Introduction
The issue of cultural competence in health care has only recently started gaining popularity. However, the lack of public awareness of the need for improvements in this area does not make the problem less important. Moreover, while cultural competency is acknowledged as an essential component of general practice, there is a significant lack of literature on the topic (Rukadikar et al., 2022). Many patients experience significant health problems due to cultural incompetence in healthcare organizations.
However, not all stories can fully reflect the complexity of the issue and its connection with the health disparity crisis in the U.S. The book The Spirit Catches You, and You Fall, written by Anne Fadiman in 1997, presents a primary example of medical anthropology that emphasizes the importance of cultural competence in healthcare. The book describes the story of Lia Lee, a child with a rare form of epilepsy, her family, and their interactions with the American healthcare system.
Description of Book
Firstly, Lia Lee’s story provides a unique insight into the experiences faced by a family of Hmong refugees. The book describes the traditions of Hmong culture and its customs, enriching the readers’ understanding of differences in attitudes towards health in different cultures. However, in defining the unique experience of Lee’s family, the book also emphasizes the systematic discrimination faced by immigrants in the U.S.
Moreover, in defining the reasons behind the systematic discrimination of immigrants in the U.S. healthcare system, the author explores the opinions of both sides and the role of their willingness to cooperate. Therefore, the book not only focuses the readers’ attention on one specific case of cultural incompetence in healthcare organizations in the U.S. but also develops the readers’ profound understanding of the issue.
Furthermore, the book is not limited to describing the family’s interactions with doctors in the Merced hospital. At the same time, the book begins with Lia’s birth in Merced Community Medical Center. A significant portion of the narrative details the family’s past and the history of the Hmong people.
For example, even though the book’s first chapter focuses on Lee’s family, in the second chapter, the author provides an informative summary of Hmong history (Fadiman, 1997). Moreover, the chapter features some of the most common Hmong folktales and thoroughly explains their meaning. Thus, by elaborating on the Hmong people’s background, the author develops the readers’ understanding of Hmong traditions before discussing the discord between Leah’s parents and the doctors.
Next, in addition to discussing the factors contributing to each side’s unique perception of Lia’s treatment, the book also addresses the fact that assimilation will not work in applying Hmong culture. Thus, the author explains that throughout the history of the Hmong people, they experienced several assimilation attempts, but they all were unsuccessful. Contrary to the American idealization of the melting pot assimilation concept, Hmong people prefer to remain isolated in adherence to their culture. Moreover, compared with other minority stereotypes and assimilation theory, young Hmong American adults are more oriented toward family and traditions (Swartz et al., 2021). In this sense, the example of Lia Lee’s case demonstrates the importance of cultural competence in the staff’s awareness of patients’ worldviews and willingness to provide individualized care based on patients’ beliefs.
Application to Course Content
In application to the course content, the book provides a more complex image of the need for cultural competence in the healthcare system. The modern conditions of globalization imply a higher level of mobility for the global population. Addressing the needs of the growing number of immigrants requires more workers with cultural competence in the healthcare system.
Moreover, Lia’s story demonstrates the importance of considering world events where a significant part of the country’s population is forced to flee from armed conflicts and persecution. People immigrating in such conditions lack knowledge of the language and local customs and require more attention from healthcare workers. For example, one of the examples illustrated by the author described that one Hmong mother thought that Baby Boy was a name chosen for her son by the doctor (Fadiman, 1997). Therefore, cultural competence should be perceived as an essential skill for health workers and not as an optional means of improving the quality of service.
Personal Insights and Feelings
Reading the book helped me understand the core reasons for issues with cultural competence in the healthcare system. Thus, I liked that the author characterized Lia’s case as a “collision” of two cultures because it reflects the struggles both sides experienced (Fadiman, 1997, p. 8). Before reading the book, I assumed that the core reason for the issue was the Western healthcare system’s unwillingness to assist the cultural needs of diverse patients. Now, I understand that in some cases, disagreements in treatment can be caused by patients’ strong resistance to assimilation and lack of mutual understanding between patients and doctors.
Conclusion
In conclusion, this paper explored the importance of the book The Spirit Catches You and You Fall for a modern understanding of cultural competence in healthcare. The paper defined the book by Fadiman as having played an essential role in attracting the public’s attention to the problem of lack of cultural competence in the U.S. healthcare system. Thus, by developing readers’ understanding of Hmong culture and describing the story of the Lee family, the author demonstrated the importance of cultural competence for modern healthcare workers.
References
Fadiman, A. (1997). The spirit catches you and you fall down. Farrar, Straus and Giroux.
Rukadikar, C., Mali, S., Bajpai, R., Rukadikar, A., & Singh, A. K. (2022). A review on cultural competency in medical education. Journal of Family Medicine and Primary Care, 11(8), 4319–4329. Web.
Swartz, T. T., Hartmann, D., & Vue, P. L. (2021). Race, ethnicity, and the incorporation experiences of Hmong American young adults: Insights from a mixed-method, longitudinal study. Ethnic and Racial Studies, 45(7), 1197-1217. Web.