“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.