The New Atlantis (Feb11,2k13)
In 1982, a tiny baby girl was brought to a Merced, California emergency room with a murky complaint. Her parents spoke no English and no hospital staff spoke their language, Hmong. Not much seemed to be wrong with her except congestion, for which the resident on duty prescribed antibiotics and told the parents to bring her back in ten days for a follow-up appointment. They didn’t, as they had no idea they had been asked to do so; but in nineteen days, they were back in the ER with a similarly urgent but unknown concern, and the whole scenario played out again.
On their third such visit, the problem crystallized — the child arrived still in the throes of a grand mal seizure. The doctors sprang into action, as doctors do, to control the seizing (which they did), determine the cause (which they didn’t), and provide her family with anticonvulsants to prevent it from happening again (which they tried).
It happened again, dozens of times. With every new seizure there was an increased risk of progressive damage to the brain, as the critical flow of oxygen was impeded.
After a few months of treatment and multiple adjustments to the prescription, the doctors realized to their dismay that the patient was not responding to the medication because she was not taking it. How could this be? Her parents were clearly devoted to her, but perhaps they did not understand. A fleet of nurses, social workers, and other liaisons was dispatched to the family home to draw up charts and schedules, stick little suns and moons on pill bottles to indicate the time to be administered, mark liquid dispensers with the proper dosage, divvy out the medication day by day, tape samples to a calendar to show what had to happen when, and explain a hundred times the utmost importance all this had to restoring their daughter’s health.
Though a translator had not been present at the family’s first few encounters with American medicine, by this point there was usually a cousin or older sibling or interpreter provided by the county, which ostensibly was to allow for all parties to make themselves perfectly clear, and, presumably, arrive on the same page as to the care of the patient, whose best interests everybody had at heart. But it turned out that the lack of a translator was the least of their problems. For reasons of their own, which health care providers vaguely sensed related somehow to “spirits,” the parents balked at many therapies no matter how carefully, repeatedly, or urgently they were explained, preferring to sacrifice a cow or rub coins on the baby’s body than to give her Western medicines with their disturbing side effects.
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