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Friday, August 16, 2019
A Hmong Child, Her Doctors and American Tragedy Essay
Introduction            America is known for having a culturally diverse society. The Hmong Group is among the population of the said society. In the story entitled â€Å"The Spirit Catches You and You Fall Down†, which was written by Anne Fadiman, the main character came from the said ethnic group. The Hmong ethnic tribe is known for their knowledge and practice of traditional and primitive medical processes in healing their sick members. Based upon their beliefs of spirits, they usually create their medical observations on the patients and later on apply the practices they know are needed for the patient’s recovery. The question is that â€Å"since their traditional practices have been proven effective for many members of their group for the past years of their history, does it guarantee that their ways of healing the patients that they treat are better than that of medical processes? Is there any possibility that the medical practices of the modern medicine be integrated with the cultural ways of the ethnic groups and still gain better results on the patient’s recovery later on? How effective could the said kind of medical processes be when it comes to actual application? These questions with regards to culture and its effect and influence towards medication would be the main topic of this paper and the subject of the discussions that would follow. About The Case            The story, as written by Anne Fadiman involves a young child who is afflicted with a serious illness. The girl’s name is Lia, a preschooler who has been experiencing developmental delay since she was in her younger years. As she grew up, she developed more serious health problems such as major seizures every now and then accompanied by several series of severe convulsions and cerebral Anoxia. Because of the said situation, the young child was profoundly impaired and physically incapable of doing the normal things that a young child naturally does. She was not playful and she had fewer chances when she used to react on the situations that are happening around her.            The parents of Lia, who were traditional Hmongs, believe in their cultural medication. Hence, whenever she passes out, or looses her consciousness, they claim that it is simply because she has ‘lost her soul’ and thus needs to  receive ritual practices to be able to regain her own self. For several times of having seizures, the ethnic elder of their tribe has tried reviving the young girl through ceremonial ministries and application of herbal medicines which were prayed over for her benefit.            Upon knowing this, the medical experts who used to handle Lia’s case before she went home believed that the further developments of her illness towards becoming worse was caused by the neglect of her parents in giving her anti-convulsant medications. The said anti-convulsants are known to be strong and really affect the system of the child as it tries to ‘repair’ the damaged brain tissues of the child every time she looses her consciousness.            Later on, the medical practitioners who were supposed to both evaluate and take charge of Lia’s health situation was moved to get the child from her parents and bring her to a medical center where they believed she could be more closely observed and cured as well.            However, the medical processes used by the said practitioners were not as successful as they believed it would be. As for a fact, the terminality of the case of Lia even pushed to a worst condition until her parents were advised to take her back home, especially when they started to believe that her case could not be met anymore and that there is only a little time left before she dies.            Upon coming home, the tribe or the ethnic group of Lia performed several rituals again which they strongly believed would help her recover. As a result [as the tribe members claim] is that the young girl did not die. However, she was brain dead. This means that although she still breaths, her brain does not function anymore making the other systems of her body useless as of the said moment.            Knowing the situation behind Lia’s case, a Diagnostic and Statistical Manual (DSM) Protocol shall be created regarding her case. Hence, by doing so, the author of this paper hopes to help in turning the situation around by answering the question â€Å"What could have been done that could have contributed better on the progress of the healing process of Lia?†The DSM Protocol            The process of pre-medication and therapeutical approach towards the illness shall be applied on the DSM protocol that follows: Interview The interview shall be performed for the sake of creating a basis for the creation of the medical protocol that needs to be applied for cases such as that of Lia. The interview then would be addressed to several parties that are involved in the direct healing practice that needs to be applied for the patient. The said interview is subdivided into three major sections. Interview with the Parents of the Patient Since they are the ones who regularly attend to the patient and are also the ones who are directly affected by the illness of the child, it would be best to know how they are able to give the child’s needs amidst her health situation. It would also help if they would be asked on what kind of ‘home nurses’ they are to be able to meet the medical requirements