How to... Teach Culture

Quickly after being accepted to Yale, I received a package in the mail containing a book called The Spirit Catches You and You Fall Down, and instructions to "read the book by August 30, so [that I could] join in the discussions in a meaningful way". Now, before college, we were given a similar assignment called the "Penn Reading Project", but the book was not free, and the discussion about the book was both OPTIONAL (meaning all the cool kids skipped the discussion to sleep off their hangovers and prepare for the next night of drinking), which I found out much later than my overachieving self would have liked as I obviously had already read the Autobiography of Benjamin Franklin cover to cover thinking that there was some hidden test or something else "very high school" to check up on my completion of the task, and did not include an appearance by the AUTHOR herself. So, while I was initially skeptical and believed that I could pass on this assignment before I spent hours doing it (for once), I soon not only felt obligated to read the book for the sake of appearing somewhat knowledgeable in front of my future peers and professors, but I also did not want to disappoint/make a fool of myself in front of the author, a National Book Critics Circle Award winner for this book.

Being one of the few premedical students who chooses to major in a non-science discipline, let alone Anthropology, I quickly realized that this book was assigned in an attempt to summarize to all the biology majors and all of the chemistry enthusiasts in my class the entirety of what I had spent 4 years, a Masters degree, and a thesis studying: the importance of culture to medicine, or more specifically what happens when the "culture" of medicine collides with the culture of a patient around a specific illness or disease. The book details a child named Lia's suffering from a severe form of epilepsy, and the different perceptions/reactions/actions of the physicians who cared for her and her family members, Hmong refugees from Laos, around her illness episodes and her prescribed medication regime. By following this one case (a truly perfect example of an ethnography that paints a complete picture of the problem), we tragically see this clash of cultures, as evidenced by misunderstandings, illiteracy, communication barriers, and a complete lack of cultural understanding or training.

Even to me, someone who has read books like this before (and was actually almost assigned this particular book in a previous class) and who has studied non-Western forms of medicine, I read the pages of the book and I became somewhat overwhelmed, since even I did not know what I would have done differently as a doctor. As idealistic future physicians, we want to believe that when we are doctors, we will be great healers who will do everything in our power to help, not hurt, a patient; yet, we still would not know how to speak the language, and doubtfully would have known all of the Hmong traditions around medical care (I mean, it seems impossible to know everything about EVERY culture of a person who could be your patient), so likely, the same tragic outcome for Lia would have just repeated itself. Like any believer in the power of Western Medicine to cure and to heal, I would have thought that my patient understood what I was telling them and would follow a prescription regimen exactly as I told them (I mean, why wouldn't they?). Yet, if this book taught me anything, it is that I would be wrong. Because this novel planted a seed of doubt in my head and made me nervous that I will kill or seriously injure a patient simply because I will not understand them, I cannot imagine what reading this text is like for/does to a science major who has never heard of the Hmong and probably scoffs at the use of "alternative" medicine. In the end, for my classmates and my sake, I can only hope that since my school is taking the time to make me ask these questions of myself before I even approach a patient, after medical school, I will have had some cultural training to be able to check that my patient is on the same page as me, to better understand how to compromise in care between different forms of healing, and maybe, to more successfully work together with, instead of at odds against, the families to help save their children.

As I enter this next phase of my life, I am happy that the things I have learned in college broadened my scope and made me a better human being, which in turn will make me a better doctor. I am happy that the school I have chosen to attend values this knowledge and wants to impart it on my future colleagues (even if just for a second), so that they might be more understanding and more competent physicians in the future. And, I am happy that soon (well, after quite a few years of training and practice), I will have grown up to be what I always knew I wanted to be. Hey, I guess dreams really can come true.