BIRTH
Several discrepancies in the documentation of names and birthdates arise within the first chapter.
If documentation were performed by a dietetic professional instead, what principles and standards of the Code of Ethics would be breached and why?
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The Hmong phrase, hais cuaj txub kaum txub, (pg. 12) means “to speak of all things.”
How can the phrase be applied within the clinical setting in “seeing the whole patient?”
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How can we be more like the Hmong? As in, how can we be resolute in our choices and be confident in the decisions that we make?
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Chapter 4: Do Doctors Eat Brains?
Pg. 33 U.S. approaches to healthcare are vastly different to those of the Hmong culture.
What are your thoughts on, “A txiv neeb might spend as much as eight hours in a sick person’s home: doctors force their patients, no matter how weak they were, to come to the hospital and then might spend only twenty minutes at their bedside.”
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"On another form, in the space marked “Communication Problems,” another nurse has summed up the situation with a single word: “Hmong.”
How do you avoid being culturally insensitive, how will you avoid it in the future?
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Why aren’t alternative medicinal therapies widely used in the US, and why aren’t they more accepted?
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Hmong people are very resilient and inspiring. What are some values we can takeaway from learning about their history?
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The Hmong and the Greeks believe that certain diseases are sacred or a blessing, do you think it is seen that way in American culture or do you think it could be possible that the western world can feel the same?
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Why were doctors so eager to undermine the authority of the shamans in the Thai refugee camps depicted in this chapter? What is the underlying factor that prevents doctors from working with cultural groups in general?
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In this chapter, trust is something that is lacking for the Lee family. What would be some alternatives that MCMC did not explore that might have helped the Lee family to trust the staff more?
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What do you think about how Hmong view “soul loss” as an illness when American’s rarely see mental health in the same way?
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How do you feel people/ cultures who are not familiar with the Hmong culture react to their differences? What values do you appreciate from their culture?
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If exceptional care is expected to be given to all patients, where is the committee that requires interpreters? Where are the audits to see that these services are available and being utilized? What would need to change systematically to ensure all populations were being served equally?
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Conquergood emphasized, "a productive and mutually invigorating dialog, with neither side dominating or winning out." How can we as nutrition professionals encourage 2 sided relationships with clients?
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How much of Neil's (pediatrician) note to Health Department alleging child abuse was due to judgement of and frustration with Lia's parents and how much was true concern for improving Lia's well-being? Was such a drastic step really the only option? Was he trying to teach the Hmong a lesson?
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Hmong people’s beliefs are characterized by the actions they commit, for good or bad, and the stories of their cultural past. Ideas such as “twiv neeb” referring to a shaman believed to have greater powers is thought to be able to help and heal. Could there be power in living a life more creativity like them, and less by “the books” so to speak, and if so, how so?
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"The Hmong never had any interest in ruling over the Chinese or anyone else; they wanted merely to be left alone, which, as their later history was also to illustrate, may be the most difficult request any minority can make of a majority culture." (14)
I believe the last sentence of this passage can be perceived as very controversial. When it comes to historical cases such as colonization, slavery and this case with the Chinese and the Hmong, I would agree that the minorities wished to be ignored. But, when it comes to the Hmong refugees living in Merced, they wanted their customs to be accepted or at the least ignored, but they do want the attention of the MCMC to help their child. At what times is it the role of the majority to ignore? To encourage assimilation?
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One thing that caught me off guard in this chapter was the mention of Lia's parents treating her sister Yer differently after she slammed the door. It was only mentioned this one time so far, which surprises me since one of this book's main themes is what makes a good parent. Do you believe that focusing more on a sick child and neglecting/treating another child differently (especially if you believe they caused the illness) is justifiable? (pg 23)
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Chapter 4:
Conquergood viewed helping the Hmong people as a compromise, he found a way to speak to the Hmong people in a way they’d understand and be willing to participate. Conquergood took the time to understand the people he was trying to help. Do you think this is a realistic method that other western doctors could have used, during those times, in the camps?
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Who is at fault for the fact that Lia is not taking the prescribed medication, is it due to the language barrier and the fact that the Lee’s aren’t being properly educated on the parameters of Lia’s disease or is it due to the Lee’s “neglect” and/or cultural differences?
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Define consent. What do you think of the hospital accepting a signature from Foua when she clearly couldn’t read or understand what she was signing? Do you believe this is a valid form of certification? What should hospitals do, or what have they done, to address true consent?
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Relate the following though/quote from the book to our modern healthcare system. What are some ways we act as if events occur in isolation? What are the downfalls to this practice? What can we do to change it?
Quote: “to speak of all kinds of things” [is] often used at the beginning of an oral narrative as a way of reminding the listeners that the world is full of things that may not seem to be connected but actually are; that no event occurs in isolation; that you can miss a lot by sticking to the point.” (p. 13)
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Lia’s parents did not necessarily see her seizures as a problem, but possibly even a good thing. What does this mean for western medicine? What would be the best way to go about handling a situation like this if you were a doctor?
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Page 33 says, “ twix neebs knew that to treat the body without treating the soul was an act of patent folly, doctors never even mentioned the soul” How does this make you feel about American medicine and treating the whole person rather than the immediate disease? Are there ways we as RD’s can be beneficial in supporting the treatment of the entire person?
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Why as humans do we often dismiss differences and change in viewpoints such as the way American medicine seems to treat the Hmong? How can we practice greater adaptability? What are other ways to approach the problem of Lia’s medications with regards to the side effects as well as the sheer need to actually take them?
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