I’ve realized that throughout this class I’ve learned so much and have reconstructed my views that I had once stood firm. Before this class, I would almost never question biomedicine. I believed that, if practiced “correctly,” it would ideally yield the best result with the patient’s health and wellness as main priority. I realize now how flawed Western medicine practice can be: by how it shortchanges the patient if communication is not effective and treatment is not a collaborative effort on behalf of the doctor and the patient/family; also by the fact that people put too much faith in healthcare workers.
Our readings really opened my eyes to the cultural and explanatory model crises that happen in this country and all over the world. Every week the readings built on one another, such as Arthur Kleinman’s article about care for the chronically ill. He highlighted how much doctor’s should rely on their patients for thorough information of their illness, because “their discourse will lead [the physicians] to the diagnosis of the disease”(130). A major concern is that Western doctors (and government) have a bias that their practice of medicine is always best fit for patients. We’ve seen that this isn’t always the case, with the video from week 4 about Inuit birth. Evacuation policy mandated that Inuit mothers be transferred to Canadian hospitals rather than giving birth in their huts. Later on, evidence showed that non-complicated at home births posed no greater danger than the southern Canadian hospitals. Ultimately it was a waste of money for flying down mothers and it interfered with the birthing traditions that the Inuit had held for centuries.
Further, the problem that practitioners don’t work with their patients or their family for treatment was shown in the book The Spirit Catches You and You Fall Down. The diagnosis of her epilepsy was obvious for Lia Lee, but the communication of what the family wanted as an outcome from her treatment and how they should go about medicating her was completely absent in the book. The doctors, following their Western belief that every disease is strictly chemical and forgetting to truly consider that Lia was more than “just her seizures,” (271) overlooked her sepsis and forced her family to push aside their cultural beliefs on illness when sending them home with multiple kinds of Western medication. As physicians, they should have considered what the family would have wanted and should have tried to accommodate the Hmong culture as a way to build trust and understanding between doctor and patient. The failure to do so resulted in a loss of trust from a family and the Hmong community.
From an outsider’s perspective, this class has shown that we as patients put too much faith in our healthcare providers; we hold them to such a high regard that we don’t question what they say. In my nursing assistant class, we learn that patient care should be taken as a holistic approach, and the patient should be actively involved in their care plan. Being actively involved in their care plan with effective communication from the physician allows the patient to understand what their physical and mental/ emotional needs are along with understanding what they want out of their treatment. It then allows for more effective treatment with a likely outcome of better perceptions of care from the patient (Ha, Longnecker). Taking this into consideration, I now think that I am more critical of diagnoses that I receive, and as I make my way through PA school and on, I realize how important it is to work as a team player, because care really is all about the patient. The movie that I reviewed, Patch Adams, would be a great addition to this class because it tells a story of a man that embodied the “perfect physician,” taking into consideration all of his patients needs and acting as their equal in order to better treat their illnesses.
Fadiman, Anne. The Spirit Catches You And You Fall Down: A Hmong Child, Her American Doctors, And The Collision Of Two Cultures. New York : Noonday Press, 1998.
Ha, Jennifer F., and Nancy Longnecker. Doctor-Patient Communication: A Review. Vol. 10. N.p.: The Ochsner Journal, 2010. http://www.ochsnerjournal.org/doi/pdf/10.1043/TOJ-09-0040.1.
Kleinman, Arthur. Chapter 7 (excerpts) – “Conflicting Explanatory Models in the Care of the Chronically Ill” In The Illness Narratives. pp. 121-122, pp. 128-136
Week 1. “Culture, Health, and Illness: Introduction video,” ANP 370: Culture, Health, and Illness. MSU. Summer 2016
Week 4. “Inuit birth video,” ANP 370: Culture, Health, and Illness. MSU. Summer 2016
Week 7. “Limits of Biomedicine video,” ANP 370: Culture, Health, and Illness. MSU. Summer 2016