussion has circled around this, and the "collision of two cultures" is part of the book's title. However, there are certain moments in the book that really cause an alternating sense of shock and confusion, and I find myself asking "how could the doctors act like this?" and "how could the doctors have done anything else?"  The most shocking of these moments for me is when Lia is admitted to the ICU at Valley's Children's Hospital in a terrible condition and Dr. Kopacz worked on her for hours without even noticing her sex.  This oversight is not the result of neglect on the part of the doctor.  We have discussed this lack of individual care by doctors quite a bit in class.  Rather, it seems to me that this was caused by the incredible amount of work required by Lia's ailing body over the many hours Dr. Kopacz worked on her: one organ failing after the other.  As Fadiman so aptly puts it: "here was American medicine at its worst and its best: the patient was reduced from a girl to an analyzable collection of symptoms, and the physician, thereby able to husband his energies, succeeded in keeping her alive" (147).

The huge collision occurs when one considers the huge amounts of medicine being administered to Lia from her parents' perspective.  The chapter begins by narrating Lia's medical crisis and the steps the doctors took to counteract it.  It is only later in the chapter that a full laundry list of all the medicines given to Lia over this time is provided, as well as the medical necessity for each one.  And it is also at this point that Fadiman quotes Nao Kao as saying "[Lia] got very sick and I think it is because they gave her too much medicine"(148).  "American medicine" was doing its best to deal with the medical puzzle of a patient, and meanwhile, the parents of the young girl believed these care-givers not to be healing, but destroying.

Communication is Key

While reading the chapters in The Spirit Catches You and You Fall Down along with thinking about the seminar I attended led by Anne Fadiman, I realize that the biggest problem with Lia's story is the ability to communicate.  Lia's doctors could not explain to her family the seriousness of her condition which made it nearly impossible for them to make her parents understand how important giving Lia the proper dosage of medicine was.  Lia's family in return could not explain to the doctor's their cultural beliefs and why they would take Lia off the certain medications.  Then with a cultural broker, I wonder if both sides are adequately able to explain to the other what they want the other to hear.  Indeed having a translator is important, but I also believe that it makes it much more frustrating for each of the sides because they can only understand what the "middle person" is telling them.  I think that this book makes it very clear that having translators are important and essential to help patients of different backgrounds than their doctors.  While it may  be near impossible to have a translator for every language, it is definitely helpful to have many depending on the distribution of different cultures in a certain area.  Hopefully as more medical students are required to read this book, hospitals will place more emphasis on finding translators to help their patients.

We talked in class about the importance of finding a medium between two cultures: the Hmongs and the American medical system. However, the main problem in this particular case is that the two cultures seem to contradict each other in their most elemental forms. Although it is possible to gain the trust and respect of the Hmong, the way to achieve this intimacy takes lots and lots of time. Consider Anne Fadiman’s experience. She writes that the first couple of visits with Hmongs were disastrous. However, she took the time to find an appropriate way to be introduced to the Lees (through the cultural hierarchy). After this initial meeting, it takes a long time and the help of a superior translator (or more accurately, cultural broker) May, to gain a good relationship with the family. Thus, it is possible to somewhat bridge the cultural differences. However, for the doctors in the hospital to do this would require going against the basic nature of the American medical system which is to treat as many people as possible in the shortest time frame while still giving effective treatments.
Thus, to find a compromise between the two is difficult. However, this book presents the first step to a compromise which is simply more understanding between the cultures. It is interesting that to get the Hmong message across took years and years of intense research and cultural emersion. If more people make an effort to bridge different cultures, the job of understanding would be made easier. The next step in compromise would be to develop much more communication between the two. Once communication is established, it would be so much easier to understand the reasons why your culture (as a Hmong or American doctor) needs to be compromised a little in some situations.

The Spirit Catches You and You Fall Down

In The Spirit Catches You and You Fall Down by Anne Fadiman, a clash of cultures is demonstrated. I really enjoyed the opening chapters of this book, because I learned a lot about the Hmong culture and tradition. It was interesting to see this particular culture functioning in an American society, especially in a medical environment. This situation demonstrated the reality of biases in health care and medicine. What is it right? Who decides what is right? How should doctors treat patients without disrespecting their personal values? These questions are hard to answer. Yet, medical students are being educated about these issues, so when needed they will know how to address these differences. In addition, the difficulties the doctors and the Lee's faced in the Merced hospital should be taken into consideration. Translators should be a part of the hospital budget, because not everyone in hospitals speaks English. In America, English is not required, so these non-English speakers should not have to face the burden of miscommunication.

This issue is happening all across America, not only at Merced hospital. Even the media has taken into consideration this issue, but using it as plots in their weekly sitcoms. The Grey's Anatomy clip did not show the reality of a Hmong patient's situation, but brought attention to the issue. I think it is important to acknowledge that not all doctors or hospitals disrespect cultural values. A family friend of mine was going into labor and in order to protect her baby, some Indian rituals were performed. My mom said that the doctors and hospital staff were respectful and did not mind the rituals. Thus, even though these problems exist, they don't exist everywhere.

