The Girl-Geek Anthropologist

I just got back from hearing Anne Fadiman's lecture at Clark University. Anne is an author who wrote a ground breaking book called "The Spirit Catches You, and You Fall Down". It is the story of a little Hmong girl in Merced, CA who is epileptic, and her parents who think that she's not ill, but has been touched by the spirits, and she is being prepared to be a shaman. The doctors think otherwise. The book is about that confrontation, and the ensuing "dialogue". The little girl has been in a vegetative state for the last eight years, and she's being cared for by her parents who maintain the same beliefs.

As a medical anthropologist, this is a fascinating read, and very easy and accessible to the general audience. It's now required readings for literally millions of students in all sorts of classes. The entire incoming freshman class at Clark U. had to read it.

Now, I have to admit, I've actually not read the full thing, but have skimmed it. I have resisted reading it because everytime I tell people what I do, they say, "oh, like that book The Spirit...". So, I don't want it to influence me while writing my dissertation.

At the end of the book, Anne cites Dr. Arthur Kleinman, who is a leading medical anthropologist, and cross-cultural psychiatrist. Brilliant doctor, and a personal favorite. The end of the book contains eight questions that he came up with that doctors who are faced with a cross-cultural situation can ask of their patients. The goal is to reach an understanding of cultural categories that doctors can use as a bridge with their patients.

In my experience, doctors still resist the whole idea of cross-cultural communication. Many have a very difficult time stepping out of their culture and biases to see their patients' point of view. And, patients, especially those who have not been exposed to Western biomedicine, have a difficult time translating their beliefs to the doctors. The clinical encounter then becomes a jumbled mess of miscommunication.

At the end of the lecture, I asked Anne how she has been able to convince doctors to adopt she is proposing. I have had to deal with doctors who have been incredibly resistant to even considering anything other than what they know to be the "RIGHT" way to go. And, many put their ethical and moral standards first and foremost in dealing with patients. Her answer was really not very satisfactory. She said it was not an either/or situation, but that doctors and patients need to recognize their assumptions and biases, and work through them with the other. Errr... that's really not all that helpful, Anne. As a medical anthropologist who is in the hospitals trying to serve as a cultural broker, "they both have to come to the table" is not a very useful and practical thing. She said if there's no harm in what the patients are doing (whether it be through the use of allopathic medicine or seeing a shaman), then the doctors should respect that. But what if the situation is harmful. Then what? She merely mentioned it without offering any useful suggestions.

So, while on the one hand I really like what she's done, and truly appreciate the groundbreaking project she undertook, I'm not satisfied with her conclusions.

I'm still debating whether I would use this book in a class. Maybe I should read the whole thing before I make that decision, though.