Importance of Inter Cultural Communication in the Medical Profession

Importance of Inter Cultural Communication in the Medical Profession.
The Spirit Catches You and You Fall Down is a book by Anne Fadiman that highlights the tale of a Hmong kid, Lia Lee with epilepsy, whose tragic demise unfolds the unfortunate results of lack of inter-communication in the medical field. Cultural and Ethnic Studies is a discipline that if embraced can eliminate many barriers across all professions regarding different cultural beliefs and affiliations. Despite the fact that the medical profession has grown to the advanced stage, physicians need to be well conversant with various beliefs of different people to facilitate efficacy in service delivery. The importance of intercultural communication in the medical profession is emphasized in this paper.
Lia Lee had her first seizure at the age of around three months when a door got slammed by her older sister Yer. According to the Hmong ethnic group, her parents had the feeling that her soul departed as a result of the noise produced by the door (Fadiman, 1997). ‘Qaug dab peg’ is what her parents diagnosed the disease to be, meaning “the spirit catches you and you fall down.” The act by Lia’s parents to seek a medical intervention to her situation at Merced Community Medical Center (MCMC) shows that despite being culture-oriented, they also believed in modern medical practices intervention. However, her parents also relied on traditional methods of healing such as engaging Neeb to call back Lia’s soul.
Due to lack of interpreters in the medical facility, Lia’s condition was misdiagnosed.

The miscommunication barrier complicated Lia’s medical regime since her parents were either unwilling to follow the instructions of the doctor, or unable to do so, or both. Lia’s medical condition worsened to the point of showing mental retardation (Fadiman, 1997). From the above summations, it is evident that the author’s point is that Lia’s condition could have been correctly diagnosed and successively managed had there been a proper communication link between the doctors and the Hmong ethnic group. The author shows the fallouts in western medical care when it comes to attending to patients whose beliefs differ to those of the western doctors.
The Hmong Lee family faced health issues mainly due to strong cultural beliefs by the Hmong ethnic group at large as well as the lack of proper communication link between the Hmong people and the western doctors. The doctors diagnosed Lia with epilepsies while her family believed that her soul had departed from her because of the noise of a slammed door. The Hmong taboo against the western medical procedures resulted in their lack of compliance to doctors instructions. For instance, they believed that taking one’s blood on a frequent basis can be fatal since according to them the body only contains a finite amount of blood.
Having originated from China, the Hmong finally settled in the United States of America (USA) where they endured tragedies such as violence and high rates of unemployment. Their adaptation to the United States was faced with difficulties because of their high cultural beliefs. According to Fadiman (1997), their strong cultural beliefs dictated their feelings toward western health care and health care providers. The fact that the Hmong took taboo against most western medical procedures; western doctors did not have an easy time with their Hmong patients.
The Hmong people have fought many different people claiming sovereignty over their land for more than a century. A foreign government over the land of the Hmong people could mean the imposition of new practices to the Hmong people regarding their culture. The Hmong people were defiant to such a change and rather stepped out to protect and strengthen their culture. This engagement caused a greater unity among the Hmong people an aspect which enhanced their cultural beliefs. In the era of the Vietnam War, the Hmong people got recruited by the Central Intelligence Agency (CIA) to fight against communist forces in Laos. To escape persecution, the Hmong fled their homes after the United States withdrew its support from the fight. The majority of the Hmong people eventually relocated to the United States, where they went through slander, violence, and hardly got employed.
It was unfortunate that the Lees’ were reluctant to give Lia her medicine as instructed by the doctor. Because of great cultural beliefs, the Lees’ felt that the situation of Lia had some spiritual giftedness, a fact that led to the compromise of doctor’s prescriptions against Lia’s medication. This aspect only worsened Lia’s condition. One would wish that the family of Lia complied with doctors orders and for once overlook their beliefs to help in improving her condition (Fadiman, 1997). What the parents of Lia did not want to take away from her is spiritual giftedness that they believed her situation showed a sense.
The health care providers saw Lees’ family as one that needed help. The primary physicians of Lia, Peggy Philp, and Neil Ernst provided the highest level of medical care they could provide to her. The doctors were willing to assist Lia regardless of her cultural and ethnic affiliations, only that they misdiagnosed her condition mainly because of lack of an interpreter. The American doctors, however, did not understand the remedies of the Hmong practices relied upon by the Lee family. Lia’s primary physicians had her separated from her family after noticing her worsening condition and handed her into the care of a foster home for one year. This action caused friction with her parents. Peggy and Neil knew little about the culture of the Hmong yet did not ask about the beliefs of the Lees concerning Lia’s condition (Fadiman, 1997).