Cultural Obstacles

First off, I just want to say how much I respect the author, Anne Fadiman, for going in and really trying to understand the Hmong people and Lia's family. Her attention potential miscommunication and her understanding of cultural context is portrayed nicely throughout the book for the reader (although there seems to be a bias in favor of Lia's family).
On a more general note, the culture clash represented in this book seems to be a microcosm of how people operate in general. There is an attitude, especially on the side of Lia's doctors (Neil Ernst and Peggy Philip), that they are right and that Lia's Hmong parents are wrong. A frustration is borne out of this on both sides, especially since their beliefs toward medicine come from such different cultures.
On page 41, Neil and Peggy are described as workaholic and idealistic. They seem to see things a certain way that borders on stubbornness. When dealing with Lees, this seems to get in the way of seeing things from the parent's point of view, an element that hindered understanding and subsequent progress for Lia's condition.
I think that Lia's removal from her parents into foster care could have been avoided if her doctors had really tried to understand things from the Hmong (especially culturally displaced Hmong) perspective, rather than try to radically change things. There was obvious mistrust from the beginning on both sides due to this misunderstanding. I think frustration led Niel to make his decision, and it was heartbreaking to read that such a thing happened.
The cultural differences are made even more evident later on around page 104, when Foua describes daily life in Laos, and how the skills there were not transferable to the States. Fadiman also made a good point in how the government took away her last remaining skill--being a great caretaker to her children. I can't imagine what it would be like to feel like that. I think for a lot of people who move to the U.S. from countries like Laos, the complete reversal of daily life and expectations and interactions can really take a toll. If the doctors and other people involved with Lia's case tried to understand this like Fadiman has, there might not have been such turmoil in how it was handled. Of course, like we discussed in class the other day, American medicine is fast and often impersonal, sort of like a constant 'treat and go and treat and go,' assembly-line fashion. Maybe it has to be the system that needs to be changed in order to allow this personalized interaction.

The Spirit Catches You and You Fall Down

While reading Lia Lee's story, I am constantly asking the question of what should have happened, should have been done, could have been more successful, etc. In this case there were many mistakes made early on, on the side of the parents and the doctors. The misdiagnosis at the beginning made it harder both for Lia's recovery and for the parent's
trust.
I have tried to imagine a system in which the Lee's could have encountered Western medicine,
worked together with the doctors, and been more successful in helping Lia. While her condition
seems to be so serious that there was probably no perfect "happy ending" possible, I feel
like the situation would have been at least better had the hospital had the correct knowledge
and resources to overcome the communication barrier.
This is, undoubtedly, a daunting task. The individuals in the book who are successful in
communicating with the Hmong each have their unique way of going about it. I'm not sure if a
system could be put in place to make this goal achievable for everyone. First of all, it
takes a lot of time and patience, which are not always available from modern Western doctors.
A lot more was needed than simply a translator; they needed (as Sukey Waller called them) "cultural brokers." I'm not sure if an "ideal" system could have existed at all.

A Response to 'Class Act': What can we do?

The assumptions made certainly prove to be more harmful than helpful, but something we didn't talk about in class really got me thinking...

In talking about how doctors could possibly try and be more open-minded and accepting towards other religious/cultural practices it made me think that it really doesn't exist just in doctors.

Some of this seems to be "common knowledge" to me simply because most people are taught this openness as a way of connecting to people and respecting their decisions. It is simply that this issue is placed in a medical/scientific context and therefore treated differently. It's like we are trying to say that doctors need to go through special training to be able to talk to someone, but when that something they talk about happens to be about their health and their life, we feel as if it carries more weight.
In my opinion, it stems directly from the fact that this practice is deeply rooted in "science" that is related to "truth" which can have no blurred lines in their opinion.

I have no idea how to overcome such an issue, and am worried about the medical field and profession. It seems like more people are attempting other forms of treatment for health, but are our systems really changing? They are clearly the problem, but there doesn't seem to be much being done.
What can we do in our lifetime to help this situation?

Hmong Culture and Western Medicine

I have read this story about Lia in several classes before, yet I still find it interesting each time. Fadiman provides such a vivid and detailed description of what happens to Lia over so many tough years, and each time I find that I can sympathize more and more with each of the characters. However, I find that I am most interested in Neil and Peggy and the ways in which they treat Lia and her family.

Today in class I mentioned the idea of the LEARN model, and this is something that I wanted to discuss a little further. This model stands for Listen, Explain, Acknowledge, Recommend, and Negotiate. Each of the letters in this acronym becomes very important in the relationship that is formed between a doctor and his/her patient. Regardless of cultural, ethnic, or racial differences a relationship based upon trust must exist to ensure the most positive health outcomes. Fadiman points out in the story that a certain reluctance or ethnocentrism prevents this model from being put into use, and it becomes very tragic for Lia. Neither Neil and Peggy nor Lia's family care to learn more about the meaning of Hmong girl's condition. The worst part about the first section of the story is that the reader remains in the dark about what Lia's parents really should be doing. They hold their traditions and culture very close to their hearts, just as the doctors at Merced Hospital do, too.

