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The clash of Two Cultures EssayThe Collision of Two Cultures Implications of Cultural determine and Beliefs on Caring Concepts Abstract This written report is a personal response to Anne Fadimans book The Spirit Catches You and You Fall Down. The paper includes a compendium of the book, an overall impression of the reader, a discussion of three major themes evident in the book, and a explanation of a smirch from the book and how the situation could be handled differently using references and material learned in 3020 Transethnical Nursing. Keywords culture, ethnic barriers, values and pictures, talking to barrier, assimilation process The Collision of Two Cultures Implications of Cultural Values and Beliefs on Caring Concepts After I finished my second summer semester this year I had 3 weeks break before starting fall semester, w present I enrolled for this class. I had acquired my books already from a fellow pupil and went space to enjoy my three weeks of not studyin g just springing.As I was putting the books remote at home, I started reading the back of Anne Fadimans book The Spirit Catches You and You Fall Down w here(predicate) a journalist of The Washington Post referred to the book as utterly engaging, readable, and a superb piece of writing. instead of storing the book I carried it upstairs and put it on my night table. That correcting after I nest up in my bed I got to know Lia lee(prenominal), her parents, her doctors, and I learned nearly the struggles that were involved in caring for an ill child that sat between cardinal cultures the Hmong culture and the culture of American wellness precaution professionals.Anne Fadiman takes the reader on a cultural journey where she describes the case of Lia Lee, a Hmong infant that suffers from epilepsy. As she tells the story of Lia and her immigrant family that had to flee from their home terra firma and eventually gained entrance into the united States, she reveals the history and c ultural traditions of the Hmong pile. Moreover, she describes how her parents and the aesculapian exam community of Merced Medical Center in California strive to help Lia as they try to plow and foreboding for the epileptic child each in their own way.The values and intuitive feelings that two sides h anile count to be irreconcilable at the time because the two sides do not know enough close each sassy(prenominal) to even try to guess that both(prenominal) sides mean well and try their ruff to help Lea in her struggles to regain her health or control the condition. Fadiman details the misunderstandings that arise when two cultures come face-to-face but cannot understand each other. Lia arrives in the hospital with epileptic ecstasys which her parents blamed on a slammed door, a spirit catching Lia, and subsequent soul loss.To the western doctors, who know little ab forth the Hmong hoi polloi and their culture, Lias seizure was caused by dys drop dead in her brain whi ch can be case-hardened with medication. The doctors are unaware of the fact that the Lees diagnosed Lia with qaug dab peg which is the Hmong word for epilepsy, though considered potentially dangerous in Hmong culture it to a fault distinguishes a person and may be indicative of a possible future as a shaman. The Hmong, like American Indians, are circular thinkers who see linguistic universal connections in all things.The Hmong, unlike Americans, dont split the mind and the body. To the Cartesian, linear thought process doctors, aesculapian checkup checkup health cannot be restored by bargaining with spiritual powers and offering animal sacrifices. The book also touches on historical and political events which go through shaped the character traits of Hmong and Americans. For centuries the Hmong cave in resisted persecution, manipulation, and domination by other Asiatic groups. They are a proud mickle and cherish their independence.The Hmongs challenge of authority frustra ted the American doctors who arent used to having their authority questioned. The Lees non compliance with the western medical preaching was rooted in their belief that the family devises the decisions for their children which in their culture is in the best interest of the child. The Lees were convinced that the medication regimen only do Lia more(prenominal) ill and refused or altered the medication regiment. The doctors retaliated and showed their power by removing Lia from her parents home to foster care where they hoped Lias condition would stabilize.However, there was that fear that lingered over the medical community in the Merced hospital that Lia would one day come in with the big one, the doctors called a grand mal seizure that would deprive the child of vital oxygen to her brain and either take her brio or sacrifice her in a vegetative state. Inevitably the day came that Lia suffered a grand mal seizure. Since, her higher brain function has ceased and she was lefto ver in a state that the western doctors described as dead, however, for the Lees it was the soul that had now left her body with no return.Lia was taken home from the hospital where the medical team thought she would die presently after. However, the Lees loving competent care kept her alive, a manner that in western value and belief system is not worth living, whereas the Hmong see it as a variation of nature and care for Lia even more, still hoping that her soul may return to her body one day. After finishing the book, I caught myself thinking that maybe Lias soul would one day return to her body. I truly enjoyed reading this cross-cultural account that is full of association and derives wisdom from people of different life-ship canal.Somehow, the book allows the reader to step