There continued to be great misunderstandings between the doctors and the Lee family, as the Lees grew more non-compliant. They never trusted the doctors and failed to understand the importance of following the directions of the doctors. They would give her double the dosage prescribed or totally withhold the medication, which was responsible for the retardation in intellectual development of Lia. They also believed that a drug should not be taken forever, hence their decision to stop the administration of the anticonvulsant altogether. In the Hmong culture, the world could not be controlled by people, as opposed to what the American doctors believed in. Western medicine sought to actually control the world and go against the very destiny the Lees tried not to interfere with. The doctors and nurses at MCMC had several problems with the Hmong, because this group of people was very stubborn. They were never contented with the services provided by the American doctors. They complained about everything, and the doctors were so annoyed with their attitude that at some point they even said that the best way to help the Hmong was to shoot them in the head. The doctors were not interested in understanding the Hmong; and they were not trained in cross-cultural medicine, either. Therefore, they could only provide a limited scope of services to this unique group of people. When one of them was admitted to the hospital, they proceeded to perform their rituals in the hospital. This created a lot of commotion, since they used gongs, amulets and even animals for their sacrifices. They insisted on their own foods, and even brought in their own medicine. The Hmong also practiced dermal treatments, such as cupping and acupuncture, which are part of their culture (Alper, Tjosvold & Law, 2000).
The stubbornness of the Hmong made them receive poor health services. They believed that expressing an illness would make them lose their dignity. The doctors were, therefore, forced to just deal with the condition they could see in the patient. To worsen the situation, the Hmong dictated what medication was to be administered, and always insisted on being given a medicine, even if it was not necessary. The doctors at MCMC believed that it was their duty to decide how to treat patients, but the cultural differences between them always left them at logger heads with the patients. Dr.Roger was the first to understand what the Hmong really wanted. He realized that those people were against the American medicine. He, therefore, decided to do things their way and allowed the Hmong to hold their own rituals and bring in their own medicine. He even went so far as to stop performing operations on them. This is very unethical in the field of medicine, but Dr. Roger argued that it was their body, and hence they were free to make their own decisions. This led to the Hmong receiving substandard medical services. They, however, liked this particular doctor very much, since they believed that he had inferior skills compared to their own (Batcheldor, 2000).
When Lia was transferred to the foster home, her condition deteriorated even further, and she had more seizures than she experienced in her own home. The doctors believed that Lia’s condition had worsened when she was at home due to the non-compliance of her parents with medication administration. They thought that if she had been taken to a family where medications could have been given to her as prescribed she would have been fine. This was, however, not the case, and even though the Kordas did their best to take care of Lia and even took her to hospital five times a week, her condition worsened. This led to the Kordas starting to understand the Lees; they even recommended that Lia be taken back home, since she seemed to be better off with her family. The turn of events in this chapter complicates the relationship between the Hmong culture and the American medical practices. Even though the Lees had every prescription wrong, Lia seemed to be better off with them than with anybody else. It, therefore, proves that the belief of the Hmong that the health of a child was the responsibility of the parent and not of the doctor, was actually true (Alper, Tjosvold & Law, 2000).
When the author visited the Lees, she came to understand the Hmong culture well. She even realized that the Lees were very good people, and the doctors were just not willing to understand them. The lack of understanding between the two groups made Lia’s mother feel belittled, thus creating a state of war. As the author came to understand later on, the Hmong were not willing to associate with anybody they thought looked down upon them. This was the cause of all the problems that arose from the misunderstandings between the doctors and the Lees via the interpreters. They felt that the interpreter did not translate well what they meant, thus distorting the vital information. The Hmong never used the calendar, either; this made it difficult for the doctors to monitor the progress of Lia. The author, however, took it upon herself to understand their culture, and was, therefore, able to accept their feelings, thus making them become good friends (Batcheldor, 2000).
When Lia had a big seizure, the doctors lost all hope of saving her, and she was actually thought to be nearing her death. The doctors had tried all they could but the Lees saw it differently. When the life-supporting machines were removed, they felt that the doctors did so in order to give it to another person. This was due to the appalling illiteracy in the Lees family, which was a big challenge to be overcome, if they were to receive the best medical care. The Lees, however, did not lose hope; in fact, they wanted Lia to be taken back home in their apartment despite her brain being nearly dead. They believed they could nurse her back to health by using their traditional medicine. When she was readmitted to MCMC, Nao Kao demanded that her subclavian line be removed, and Peggy actually believed that they wanted Lia to die with dignity. However, the Lees believed that the hospital and the medicine were the reason for Lia’s condition. The Lees had no confidence whatsoever in the American medicine, and when the brain death occurred, they lost hope completely (Alper, Tjosvold & Law, 2000).
The theme of cultural understanding constitutes the main theme of this book. The American culture and the Hmong culture seem to conflict in every aspect, but especially in the area of medicine, and this is what led to the tragedy that befell Lia Lee. The book records comprehensively how the differences between the Hmong and American cultures led to terrible misunderstandings. Those included, in particular, religious differences, language barrier and traditional practices. Because of the conflicts Lia ended up being in the state that she was. In a community with mixed cultures, people must try and understand one another’s practices, beliefs and cultures. This would create harmony and mutual understanding. However, this was not the case with the Lees and their daughter. The doctors believed that they had every diagnosis right, and it was their duty to make Lia get well. The Hmong, on the other hand, had their own belief, and they felt that they could handle the situation without interference from the doctors. Due to the lack of understanding and compromise, Lia found herself at the receiving end of the cultural conflict (Alper, Tjosvold & Law, 2000).
The second theme in this text is a little medicine, a little need or soul. This is a theme of compromise between the two conflicting cultures. The Lees had brought their ideas to the author so that she could understand their culture and help them inform the doctors on how they felt about the condition. If only the doctors had taken time to try and understand the Hmong cultural medicine, Lia probably could not have suffered as much as she did. The doctors refused to seek the input of the Lees in dealing with the situation, thus leading to the final seizure that damaged her brain and made her end up in a vegetative state. The doctors mainly saw the life of the child as the most important thing, while the Hmong culture placed much emphasis on the soul, and none of them was willing to compromise (Simmons, 2009).
The other theme in this text is that when everything else is gone, there is love. The doctors and the parent both took hard stands, none willing to compromise. Both groups believed to be doing their best for the child, and they both saw the other group as being wrong (Batcheldor, 2000).
In conclusion, both the doctors and parents loved Lia very much and wanted her to survive against all odds. After all the cultural conflicts and failure of medicine cure her, both the parents and the doctors regretted. They both contributed to her brain damage, but still Lia lived on, the doctors loved her because of her lost potential. The parents too loved her because she was their beautiful little girl. When nothing was left of her, love still prevailed.