Cultural Reading

August 6th

I mentioned earlier I’ve been reading “The Spirit Catches You and You Fall Down.” What an incredible read. I am enthralled in part because I’m now working with refugees. These excerpts capture the nature of this excellent book and the cultural chasm it describes. Again, the story en sum is about a Hmong refugee family with an infant daughter (Lia Lee) who has epilepsy and the American medical system that tries to treat her for this illness. The conflict lies in the fact the family doesn’t consider epilepsy a sickness, but instead a blessing.

When interviewing one of Lia’s doctors after the fact:
Then I asked, “Do you wish you had never met Lia?”
“Oh no, no no!” His vehemence surprised me. “Once I might have said yes, but not in retrospect. Lia taught me that when there is a very dense cultural barrier, you do the best you can, and if something happens despite that, you have to be satisfied with little successes instead of total successes. You have to give up total control. That is very hard for me, but I do try. I think Lia made me into a less rigid person.”

In response to Lia’s family’s response to her disease progression that it was the medical system, not the epilepsy that made their daughter suffer:

“It was also true that if the Lees were still in Laos, Lia would probably have died before she was out of her infancy, from a prolonged bout of untreated status epilepticus. American medicine had both preserved her life and compromised it. I was unsure which had hurt her family more.”

When consulting a medical expert, who wasn’t involved in her treatment, about her case:
“I told him what had happened later — the Lees’ noncompliance with Lia’s anticonvulsant regimen, the foster home, the neurological catastrophe — and asked him if he had any retroactive suggestions for her pediatricians.
“I have three,’ he said briskly. “First, get rid of the term, ‘compliance.’ It’s a lousy term. it implies moral hegemony. you don’t want a command from a general, you want a colloquy. Second, instead of looking at a model of coercion, look at a model of mediation. Go find a member of the Hmong community, or go find a medical anthropologist, who can help you negotiate. Remember that a stance of mediation, like a divorce proceeding, requires compromise on both sides. Decide what’s critical and be willing to compromise on everything else. Third, you need to understand that as powerful an influence as the culture of the Hmong patient and her family is on this case, the culture of biomedicine is equally powerful. If you can’t see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else’s culture?”

Excellent read, four out of five bananas absoloodle.

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7 Responses

  1. The Spirit Catches You… is a touchstone book for me; I’m so glad you liked it. I loved Anne Fadiman’s first collection of essays, too (Ex Libris).

  2. This sounds really good! There are so many cultural issues that I as an American think are just WRONG, rather than seeing them in their cultural context. Like right now I’m grappling with the concept of “stealing” versus “taking what you need” here in Mozambique. It would be nice to read something that objectively shows both sides . . .

  3. Yup, good stuff. Sure gets one out of one’s “my way or the highway” rut, doesn’t it? 🙂 We really do all have to work together in this world. Admitting that Western ways are not the *only* and/or *best* wisdom is a good first step.

  4. this is fascinating kelli! thank you for the great review!

  5. Interesting! And, btw, you are a speedy reader (or never sleep!). ~D

  6. Oh, I’m always excited to hear that people are reading this book! I work with Hmong refugees, and their teenage children, every day. It’s the most rewarding work I’ve done yet — take THAT, peace corps!


  7. I just finished her other book, Ex Libris, and I really, really enjoyed it..This sounds like an interesting one, too..I learned about the Hmong when I took anthropology a couple of years ago..