Saturday, March 22, 2008
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.
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3 comments:
I agree that this book does a lot to encourage people in medicine to be aware of cultural differences that can intrude upon care-giving. For me, one of the most striking examples of the miscommunication is in Chapter 11, which documents Lia's two hour convulsions that ended up taking her from MCMC to Fresno. Throughout the chapter, Fadiman quotes the doctors as saying things like "I told the parents, and they understood," only afterwards to detail the huge state of confusion of the parents over the doctors' words and actions. Clearly the doctors were aware of this confusion, and I think it is precisely this awareness that led them to avoid not only talking to, but even eye contact (according to the adoptive parents) with Foua and Nao Kao as it became clear that Lia's condition was hopeless. I don't know how much of this confusion could have been avoided by more culturally knowledgeable doctors, since such critical medical situations are always confusing and heart-breaking for parents. However, a "middle person" who might explain to the parents that the spinal tap administered was not the main cause of her decline would certainly have helped some of the confusion.
I agree that the only plausible thing for the medical system to do is train more translators. However, even this would not be the ideal situation. Fadiman made it very clear while describing the Hmongs that they are an obstinate people. They would rather flee or die than admit defeat. Furthermore, they have cultures and practices that have dated for thousands of years. It seems unlikely that even with the help of a translator, that too much leeway can be gained when trying to treat these people. That being said, I think that doctors need to realize this and take it into consideration. For example, if they had treated Lia’s parents with this cultural sensitivity, then they would have realized that the Hmongs do not follow a Westernized time system. If more thought had been given to details such as this, then a more effective way to treat Lia could have been implemented.
I agree that doctors should be more concerned not only about their patients' problems, but also about their cultural views. While reading the book, I found that the main problem between Lia's family and the doctors was the communication which did not actually existed. It was really shocking for me this chapter in which the author was talking about the confussion in which Lia's parents had taking her at home. They signed the requirements which they should to follow in order to make Lia feel comfortable, but when they took her home it was not like that. Doctors concluded that her parents were not familiar with Lia's medicines and did not give her the right treatment. I think that this kind of confussion became from the fact that Lees did not speak English and they could not understand the doctors. In such serious conditions, like Lia's condition, doctors should be more aware and helpful for her parents. For example, America is one of the most humungous powers in the world of medicine, so it should dispose of different supplies which can be beneficial for its patients. I concluded that one of the most important ones are the translators. These are the people who will make the connection between doctor and parient and also help both sides to become close to each other. In Lia's case there was almost no communication between the doctotrs and her parents wjich I think was the main issue with her treatment. It will be better if medicine tries to direct more financies to traslators in hospitals.
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