Feel free to pull out your favorite quotes, use this forum as a rant and rave, anything goes. I know that some of you have been having some issues using the comments section so here is a quick fix:
- Next to the comments box there is a drop down box - click on that
- Most of you use gmail so click the google version
- If you use/have used blogspot before you can log on with your normal gmail name and password
- If you have not used blogspot you can register (no worries you do not have to start up your own blog)
- You should now be able to log on and start posting
- If you CANNOT get your posts to work, email them to me and I can post them on your behalf!
As I continue to meet people in the field, especially those who work with vulnerable populations one of the big themes that seems to be ever present is cultural compliance; I know as an AmeriCorps member I listened to several speakers during my orientation and we discussed how learning the language of your client is only half of the equation.
I enjoyed that Francesca Farr used the term cultural broker. With this term she looked at the interpreter as an individual. Not only was an understanding of the Hmong language vital, but also, and in some instances, it was important for them to know about the Hmong culture. The integration of indigenous medicine with Western medicine reminded me of the work that is being done at La Clinica del Pueblo in DC. Not only do they have PCPs, they also have pharmacists and staff who are well versed with a variety of cultures from South America. By talking about various traditions and medicines, the PCP can make sure that the patient is getting the best possible care and make sure that the two are not working against each other.
Throughout the book my heart really went out to the family. I could not imagine what it would be like to be dropped in a foreign country, not knowing the language, and having no idea what was going on with my sick child. There was definitely a lack of communication and understanding between the two parties which was having a negative impact on Lia's health. Do I think the parents are totally to blame here with the "non-compliance" of her medical treatment? Absolutely not. If there were more resources and/or an understanding of the importance of their traditional healing methods alternatives could be found.
Another thing that struck me was that one of their daughters was doing a majority of the translating between the family and the doctors/social workers.
"after Jeanine left, Foua and Nao Kao were able to ask May [their daughter], as often as necessary, 'Explain what Jenny said again.'"Unfortunately this is an all too common reality for many families, especially if they have just immigrated.
One of the most profound quotes for me in the book was Neil:
The author asked "Do you wish you had never met Lia?"
"Oh, no, no no. 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 success instead of total success. 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."One last thought is that I HATE the metaphor of a Melting Pot. Back in high school I was on the Forensics Team (think speech and debate NOT dead bodies). During my junior year I was competing in Original Oratory, a category where students write a 10 minute speech on a topic of their choice, memorize it, and deliver it to the other orators in their round. One girl spoke about having parents who immigrated to the US. She told us to picture the metaphor of the US being a melting pot for but a moment. If we were to add all these different cultures or colors and stir them up, they would become a murky color. Instead she asked us to picture a stained glass window, where each culture/person was a color. When all the colors come together they do not make a sludge, but instead make a brilliant design or picture. Each section can be appreciated for its own beauty, and even more so when the whole piece is taken into account. AMAZING!!
A Chagall piece for your viewing pleasure - I think it helps bring the point home
Some questions for the audience:
- How did you feel about the Lees' refusal to give Lia her medicine? Can you understand their motivation? Do you sympathize with it?
- Was taking Lia away from her parents the right decision?
- What were your major themes/takeaways from the book?
1. I can definitely sympathize with the Lees. It must be scary to transition into a completely different system and way of thinking. It is hard because I feel like they loved their daughter so much the way she was and didn't anything was wrong - a beautiful sentiment. If I went somewhere else and they told me that something was wrong with me or my child but I thought she was completely normal, or even special, I would be skeptical about fixing it. What makes one handicapped and one gifted? Why do we not try to fix musical savants or people with (in our culture) extraordinary talents?
ReplyDelete2. I strongly believe that she should not have been taken away from her parents. That would just have escalated their fear of the medical system and american traditions and make them even less likely to trust doctors. On the other hand, I am not sure where you can draw the line between freedom of religion/spirituality/etc and abuse, especially when children are involved. Say a typical american parent is not taking their child in to the doctor for their well child check ups or allowing them to be immunized. Is this abuse? Can Children and Youth Services (CYS) become involved, and when? Or even taken further, as we discussed in my class, what about cases where the mother refuses to have a c-section, say because of her religion, but the baby would die otherwise - can it be court-ordered? Is that legal or is is justified? What about cases where parents allow their kids to spend hours online or eat very unhealthy foods? Or in cases where the parent is critical of the child or just plain absent? EVERY parent makes mistakes. I am really not sure about these borderline cases. In addition, like we talked about during pre-service, there is a difference between outright compliance of medication, and a compromise and agreement between patient and doctor. I wouldn't want to just be forced to blindly agree to whatever my doctor was saying if I didn't understand it - and I believe everyone has the power to understand medical issues when simplified and explained correctly by their doctor.
3. I think one of my main takeaways was all the different factors that might need to go into providing healthcare for an immigrant population, especially an understanding of their culture and the way they view health. I saw from the patients side scared parents who were stuck dealing with a viewpoint they didn't believe. And from the doctors side, it is hard to sit by and watch your patients make decisions against your recommendations - but people do it all the time. And how much autonomy can we give to people based on their religion, beliefs, how they believe the media spin on things (HPV vaccine/vaccines in general anyone?). Or when they don't take their blood pressure medicine because there really are no symptoms of high blood pressure until it is too late? Or the person with diabetes who still drinks too much pop (soda)? At what point can we interfere - if we can at all? People can still choose to kill others even though there are laws against it, and there will be consequences, just like there may be consequences of other health choices (or there may not be!). I know this was really long, and really late, but I really enjoyed the book, your thought provoking questions, and the discussions we had in my medical anthropology class surrounding these topics.