I find that Neil and Peggy, as Western doctors, act in a particular way that is very indicative of American culture and its presence in this world. Neil's decision to place Lia in the custody of the state is extremely aggressive - I believe that this was an unjust decision. Although he frames his decision in the sense of non-compliance, Neil's behavior exactly reflects how many doctors practice Western medicine. Americans tend to consider only certain parts of a disease, are concerned only with diagnosis and treatment, and rely heavily on different forms of intervention; they are extremely aggressive. Also, western doctors are afraid of the litigious nature of American culture. Neil demonstrates all of these things.

Cultural competence and sensitivity become a major theme in Fadiman's first chapter. And although we don't exactly see how this can surface with Lia's situation, the reader quickly understands that they are absolutely imperative for the health of the child. Along with these two ideas, cultural humility becomes a very important idea. Because of the historical context of the Hmong people and the emphasis that we place on both science and innovation, Fadiman demonstrates that neither culture is willing to back down. Throughout the first section of the book we see many ways in which Lia and her family are affected by the structural violence that exists in our modern world. This is something we have certainly seen in some of our past readings; it applies directly to the readings about the Native Americans and also the audio clip about the Tuskegee experiment. Historical context and social structure are affecting the ways in which we deliver medicine and medical care in today's world to various groups of people. These effects are rarely ever positive.

Today's Discussion...

After today's discussion, I realized that although the technology in our medical system may be "advanced," it is not as thorough as it could be. There are still many improvements that can be made that would benefit both the medical practitioners and the patients. As we had discussed in class, communication is one aspect that could be worked on. If the communication were more efficient, then a greater understanding between the doctor and patient would also result. However, the understanding that would stem from respecting the values and traditions of other cultures is just as important. This idea represents that more than just a communication barrier, there is also a cultural barrier that must be overcome in some cases.

One such cultural difference between American society and the Hmong people is what is to be treated, the person or the disease? In the case of Lea Lee, Hmong values interpret her "disease" as a condition that can happen to anyone. They do not try to fix the problem, viewing the treatment involved as more of a crisis than the condition itself. In American society, however, Lea's condition is seen as a disorder, something that must be treated; the only way to go about this, though, is to treat the symptoms, which may lead to other negative effects on Lea's body. Such differences in thought show the cultural differences that groups of people may have. Moi brought up a point in class today that I definitely agree with: rather than attempting to learn about the variations in thought a group of people may have, it is more important to respect such differences. Just like different groups of people may have various ways of thinking, individuals of a specific group may also vary in thought. Thus, it is not as important to categorize groups of people as it is to understand each individual for what he/she may believe in.

The Road to Hell is Paved with Good Intentions

Remember the saying “when you assume, you makes an ass out of you and me.” Well, it kept going through my head as I read the first part section of this book. One assumption led to another which led to actions that had grave consequences. The doctors would not give the Hmong women the babies placentas because they assumed they wanted to eat it. This led many of them see these Hmong individuals as backwards, dim individuals who had so much to learn. This and other assumptions further exacerbated cultural barrier and made meaningful communication nearly impossible.
The first few chapters show how so many important things can be missed the rush to treat one patient and move on to the next is coupled with assumptions. The doctors and nurses assumed that because Foua signed the release papers she could read. This turns out to be a horrible assumption that leads to problem after problem. I was just talking to a classmate who said that divisions exist because we can never understand 100% of another person’s background. I do not feel that one needs to understand a person 100% to know how and how not to approach that individual in a way that can reduce barriers and division. It’s hard to say that if the doctors and nurses who had attended to Lia during her first emergency trip had tried to understand where the Lees were coming, from the sequences of events which occurred would not have been a grave.
There are two ways which Lia can be treated and due certain events and factors they seem to be competing rather than complementing each other. The traditional western medical approach practiced by Dr. Ernst and Dr. Philp relied on the belief that their medical school knowledge was the only way to deal with Lia’s problems. We then also have the family who feels that they best way to help this young girl is through the ways their culture deals with illness by addressing the matters of the soul. No doubt both parties want to help the girl, but the way in which it is done ends up causing more harm than good. The Lees saw western medicine and the hospital as something with which to hedge their bets, a sort of last ditch effort and not as the primary source for curing their daughter; the doctors did not see it this way. One of the concepts we have discussed in class and see again in this book is the issue of ownership of one’s body and taking an active role in deciding how an illness should be treated. For Andre Lorde, an American college professor, making her intentions known are not as difficult as it is for a young girl whose parents do not fully understand the culture of those helping their daughter and thus cannot adequately state their intentions
As I am reading this book, one thing I have to keep reminding myself is that it was written nearly 10 years ago about events which happened between 15-20 years ago. It can be very easy to forget that. I feel some of the issues addressed in this book have changed/improved and others have become a bit more complicated especially in relation to other cultural groups.

