Medical training is all about treating patients who understand, there is little training for the patients who are not "normal," and so the medical community is ill prepared to deal with other cultures. The American doctors were saddened by Lia's condition, which deteriorated to a vegetative state after a two-hour long seizure, but they never took the time to understand how to really communicate with the Hmong. Even the social workers did not really know how to communicate with them. Much of the clash of cultures was due to lack of a common language, but even more was due to arrogance and sheer ignorance. The social workers and doctors could not conceive of people who did not read, did not know how to tell time, and could not understand even basic commands, even if they were translated effectively. The Hmong were from a poor, agricultural culture, and things Americans take for granted were unknown to them. It is especially sad that a little girl like Lia was the one who was caught in the middle, and that so many people did not learn anything from her story. Her story proves that two cultures can learn from each other, but they have to want to learn, and many of the people in Merced did not want to learn about the Hmong, they only wanted to blame them when they did not conform to "normal" Western culture.
While the American doctors, with years of training, were quite sure of their expertise and knowledge, the Hmong were not. They distrusted the doctors, and it often seemed that the medicines they prescribed actually made the condition worse, rather than better. The Lees often stopped giving anti-seizure medications for just this reason. They did not understand that altering the doses even a little bit could cause drastic results. They also did not understand that the cost of the medical care they consistently received was forever mounting, and since they were Medi-Cal patients, they had not paid a cent. Some Hmong patients at the Merced hospital attempted to explain the Hmong philosophy. One said, "But the Hmong, he will want the doctor to calmly explain and comfort him. That does not happen. I do not blame the doctor. It is the system in America" (Fadiman 62). This immigrant understood more than most. Unfortunately, most doctors do not "explain or comfort," they expect patients to listen to and abide by their diagnosis since they "know more" than the patient. The Hmong want more than curing from their doctors, they want understanding, and the Lees were not getting this understanding from their doctors. They lived in a world they literally could not understand. Everything was in English, and they could not speak or write it, they could not even write Hmong. People who ordered them to do things they could not understand surrounded them. They were afraid and angry, and it is not surprising. It is also not surprising that they decided to treat their daughter the best way they knew how, with their own superstitions and beliefs. She did not seem to be better despite the American treatments, and they did not have any idea what else to do. It was a terrible time for them, and the American doctors, too.
In conclusion, Lia's story is a clash of cultures that took little time to understand each other. The Lees came to America without understanding the language or the culture - expecting to continue their old world ways and customs in a new world. The American doctors had little or no understanding of the Hmong or their needs and beliefs, and expected them to understand and adapt to American culture instantaneously. Both sides showed incredible misunderstanding and misconceptions, and neither side knew how to reach the other. It was a sad case of cultures who did not know how to blend, and people who did not know how to communicate, and it shows how cultural barriers can adversely affect the lives of everyone, no matter what culture they come from.
Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of…