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.
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I agree with you that the situation could have been handled better, but how could the doctors have really understood the Lees? The hospital needed funds specifically for translators and "cultural brokers" which they simply didn't have. From the beginning, they were on a path of miscommunication which was difficult to fix.
Not to gang up on you or anything, Nikita, but I feel that Hadas has brought up a valid point. While I wish to place the doctors with more fault than Lia's parents, I would be unfair if I did so. Doctors at hospitals, especially those at a place like MCMC where funding is low, are stressed out and cannot deal with everything with a calm mind. Their wish to get everything done in a timely manner and help out as many people as possible make them act in a way that would seem to compromise the identity of the patient. Yes, doctors could have tried to negotiate around the cultural barrier and perhaps may have given Lia a better life than she had, but doctors are not machines that can run at full capacity all the time. Doctors are humans that have limits. There is an ease to applying the same procedure to everyone no matter who. Those who do not follow the formula are dumb and should be force3d, one way or another, to do something that is good for their health. This sort of thinking would dominate in the mind of a doctor who has just gotten out of medical school and wishes to apply the knowledge he has learned to the world. Also, doctors who have not experienced varying patient backgrounds may not understand what a cultural barrier is in the patient-doctor sense. Things could have gone better for both parties had both been more knowledgeable, but I feel that America has learned its lesson from events such as Lia's and we students have been exposed to something to make us more aware. It is a step in the right direction that can potentially save more lives in the future.
I mentioned at the bottom the idea about the pace of medicine. I understand that doctors can't handle every little subtlety and problem that gets thrown at them.
I think one of the problems with the book, in general, is that Fadiman presents a sort of biased view against the doctors and favors the Lees as helpless victims. While she mentions a more clear stance on the subject a couple times, she seems to generally present the American medical system, the individuals included, as impersonal and narrow minded.
I want to say that doctors in general are one of the busiest people in out society and they also have the most responsible work-to save person's life. But my point of view is that even though they should be more aware not only for people's physical health, but also for their mental health. Every patient deserves the right to be hear out and understand. I know that it is too expensive for hospitals to pay for translators, but they have to choose which one is more important for their patients-to be comprehend or to make them feel uncomfortable in their situation.
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