W6: Lia’s Upheaval of Western Medicine

Some revolutions are triggered by a single person. Lia Lee’s story did just that. Throughout their lives, the Lees unknowingly metamorphosed many people’s views of healing, culture, authority and the American medical model.

By learning of the Hmong’s long and detailed history- full of pride, eviction, tenacity and eventually forced assimilation- it is blatantly obvious why the Lee’s possessed the attitudes that were shown in The Spirit Catches You. These people were repeatedly forced from one land to another; in the book, Fadiman makes the observation that they are a people who would rather die or flee than have to assimilate. However, because of the unfortunate events of the Vietnam war, and the “Quiet war” in Laos, they were forced to do just that. These people could not have felt more out of their element. In “The Split Horn”, a young girl shares her view of her family’s refugee status, and states that her parents weren’t even aware if they were allowed to practice their own religion in this new, exotic country. (2013) When your world is turned completely upside-down,and you’re unsure what is now considered right and what is wrong, the obvious choice is to continue to teach and act the way you always have, albeit secretly, if needed.

Therefore it is only natural that the Lees would try to use their known methods of healing, while simultaneously tailoring western medicine around their own needs. They wanted to use the techniques their ancestors had known to be helpful, but also out of fear of consequence feigned compliance with the doctors who they reluctantly accepted help from. The Lees were compromising everything they had ever known, in an attempt to be cooperative without sacrificing their individual pride, and rich, beautiful culture. Naturally, they were angry when the American doctors did not do the same in return. Most of Lia’s physicians did not take the wishes and beliefs of the family as seriously as they should have. Some scoffed at these Hmong methods they had been taught were medieval, and some even allowed their own frustrations towards the family they seen as delinquents to manifest in a way that negatively impacted the Lee’s medical experience as a whole. Because of all of these factors (cultural/language barriers, arbitrary frustration or distrust, etc.) western medicine failed this family.

The part I find the saddest is how easily many of the problems could have been avoided with a bit of sympathy, empathy and education. Although neither side, western doctors or Hmong patients, are fully to blame I can’t help but be much more angry with the Americans. I must give credit for the attempts to find interpreters when they were easily accessible, and making Lia’s health regimen as simple as possible so as not to confuse the parents. However, they did not put forth the same amount of effort into understanding the Hmong’s beliefs, as the Hmong put into understanding the American ways. I believe this case could have been handled more effectively if the doctors made exceptions to what methods they regularly enforced. From my perspective, the Hmong did not ask to be taken away from home after fighting a war and thrown into America- therefore they should not have been treated as the American patients who were raised to take a doctor’s advice as law. Additionally, because these people were such a special case, there should have been special care to respect Hmong healing. More research into culture could have made a huge difference on Lia’s health, as well as the psychological health of her parents, which is equally important to physical health.

I found an article by a med student, Aradhya Nigam, who is the son of non-American parents and a doctor. His thoughts on The Spirit Catches You gives a very unique and well educated perspective. Nigam’s article can be summarized by one quote: “A patient-centered approach requires more than a discussion of patient-physician relations. In Lia’s case, the Merced doctors struggled working with the Lees’ cultural interventions and their mistrust of Western medicine. The Lees distrusted Lia’s anti-epileptic medication, but trusted animal sacrifice to help Lia. Although I am hesitant towards such extreme traditional interventions, I believe accommodating a patient’s culture and beliefs yields positive influences on his or her overall welfare and care, granted it does not interfere with medical treatment.” (Nigam 2014) This view could have made an immense difference in Lia’s case. As a more drastic measure, perhaps we should require every financially able hospital to employ a medical anthropologists for families such as the Lees.

Aradhya Nigam, “The Making of a Silver Lining in Epilepsy”, In-Training, Stories from Tomorrow’s Physicians (2014)

3 thoughts on “W6: Lia’s Upheaval of Western Medicine

  1. Hi Amanda!
    I thought you did a really nice job on your post! I also found the saddest part of the whole story was how easy many of the problems could have been avoided. Both the parents and the doctors were very uncompromising. They both thought they were right and the other was wrong and science clashed with culture. I also have to agree that while neither the parents nor doctors were fully in the wrong, I also blamed the Americans. The Hmong were thrown into a country hundreds of years ahead of the country they came from and had no idea what they were allowed to do. The Americans know how the healthcare system works and should have tried to understand the Hmong beliefs and how their healthcare system works. The Hmong were forced to leave their country or they would have been killed and they did not ask to be thrown into an entire new culture, therefore they should be able to keep their views on healthcare. I think that when it comes to immigrant healthcare, both sides need to be willing to compromise a little and instead of a clash between science and culture, it should be a combination of the two.

  2. Hi Amanda! I really enjoyed reading your post this week. I think we agreed on a lot of the same issues surrounding the effect of the Hmong people’s past. I, like you, understand why the Hmong people could have been un-trusting towards the United States and our way of doing things, specifically the Western medicine aspect of our lifestyle. Learning about the Hmong people’s hard past within the Vietnam war and the war in Laos, completely explains the struggles that they have been through and why they are so adamant on using their own methods of healing, over the treatment within Western medicine. I thought it was smart of you to also include the fact that Fadiman noted that the Hmong people are a people who would rather die or flee than to have to assimilate. This is also a great explanation as to why the Hmong people made their trip to the United States and why they are having trouble letting go of their own medicine and healing processes and adjusting to the Western medicine. I also watched “The Split Horn” and thought it to be interesting, almost like a parallel story to the experiences that the Lee family went through. Adjusting to life in a new country can be hard on many different cultures so it was interesting to see it occur with another refugee family, along with the Lee family.

  3. I agree with you that the American doctors probably should have made more of an effort to try to understand the Lee families culture, rather than being dismissive of it. However, I also slightly disagree. I don’t think doctors should be obligated to understand the Hmong’s beliefs. My thinkings is that if a doctor tries to treat a patient in a way they don’t approve of or the patients family wants to preform some traditional ritual, then a doctor should make a reasonable attempt to accommodate them upon request, so long as it doesn’t harm the patient. However, it is not their obligation from the start to understand their beliefs, doctors already have to know more information than most other professions, forcing them to study others cultures is a waste of time. Also even though the Hmong did not ask to be here, there isn’t a law that is forcing them here. So if they are unwilling to assimilate then they are free to leave and go where they feel more comfortable. Like I mentioned earlier, obviously doctors should being willing to make reasonable accommodations, but I also think many problems with immigrant and refugee health stem from them not willing to assimilate. My article showed also confirmed that lack of assimilation was a significant factor.

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