Lia Lee and family

Anne Fadiman's account about the events concerning Lia Lee, the daughter of Nao Kao Lee and Foua Yang, Hmong parents, is a riveting tale. From the very beginning she states that many of the problems and frustrations of the parties involved with Lia's epilepsy stemmed from the cultural barrier that prevented common grounds from being reached. Anne Fadiman does a good job explaining the characteristics the Hmong culture has instilled in its people: from the nomadic lives and tenacious fighting to spiritual medicine and strong family values. The depiction of the picture the Hmong people had of American doctors and vice versa helped tremendously in order to comprehend how uneducated each group was towards the other.
As I read, I found myself amazed at the ignorance and lack of initiative the American doctors had when dealing their Hmong patients. Fadiman mentioned that during medical school, students would be taught to practice medicine a certain way and expected a certain type of approach towards their patients. The author also said that Merced Community Medical Center had many doctors who had just gotten out of medical school and did not have much field experience. Yet even with all this, somehow, I wish to blame the doctors for all the troubles the Lee family and many Hmong patients had at American hospitals. I might not be the best at recognizing different cultural values but I have learned to respect the fact that there are many different kinds of people out in the world and many do not think and same way I do nor hold the same values. Perhaps I have the advantage of hind-sight that these doctors did not have. I have history to back me up and experiences that have exposed me to different cultures that has trained me to see people as individuals with different ways of thinking. I hope that someday, we can all know that different cultures exist and not treat someone poorly because of it. People should not be treated the same (equally) but the fairly to respect their own values, however hard that may be.

How We See Fat

Before reading the article, I wondered why in our society we are so obsessed with body image. There maybe many causes: the emphasis on the visual, fashion, health, etc. I really can't pinpoint any definite reason. All I know is that the obsession has led both men and women to both physical and mental unease. How can an individual not be affected by such an onslaught? For me, when I see a constant influx of beautiful, tall, and slim models, I have to keep reminding myself that my body cannot fit into such a mold. I think I would probably have some kind of eating disorder if I hadn't grown up in such a stable environment.
While reading the article, the author listed some of the lengths people go through in order to obtain a "healthy" body. Gastric bypass, constant dieting, dangerous substance (like phen/fen) are all means that could potentially hurt more than help. They are constantly promoted as quick fixes for monetary gain, without regard to actual health. This led me to think about how many of today's "ailments" result from society and/or monetary greed? The propagation of our obsession, I feel, can find its one of its biggest perpetrators in these pharmaceutical corporations. Which is a scary thought.
A relation that the author mentioned really stuck out to me, and involved the intertwining of commodity and popular culture. The rise in use of dietary products in fighting fatness is alarming. And it's not even health concerns that drive this growth. People aren't afraid of obesity--they are afraid of looking obese. In my other women studies class, we read a short science fiction story on how this woman traded her original, fuller body for that of one that is slimmer and more petite. Such body transactions seem to be manifesting right now. We want and expect to get slimmer quicker. The media seems to be saying, "Just buy this, and you'll get the body you want!"
The author goes on to talk about the hostility towards fat, and the context of past views on fat. I know Stephanie mentioned how our perceptions of fat can depend on the economy. In the past, fat was seen as good because the rich used to be fat-- a sign of wealth and fertility. Now, fat is seen as a transgression, illness, and either asexual or extremely sexual/devouring. The hostility seems to be the result of people looking for another way to differentiate and condescend.
On a more positive note, I recently read an interview with Beth Ditto, a great singer who happens to be fat. She seems to embrace her figure and makes no excuses for eating what she wants. She seems happy and has no qualms about who she is. As a woman in the music industry, this is especially admirable, especially with the Jessica Alba's in the world who are considered "curvy" when they are size 0 instead of size 00.

To become thinner and thinner

As we discussed in class on Thursday, media often associates being thin with being healthy. However, as Anya and and Stephanie mentioned in class, we also get mixed messages about being healthy. In my textbook for PE class “Fit & Well”, the authors says that “Body composition, the body's relative amount of fat and at-free mass, is an important component of fitness for health and wellness . . . Unfortunately, many people don't succeed in their efforts to obtain a fit and healthy body because they set unrealistic goals and emphasize short term weight loss rather than the permanent changes in lifestyle that lead to fat loss and a healthy body composition” (Fahey et al. , “Fit and Well”). The authors also mentions that “even in the absence of changes in body composition, an active lifestyle can improve wellness”. As one of the women whose interview we watched in the class mentioned, some people, for genetic reasons, have larger then average figure despite of their active life style. It is very sad that so many women's magazines are advocating thinner and thinner body without putting emphasis on balance in body composition and long-term healthy life style.

These erroneous promotion effects women of all ages and sizes. In Korea, where the average body size is smaller than U.S., the definition of “thin” is even worse then in the States. When I visited Korea after living in the States for four years, first thing many people said to me was that I gained weight. Although I am usually not so concerned about weight, whenever I plan to visit Korea, consciously and unconsciously I started to get concerned about my weight. What is worse, I think these trend of getting thinner is spreading to younger age group, as years go by. I remember when I was middle school, weight was not a big issue among my friends. However, it seems like young girls are no longer free from pressure to be thin. In one of Ugly Betty's episodes, several girls from Betty's brother's middle school visit magazine publishing company. When one of these girls saw models walking around the office, she looks herself and says how fat she is, and that she will skip her lunch (in the show, she looked skinny already). I don't know how common this is among teenage girls these days, but what is clear is that nowadays, we cannot go a single day without encountering weight loss articles and advertisement, regardless of age and gender. I've realized how important it is to have correct information for myself about healthy weight and body composition, in order for me not to be tricked by “health” magazine articles. It is also important to stop stereotyping people who weight above average and always seeing them as having medical or social problem, as Kathleen Lebesco and Jana Evans Braziel put it.

