New England Journal Of Medicine, Volume 353, Issue 13 (2005-09). pp. 1317-1318.
Language:
English
Abstract:
This article briefly discusses Anne Fadiman's 1997 book, "The Spirit Catches You and You Fall Down," about the worsening conditioning and eventual death of an epileptic Hmong girl (Lia Lee). Tragically, this story became an object lesson in how not to provide cross-cultural care. Modeling a theoretically ideal approach to such care, Fadiman spent months getting to know Lee's parents, attempting to understand their reality in general and their truth about Lia in particular. Fadiman gradually developed a multidimensional sense of the parents' characters and the Hmong culture that had shaped them. From this position of compassionate comprehension, she recognized their noncompliance as a complex, logical behavior. In care settings where the culture of many patients is foreign to the staff, it seems reasonable to undertake the sort of focused training that occupied the last generation of cultural-competency advocates. Fadiman models this effort too, countering the failure of imagination that blinded Lia's care providers to the incompatibility between their own health concepts and those of their Hmong patients. Despite, and because of, such lapses, Fadiman's account holds important lessons, including a critique of the notion of "compliance." (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)