Stress and the Clash of Cultures

Refugees from Laos began immigrating to the United States in the 1970’s. Since then, over 100,000 Hmong have settled in the United States. Many came because they felt they had no other option. They could not return to their homes in Laos because they faced persecution, and they had to leave the refugee camps in Thailand due to closure. Anne Fadiman’s book, The Spirit Catches You and You Fall Down, explores a Hmong family, American health care, and the disastrous encounters between the two disparate cultures.

Lia Lee, born in 1981, developed symptoms of epilepsy. However, by 1988, Lia was brain dead after years of misunderstanding, over-medication, and culture clash. Fadiman states that what the doctors saw as clinical professionalism, the Lees viewed as arrogance and cold indifference. Additionally, Fadiman shows readers how each party blamed the other for Lia’s illness, yet the assumptions and beliefs that each group brought to the doctor-patient interactions were never explored. American doctors saw Lia’s epilepsy as a neurological abnormality, but the Lees perceived Lia’s illness as a loss of her soul. They believed only appeasement of the lost soul and the restoration of spiritual order would cure their daughter.

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Western medicine is considered superior to other medical systems in the world, and because of this fact, other beliefs about causation, diagnosis and treatment of disease are disregarded and/or denigrated. Lia’s mother, Foua, explains her daughter’s illness and the desire for American doctors to understand their point of view:

“Your soul is like your shadow…[s]ometimes it just wanders off like a

butterfly and that is when you are sad and that’s when you get sick, and

if it comes back to you, that is when you are happy and you are well again…

but the doctors don’t believe it. Each group holds their beliefs to be true. If people lose their vital organs after death, their souls cannot

be reborn into new bodies and may take revenge on living relatives;

so autopsies and embalming are also taboo” (Fadiman 33). In the end, everyone lost a little bit of his or her soul. Although, Lia’s parents and her doctors both wanted what was best for Lia, lack of understanding led to tragedy. The hospital norms prevented them from using their customary resources of ritual and healers necessary for coping and helping during the healing process, and they dreaded the use of prescribed treatments.

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**Bibliography**

Fadiman, Anne. The inability to discuss their beliefs about illness and expectations regarding treatment leads to frustration and poor adherence to treatment plans.

“Most Hmong believe that the body contains a finite amount of

blood that it is unable to replenish, so repeated blood sampling,

especially from small children, may be fatal. In reflection, a doctor describes the gap as a “layer of saran wrap or something between us…we were reaching and reaching…but we couldn’t touch them.

American health care professionals focus on the disease rather than illness, and concentrate only on the individual and not on the individual as part of a much wider social environment.

Approximate Word count = 1347
Approximate Pages = 5 (250 words per page double spaced)

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