Recently read The Spirit Catches You and You Fall Down, a required reading for the study abroad program I leave for in three weeks (IHP’s “Health and Community” program), but also a great literary look at the clash between Western medicine and non-Western cultures, as well as the tragedy that can result from a lack of communication. The story centers around Lia Lee, a Hmong child living in California who is diagnosed with severe epilepsy.
One thing that becomes clear throughout the book is that doctors could stand to gain from a little more humility. There are some things medicine doesn’t yet understand. Part of our confidence in Western medicine arises from the mechanistic view of biomedicine, but when seven out of ten cases of epilepsy have no clear cause, we must resort to symptom management. And symptoms don’t always respond in a predictable, linear fashion. Lia seized more frequently after being placed in a foster home, despite strictly following the anticonvulsant prescriptions. Is it beyond the realm of possibility that being separated from one’s parents can have a detrimental effect on one’s epilepsy?
The point of this story is not that Lia should have been left with parents that changed her medications at whim. The point is that an effort should have been made to reach out to Lia’s parents through a way that they could culturally understand. If there’s a repeating theme throughout Fadiman’s book concerning doctors, it’s not that they were stubborn or didn’t care about their patients’ perceptions of treatment; it’s that they never asked. Then again, doctors are busy. “It wasn’t like we didn’t have six billion other things that we had to think of,” says one doctor in the book. Okay, then let the social worker worry about things like that. But then make sure you view that social worker as a vital part of your healthcare team, not “a large pain in the ass”.
Be it recognizing the possibilities beyond what Western medicine currently understands, or ceding some piece of authority to those who didn’t spend more than ten years of their life in school, I think some doctors can stand to improve the quality of the care they provide by simply showing a little more humility.