Chapters 3-5 opened with an event from Lia’s infancy. When she was three months old, her sister slammed the front door of their home very loudly. The Lee family believes (in accordance with Hmong tradition) that the loud sound of the slamming door startled Lia’s spirit so much that it left her body and became lost. In Hmong, this is represented by the phrase “qaug dab peg”, which means “the spirit catches you and you fall down”. For the Hmong, the “spirit” is a soul-stealing being whose displeasure one ought to avoid incurring. Fadiman explains that children are regarded very highly by the Hmong, as they are the most treasured possession a person can have. Fadiman also gives an account of Lia’s admission to a hospital in California. Her physician, Dr. Dan Murphy, approaches her case rationally, as any physician immersed in American medical culture would. He treats her, and prescribes drugs to cure her pneumonia and prevent further seizures.
This section also marks the beginnings of the tension between Hmong culture and American medical culture. Dr. Murphy later prescribes phenobarbital for Lia, but due to a misunderstanding, Lia does not receive the medication as instructed. Lia’s nurse and doctor are frustrated by what they see as the parents’ unwillingness to comply with physician instructions, even when it involves their daughter’s health.
The Hmong’s valuation of children highlights how difficult it will be for Lia’s parents to make the decision they do concerning her medical care. Lia’s epileptic condition, in fact, is considered to be a blessing. The spirits chose to reside in her, indicating Lia has the capability to one day become a shaman. Because of this, she is regarded much like a member of royalty.
These chapters reminded me of ideas about suffering in Christianity. Suffering, while it is painful, can be purposeful. While we don’t seek it out, it can still be a source of instruction. As Paul says, “Three times I begged the Lord about this, that it might leave me, but He said to me, ‘My grace is sufficient for you, for power is made perfect in weakness.’ I will rather boast most gladly of my weaknesses, in order that the power of Christ may dwell with me. Therefore, I am content with weaknesses, insults, hardships, persecutions, and constraints, for the sake of Christ; for when I am weak, then I am strong.” -2 Cor. 12:8-10. While it may seem contradictory, from this perspective, God uses our weakness to form our strength. Moreover, weakness allows our strength to be elevated and “perfected”.
As a future healthcare professional, I will certainly do everything in my power to ease my future patients’ suffering. Whether a physician embraces suffering as painful and inevitable (but possibly valuable) or tries to avoid it at all costs can have huge implications for how he/she sees and treats patients. We can examine this idea through the lens of attitudes toward death, particularly in the field of healthcare. Like suffering, we can embrace or try to reject death.
We read an essay by William Mays in my Bioethics class dealing with this topic. Mays labels western society’s approach to death the “pornography of death”. This refers to society’s two-fold approach to the subject of death: much like pornography, we simultaneously label it taboo and obsess over it. It is a positive feedback loop. Because it is taboo, we avoid it for the sake of “propriety”, yet we also obsess over it because we are never allowed to engage with it regularly in some way. We end up engaging with death indirectly, as in the case of violent video games. Thus, discussion of death is relegated to the realm of the morbid and morose. As a result, we are not comfortable enough with death to see it as a sad but natural part of life, or see that it can be healthy to openly discuss it.
For Lia’s family, suffering is not seen as a means of sanctification or instruction, but much like in Christianity, it is not something one tries to avoid at all costs. Christianity and Hmong culture both see value in suffering, albeit for different reasons. If we were to follow the Christian model of suffering and death, what implications would this have for interactions between patients and their physicians? I don’t know the details of the tragedy Fadiman alludes to on the book’s back cover, but I’m sure applying this model would have completely changed the tone of the clash between these two cultures.
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