Subsequent Care: Part I

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Ultimately, Mr. Moua was on a ventilator for almost two weeks and was in ICU for almost one month. It was determined that his pulmonary hemorrhage had been caused by pulmonary tuberculosis, and so was given anti-TB therapies.

Once discharged from ICU, he thanked the nurses and doctors for saving his life, and commended the value of the ventilator, oxygen, and medications. He acknowledged to Dr. Khang that his fear of nurses and doctors harming him was unfounded, but still, throughout his ICU experience, he was afraid every day of the invasive procedures that occurred without his control.

The day after he arrived home, Ms. Richardson and Ms. Yang greeted Mr. Moua at his home. Ms. Richardson introduced herself as a public health nurse who was going to monitor his tuberculosis therapy every day and introduced Ms. Yang as the Hmong interpreter.

Mr. Moua smiled politely, offered them a seat, told his wife to get them something to drink, and then whispered to his youngest son so that the interpreter couldn’t hear him, “Monitor? Watch me? What do they mean, ‘watch me’? Can’t I take my medicines myself without being watched? Americans call this country “freedom country”, I don’t know. Where is freedom, when a nurse comes to my house every day to watch me take medicines?”

Ms. Richardson, with Ms. Yang’s translations, talked about TB and the TB medicines for 30 minutes, and then offered Mr. Moua three TB pills and told him to swallow them in front of her and then open his mouth so she could see that the pills were swallowed.

Mr. Moua felt indignant and insulted. Smiling, without anger in his voice, Mr. Moua said, “I am glad for your care and assistance, as I have been very sick in the hospital and appreciate any help you can give me. But I am an elderly wise man who can take his medicines without being watched. Thank you very much.” And he stood to show Ms. Richardson the door.

Questions for Discussion

Questions for Discussion

1. What do you think is causing Mr. Moua to feel insulted? Why do you think he has chosen to express his discomfort in this manner (i.e., whispering to the son, and then politely telling the nurse to leave) rather than directly confronting the nurse?

2. What do you think Ms. Yang’s role is, as an interpreter? Does it include being a cultural broker? If not, what can Ms. Richardson do to help? If yes, how do you think that she could help improve cultural understanding and resolve a negotiated mutually agreeable decision?

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