L48 Anthro 3283 Chapter Notes - Chapter 18: Allopathic Medicine, Septic Shock, Biomedicine
Fadiman Ch. 18 (p. 262-277)
• Anne doesn't think her life was ruined by septic shock or noncompliant parents, but by
cross cultural misunderstanding
• Many Hmong medical cases turned out badly; mostly because of cultural
misunderstanding; hospitals did not have interpreters or try to work with the family’s
belief system
• The successful cases – had interpreters, a cultural broker (an equal) not a translator (an
inferior)
o Francesca Farr’s case – worked with the family’s belief system, did not carry her
belief system, never threatened, criticized, or patronized, said hardly anything
about Western medicine; loved the Hmong
• Neil and Peggy – by Kleinman’s definition – were excellent doctors, but imperfect
healers
• Bruce Bliatout says to improve Hmong health care, need to practice conjoint treatment
– integrate Western allopathic medicine with traditional healing arts
o “a little medicine and a little neeb” – Nao Kao
• Kleinman says the doctor cures the disease, but the indigenous healer cures the illness;
believes that conjoint treatment does more than promote trust between the doctor and the
patient
o Because illness is so profoundly affected by psychosocial factors, it actually
improves the outcome
• The Lee’s medical regimen for Lia ran parallel to Lia’s medical course, but they never
intertwined; Neil and Peggy never asked about it or recommended it to them
• Conquergood says there is no one better than a txiv neeb to span the gap between the
medical and spiritual
o Shamans see 2 modes of healing, natural and supernatural (biomedicine vs.
traditional) as complementary rather than contradictory
o A txiv neeb is more of a psychiatrist than a priest
o they exclude guilt associated with the suffering (unlike a doctor who says if you
don't take these pills/ have this operation/ or come to your appointment, you’ll be
sorry)
• in the mid-80s, Nationalities Service of Central California in Fresno received a federal
grant to establish “an integrated mental health delivery service utilizing Hmong healers
and western mental health providers”
• Example: Hmong with gallbladder problem; the txiv nee performed a ceremony first in
order to release the pain, but the pain persisted and the client accepted it was not a
spiritual problem and consented to surgery; the surgery was successful and the illness
was cured
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