Understanding the Hmong’s political history with the United States is important because it is very reflective of how the Lee family experienced the US. The Lee’s distrust of the American medical system stems from a deep betrayal of the American government: the U.S. pulled out of Vietnam, despite promises of protection to the Hmong people who fought on the side of the Americans. The withdrawal of troops resulted in mass killings of Hmong people which forced them to leave their homeland to seek refuge. Many believed that by leaving their homeland and reestablishing themselves in the U.S. they could provide more stability in their cultural beliefs (Fadiman, 1997). The idea of America as a “cultural melting pot” seems far from reality as we track the Lee’s existence. Dealing with America’s medical system proved almost as frustrating as it was to read. The biomedicine of the west paid no cultural respect to the Lee family as they struggled with their daughter, Lia, and her diagnosis of severe epilepsy.
Thinking of the Hmong political history, it is easy to empathize with the Lee’s hesitance to trust their doctors. After experiencing a genocidal tragedy that stemmed from an unfulfilled promise of security, coupled with the sheer culture shock that the Hmong people experienced after moving to the U.S., must have created an even greater divide between the two societies. The Hmong people left behind their home, which was rooted in such deep tradition, and lost much of what they left. The dispute between Lia’s family and their doctor’s treatments was simply the “icing on the cake”. This book was truly about cultural understanding and learning how to “walk a mile” in another shoes.
In chapter 18 of Anne Fadiman’s book (The Spirit Catches You and You Fall Down) there is a wonderful passage that describes the anthropology of biomedical doctors, and how they become so separated from their human “subjects”. It goes into detail about the high demand of their job, which places such a large emphasis on not letting people die, that they dissociate to escape from becoming “overwhelmed by their chronic exposure to suffering and despair” (Fadiman, 1997). I found this similar to compassion fatigue that is experienced by many social work colleagues. They get into the business because they care so much about helping people, but they realize so fast that there is so much trauma in the world that they become almost desensitized from the horrors they intercept daily. According to a study in a Secondary Traumatic Stress journal, compassion fatigue is a large problem facing the U.S. and must be dealt with by therapeutic interventions that assist the professionals by helping them understand their feelings and allowing them to talk about their experiences. This “burnout” experienced by many health professionals could be a factor in the cultural discrepancies that happen between doctors and patients much like that of the Lee family (Figley, 1995). Educating our professionals to become more culturally aware and tolerant is important. Fighting for policies that encourage an open and equal, trusting relationship between patients and doctors is important. However, to improve our medical field I believe that equipping our medical professionals with necessary therapies to help reduce the impact compassion fatigue could have on their practice would be widely beneficial to the whole medical field.
- Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Straus, and Giroux, 1997.
- Figley, Charles R., and Hudnall B. Stamm, Ed. “Compassion Fatigue: Toward a New Understanding of the Costs of Caring.” American Psychological Association. Secondary Traumatic Stress: Self-care Issues for Clinicians, Researchers, and Educators, 1995.