Cautionary Tales with an Anthropologist vol. 1.1

Today's cautionary tale is about a Californian doctor and a 4 year old Hmong refugee from Laos, named Lia. Lia was diagnosed with severe epilepsy by western medical standards, this is her story and an important reminder of the risks of ignoring cultural differences...

In the western medical system, the training doctors receive is connected to solving for symptoms and not always the cause. It is also seen through a very narrow lens which leaves little room for other perspectives. The use of natural remedies and holistic medicine are often turned down or seen as inadequate or even neglectful.

The Hmong refugee community in California is no stranger to this reality, as doctors deny them their rituals, music, prayers and tonics in the name of their superior medicine.

There are many stories of parents being arrested by Child Protective Services because the western doctors didn't understand or seek to learn about traditional treatments and their efficacy. Stories of women being sent for psychiatric treatment because they speak about spirits as a reason for pregnancy complications.

Lia's story is not dissimilar in that the key to saving her life, was understanding her culture and showing respect to her community so trust could be built and the western medical treatments could be performed without issue.

Lia's convulsions were frequent and there was great concern from the doctor.

In her community however, the seizures were a symbol of her soul being separated from her body and was seen as entirely metaphysical. They described what Lia was experiencing as "the spirit catches her and she falls down".?

Lia clearly needed treatment, but where western medicine failed her was by not acknowledging the traditions and rituals of her culture. Instead, they labeled her parents as 'difficult', 'uncooperative', 'disruptive' and began treating them as such, because "the Hmong didn't fit the pattern they had been trained to deal with". They didn't take time to listen and learn about the Hmong culture from her parents so they could find local or relevant terms to explain their treatment plan for Lia.

Instead, they removed consenting power from the parents and implied consent given the "severity of the issue" which allowed the doctors to take full control of any medical treatment for Lia.

When we don't take the time to obtain the proper tools and resources for cultural differences, we often find ourselves in situations like this one. Situations where there are two separate and seemingly effective approaches to solving a VERY urgent problem.

But Lia's story doesn't end there. In the mid 80's, the Nationalities Service of Central California in Fresno received a short-term grant of just over $100K USD. The purpose of the grant was to create an integrated mental health service offering that combined the western medical practices with those of the Hmong healers (twix neebs). A lesson that was learned in part, thanks to Lia's experience.

This grant, while short-term, created a precedent in the United States Health Care System, one that demonstrates the power of cultural integration, not cultural assimilation.

In the end, Lia went into septic shock due to delays on treatment and fell into a comma. She remained in one for over 25 years while her family cared for her, washed her, and prayed for her soul to return to her body.

As author, Anne Fadiman wrote in her book about Lia's case, "The Spirit Catches You And You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures" writes: [...] I have come to believe that her life was ruined not by septic shock or noncompliant parents but by cross-cultural misunderstandings."

Someone's physical health might not always hang in the balance between two cultures, but their mental health absolutely does.

It is our responsibility as leaders to learn from these lessons and to seek out the tools that help us integrate cultural differences rather than turning a blind eye and hoping one day they will grow legs and walk away.

Curious to learn about some of these tools? Shoot me an email: [email protected]. We can have a no-strings-attached chat about what you've been experiencing and build a plan for how to create true integration.