MIXING EAST AND WEST

To maintain a good balance of yin and yang, Chinese culture also dictates the importance of keeping a healthy flow of chi, or "vital energy", in the body in order to "maintain health and prevent illness or injury" (Olson, 29).  Physicians are able to help people with an imbalance of chi restore their balance through a variety of Eastern practices, such as "acupuncture, acupressure, and moxibustion (the laying of hot coins on certain parts of the body)" (Olson, 29).  Herbal medications can also be prescribed in order to correct the flow of chi within a patient.

In many cases involving an elderly Chinese immigrant and Americanized children and grandchildren, it seems likely for the elder to gravitate more towards using traditional Chinese medical practices while their children urge them to consult Western doctors and prescription medicines.  While both parties are simply more comfortable with what they know and what they grew up with, the constant disagreement between the elder and their progeny could result in a blending of both Eastern and Western practices.  

In some instances this would be fine; in fact, many Western doctors are finding benefits in combining Chinese traditional treatments with Western techniques.  In an interview with the director of the University of California, Los Angeles Center for East-West Medicine, Dr. Ka-Kit Hui, Hui supports the idea of "complementary medicine".  He believes that the main difference between the two styles of medicine is that the Western style examines disease in a very detailed, micro way, ultimately striving to "locate where the organs, cells and molecules are in trouble".  However, the Eastern practices view disease in a very macro scale, trying to understand problems in a more holistic sense.  By combining the two, for example, by pairing Western prescribed medicine with tai chi exercises for back pains, one is able to combine a very examined medicine with a more natural healing.  

However, there can be problems resulting from the combination of Eastern and Western medicines.  Reports of Chinese elderly using a combination of Western medicines and Chinese herbal medicines at the same time are not uncommon. (Hessler et al.)  This can be dangerous, especially in consuming the two different types of medicines, because of the risk of "drug interactions and toxic substances" (Olson, 29).  Because the two prescriptions are not coming from the same source, rather coming from two different parts of the world and two radically different styles of thinking, there is no way to know if taking both prescriptions together would bring about negative results within the patient.  Serious side effects resulting from poisoning could occur as a result of the interaction between Chinese herbal treatment and Western prescribed or over-the-counter medication.  (Yee and Weaver)

Thus, it is important to be aware of the risks in combining Chinese and Western medical practices.  Due to the different styles of perceiving disease and treating it, the most important thing is to be conscious of what is being consumed.  While more and more Western doctors are beginning to see the positive effects of Chinese practices, this does not mean that any an all herbs can be taken alongside pills and other Western prescribed medicines.  Attempting to compromise between the elderly Chinese customs and modern American practices could come to fatal results without a proper knowledge of both styles of healing.

SOURCES:

Chelan, David. "Multicultural Health: Eastern Medical Practices Augment Western Techniques." Smart Business Los Angeles (2006): Web. 23 Apr 2011. <http://www.uclahealth.org/workfiles/documents/insights/UCLA_LOS_0206.pdf>.

Hessler, Richard M., M. F. Nolan, B. Ogbru, and Peter K.M. New. 1975. "Intraethnic Diversity and Health Care of Chinese Americans." Human Organization 34, no. 3: 253-362.

Olson, Laura Katz. 2001. Aging Through the Ethnic Lens: Caring for the Elderly in a Multicultural Society. Lanham, MD: Rowman & Littlefield Publishers, Inc., 2001. 29. Print.

Yee, Barbara W. K., and Gayle D. Weaver. 1994. "Ethnic Minorities and Health Promotion: Developing a 'Culturally Competent' Agenda." Generations 18, no.1 (Spring): 39-44.

CREATING BALANCE THROUGH DIET

The traditional Chinese view of health, both physical and mental, resides in the belief of balance and equilibrium of the yin and yang energy forces.

"Yin (the female element) represents the passive principle or bodily forces described to darkness, cold, wet, and emptiness.  Yang (the male element) is equated with the active principle, characterized by light, heat, warmth, dryness and fullness." (Olson, 29)

By living a balanced life, it is the Chinese belief that good health and prosperity will naturally follow.  However, the Chinese concept of a balanced life does not necessarily mean eating well-rounded meals and exercising, as would be the American way of thinking.  According to the Chinese, certain foods are considered to be "warmer" or "cooler", and consuming such foods would ultimately affect a person's internal balance of yin and yang.  While foods like ginger and hot tea are thought to affect the yang element, foods such as bananas, watermelon, and most vegetables would cool the body, affecting the yin element (Koo, 759).

For the Chinese elderly to believe so strongly in the concept of yin and yang, practices that seemed to make perfect sense to them could go against Western styles of thinking.  For example, because elderly people are seen to possess more yin element "because of their age and physical conditions", according to the yin and yang food beliefs they should refrain from eating most fruits and vegetables (cold foods), which would affect the imbalance of yin and yang in the body (Olson, 29).

