Table 2.
A Student's Journal Entry Answering Arthur Kleinman's “Eight Questions”
Arthur Kleinman's “Eight Questions” | A Korean Patient's Response | An American Patient's Response |
---|---|---|
1. What do you call the problem? | I don't know. It seems that he/she loses control of her brain. It is a sort of a shock. | Epilepsy |
2. What do you think has caused the problem? | The mother was shocked or surprised during her pregnancy. | A structural or metabolic abnormality in neuronal firing. |
3. Why do you think it started when it did? | When the mother undergoes a shock during her pregnancy, it disturbs the baby's mental state. After birth, the baby will always be affected, and it will be noticed by other people. | There may have been a specific trigger which led to the development of seizures. |
4. What do you think the sickness does? How does it work? | It destabilizes a person's mental energies. | Epilepsy results in synchronous neuronal firing in the brain. |
5. How severe is the sickness? Will it have a short or long course? | I don't know. I expect my doctor to determine this. I am eager to know. | I don't know, but I am sure my doctor will tell me. I may also seek a second opinion from a tertiary hospital. |
6. What kind of treatment do you think the patient should receive? What are the most important results you hope he/she receives from this treatment? | She needs an herbal medicine, or a traditional mixture or potion. If the right medicines are taken, then her mind will be able to slowly come back to harmony. | We need to get the most up-to-date medications. The newest treatments will offer the most hope for controlling epilepsy. |
7. What are the chief problems the sickness has caused? | This problem worries the family and friends. In addition, other people may wonder what is happening. It doesn't look good. | Epileptic seizures have led to self injury and asphyxiation. It has also been stigmatizing. |
8. What do you fear most about the sickness? | We fear that our child will never have a normal life. | I am confident we will solve the problem. I just hope this disease is curable. |
* These questions are designed to elicit the patient's perspective on his/her illness and therefore help the provider become aware of important cultural perceptions.Students were asked to answer the eight questions for the American and non-American cultures based on readings, class discussions, and patient interactions.