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.
5 comments:
I made a similar connection in terms of the melting pot idea. Growing up, we are taught to learn that America's melting pot is great and awesome. In terms of the Hmong, this is not the case. By scattering them throughout the country and breaking them apart, we are expecting them to betray their cultural identity.
I like the relation you make to the power of the medical authority. It's scary to think that someone could have power over your body just by signing a note saying that something is wrong with you. Especially in terms of marginalization, this type of authority over minority groups makes the victims almost powerless to stop them. The idea of medical pluralism seems to take away from that authority by stating that there is no one possible way to approach medicine and healing.
As a First Year (Direct Practice, Master's of Social Work) student at Arizona State University, Tucson, AZ Fadiman's book was a required reading for our take home midterm, for our Diversity & Oppression class. What a fabulous book. "The Spirit Catches You" should be read by all health professionals and social workers. Outstanding book.
While I agree that there are hegemonic elements, it is important to note--as Fadiman herself does--that without biomedicine, Lia probably would have died. I say that not to justify the doctors' decisions, but rather to highlight that without their treatment, Lia would have had no future. Perhaps conjoint treatment would have been better, and Fadiman makes a great case for cross-cultural medicine, but the reality of Lia's case still required some reliance on biomedicine.
I really enjoyed reading this book which was both a well written story and a insightful glimpse into the Hmong culture. And whilst I feel a great deal of sympathy for what Lia and the greater Hmong community had to endure in a foreign land such as the U.S., I also think it would too simple an answer to place all the blame on the Western government (or mentality) for their sufferings. After all, migration and resettling(or exodus, which ever you want to call it) is a complicated and difficult process. I can appreciate that the Hmong people wanted to retain their cultural identity, but at the same time, they cannot expect everyone else to reshape infrastructure, government policy or indeed, the Western culture to accommodate them...
To the previous comment about reshaping and restructuring government to accommodate the Hmong, I believe it is more about having a voice-to be able to have some control or input over decisions that affect them. The resonating idea is that it is misunderstandings from both parties involved and not just one or the other. As for the Hmong refugee status, they are just another casualty of warfare and all of it's baggage. War doesn't have eyes.
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