MountainMornings

The first night in Nashville I left my book club book in the car. Not wanting to go downstairs and back outside in my nightgown, I picked up a little paperback I found on the bedside table, The Spirit Catches You and You Fall Down, by Anne Fadiman. Little did I know how much I would enjoy reading about the Hmong people of Laos…currently living in California.http://www.nytimes.com/books/97/10/19/reviews/971019.19konnert.html

It’s a story about seizure disorder, and about the many ways modern medicine can fail a refugee population. Cultural dissonance is bound to happen when doctors want to order invasive tests for a baby who’s only problem is that her older sister slammed the door coming in and so an evil spirit invaded her body. For the Hmong, animal sacrifices, amulets, and strings around the wrist should cure her, but instead her parents, who speak no English, are supposed to dose her with a varied cocktail of drugs many times a day. You can see where we’re going.

But it’s not all medicine. I’m almost done with the book and I’ve had quite a history lesson on Southeast Asia. I was talking about the book to one of the Bride and Groom’s friends, an academic internist at Vanderbilt. She said it was required reading in her medical school. “Which medical school did you go to,” I asked. “Yale,” she said.

This morning, after working all night, my ER doctor asked me to read this article.
http://www.theatlantic.com/magazine/archive/2013/05/how-not-to-die/309277/

Have no fear, yes, it is about dying. Let’s face it, the spirit eventually does leave us and we all have to think about this stuff, unless of course denial works for you. It’s about a doctor who becomes an educational/documentary film maker. He makes short films that actually show people what advanced dementia (among other maladies) looks like, and he tells us to have “The Conversation” with our doctors:

“In the health-care debate, we’ve heard a lot about useless care, wasteful care, futile care. What we”—Volandes indicates himself and Davis—“have been struggling with is unwanted care. That’s far more concerning. That’s not avoidable care. That’s wrongful care. I think that’s the most urgent issue facing America today, is people getting medical interventions that, if they were more informed, they would not want. It happens all the time.”

Which made me think. Sometimes, even when you speak the same language, you still can’t communicate.