Shee Yee is a hero of the greatest folk tales of the Hmong. Shee Yee shape-shifted into various forms thus escaping nine evil dab brothers eventually biting a dab in the testicles. Shee Yee is presented as a symbol of the Hmong people by the author at the end of chapter twelve. His character is that of a bright person as he can fight and escape rather than to submit or surrender to oppressive forces or power. In Thailand, many Hmong refugees just like Shee Yee fled to a Buddhist monastery near Bangkok whenever pressured to either immigrate to the United States or return to Laos. The Hmong culture is reflected intelligent and resourceful culture by the Shee Yee folktale (Fadiman, 1997).
txiv neeb (Shaman) understood as ‘the father or master of spirits’ is the core of the Hmong culture. Hmong cosmologists believe that human body hosts several souls. Diseases, depression or even death can result in the event of separation of a soul from the human body (“Mary Elise believes,” 2002). ‘soul-calling’ rituals have to be performed to restore back the soul and thus bring back the integrity of life. An average American doctor can learn to appreciate other people’s culture such as the txiv neeb believes by the Hmong people. A Hmong can as well learn to understand the medical practices by the American doctors which are based on scientific facts rather than mere believes (Fadiman, 1997).
Lia’s foster parents were so caring and provided the best medical care to her as they possibly could. They had much affection for Lia. Foua and Nao Kao, who are Lia’s parents had the belief that Lia’s medical condition was of spiritual origin which required spiritual approach. This theory put Lia’s parents at odd with her doctors.
Jeanine Hilt, the only American who fully won Lees’ trust was the Child Protective Services (CPS) caseworker assigned to Lia during her stay in the foster home. Jeanine volunteered to educate Foua and Nao Kao on how to measure and administer Lia’s medication for Lia to be allowed to return home. Jeanine was also the only American who sought to know Lees’ knowledge about Lia’s illness and the approaches they took to remedy the situation. This close relationship earned Jeanine full trust from the Lees’ (Fadiman, 1997).
Lia Lee is a person of value despite her situation as she facilitates the demonstration of the need of American medical world to re-evaluate Inter-Cultural Communication in the Medical Profession. Through Lia’s life, many lessons can be learned from both sides; the Hmong and the American doctors. American doctors can learn about the Hmong cultural practices as well as beliefs while the Hmong people can learn about the American medical practices (“Mary Elise believes,” 2002). Through Lia’s life, the author is also able to point out the disadvantage of holding too much traditional and cultural belief when it comes to matters medical attention. The Lees’ compromise on doctors’ prescriptions as they believed it would take away the spiritual giftedness of their daughter.
Lia Lee is a legend. The life of Lia Lee teaches that life is full of struggles and one should face the challenges of life till the end. Lia spends most of her days practically on the patients’ bed in her quest to attain freedom from the yokes of epilepsies. Her parents, though, limited by their strong cultural beliefs takes a step of taking Lia to the hospital, a sign that they had hope in the situation of their daughter. In the same way, people need to be hopeful in all their life endeavors.
The Spirit Catches You and You Fall Down book is influential as it has demonstrated the importance of having inter-cultural communications in fields such as the medical field. The outcomes of patients from different cultures can be improved by acknowledging their belief systems (“Mary Elise believes,” 2002). Cross-cultural programs can be helpful in improving intercultural communications. An example in which cross-cultural program has been successful is one in which working of shamans alongside western healthcare providers is encouraged.
Acknowledging other people cultural believe can harmonize the delivery of services in many fields including the medical field. Intercultural communication can be achieved by organizing cross-cultural programs where different communities can learn and appreciate other cultures and believes. It is recommended that medical set ups should embrace the practice of learning different cultures for easy handling of patients. The life of Lia, however, teaches how one should never give up in life but instead endure challenges.
References
Fadiman, A. (1997). The spirit catches you and you fall down. New York: Farrar, Straus, and Giroux.
Mary Elise believes. (2002). JAMA, 287(1), 14. http://dx.doi.org/10.1001/jama.287.1.14