Book Review #2- “The Spirit Catches You and You Fall Down” Chapters 4-6 According to chapter 4 in the book, what perceptions of American physicians may have affected Hmong refugees’ ability to feel th

Running Header: THE SPIRIT CATCHES YOU, AND YOU FALL DOWN BOOK REVIEW

THE SPIRIT CATCHES YOU, AND YOU FALL DOWN BOOK REVIEW

Oluwafunmilola Kila

Ms. Bishop

NM 245 Cultural Diversity in Nursing

May 20th, 2020

You are missing your Author note which goes here .

1. Explain why Foua Yang’s birthdate may have been different in various locations in the medical charts?

Lia was the second last born in a family of 15 children between Nao Kao Lee and Foua Yang. Her birthdate set a record of first where she was the first child of the Lee's to be born in the hospital and being the first child of the Lee's to be born in the American soil. Medically, the birthdate of Lia was different. Unlike other children who Foua delivered by herself without the help of an attendant, Lia was delivered in a hospital with amniotic sack raptured for a quicker delivery. She was born with 8 pounds and 7 ounces; later she was administered vitamin K injection, silver nitrate and a bath. Her birthdate in October was not specific only compared to opium field second wedding season. She was given the name Lia, a Hmong name and in a month, Nao Kao organized a soul-calling feast attended by many Hmong’s natives.

1. Describe how the history of Hmong people, as discussed in chapter two may have influenced Foua and Nao Kao's perception of the physicians and nurses who appear to be in charge of their daughter’s care?

Isolating themselves in their own culture, weathering oppression from the Chinese and refused to adopt the Chinese culture, the Hmong moved to Vietnam and later experiencing the western doctors' practices in Thailand refugee camp. With a compelling history of unique birthing customs, beliefs of spirits and souls, the radical independent community preserved their traditions for thousands of years through defiance to change and a culture of creating their tragic destiny. As the physicians diagnosed Lia with a brain disorder of epilepsy, her parents believed it was an evil spirit which catches you, and you fall, which is also a healing spirit, need. Nao family felt the physicians had disregarded their customs and beliefs. The doctors were hoping for curing the disease while the parents regarded this as a community honor and prestige.

Furthermore, Lia's sister died in Thailand hospital, giving the Nao family a reason to be skeptical about the doctors. They also did not trust the doctors who were Christian's missionaries. The doctors did not acknowledge traditional medicine and did not respect customs and beliefs practices. The cutting of spirit strings from wrists or neck wrings holding infant's living souls by doctors and nurses, and the undermining of shamans brought a drift between the two sides. Foua and Nao had a dozen reasons to have a different perception on the doctors and nurses at the Merced County Hospital.

1. How do you think to have an interpreter might have improved the outcomes of Lia's numerous emergency room visits up to this point?

Through her early childhood between one and five years, Lia had visited the hospital several times. She was experiencing seizures, breathing difficulty, foaming, vomiting back-arching, limbs thrashing and urinating symptoms that Foua and Nao Kao did not comprehend. Lia was attended by pediatricians, Neil Ernst and Peggy Philip who were devoted to take proper medical care of Lia. However, there was a communication barrier between Lia's parents and the doctors attending to her. In some instances, Lia's father would disagree with the operation performed on her veins due to the overweight from the intravenous medication side effects administered. He would also not trust them for tying her up, and when she fell instead of comforting her, they would cage her inside her crib. She needed close attention from nurses, and her parents also supported her refusal to take medication. It was unclear of her continued seizures if it was because of underdose of prescription or refusal to give her the medication as instructed by the doctors. The doctors tried their best to inform Foua and Nao Kao how to administer dosage through calendars, stickers and taped samples. Communication was still a difficulty. The nurses confirmed Lia was not compliant of the prescription offered. Her condition defoliated further with symptoms of abnormal hair growth, gums bleeding and hyperactivity led Doctor Murphy to place her on a respirator. The Hmong's attitude on the medication is dangerous when dealing with a doctor. Symptoms of being retarded emerged, which made the doctors frustrated by her parent. Determined to even learn the Hmong's culture for smooth coordination with Foua and Nao Kao, Peggy and Neil could not get the cooperation required to take care of Lia. They began modifying their child's treatment at a critical condition that led to the intervention of Child Protective Services from removing her from their custody to a foster home when it was too late. Having an interpreter could have easily made her primary care from the parents and understanding from the doctors a clear channel of treatment operation for Lia easy. The communication between the parents, doctors and nurses could have improved prescription compliance as well as symptoms assessment.

1. Discuss the differences in conceptual frameworks that may have led to Foua and Nao Kao and the caregivers at Merced County hospital to misunderstand one another during Lia’s admissions?

Medical beliefs

Hmong's medical beliefs differed by that of the doctors in various ways. As a culture, they viewed surgery as a taboo which Lee's disagreed with the doctors. The Lees viewed their daughter's illness as detachment of the soul from the body, whereas the doctors saw it as a brain disorder. This led to noncompliance of Lia's medical treatment.

Compromise

Doctor Neil and Peggy could not compromise their medical standards and provide less good care for their Hmong patients, including Lia. They go the extra mile in learning Hmong culture from National Geographic's books trying to understand their patient's ideologies. On the other hand, Nao Kao, Hmong’s by tradition, with a history of being stubborn to compromise over adopting a new culture of the dominant Chinese and French explains how the Lee family has been challenging on choosing the western medicinal treatment for their daughter. However, Neil's hamartia personality and ideology of being a good doctor make him administer advanced medication to Lia. He goes ahead and ensures Lia is taken from her parents to a foster home makes him similar to the Lees inability to compromise.

Power

The Hmong’s are respectful to their power structures in terms of family setup and clan leader's hierarchy. Doctors being learned to view themselves as superior to their patients, therefore, demand more respect for their views. They see Lee family as a threat to their child wellbeing. The lees find the doctors as an influencing power that they find it insulting to their culture. This makes it hard for both to have a common ground on Lia's care.

1. How may have Foua and Nao Kao experienced cultural pain during the experience of Lia’s birth in the United States?

The Hmong’s, as a community, have faced cultural pain through their history. They incurred fatalities during Laos's wars and were subjected to screening for mental and contagious diseases before migrating to the United States. Majority of the Hmong’s suffered from ailments like diabetes caused by traumas they endured. This caused them to pain that doctors could not be able to treat effectively. They refused to take some medicine pills due to size or color, and others would harm their children with an overdose of motion sickness medicine. Their women would deliver in hospitals believing children born at home would not become United States citizens.

Foua suffered culturally when after giving birth to Lia, the placenta believed to be a channel the soul travels in to reunite with its ancestors was destroyed. By having an assistant on her birthing made their culture of delivering her children by her hands not practiced during Lia's birthing.

You are missing your concluding paragraph. All APA assignments require an introduction and concluding paragraph.

Grading Rubric

Please use the template I gave you for the assignment to help you improve on your use of APA. You can also visit the Student Resource Center for APA information: https://herzing.libguides.com/library19/citation

REFERENCE

Fadiman, A. The spirit catches you and you fall down. 1997. New York: Farrar, Straus and Giroux