Role of Cross-Cultural Misunderstanding in Ruining Lia’s Life

Lia is born of a loving Hmong family, and just three months into her life, begins to reveal epileptic symptoms. According to the Hmong community, the condition is curable, and the presence of spirits in such a patient’s soul is considered a blessing. However, American doctors in a community medical center fail to understand and appreciate Lia’s parents’ approach to the child’s disease, and are only interested in saving this child’s life. As the conflict develops, it becomes apparent that the child will not be healed; but this is not without the doctors realizing the importance of compromise. In this book, Anne Fadiman claims, “I have come to believe that her [Lia’s] life was ruined not by septic shock or noncompliant parents but by cross-cultural misunderstanding” (Fadiman 262). Before making this claim, Fadiman had come to fully understand the Hmong culture. This statement was thus an affirmation that her parents’ primitive treatment to epilepsy was not to blame for Lia’s devastation, but the cross-cultural misunderstanding that surrounded her life. Based on the evidence provided by Fadiman and supported by the views of critics, this essay aims to reaffirm that cross-cultural misunderstanding was to blame for Lia’s ruined life.

The Hmong culture was partly to blame for the problematic treatment of Lia. Shamans, the community’s doctors, needed time in their patients’ homes, where they diagnosed and treated based on the patients’ symptoms. If a patient died, human error in his/her treatment was not a possibility, and instead – they considered disease to be fulfillment of the wishes of the spirits. The method used by modern doctors at the Merced Community Medical Center, including taking of blood samples and stripping a patient of her clothes, was therefore considered immoral (Twiss 167). As such, the Hmong community, including Lia’s parents, was unwilling to coordinate with the modern doctors in their effort to salvage Lia’s health. This factor increased the cross-cultural misunderstanding; making Lia’s treatment even more problematic.

The Lees were appreciative of their daughter, in spite of her condition. This entailed appreciating her obese nature, because according to the Hmong culture, a chubby stature signified good parenting. Her thick skin made it difficult for the medics to trace a vein, and considering her condition, she ought to have been immobile as drugs were administered. At one point, Lia’s parents, the Lees, are observed to untie her during treatment so she could sleep beside them. They could not understand the reason behind which she was tied, and as such, thought of the doctors as sadistic. At this point, the role played by Jeanine Hilt, an American social worker, can be properly understood. It was Hilt’s tenderness and understanding that was responsible for the minimal compromise that characterized the situation (Twiss 172). Because of Hilt, Lia’s parents, the Lees began to appreciate that Americans were equally thoughtful, only that they employed alien techniques to treat their patients. While Hilt served as Lia’s advocate among the doctors, misunderstanding between the doctors and the Lees persisted, and it was rather impossible for Lia to be treated.

Lia’s doctors, Neil Ernest and Peggy Philp, ought to have taken a better approach in bettering her medical situation. While their misunderstanding with Lia’s parents did not influence their willingness to treat the young girl, it is apparent that they were reluctant to consider the Lee’s grievances. The Hmong community was willing to integrate their treatment measures with those of the modern doctors but the modern doctors dismissed the traditionalist methods as primitive and detrimental for a critical condition like Lia’s. Instead, they recommended scheduled medication, to which the Lees complied (Fadiman). The consequence, including the ultimate seizure, and resultant brain damage made it apparent that modern medication was not enough. After the modern doctors had given up on her, expecting her death to occur hours after dismissal from the hospital, traditional doctors came in handy and even caused her condition to stabilize. This sequence of events is an affirmation that the doctors ought to have given a chance to the Shamans, whose initial contribution might have ensured a normal life for the girl.

Language barrier was a major factor that served to extend the boundary existing between the two cultures. Some of the utterances made by the doctors were interpreted right but were understood wrongly (Swartz 2). This resulted in a worsened discernment of the American doctors by the Lees and Hmong as an entity alike. In the case of an emergency, the Lees needed to contact an ambulance, but could not communicate with the hospital.

This necessitated the involvement of their learned nephew, who would call an ambulance. The interpretation process would at times limit the effectiveness of the message intended by either party. For instance, when Lia was undergoing critical care in MCMC, the Lees needed to be comforted, a process which had to be done by an interpreter. Before the final discharge, miscommunication between Lia’s mother and the doctors had her think that the nurses disconnected medicine tubes off Lia in order to give it to some other patient; a mean act. In the same incident, Lia’s father was made to sign a letter of discharge for Lia, which would happen in two hours. However, he understood this as a letter to guarantee death in two hours. Such wrong interpretations eliminated any possibility that the two cultures would finally appreciate each other. Cross-cultural miscommunication was therefore a major cause for the intensification of Lia’s problem.

Although cross-cultural miscommunication was to blame for the problems experienced in an effort to treat Lia’s condition, ignorance and superstition had a significant role to play in determining the outcome of the entire situation (Swartz 2). Ignorance by Neil Ernest and Peggy Philp was the reason why the girl’s soul was not considered important in curing her body (Fadiman 265). The superstitious notions held by the Lees had a role to play in determining the outcome of Lia’s treatment, because in accordance with their beliefs, she got worse each time modern doctors administered treatment on her.

While it was a health condition, the issues that surrounded her epilepsy, especially the tug of war between her traditional parents and modern doctors politicized her treatment. However, cross-cultural conflict was the main reason to Lia’s failed treatment. The outcome of the story reveals that American doctors finally understood why Lia’s parents insisted upon administering traditional medicine. However, considering that the American doctors failed to restore her health, the reader is left to believe that the Hmong culture never got to understand why proper modern treatment is important.

Work Cited

“The Spirit Catches You And You Fall Down.” Oriental Medicine Journal 16.4 (2008): 39. Alt HealthWatch. Web. 27 June 2012.

“Why Cultural Awareness Matters To American Medicine.” Quarterly Journal Of Speech 86.1 (2000): 111. Communication & Mass Media Complete. Web. 27 June 2012.

Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Straus and Giroux. 1998

Swartz, Leslie. “Clinical writing and the culture problem.” Journal of Child & Adolescent Mental Health Aug. 2008: 2. Academic Search Complete. Web. 27 June 2012.

Twiss, Sumner B. “On Cross-Cultural Conflict And Pediatric Intervention.” Journal Of Religious Ethics 34.1 (2006): 163-175. Academic Search Complete. Web. 27 June 2012.