Thursday, March 20, 2008

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.

2 comments:

Alice said...

When I attended Anne Fadiman's lecture, she emphasized the point made in Claire's post about finding a medium. Fadiman said she spent hours in the car with May in order to fully understand the Lee's way of life, their actions and as well as Hmong traditions. When the Lee's acknowledged that Fadiman was making a clear effort to understand their culture rather than make them change their ways, they were much more willing to communicate through the cultural broker their beliefs and thoughts about their current situation. I think that Fadiman acts as an important role model for those involved in the medical community. It is important to understand and respect the cultures of your patients. It is wrong to make their change their beliefs and ways even if it may get in the way of their "Western" healing. Doctors should definitely try to accommodate patients of different cultures and make sure to emphasize to their patients that they respect their culture. Only if patients beliefs are significantly getting in they way of their healing should doctors take steps to overrule their beliefs. And in doing so, doctors should be able to communicate their actions and reasoning to the patients.

Hadas said...

I agree that this situation seems incredibly difficult. The two cultures clash in such a way that communication is about as complicated as it can get. Respect is definitely a key issue. Alice brings up Fadiman as a "role model," I see several characters in this book playing that role (Jeanine, Sukey). Doctors should learn from each other's failures and successes in these situations, and much can be learned from the people who were successful. So I think it is accurate to describe Fadiman as "role model."