W6: Foreign Lands and Foreign Germs

America has always been referred to as “the land of freedom,” where all your dreams can come true. Of course the debate this week has brought on is, is America only ideal if you go after the AMERICAN dream? The experience of the Lee family within America’s biomedical system is a prime example of this. Additionally, the Split Horn video showed the struggle of the Hmong culture to stay alive when the next generation is also brought up by American traditions. Both the book and the movie show the struggle and the loss that the Hmong culture faced (and still do) when the war in Laos destroyed their home and displaced their lives. They were thrown into refugee camps in which their identities were blurred with the other survivors, and forced to live a life that wasn’t theirs. Eventually, the only thing one can depend on is oneself, their family and their culture. So then, once the Lees and the Thoas make it to their new homes, their culture is all they can identify with in a foreign land. It is the only thing that still ties them to their original home. Therefore, in a land that is supposedly free, there should be no reason for them to not practice their culture, even in medical emergencies.

Further, before any immigrants can come into the country, they must undergo a physical exam to clear for deadly diseases such as tuberculosis, diphtheria, leprosy, etc. Our readings this week mentioned how the doctors are not very thorough in the examination, in which for leprosy they just check the skin, and blood work is taken for HIV testing (Fadiman). Personally, I think that a full work up should be done on incoming citizens so that they understand their health going into new territory. It’s common knowledge that people from different geographical areas can run into health issues when they move to somewhere else, and are not immune to the new country’s “germs” as they are to the people that they grew up with. Additionally, the way of life could be very different. For instance, in Laos there is a lot more physical labor that goes into daily life, like working in the rice fields and maintaining their animals, than there is in urban life where the only land that you have is your home and maybe a patch of grass. This can cause an increase in occurrences of high blood pressure and fat formation around the abdomen that we see with Paja Thoas.

Although Lia Lee did not contract Pseudomonas aeruginosa by entering the country (her doctors did not find her septic in any of her previous visits), I decided to look into the pathogenesis of this bacterium to see where it comes from, how common it is in the United States, and how often does it cause health complications. P. aeruginosa is an opportunistic pathogen, originating from soil and other warm and moist environments, that infects its hosts when their immune system is usually already compromised; it can cause an array of subsequent complications for the host, usually leading to mortality. It is easily mutated, making it hard to treat with antibiotics because of its resistance. Additionally, the body’s response to this pathogen usually results in severe tissue damage from inflammation. Further, most P. aeruginosa infections are nosocomial (Gellatly, Hancock). This means that Lia could have easily gotten an infection from one of her many clinical visits, between all of her medicine injections or IVs to droplets from a contaminated sterile field. It’s saddening how easily nosocomial infections could be prevented with proper sterile technique, however Lia’s immune system was so suppressed from her Depakene medication that she had a very high chance of contracting something during her visits. It’s not certain if Lia Lee would have still had her grand mal seizure had certain drugs not have been prescribed, and therefore allowed for the opportunity of infection (Taylor).


Gellatly, Shaan L., and Robert E. Hancock. “Pseudomonas aeruginosa: new insights into pathogenesis and host defenses.” In Pathogens and Disease, edited by Patrik Bavoil, N.p.: FEMS, 2013. http://femspd.oxfordjournals.org/content/femspd/67/3/159.full.pdf.


Taylor, Janelle S. 2003. “The Story Catches You and You Fall Down: Tragedy, Ethnography, and ‘Cultural Competence’“. Medical Anthropology Quarterly, Vol. 17, No. 2, pp. 159-180.
Fadiman, Anne. 1998. The spirit catches you and you fall down :a Hmong child, her American doctors, and the collision of two cultures New York : Noonday Press.

3 thoughts on “W6: Foreign Lands and Foreign Germs

  1. Hi Mace, I like your post because it parallels my thoughts after going through a few weeks of this class. I am concerned that our country has just become “all talk.” We talk about the American Dream like it is something worth striving for, but I worry that our country is too absorbed in the American way, as if there are no other “ways” out there. Our healthcare system and the inequalities that follow it are a prime example. I feel embarrassed about what has happened to the Hmong people in their own land and I empathize even more with them that they struggle to keep their own dream, their own culture, alive in America after they were forced in. I come from a family of Greek, Italian and Mexican heritage and when my uncle decided to marry a German in the midst of World War II, I found it difficult to understand why there was such uproar in my family. I questioned the uproar again when my grandpa, originally from Mexico, decided to marry an Irish woman. There was a lot of clashing of cultures, and while I knew that my great grandparents got angry about these situations because it was not something they were used to, I never understood fully why it mattered so much. Then I watched the Split Horn video and it became crystal clear; much like the Hmong father who was so close with his culture, my great grandparents were close with their culture, as it is all that they know. All of a sudden, everything is shifting beneath them in this new culture and they are struggling to keep their own culture alive under the weight of the new American culture. You are correct when you say that they are being immersed in a culture that is not their own, and therefore, all they can rely on is each other and their own traditions.

  2. Hi, Your post was extremely interesting to read and really made me think. I thought it was interesting, and absolutely correct that you stated America is only the land of the free if switch your lifestyle and completely left everything you’ve known behind. As we saw in the video, the Hmong families came to America and attempted to keep their culture going, yet they continued to lose followers, even family members. I never really realized how difficult it may be to keep a culture alive when you come to America, especially when there may or may not be a lot of people apart of the same culture as them. I think it is extremely smart that you stated we should reacquire full health scans before entering America. Not only does it help the immigrants, but it also could prevent a lot of illness from traveling back to the united states. As we learned last week, Ebola entered America, and it may or may not have happened if there was a mandatory check up for each person coming to America. I think this should be mandatory not only for coming to the United States, but it should be required no matter which country people are traveling to.

  3. Hi Mace,
    I like how you made the point of people come to America seeking the American dream only to find out that it is less stellar than they had imagined. A lot of this does have to do with the healthcare system because it seems like this is where religion is suppressed the most and one would think this is where it is observed the most. I think religion should be respected most in the healthcare field because what do people do when a loved one is sick, dying or having surgery? They pray for a better out come. Hospitals probably see more religion practiced than a church does. You also mentioned how people should receive a full workup of a medical examination before they enter the US. This could be very beneficial to the immigrants because through this doctors could recommend the best areas for them to live. We could also try to place refugees in areas where they would feel most at home and where their culture would be widely accepted and try to get doctors in their area to understand their religion and cultural beliefs. Your suggestions for helping refugees sound like they would be very beneficial and help create the good American dream again.

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