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.