out of ones own culture and look at the world like a Hmong. reference of cultural differences is important in a clownish that consists of mostly immigrants. As people of one country we want to take car e of each other, understand each other, and live with each other. Therefore, people posit to get to know each other and understand the cultural backgrounds, value and belief systems. That is my opinion as a person. Looking at the book from the emplacement of a nurse makes it even more valuable.I take aim always liked the idea of culturally congruent care and arrive tried to co-ordinated it in my daily practice as a nurse. After reading this book, however, my perception of cultural care has changed. Anne Fadiman has spent years on her research on Hmong culture and her goal to make people understand the vast differences in values and beliefs of people from cultures that are different than main stream culture here in America. Her efforts make it possible for other people to embrace the knowledge she has collected and hopefully people are able to use the knowledge to make a difference in somebody elses life somebody else, like Lia.Fadimans book illustrates how much time, commitment , and energy is necessary to understand another cultures perspective on health and wellness and to translate that understanding into the day-to-day practice of medicine and caring. Incorporating cultural beliefs into medical care can go a long way to help people cope with illnesses. A little medicine and a little neeb, is what Nao Kao, Lias Dad said. In these simple words is mysterious much of the truth that would have helped the Lees to cope better and comply more with Lias medication regimen.If the resolution would have been different is questionable, however, the cultural aspect of Lias care was disregarded by the medical staff, both nurses and doctors and led to more complication than necessary. The involvement of a twix neeb would not have harmed Lias medical interference it would have enhanced it. The twix neeb, a shaman conducts his work on a metaphysical plane. He unremarkably mediates between the earthly and the spiritual world, however, there is no evidence that this t reatment hurts anybody (Fadiman, 1997, p. 267).According to Dwight Conquergood, who has seen medication bottles on the altars of neebs, they do not resist medications, sooner they incorporate it in the heeling process (Fadiman, 1991, p. 268). The book delivers much aliment for thought for whom ever is hungry for it, but it is especially useful for medical staff and doctors who dedicate their work to helping others. Anne Fadiman makes clear that we treat people and not diseases or body parts. On that note, she quotes William Osler who said rent not what disease the person has, but rather what person has the disease (Fadiman, 1997, p. 75). The major theme in Fadimans book is cultural barriers. Language, cultural values and beliefs, and immigration status play an extensive spot in assimilation and acculturation to a new society. The language barrier that the Lees experience along with their different values and beliefs do it difficult for the Lees and the Merced medical staff to c ommunicate with each other to navigate the treatment for Lia. Through Fadimans book, it becomes clear that language is an expression of cultural beliefs.In Hmong language epilepsy is explained in spiritual terms and is, therefore, an expression of their culture that is rooted in the natural and spiritual world. In English epilepsy is explained as a disturbance of brain function, which expresses western values and beliefs that are based on knowledge derived from science. The use of translators only added to the miscommunication of the two sides, especially the use of unskilled people like a janitor or an aid which they used in this case. Fadiman states that cultural brokers are needed to help a situation where the divide between cultures is extensive.In one of his interviews with Fadiman, Neil Ernst, the pediatrician involved in Lias care describes the cultural barrier as being a layer of saran wrap between the Lees and the medical staff of Merced Medical Center. He states that, you could get somehow into the area where you thought you reached them but you could never be sure that they understood. In 1980 when the Lees came to America cross-cultural medicine and care concepts were perceived by the medical community as form of political bamboozlement.Physicians felt that these ideas were an assault on their rationality rather than a potentially lifesaving therapy (Fadiman, 1997, p. 273). Fadimans book was a necessity to open the road for cultural congruent care concepts. It serves as a testimony that ethnocentrism on behalf of a majority culture could prohibit people from seeking care or negatively influence the outcome. The description of birth practices and beliefs in Hmong culture is a good example for inhibiting people to seek care.Prenatal care is highly valued in western culture, however, in Hmong culture where our understanding of medical care is nonexistent women take care of their needs. Even in the process of giving birth, as Fadiman describes in the f irst chapter they deliver their babies by themselves. If help is needed, the husband is utilize to aid in the birth of a Hmong baby. The Hmong women came to the hospital to give birth only because they had heard that if they do not deliver the baby in the hospital it will not be accepted as American citizen and they could not collect money from the government.If it wasnt for this misconception, the women would have avoided the hospitalization. The Hmong people were political refugees. Fadiman pictures the Hmong as passing different from typical immigrants who are grateful and happy to have landed