“Ask not what disease the person has,
but rather what person has the disease”
(Fadiman 1997:275)
but rather what person has the disease”
(Fadiman 1997:275)
Cultural competency was severely lacking in Lia Lee’s case, the doctors caring for her did not understand, honor or respect the cultural beliefs of the Lee’s which may have allowed them to effectively work together. The Lee’s believed in “a little
medicine, a little neeb” (neeb=healing spirit). As Nao Kao stated to Fadiman (1997), “Sometimes the soul goes away but the doctors don’t believe it. I would like you to tell the doctors to believe in our neeb” (100).
Applied medical anthropology, unfortunately, was not utilized in the case of Lia Lee. The medical staff at Merced Community Medical Center had no working knowledge of the Hmong culture, health care behaviors or beliefs.
Critical medical anthropology at the micro-level, physician-patient relationship, was not applied in Lia Lee’s case. The
position of the doctors was to either follow their instructions or be labeled as “non-compliant”(Fadiman 1997: 48). There was an over-whelming air of superiority and dominance by the health care community toward the Lee’s. Within the local health care system, Lia was afforded the best available healthcare without regard to status or income. Within the community of
Merced, where many Hmong immigrants lived, there was a lack of knowledge regarding the cultural beliefs of their residents.
With the rapid pace of migration, urbanization and technological advances in medicine, medical anthropologists conduct critical research to promote human wellness, the relief of suffering, and the treatment of disease in an ever increasingly diverse world. With the research provided by medical anthropologists many positive changes have been made in providing culturally competent healthcare.
Anne Fadiman’s (1997) book, The Spirit Catches You and You Fall Down, has made an enormous impact on the medical community. The book is now used as a text for many health professionals to understand the need for cross-cultural education. As Fadiman stated “...the medical schools they attended had never informed them that diseases are caused by fugitive souls and cured by jugulated chickens” (Fadiman 1997:61).
Margalit Fox (2012) wrote an article, published in The New York Times, entitled “Lia Lee Dies: Life Went On Around Her,
Redefining Care”. In the article she gives this update: “In Merced and far beyond, Lia’s legacy is pervasive. In 1996, largely in response to her case, Healthy House, a social service agency that facilitates medical care for Merced County’s non-English-speaking residents, was founded in Merced”. The hospital now has interpreters available and Hmong shamans are allowed to visit patients and practice simple rituals (The New York Times website).