anthropology assignment

When practicing medicine in an intercultural environment, the importance of a translator cannot be underestimated. In a scenario where I was the practicing physician in a community that worked with (specifically) Hmong refugees, my first and primary concern would be to have a staff of interpreters at hand during all hours of operation. As I am not wholly familiar with Hmong society, practices and belief systems, it would be important to me to have an interpreter who was familiar with the culture, as well as the language. Aware of my ignorance, I would be open to cultural education on how to pursue medical matters with patients and families in a sensitive and sympathetic manner.

In the case studies, the parents of little Daisy acted on the suggestion of the physician, who was sensitive to the needs of the family and allowed them to perform ceremonies essential to their own medical practices. However, Daisy did not survive, and both sides of the cultural gulf blame them for their misapplied trust.

The parents of baby Neng had a much different story to tell. While Daisy’s parents encountered a physician who was sensitive to their input, Neng’s parents encountered a physician who felt it her responsibility to “save Hmong infants from their parents”[1]. The assumption on the part of the physician that Hmong parents were irresponsible and did not care about their children-while blatantly ethnocentric- resulted in traumatic and unnecessary police intervention and the subsequent flight of the family.

It is difficult to simply provide clear-cut solutions to complex social dilemmas. As a physician, I would imagine that my first priority-especially in intercultural environments-would be to educate myself on local attitudes toward Western medicine, as well as the traditional medicine practiced by the community. This would not be difficult. A simple Google search could have helped Neng’s physician to understand the potential hesitations the family might feel, and perhaps she could have better worked toward a satisfying solution.

When faced with the dilemma that Neng’s parents encountered with regards to the possibility of a life-threatening infection, I cannot say that I know exactly what I would do to care for the infant. If I felt his life were in danger, I would probably get the courts involved, however, that would be my last recourse, not my first. This action both frightened and alienated Neng’s parents, and weakened any influence that physician would have in that community.

If a child of Hmong parents were presented to me, feverish with no other symptoms, I would first communicate-via interpreter- with the family, to ensure that both parties sufficiently understand the situation. I would explain my fears, and what I wanted to do, and why I wanted to do it. I know enough about Hmong culture to realize that this is a family issue, and thus more people would have to be consulted. If the matter were urgent, I would encourage-at the very least- fever-reducing medicine in the meantime. During the time taken to collect the family, I would possibly inquire about any other medical consults, or cultural healers that the family trusts. It could help to involve them, in order for the family to feel more comfortable with the proceedings.

Above everything else, it would be my duty to treat the child, and I realize that sometimes things simply do not go as planned. While I recognize the occasional need for drastic action, I think that most people just want what is best for their child, and are willing to collaborate with the doctor, if they feel that the doctor is willing to listen to them. This is not just an intercultural application. It is easy for a patient of any culture to walk into a Western hospital or medical facility, and feel powerless. The fact that there is a system in place that can be activated to remove parental right from a child’s treatment-however justified- indicates that parental rights are not paramount, and that is a risk that some are simply unwilling to incur. It would be my aim to work to prevent the need for this type of power-struggle and to work with parents for the health of their child.

This process unquestionably takes a great deal of time, overall. Doctors these days have rosters of thousands of patients and don’t generally have the time to sit down for a Hippocratic heart to heart. However, this is perhaps the necessary difference between what Western medicine currently is, and what Western medicine could possibly become. The LEARN model (Listen, Explain, Acknowledge, Recommend and Negotiate) is an excellent practice for physicians, not only because it is simple, but because it serves as a gentle reminder that even doctors have something left to learn.

[1] Healing By Heart P.121