Everyone has a different understanding of health care, of medicine and of the body. This is because everyone has a unique history and have lived different lives. For example I have had a nephew with spina bifida, a father with an aortic aneurism and a stepfather with cancer. For me each of these things had one thing in common – western medicine, sets of treatments and plans that have given excellent prognosis. Because of these moments I believe in western medicine, but that is my history I have been raised believing in American Doctors, trusting them. The Lee’s very much did not have the same upbringing, their history differs from mine and from a lot of the citizens raised in America( or other Western Worlds). The Lee’s, prior to their refugee time, did not have western medicine but trusted in a more spiritual type of practice. For me one of a bigger differences, which was mentioned in lecture, was views of death in western medicine death is failure, and we do everything to prevent it- for the Lee’s it is a journey they must prepare for. Even the differences between seizures vs. spirits. Everything between the two cultures is a dichotomy. And because when they came here and sought out medical attention, like many dichotomies, there was one ‘right’ way and one ‘wrong’ way of treating to each of the parties. It is no wonder the Lee’s were hesitant with all the drugs, it is not their history. Rather than physicians (metaphorically, and somewhat literally) pushing pills in their face, if they wanted the Lee’s to follow their recommendations they needed to understand where their hesitations came from. In this case a lot of it had to to with their involvement in the proxy war, in the refugee camps. In chapter 17 of Fadiman’s book, psychiatrist and medical anthropologist Arthur Kleinam discussed that a mediator is needed in these situations, which I agree with. Mediators allow for both parties to feel heard, and understand. Which means more “compliance” which was so often used in the Lee’s story. But when I use compliance I mean compliance on both sides, the physicians as well will be more compliant with the Lee’s wishes.
I would also like to add this should also extend to anyone reading about the Lee’s story and their American medical experience they should be aware of their past. Que the term ” Don’t judge a book by it’s cover” well in order to understand someones( the Lee’s) decisions understanding where their decisions are rooted is essential.
To further answer the second question in the prompt I am not sure if it would be easier to target a better way to treat refugee treatment specifically or to rather educate physicians as a whole to be more understanding. For example if you look at the medical school curriculum at Stanford Medical school from years one through 4 it is; genetics, microbiology, renal system, hematology etc. etc. Which of course is beyond important but I think a step forward would be courses in world medical practices. Not for the goal of practicing such techniques but to learn they exist and what they stand for. Physicians should be more equipped in understanding diverse cultures( especially since America is such a diverse community). For example in lecture it was discussed a physician who had no idea why he was so liked within the Hmong community( which turned out to be because he did not cut). Any way if he had some understanding of other cultures maybe he would be aware of why and be even more eager and willing to continue his lack of cutting, or inform other physicians.
In general in needs to be less of a dichotomy, not a you vs us(or U.S.) the medical field needs to be more understanding of cultural differences, willing to somewhat compromise and more interested in the history of its patients rather than the problem at hand. Which is a point I have made in previous blog posts- the chart of a patient does not have all the information.
“SOM Curriculum Schematic” Stanford Medical School, accessed August 10, 2016. http://med.stanford.edu/content/dam/sm/md/images/SOM%20Curriculum%20Schematic%202015-16_Page_1.jpg
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. Anthropology 370. MSU. Web. 10 Aug. 2016.
Gabriel, Cynthia. “The Spirit Catches You and You Fall Down.” Presentation for the course ANP 370: Culture, Health, and Illness, 2016.