Female Bodies

Today’s discussion was almost scary how much it applies to my life. Within the past two days, I have had almost identical talks with my friends about these issues. A couple of days ago, I was at the DUC with a friend and we were talking about how hard it is to eat healthy food because we think it does not taste as good. But this segued into the realization that healthy foods such as organic and locally grown food is much more expensive than other types of food that happen to be very unhealthy such as McDonalds or any other fast food chain. Thus, size very easily becomes a commentary on social class. And certainly, this has been true throughout history as well. Like Stephanie and Anya outlined in their presentation, it used to be considered a mark of wealth and abundance to be more corpulent. I think that this association is dangerous because it separates the classes visually as well as monetarily.
I also had another discussion with a friend recently. He asked me if I thought that the ideal of very skinny women and muscular men would still be prevalent if we had no movies or magazines. I do not think that we would have the same ideals or at least not to the extreme it is today. The movies and magazines make these tiny women the unattainable goal. However, without this media, I think that society would go back to considering more corpulent women as the ideal as it was before. Either way, I think that society would use weight as a social tool to promote the differences between the classes. This issue in our society is scary. I remember when I was in 5th grade being ashamed of my body. Looking back on that time, I get a deep sense of regret. Especially when you’re a child, you should not be concerned with your body unless it is very unhealthy. I wish this same concept could be applied to grownup today as well. We have so many other worries in life without having to obsess over weight because every woman is different. We all have different shapes, metabolisms, and heights. It is unfair and absurd that we should all be striving for the same goal.

Female Bodies

Today’s discussion was almost scary how much it applies to my life. Within the past two days, I have had almost identical talks with my friends about these issues. A couple of days ago, I was at the DUC with a friend and we were talking about how hard it is to eat healthy food because we think it does not taste as good. But this segued into the realization that healthy foods such as organic and locally grown food is much more expensive than other types of food that happen to be very unhealthy such as McDonalds or any other fast food chain. Thus, size very easily becomes a commentary on social class. And certainly, this has been true throughout history as well. Like Stephanie and Anya outlined in their presentation, it used to be considered a mark of wealth and abundance to be more corpulent. I think that this association is dangerous because it separates the classes visually as well as monetarily.
I also had another discussion with a friend recently. He asked me if I thought that the ideal of very skinny women and muscular men would still be prevalent if we had no movies or magazines. I do not think that we would have the same ideals or at least not to the extreme it is today. The movies and magazines make these tiny women the unattainable goal. However, without this media, I think that society would go back to considering more corpulent women as the ideal as it was before. Either way, I think that society would use weight as a social tool to promote the differences between the classes. This issue in our society is scary. I remember when I was in 5th grade being ashamed of my body. Looking back on that time, I get a deep sense of regret. Especially when you’re a child, you should not be concerned with your body unless it is very unhealthy. I wish this same concept could be applied to grownup today as well. We have so many other worries in life without having to obsess over weight because every woman is different. We all have different shapes, metabolisms, and heights. It is unfair and absurd that we should all be striving for the same goal.

Corpulence

The introduction by LeBesco and Braziel was very interesting and brought up a great deal of points about society and its view of obesity. One of the most interesting points brought up in the introduction was that many doctors, nutritionist, and others within the medical and pharmaceutical communities condone the use of synthetic dietary products by obese individuals. These synthetic products could possibly cause side effects that could be very harmful to the consumer in the long run. One example of a synthetic dietary product that the authors discuss is the product Olestra, which is a fat substitute. The authors state that Olestra is shown to "leech the body of other nutrients...believed to help prevent cancer." After googling Olestra, I also found that other side effects of Olestra include loose stools and abdominal cramps. However, the FDA approved Olestra in 2006. Olestra is also used in the making of low-fat potato chips.
The price that many people pay to be thin is quite great. With the introduction of risky weight loss surgeries and "wonder pills", many people are risking their lives to live up to society's standards of beauty and health. It is sad how much focus is placed on the obese and how little focus is placed upon anorexia and other eating disorders. Its as if society says that its okay to starve yourself as long as you are thin.

Female Insanity

The article The Female Malady raises many important themes that have previously been brought up in class. For instance in Victorian times women who desired sex, roles outside the home, wanted divorces, etc. were deemed insane. Any deviation from the societal norm was considered insanity. This illustrates not only man's fear of female sexuality, as has been examined by how lesbians are viewed and treated in modern day society, but it also shows the imposition of the ideas of normal. In Victorian society females were suppose to be demure, sexless, obedient wives and devoted mothers. If a woman didn't fulfill these roles then she was deemed insane. The course of actions that doctors took to treat these women, performing clitoridectomy and having women in asylums take up traditional roles like cleaning and sewing, reinforces society's fear of female sexuality. The very ideal of female sexuality contradicted every Victorian ideal. These same paternalistic attitudes towards women's sexual behavior can be seen in America during the early 1900s. As we read previously many of the woman who were coerced into being sterilized during this period were not actually "imbeciles" as the doctors claims, many were women who had children out of wedlock or engaged in other sexually "deviant" behavior. This article really highlights the horrible treatment women received in asylums and the stereotypes that were forced upon them, however, it is also important to note that many of these prejudices and stereotypes still exist in modern day psychology and psychiatry. 