of their child’s health status. The interview shall help the psychology experts to understand the environment of the child and thus identify what factors [may include emotional and social] affects the healing development of the patient. Interview with the Physician The Physician’s records as well as his own opinion towards the health situations of the patient are among the important sectors of this research. To be able to know the medical observations that they have done towards the patient’s situation, the development of the therapeutic process would be more practical and medically authorized. Interview with the Elders of the Ethnic Group An interview with the elders or the chief leaders of the ethnic group that the patient is joined with would help the person analyzing the situation to gain some knowledge about the basic cultural background of the patient and how the said traditional practices could be incorporated into the medical practice that would be applied to then patient afterwards. Tests The tests would involve oral, practical and medical tests: Oral tests This would be done with the patient [Lia]. This test would measure the development of the child with regards to the mental reasoning that she is able to use as she is asked some questions. [the author of this paper preempts that the patient is still at the first stage of her illness when she is still having slight seizures pertaining to the developing status of her illness. Practical tests This test involves both the parents and the child. They would be asked on how they are able to meet the challenges of the situation together. It should also include the ways by which they are able to treat their child during situations wherein their child experiences seizure and other health problems relayed to it. [It could be an inquiry on what they value better, the medical ways of healing their child or the traditional ways of dealing with the said health problem] Medical Tests The medical tests are almost the same as that of the interview with the physician attending to Lia’s case. Only this time, it would be based from the hard copy of the medical tests that have been made to identify the child’s sickness. Observation The observation on the patient would be based on both the written output of the interviews and tests that were done on the earlier part of the protocol, as well as with the actual observation of the situation of the patient during regular days. Life Records This mainly involves the observation and analysis of the life of the child as an infant and how she was taken care of by her parents. It would also be a measure on how the tribe tried to help in the child’s recovery through the application f traditional practices and cultural beliefs. This would allow the one working on the analysis to understand the possible sources of the aggravating health situation of the child. Assessment This process involves a more in depth observation of the situation. Assessment of the results that were collected would be incorporated within the healing [therapeutic] processes of medicating the patient. Clinical Inference After all the processes are done, it could be expected that the clinical application of the healing process could already be done.  The pre-trial and the actual application would help the patient, the relatives and the physicians involved in the case understand the importance of working together to be able to complete the healing process.            With the application of the said protocol comprising of six major processes, it could be noticed that the author of this paper aims to integrate some of the cultural practices within the healing process not only to avoid ethical issues and cultural conflicts in the progress of the healing the patient but also to evaluate ways buy which some of the cultural practices of the said ethnic group could help in the process of healing. Hmong Cultural Sensitivities            There are three major ways by which the Hmongs treat their patients. Most often, they tend to base this from their own diagnosis of the situation. As for Lia’s case, they believed that every time she passes out or losses her consciousness, she looses her soul. Thus they have to apply the three major practices to be able to regain her back. The three practices are as follows: Herbal Medicine application (A leaf that has been prayed over is applied on Lia’s body to regain her strength) Ceremonial Ministrations of a traditional practitioner (involves the prayers ad some group rituals that the ethnic tribe does to call the spirit of Lia back to her body) Sacrificing of Animals (Most often that not, this rituals are focused towards the gods of the tribes as a way by which they ask for the guidance of their gods for assistance in healing the sick member of the group) With the three major traditional ways that the Hmongs use, it could be noticed that the most important factor there is that has strong possibilities of being incorporated in a medical process is the use of herbal medicine. The reason behind this shall be tackled in the paragraphs to follow.            