in America, the land of hazard and freedom. As a group, the Hmong have a history of vehemently resisting assimilation. The Hmong refugees were not here because they treasured to be they were here because they had no other choice.The CIA-led quiet war in Laos had destroyed their homeland villages and made life as they knew it impossible. The life that the refugees found in the United Sta tes was strikingly different from their life in the mountains or in the refugee camp in Thailand. The culture shock caused many a(prenominal) to cling more zealously to the old ways and to one another. This explains, at least in part, why after being in the United States for a number of years, the Lees appeared to speak virtually no English. Fadiman claims that Lias mother, even after being in the U.S. for several years, had no idea how to operate the family telephone. In Transcultural Concepts in Nursing administer, Andrews and Boyle list many instruments that affect the process of assimilation and acculturation to a new culture. As first generation immigrants, the Lees came to this country as a middle aged couple with their children. Whereas, Foua, Nao Kao and their peers had many difficulties getting used to the new life the book reveals that their children embraced the new experience and grew up to be bicultural.As involuntary immigrants the first wave of Hmong people clung m ore to their cultural traditions as voluntary immigrants would do. Fadiman chronicles migration patterns of Hmong people inside the United States. After landing here the Hmong were dispersed across many states to divide the financial burden among the communities. However, the Hmong did not want to live isolated from each other in this strange new environment. So against governmental plans they settled in immense groups to practice their traditions and help each other.Therefore, the assimilation to the new culture was slowed and delayed. Educational status is another factor that slows assimilation. The Hmongs educational level was not comparable to western standards. As an indigenous mountain common people who lived off their land knowledge was limited to what was necessary to survive in that environment. However, when the Hmong came to the United States the pattern of knowledge that was needed to survive changed drastically. To gain entrance into a society different than your own a new set of knowledge needs to be acquired to compete for resources.Caring for people from a culture that has a different set of values and beliefs takes understanding and knowledge on the behalf of the professional that delivers the care. In nursing delivering cultural congruent care is a concept that was established by Madeleine Leininger who developed the theory of Cultural Care Diversity and Universality (George, 2010, p. 404). In their care practice nurses need to consider the interrelationship of cultural care, well-being, health, illness, and remainder as it is viewed by people from different cultures (George, 2010, p. 11). The approach should be holistic and explore multidimensional ways of caring. The nurse should seek to discover cultural care universalities and diversities and be able to apply it. Cultural care preservation, accommodation, and restructuring are key concepts of cultural congruent care delivery. Applying my knowledge from this class to the care of Lia I w ould have tried to establish a working relationship with the family and their twix neeb to preserve and maintain their values and beliefs.The involvement of the neeb would have shown Lias family that their values and beliefs were acknowledged and not disregarded. Moreover, the twix neeb could have acted as negotiator to ensure that the Lees adhered to the medication regiment. Fadiman describes situations in the hospital where Lia was put in restraints to not interrupt her medical treatment by pulling on tubes and IV lines. The Lees were enraged about the restraints and tried to free her from the coercion of force that was administered by the medical professional at Merced Medical Center.Involving a cultural broker like Fadiman terms it would have helped to concert the different views of treatment. The Lees wanted to care for her daughter by holding her and having her close, however, the medical staff wanted to maintain their treatment modalities to get Lia the medical treatment that she needed. A holistic approach is of utmost impressiveness and maybe some agreement could be made to how the parents could have held and be close to Lia without interfering with the treatment modalities.Restructuring Lias environment and treatment would have been a matter of more sensitivity on behalf of the medical professionals involved. Foster care did not improve Lias condition and the coercion of power on the Lees did not improve their compliance or strengthen their beliefs in western medicine and treatments. A more sensitive approach through home care services might have been more effective in the treatment of Lias epilepsy. Teaching the Lees how to read a clock, how to use the Gregorian calendar, would have been a useful approach to improve Lias condition.Community classes on western values and beliefs would also be of interest to help people from different cultures to assimilate to main stream culture. The tragedy is that both the doctors and the family genuinely wanted t o help Lia, but their lack of communication and inability to understand each other, culturally, and linguistically, made mutual efforts impossible. Anne Fadimans research effort created a valuable resource for people in solidifying and caring professions. Understanding the importance of incorporating cultural values and beliefs in the deliverance of care can make a difference in somebody elses life.