Women are diagnosed with anxiety disorders and unipolar depression twice as often as men. Also, other certain psychological disorders are mainly attributed to women like hysterical somatoform disorders, where the person is convinced that something is medically wrong, but nothing is. Dependent and histrionic personality disorders have also commonly been more diagnosed in females than males. These diagnoses reveal that many of the common stereotypes about women being emotionally unstable, dependent on others for care, and vain are still seen throughout psychology. Another interesting thing to note is that homosexuality was only removed from the DSM manual in 1973. So while, many attitudes are changing and women are becoming the dominating force in psychology it is still interesting and disturbing to see the prevalence of many of these Victorian views. 

Lebesco and Braziel

I really enjoyed reading this article by Lebesco and Braziel. I think that they have highlighted a lot of interesting points about our conceptions and perceptions of fatness in both a historical and modern context. I first appreciated that the authors set-up their chapter with a series of questions that forced the reader into thinking about 'fat' before getting into the meat of the text. The idea of 'the fat body' has evolved very much over time from a variety of perspectives including the pyschosocial, cultural, and political. The objective tasks of trying to unmask this whole idea is extremely daunting, but the authors do a wonderful job.
Lebesco and Braziel spend some time discussing the language and feelings that we use when talking about fatness. Many times people use pejorative language, and this is certainly true in our society. From this idea the author focuses on how the pejorative language affects psychological discourse; the authors later discuss how we specifically see this with the use of sympathetic language. Why is it, if the ideas of fatness has evolved over time in a many spheres, that people feel that it is necessary to use this language? Similarly to what Lebescso and Braziel discuss in their work, I have learned the varying perceptions of what is normal in society in terms of weight. Some Pacific cultures believe that it is better to be fat, from an evolutionary and economic perspective, while we in our own culture expect people to be so thin.
Much of the discussion in this text reminded me of a discussion that I previously had in a medical anthropology class that I am currently taking. While discussing the epidemic of obesity my professor brought up the idea of body mass index or BMI. He pointed out many negative consequences of this model, such as the fact that if fails to even consider muscle mass in relation to the size of one's body. The way in which this model is skewed to the thinner side remains parallel with much of what Lebesco and Braziel find interesting about the idea of corpulence. This idea of the fat body, along with many others, can be arbitrarily based in a deep cultural context.
This article very much reminded me of some of the things that we have read this semester that make an effort to redefine the meaning of concepts and ideas that have existed for a long time. Exposing issues in a new light and context creates an open arena for discussing the anthropological forces on perception and thinking. I appreciate these authors for tackling a subject that many people are reluctant to discuss. Fatness remains important to our culture, and I thank Lebesco and Braziel for bringing it into sight.

Corpulence

As I was reading through this article, I was struck by how the word "corpulence" was used to describe people society would label as "fat." Language is a powerful tool; the English language has many words that have nearly the same definition yet the connotation behind the words can vary greatly. I noticed how I couldn't help but shy away from the word "fat" as it has been given such a negative connotation. My parents, especially my father, point out when some part of my body is chubbier than before. This action is their indirect way of saying that I need to start watching what I eat and start exercising more. I need to get that extra body taken off somehow. So much of today's images depict tall, thin females as the ideal. Although plus models exist and Dove had shown commercials of "real women" feeling good about themselves, there is no liberal fat deposits on these girls. All would be considered "fit" in a more full definition yet not thin nor fat to any extreme. Fat people have been seen as ones who are responsible for their own condition. Fat people could have prevented themselves from becoming fat yet did not. Thus, people in society are justified to look down at them. Yet, I have to agree with the article, saying that people who are corpulent should not be looked at that way. How can being "overweight" be decided by a percent body composition that can encompass everyone across the board? That sort of simplification fails to acknowledge the complexity of the human body.
The article pointed out how the medical field has seen obesity as a method of making money. I was horrified when the editors mentioned how many of the medicines that claim to help reduce one's fat composition could actually be harmful to the body. I remember the cases of drugs that were used to treat diseases that the American people were had yet ended up causing more problems. If the medical world truly only wishes to make money off the illnesses of other people, how would people of society insure their health in a world that only wants their money? Of course, patients should arm themselves with information to try and prevent their doctors from pulling the wool over their heads.

Bodies Out of Bounds

One of the biggest problems in terms of helping people maintain a healthy lifestyle is that no one provides information on how to initiate healthy habits before becoming overweight.  Authors, doctors, and trainers mostly talk about how to lose weight.  There are hundreds if not thousands of dieting books and websites to offer tips for what to eat and what not to eat, how to portion yourself in order to feel full but consume less calories etc.  Doctors prescribe many weightloss supplements in order to help people shed a few pounds. Doctors may also recommend more severe procedures such as gastric bypass surgery.  Trainers will try and whip you in to shape so that you can feel confident wearing your skimpy bikini at the beach.  All of these aspects focus on losing weight.  The problem is finding a weight that works for you, makes you happy, and allows you to live in a healthy manner without becoming overweight either by overeating or lack of exercise.

