Dec 7, 2013
Paper 3 Final Draft
Cultural Conflict: Understanding vs Belief
As Anton Chekhov, a Russian physician and writer, said: “When you're thirsty and it
seems that you could drink the entire ocean — that’s faith; when you start to drink and finish only a glass or two —that’s science”. What if the patients’ beliefs contradict their doctors’? The conflict may lead to ineffectiveness in treatment and both patients’ and doctors’ frustration. In The Spirit Catches You and You Fall Down, Anne Fadiman tells a story about the Lees, a Hmong family, and their clinical experiences with doctors in MCMC located in Merced, California. The story finally came to an end with a tragedy: the Lees’ young child Lia’s brain death. Due to the different cultural backgrounds, the contradictions on the communication and the understanding of diseases between the Hmong and western physicians result from the disparity of their beliefs and thus cause the failure in the treatment. Also, western physicians are not as empathetic as they should be when they could do better.
A story always starts with an interesting precondition. The Lees were refugees, which means they did not come to the U.S. for a tour. They stayed in Merced because they wanted to survive, but they couldn’t get accustomed to western medical system. Also, the Hmong’s views on the authority are different from those of Americans. When Americans get sick, they will consider going to the hospital and consulting the doctors. For the Hmong, they would prefer to consult the Hmong leader before they made a decision, such as whether to accept the doctors’
therapies. In addition, they were so superstitious that the “good medicines” given by txiv neeb could do more things than what doctors in hospital did to Lia’s seizures. The socio-historical situation of the Lees was the main cause of the cultural disparity in this story. According to Dan Murphy, the physician in MCMC, the clinical encounter case is only a microcosm of the contradictions: “I don’t remember having a feeling of anger, but I remember having a little bit of a feeling of awe at how differently we looked at the world”(Fadiman 53). Apparently, both Hmong and western physicians had recognized this difference. However, they still could not solve the problem, even though they knew what was going wrong and already explained their comprehensions through language. In this case, interpreters played an important role, forming a bridge between the Hmong and their western physicians. Nevertheless, interpreters can only ensure that both sides have exchanged their information about the diseases; they merely broke down the “language barrier”. The more worrying thing was that Nao Kao, Lia’s father, “put up a ‘stone wall’ and was sometimes deliberately deceitful”(Fadiman 47). It was “deceitful” because it seemed that the language barrier was the cause of the conflicts, but actually, the real cause hided behind the language barrier, which blocked the line of the sight. The “stone wall” was exactly the “cultural barrier”, which blocked between the Lees’ faith and western physicians’ belief — science. As Dave Schneider, a physician in Merced, said: “The language barrier was the most obvious problem, but not the most important. The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference”(Fadiman 68). The “cultural barrier” is the inherent part of the contradiction. Western physicians believed in science, which was like Anton Chekhov said, that they knew people can “finish only a glass or two” of water when they
are thirsty. They could prove it through experiments. The Lees, however, did not believe in science because their own beliefs made more sense to them, which was like that they thought they could “drink the entire ocean”. Western physicians thought about the diseases dialectically, but...
Cited: Doctors, and the Collision of Two Cultures. 1997. New York: Farrar, Straus, and Giroux,
London: H. K. Lewis, 1906. 3-11.
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