Runninghead:COMPARINGWESTERNMEDICINEWITHHMONGBELIEFS

ComparingWesternMedicinewithHmongBeliefs:
CulturalDifferencesinTreatmentofDisease
KellyBryce
PortlandStateUniversity

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COMPARINGWESTERNMEDICINEWITHHMONGBELIEFS

Abstract
Everydaypatientsanddoctorsmustcommunicate,butthiscanbecomedifficultwhenlinguistic
andculturalbarriersareintroduced.Thenovel
TheSpiritCatchesYouandYouFallDown:A
HmongChild,HerAmericanDoctors,andtheCollisionofTwoCultures
byAnneFadiman
exploresthelifeofayoungepilepticHmonggirlnamedLiaandherencounterswithwestern
medicine.Therearebothdifferencesandsimilaritiesbetweendiseasetreatmentinwestern
countriesandinHmongculture.Inorderforwesterndoctorstoprovideadequatemedicalcareto
aHmongpatient,thetwoculturesmustunderstandeachotherandbewillingtoworkwith
differentviewsthantheirown.

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COMPARINGWESTERNMEDICINEWITHHMONGBELIEFS

Throughouttheworld,thepresenceofsomanydifferentcultureshasdiversifiedpeoples
ideasregardinghealth,medicine,andwellness.Thesociologynovel
TheSpiritCatchesYouand
YouFallDown
byAnneFadimanexploresthis,detailingthestrugglesofaHmongfamilys
experiencewithAmericanmedicine.OneofthemanyfieldstheHmongdifferedinjudgment
includestheirknowledgeofdiseasesandtheirrespectivetreatments.AlthoughtheHmongs
treatmentsfordiseasemayseempeculiarinwesternculture,itisnecessaryforwesternhealth
professionalstounderstandandappreciateHmongbeliefsinordertoovercomethecultural
barrierandprovideadequatemedicalcare.
ThetreatmentsfordiseasethattheHmongbelieveinarevastlydifferentfromwhat
extensiveresearchinwesternmedicinehaverevealedtobeeffective.Forexample,Anne
Fadimanlistssomeofthesebeliefsinhernovel,claimingthathealersattempttoreleasefevers
andtoxicitythroughacupunctureandotherformsofdermaltreatment,suchasmassage
pinchingscrapingtheskinwithcoins,spoonsorbambooapplyingaheatedcuptotheskinor
burningtheskinwithasheafofgrassorawadofcottonwool(1997,p.34).Theseare
obviouslycontradictorytothestudiesofwesternscientistsanddoctors,whowouldmostlikely
maintainthattherearedifferentandmoreefficientwaysoftreatingdisease.Thishasledtoa
culturalbarrier,preventingaclearunderstandingbetweendoctorandpatient.Thisisevidentin
thebookwhenFadimanexplainshowmanyHmongpatientswouldnottakemedicationas
directedbytheirdoctors,statingWhatevertheprescription,theinstructionsonpillbottleswere
interpretednotasordersbutasmalleablesuggestions(1997,p.70).Miscommunicationsuchas
thiscanleadtoimpropertreatment,whichisespeciallyalarmingregardinginfantsandchildren.
Althoughthismayseemtrivial,itisinfactcrucialintermsofthestrongcontrastbetweenthe

