William Beatty of Booklist stated that the work "has a scope much broader than that of a medical case history".
The whole ethnography is talking about the culture dissonance between the Hmong's culture, and western culture. Those differences are caused by the strong beliefs in the Hmong's culture, and the difficulties to accept a new culture. We can see a lot of misunderstanding between these cultures in the novel. Often, when the doctors are trying to convince the Lee's family about Lia's treatments, it is difficult for the Lees to accept that. They believe in their own ways, no matter it is helpful or not. At this point, they will refuse to accept the doctors' ideas, and because the treatments that the doctors give are basic on the scientific experiences, so the doctors will think that the Hmong's ideas are unreasonable or even stupid.
The Hmong religious belief in shamanistic animism asserts that malevolent spirits are constantly seeking human souls, especially those of vulnerable or unloved children. In Hmong culture, epilepsy is referred to as qaug dab peg (translated in English, "the spirit catches you and you fall down"), in which epileptic attacks are perceived as evidence of the epileptic's ability to enter and journey momentarily into the spirit realm. In Hmong society, this ability must be used to help others. Qaug dab peg is often considered an honorable condition and many Hmong shamans are epileptics, believed to have been chosen as the host to a healing spirit, which allows them to communicate and negotiate with the spirit realm in order to act as public healers to the physically and emotionally sick. In the U.S., the medical community rarely has ways to communicate with people of cultures so radically different from mainstream American culture; even a good translator will find it difficult interpreting concepts between the two different cultures' world-concepts. American doctors, unlike Hmong shamans, often physically touch and cut into the bodies of their patients and use a variety of powerful drugs and medicines.
In addition to these beliefs, Hmong also have many customs and folkways that are contradicted by those of the American mainstream and medical communities; for example, some Hmong traditionally perform ritual animal sacrifice and because of very specific burial traditions and the fear of each human's many souls possibly escaping, the traditional Hmong beliefs do not allow for anyone going through invasive medical surgery.Hmong medical system is based on nature-based theory that lets life flow as it may be, whereas the western medical system is based on the modernized humanism-based medical science.So when Lia was treated by the American doctor with western medicine, Lia’s parents do not agree with them.
The book used the experience of the Lia’s family to describe the differences of the two cultures - Hmong and American. The author uses different aspects to reflect the culture differences. Because of religious difference and language barriers, led to problems with Lia’s medication.Lia was a poor girl, when she was 3 months old, she had epilepsy. Although her parents carried her to the hospital to accept treatment, her parents didn’t believe the doctor. They not only accepted chemotherapy, but also used the Hmong traditional way to cure Lia. The doctor thought her family was irresponsible to their doctor. These problems deeply reflect the difference of two culture.
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