ON HERBAL MEDICATION            Although man’s use of synthetic drugs is a modern medical development, plant extracts have been used as cures for common ills for thousands of years. Early Assyrian records describe the use of the common anemone to alleviate pain. And Egyptian medical papyri from the time of the Pharaohs reveal a widespread use of medicinal plants. (Duke, 54) The World Health Organization has recorded the use of about 20,000 medicinal plants worldwide. In Britain alone an estimated 6,000 to 7,000 tons of herbs are used annually as ingredients in some 5,500 different herbal products, and in the United States, it has been reckoned that over half of all doctors’ prescriptions are for medicines derived from plants. With as many as 250,000 known species of plants in the world, each possessing a potentially unique chemistry, scientists constantly look for clues to find useful medicines (Mowrey, 87). One of the obvious ways is to study how people treat ailments using plants growing in their locality. The discovery of cocaine started with the observation that chewing coca leaves deadened hunger pangs and eased fatigue. By isolating and modifying the structure of the cocaine molecule, chemists produced a synthetic derivative for use as a local anesthetic. Much valuable information on the use of plants is still filed away in botanical collections. Scientists who spent over four years examining 2.5 million specimens in the Gray Herbarium and Arnold Arboretum of Harvard University were able to pinpoint more than 5,000 plant species previously overlooked as potential sources of medicines. (Duke, 54) Another line of inquiry compares the chemical contents of plants. If one species contains useful compounds, related species may also be valuable. When work on a north Australian tree, the Moreton Bay chestnut, isolated castanospermine, a poison displaying antiviral activity, botanists searching for related trees suggested looking at the South American Alexa. (Chevallier, 63) It could be noted that the use of herbal medicines could out do some of the effects of the strong anti convulsant medicines that Lia received from her physicians. Hence, through the incorporation of herbal medication in the healing process it could be expected that the process would yield better results. New Culturally Sensitive Protocol            In any healing process, it should be realized that the involvement of the family, the relatives as well as the society that roams around the patient is a very important factor of the restoration process for the patient being treated Hence, in this section, a more culturally sensitive protocol shall be created: Creation of a Physician-Parent relationship This would help the physician and the parents of the patient work together through the incorporation of the cultural practices of the family in the medical process. The physicians must study if the herbal medicines would do no harm in reaction to the existing medical processes applied towards the patient. In a way, this could take time, but carefully considering things with regards the issues involved in the medication could even shorten the period of healing that is required for the patient. Integration of the Processes Close enough to the first stage; this involves more of the cultural or ethnic chieftains of the group where the patient belongs to. Their realization of the fact that some of their rituals may not be that applicable on the situation of the patient and thus would not be incorporated into the system, would help them cooperate with the healing process provided by the medical experts. Evaluation of the Strengths and Weaknesses of the New Protocol            As clearly seen, the process involves in depth study which may require time and stress on the physicians since they are at some point controlled with the way they are supposed to deal with the situation. However, thru realization of the fact that emotional and social acceptance is important for the patient’s recovery would enable them to meet with the said challenge to their profession.            However, if carefully applied, this process could help both parties [medicine and culture] see the importance of each sectors of medication and thus create better ways of healing the patients based form then practices that both social sectors accept. Conclusion            In this analysis, it could be noted that at some point, giving importance to the cultural background as well as the cultural practices of an ethnic group with regards to medicine could help in the development of medical practices that are used towards patients today. It is seen that by doing so, the integration of two worlds to result to better medical development could be considered as a way by which medicine could further progress its practices.            After all, the ancient times when people lived longer lives and dealt with less complicated diseases, people appreciated herbal and other traditional ways of medication even before modern medicine was discovered. Going back to the original cure would sure not be a hindrance to further medical progress in the future. BIBLIOGRAPHY Anne Fadiman. (1998). The spirit catches you and you fall down. http://www.spiritcatchesyou.com/bookexcerpt.htm. (December 15, 2006). Growth House Incorporated. (1999). A Hmong Child, Her American Doctors, and the Collision of Two Cultures. http://www.growthhouse.org/books/fadiman.htm. (December 15, 2006). Books: Andrew Chevallier. (2000). Encyclopedia of Herbal Medicine: The Definitive Home Reference Guide to 550 Key Herbs with all their Uses as Remedies for Common Ailments. DK ADULT; Revised edition. James A. Duke. (1998). The Green Pharmacy: The Ultimate Compendium Of Natural Remedies From The World’s Foremost Authority On Healing Herbs. St. Martin’s Paperbacks. Daniel Mowrey. (1986). Scientific Validation of Herbal Medicine. McGraw-Hill; 1 edition.
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