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COMPARINGWESTERNMEDICINEWITHHMONGBELIEFS

beliefsthattheHmongpeopleholdandthetreatmentprotocolsthatwesternhospitalsprovide
(Graff&Birkenstein,2008,p.303).
TobetterunderstandtheoriginsoftheHmongmedicalbeliefs,itisnecessarytoanalyze
Hmonghistoryandculture.ThemostimportantHmongtraditionalhealerisknownasashaman,
whichissomeonewhocandiagnoseandtreatspiritualillness.Ashamaniscalledorchosenfor
thisrolebyspiritualforces,andreceivesallknowledgeandwisdomforthisrolefromthe
spiritualdimension(Plotnikoff,Numrich,Wu,Yang,&Xiong,2002).Comparedtowestern
medicine,theHmongputalotmoreemphasisonthespiritualandmetaphysicalaspectsofthe
humanbody.Westerndoctorsaremoreconcernedwiththechemicalandbiologicalworkingsof
thebody,whichisduetotheavailabilityofeducationandresearchtosupportscientific
medicine.Additionally,asanarticlepublishedbyHarvardUniversityexpresses,Thedisrupting
effectsofthespiritshavephysicalaswellassocialconsequences.Whenthedisruptionresultsin
sickness,ashamanmayholdthekeytothebettermentofthepersonafflicted(Castillo,
19972016).BecausespiritualityissuchacriticalpartofHmongcultureandlifestyle,itis
necessarytohealthespiritinordertohealthebody.ThiscanexplainwhysomeHmongpatients
areresistanttowesternmedicine,becauseitdoesnotincludedivineormetaphysicaltreatment.
ByinformingoneselfandlearningaboutHmongculture,onecanmoreeasilyrecognizethe
significanceandimportanceofHmongtraditions.
Aswithanyculture,theHmongaremostfamiliarandcomfortablewiththeirownbeliefs
andpractices,anditisimportantforwesternhealthprofessionalstorespectthis.Inrecentyears,
manyeffortshavebeenmadetointegrateaspectsofHmongshamanismintowesternmedical
treatments.Forexample,in2009theMercyMedicalCenterinMerced,Californiaimplemented

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COMPARINGWESTERNMEDICINEWITHHMONGBELIEFS

anewpolicyregardingshamanism.TheNewYorkTimesexplainsthatthehospitalsnew
Hmongshamanpolicy,thecountrysfirst,formallyrecognizestheculturalroleoftraditional
healers,invitingthemtoperformnineapprovedceremoniesinthehospital,includingsoul
callingandchantinginasoftvoice(Brown,2009).Iagreethatwesternmedicineshould
expandingandopeninguptoothercultures,apointthatneedsemphasizingsincesomanypeople
believethatitisnotpossibletoacceptotherviewsifsciencedisprovesthem(Graff&
Birkenstein,2008,p.298).InordertoprovidegoodqualitymedicalcaretopeopleintheHmong
community,westernhealthprofessionalsmustrecognizetheirbeliefsandbewillingtointegrate
themtoacertainpoint.
Inconclusion,thepathtobeneficialcommunicationbetweenculturesincludesrespecting,
appreciating,andunderstandingdifferingbeliefs.Assuringthecomfortofapatientisjustas
importantasmedicine,andalsorecognizingdifferentviewswillensurethattheyfeelrespected.
Althoughtherearemanydifferentculturesintheworld,healthandwellnessisimportant
worldwide.Maximumhealthandwellnesscanbereachedwhenotherculturesandtheir
traditionsareacceptedandembracedbyothers.

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COMPARINGWESTERNMEDICINEWITHHMONGBELIEFS

References
Brown,P.L.(2009).ADoctorforDisease,aShamanfortheSoul.
TheNewYorkTimes.
Retrievedfromhttp://www.nytimes.com/2009/09/20/us/20shaman.html
Castillo,M.V.(19972016).HmongShamans:AJourneytotheSpiritWorld.
HarvardDivinity
School:ThePluralismProjectatHarvardUniversity.
Retrievedfrom
http://pluralism.org/affiliates/student/castillo/index.php
Fadiman,A.(1997).
TheSpiritCatchesYouandYouFallDown:AHmongChild,HerAmerican
Doctors,andtheCollisionofTwoCultures.
NewYork,NY:Farrar,StrausandGiroux.
Graff,G.,&Birkenstein,C.(2008).
TheySay/ISay:TheMovesthatMatterinAcademic
Writing.
NewYork:W.W.Norton.
Plotnikoff,G.A.,Numrich,C.,Wu,C.,Yang,D.,&Xiong,P.(2002).HmongShamanism:
AnimistSpiritualHealinginMinnesota.
MinnesotaMedicine,85
(6),2934.