In contrast, as stated by the article many people fear being fat.  People become obsessive compulsive about controlling what they eat and working out for obscene amounts of time in order to prevent themselves from gaining weight.  This also is unhealthy since many people compare themselves to celebrities and models who have their bodies sculpted for them by professionals if they are not physically altered in pictures.  This skew on how people perceive the ideal weight only contributes to the problem of people trying to lose weight because they will overachieve and lose more than what is actually healthy for their body type (thus leading to eating disorders).

As questioned in the article, who gets to determine what counts as fat?  Many people do not take the time to consider who is setting the standards and whether they would actually be swayed by others' opinions.  Recently many celebrities have acknowledged the problem that Hollywood images may portray to the younger audience and tried to steer those who are more impressionable in the right direction.  The one that comes to mind is the new ad for Jenny Craig with Queen Latifah who says that she wants to lose weight in order prevent other diseases.  I think that by addressing these problems earlier, less people will suffer from being obese as well as too skinny.

Insanity and Selective Abortion

As I was preparing for my presentation with the articles, "The Female Malady" by Elaine Showalter and "Abortion Wars" by Marsha Saxton, I was completely astonished. Showalter's article illustrates the heavy influence of male dominance on health during the 1850s. It was obvious that men were threatened by women empowerment, so they would diagnosis them as "crazy" so their aspirations to work out of the home or live outside of the domestic sphere were ceased. The cures these men devised for mental insanity were absurd. Cold water, fluid injections, and leeches---- now that's insane! The power that males had in this society is clearly displayed through the study of female insanity, because males did obtain the control even in the health field.

I really enjoyed Saxton's article. It was moving to hear this type of information from someone who is disabled and has spent their lives according to that particular lifestyle. She opened up a controversial topic, which has pros/cons to each situation. Personally, I can't justify an either side. I don't think it's right or wrong. I feel like disabled people contribute to society just as much as someone who is not disabled. There are many examples in our society today that emphasize the strong capability of disabled people. For example, in the TLC show "Little People, Big World" the Roloff family is functioning in society as any other family. Their dwarf son is a skilled soccer player, while the two dwarf parents are working and managing a large farm. Is it really fair for an outsider, such as a doctor to justify the life of a disabled person? In the Grey's Anatomy clip, I wasn't surprised to see the non-disabled people feeling sorry or labeling the young girl's life as "hell".

These two articles really made me think about serious issues that one day will affect me. I wondered about what I would do if I was an expecting mother with a predicted disabled child on the way. What would you do?

They Tell Me what I Want

Pictures taken of the women in the asylums demonstrate how photography is used to construct and maintain stereotypes. The pictures with the caption “Four stages of puerperal mania” shows how just by grooming the woman and giving her better clothes she can be made to look insane or “normal” though this may not be how she feels mentally. It seems interesting to me that what is depicted on the outside does not ever seem to match the inside. Some of these women came into the insane asylum because their sense of dress made them look insane but were in fact mentally sane. Through the asylum’s modification program, they were made to look outwardly sane while they in fact lost their minds and became docile women who depended on others to tell them how to dress, think, and act.

A sense of forced silence is present in both articles. For the women in the 19 century asylums, it allowed for other dictate all aspects of their lives. In the disabled community, the voicelessness and partial invisibility in the major public sectors creates an environment in which the experiences and what it means to be disabled and created by non-disabled people who sometimes over estimate the negative aspects. As Saxton states, “oppression is what’s most disabling about a disability, (pg 378)” because it creates a big disconnect between reality and perception. The disabled are viewed as burden to those who will have to take care of them. However, if they are given the same tools and resources for advancement and trained, they would be a bit more sufficient, have opportunities and not be excluded from the public. As a result, they not have to rely extensively on others and not be viewed as such a burden.

Sexuality in individuals other than healthy middle/high class men is tied to reproduction. Those women who were seen as sexual deviants were forced to have clitoridectomies to remove any pleasure associated with sex. Success of transforming these deviants is cited by how many of those who undergo the procedure become married and bear children. For the disabled because some see them as “unfit” to reproduce and thus have no capability of being sexual. As we continue to see, fear informs regarding sexuality and value of human life. In Managing Women’s Minds, Men feared women’s sexuality and used surgeries and modification programs to frighten women into submission. In Disability Rights, Women who learn they were pregnant with a disabled child sometimes fear that raising a disabled child requires superhuman strength and is a great burden may decide or be pressured to abort the child.

Selective Abortion

It was really interesting to read this article because it brought a lot of good points that I had never really thought about with people with disabilities. I think the part that really stuck out to me was the part about the "disabled fetus" issue, and how people view such a topic. The beginning of this section started out with the author talking to her friend about setting up a meeting for disabled people and genetic professionals. When the friend said the line about "our people," I felt that it was terrible for such a phrase to be used in that it set these two factions apart as though they were utterly different. People are humans, no matter what they look like or how they useful they are to a society. While divisions of this sort may seem inevitable, I feel as though they should be overcome in order to strive for the bigger picture.
Later in the same section, there was a part where the author mentioned overhearing people say that a baby with a certain disease should have gotten "caught." Then, the author made a distinction between wanted and unwanted offspring, and the terms "baby" and "fetus." This was especially interesting because of the way people can use certain terms, specifically scientific ones, in order to distance themselves from the reality of the situation--that the "fetus" has the potential to become a human being. This turns into a more abstract concept when the author brings up the idea of "non-humanness." I think that if people were a bit more empathetic about this idea, the issue might be less controversial for both sides. But then again, there is a tension between feminists who identify as both disability activists and pro-choice, like the author mentioned, which I thought was a very complicated stance to take. Ideally, it would be great if such things could be looked at through a case-by-case basis according to each individual.

Disability Rights and Selective Abortion

I think Marsha Saxton brought up some good points about how majority of us perceive people with disability and how they are formed due to lack of correct information. First thing is something that we discussed in the class. Saxton illustrates interactions she had with other women at a conference. They expressed awkwardness or nervousness when they meet or see disabled people. As the author mentioned, I think that the general lack of education or informations raising correct awareness about the people with disability builds walls against disabled people and negative stereotyping such as poverty or crime. And somehow, these negative stereotyping justifies "selective abortion" of babies with certain conditions. While I was growing up, occasional and limited encounters I had with people with disabilities were usually on the streets. It was not hard to see people without legs, sitting on the streets, or near train station, usually with a music box playing music and begging for money. Another encounters I had was indirect ones, usually on the television, when they are showing stories of 'heroic' disabled people. When I came to Emory, I had chances to see fellow students with disability, who were begging for money, who did not commit crime but who were just like me, except that they had difficulty walking. Despite of many similarities we share, I too also have trouble figuring out where to put my eyes, or what to say, or what to do in general. I think that it is important to be correctly informed early on in ones' childhood about similarities and differences that people with and without physical limitations have, and know that just like ethnic or gender differences we all have things to learn from the differences. I think doing this early on would be one of steps we can take to remove negative connotations attached to people with disabilities.

She mentions another very interesting point. She writes that "most doctors have few opportunities to see ordinary disabled individuals living in heir communities among friends and family". Many of their encounter with disabled individuals are at a hospital, probably when they are distressed because of visit to a hospital along with other factors that might be going on in their life. It is very interesting because, in a hospital, it is probably not uncommon to encounter patients or their families under stress. When 'normal people' are struggling in this situation, doctors would see the current health condition and the fear of surgery or something as the cause of distress. However for people with disabilities, the disability which would cause many other life struggling factors becomes the source of their distress. Here again, the lack of correct picture of people with disability creates this misconception.

My perhaps negative and grim picture of people with disabilities have changed a bit when I saw TLC's TV show called "Little People Big World". It is a reality tv show, showing the lives of Roloffs. Both parents and one of their sons have Dwarfism. There are two more boys and a girl who are average height. There are difficulties they face due to their physical conditions, such as having to built kitchens with lower counters, or sometimes being afraid of people's prejudice. However, they are very independent, have joys and struggles like 'average' household without disabled family members. Having opportunity like this to encounter people with physical limitations in not overly dramatized settings, either negatively or heroically, would be great thing to be encouraged.

Disability Rights and Women Asylums

The disabilities movement fights for the right not to have to have an abortion. In other words, expecting mothers who have fetuses that have the potential of having (a) disabilit-y/-ies should not be forced into getting an abortion. This coercion is not only direct but also from more subtle forms such as lack of information being provided to the expecting mother on how people with disabilities live life. This article by Saxon strongly reminded me of the articles we read last week about how society views those with disabilities and the lack of help they receive from the US Government. The media portrays the idea that their disability is the cause of their difficulties and lower living standards. As I think about what I instinctively believe of those who are disabled, all of it is negative -- especially in terms of economic and social dependency on others. I picture myself having a child and wondering if I would care more about how the disabilities of my child would affect me and my family or how much my child would suffer from the discrimination of others or if my child could grow up to be a strong individual who knows her (in the non-specific gender sense) own limitations. I know there are conditions in my family that I must be vigilant for, but I don't believe they are so debilitating that I would prevent my child to enter this world because of it. Thinking about the future, it would scary to think there might be a day that part of the pregnancy process would include getting an amnio test. I wish to believe that would not affect me, but it would. I liked how this article pointed out ways of thinking this society has today that should be challenged to increase the acceptance of different types of people. From this and previous articles, it seems how medicine approaches the reproduction of different groups of women reflect how society values this population group.

Like previous articles, Showalter's article about how Britain dealt with insane women during the Victorian era in a historical world controlled by men has affected the thoughts of how people deal with the same issues since then. The article showed how patients would be viewed to fit preconceived notions about them, similar to today's society where discriminations against different groups of people usually involve generalizations that individuals cannot totally fulfill. This article gave me information in things I hadn't known before. I knew that males could not accept the concept that females were also sexual beings, but the fact that ice baths would be used as a type of "cure" shocked me. From Chinese medicine, I have been taught that contact with cold is bad for a woman's body, especially during menstruation. The woman will experience pains in that area due to poor circulation that results from the cold water treatment. I get chills thinking about the treatment back then. I have to admire the psychological these physicians could produce through their tactics but the crueltly is amazing. I an glad I don't live in such an era.