This goes against the American view of having a balanced diet in order to lead a healthy life.  The conflict could arise between elderly Chinese who still hold on to their cultural beliefs and their acculturated children and grandchildren; while the younger generations see a balanced meal as being important, the elderly would see it as being imbalanced for them to consume foods that would add to their yin element rather than trying to balance it out with "warmer" foods.  The elderly could even begin to believe that, upon their posterity's insistence to eat a more balanced diet from the American standards, their family would be trying to poison them and prevent them from restoring the balance within their own bodies.




SOURCES:

Koo, Linda C. 1984. "The Use of Food to Treat and Prevent Disease in Chinese Culture." Soc. Sci. Med., p. 759.

Olson, Laura Katz. 2001. Aging Through the Ethnic Lens: Caring for the Elderly in a Multicultural Society. Lanham, MD: Rowman & Littlefield Publishers, Inc., 2001. 29. Print.

LOSING FACE AND FILIAL PIETY

Filial Piety is an important aspect of Chinese culture.  It describes an "[emphasis on] respect, honor, loyalty, and obligations within the parent-child relationship" (Tsai, 1999).  Children are expected to take care of their aging parents, almost to a point of obeying without questioning.  They must: 1) support their parents, either financially or morally; 2) continue the family line; 3) obey and respect their parents, even after death; 4) self-sacrifice; 5) attend to parents at all times, especially when old or sick; and 6) honor parents and ancestors through good achievements.

This concept of filial piety, however, can prove to be detrimental to the elderly Chinese.  Since the elderly believe so strongly in filial piety and the fact that their children should be taking care of them in every aspect of their lives, they might be too ashamed or prideful to seek help from doctors or other healthcare professionals on their own.  Since filial piety states that children must attend to their parents at all times, they might feel that they would be losing face to discuss their own health problems with strangers; instead, they could feel that their children should be the ones to tend to them rather than professionals they do not know.

With the combination of filial piety and loss of face, children must be even more attuned and aware of their parents' health issues.  However, as younger generations become more Americanized, concepts such as filial piety become less of an importance; families where both parents have full-time jobs could mean that less time is spent tending to the elderly's every need.  As the children and grandchildren live their own lives, they would be less aware of the needs of their elderly parents and grandparents, so even when the elderly still believe so strongly that it should be their progeny who take care of them, if they do not voice their pain the busy family might not be able to pick up on the fact that they are in need of medical help.



SOURCES:

Tsai, Jenny Hsin-Chun. 1999. "Meaning of filial piety in the Chinese parent-child relationship: Implications for culturally competent health care." Journal of Cultural Diversity 6.1, p. 26-34

Olson, Laura Katz. 2001. Aging Through the Ethnic Lens: Caring for the Elderly in a Multicultural Society. Lanham, MD: Rowman & Littlefield Publishers, Inc., 2001. 24, 27. Print.

PERSONAL EXPERIENCES WITH LOSING FACE

I interviewed a family friend, who wished to remain anonymous, in order to get personal experiences with the Chinese elderly and their belief in losing face in terms of refusing to receive medical attention.

She immigrated to America in the mid-60's with her parents at a young age, so while she is more Americanized, her parents and the people of that same generation did not assimilate the American culture as easily as the immigrant youth, therefore holding on to such beliefs as losing face.  As they grew older, the concepts they held on to from their homeland proved to be detrimental, and in many cases, fatal.

Are you familiar with the concept of losing face?

Yes, in terms of bringing shame to a person or their family, right?

Correct.  Do you know of anyone, particularly from the first generation Chinese immigrants, who  refused to go to the doctor because they did not want to discuss their problems with others?

Yes, as a matter of fact, my husband's father died because he did not want to go to the doctor.  For the longest time his father was constipated and couldn't use the bathroom.  In fact, I think he couldn't use the bathroom for about a month but he wouldn't talk about it and wouldn't go to see the doctor about it.  He didn't know that he had cancer, all he knew was that he couldn't use the bathroom.  He was more willing to endure the physical pain than to actually go for help.  The cancer spread very quickly, and by the time he eventually went to the doctor the cancer had spread to his liver and he died.  

Do you think that he would have been able to live had he been willing to see a doctor sooner?

I think he would have been able to live a longer life but because of his stubbornness and because he didn't want to show that he was hurting, the cancer couldn't be helped.  I think if he had gone to the doctor right away something could have been done, but because he waited so long the situation became too much to treat.  The family even told him that he needed help, my husband told him that he needed to see a doctor about it but he kept saying that he was fine and that he didn't want to go to the doctor.  In the end, its what killed him.

Actually, I know another woman whose mother has been having some leg problems, I think she said that her mother had a growth in the heel of her foot.  When she went to the doctor, the doctor suggested that she use a walker, but her husband wouldn't let her use it.  When my friend wanted to put a rail in their shower so that her mother would be able to hold on to it instead of slipping, her father wouldn't let her put it in.  

Why do you think her husband was so against using aids to walk and to support themselves?

I think its just that generation in general, they don't want to be seen as growing old or being handicapped because its something so shameful.  Maybe when they were growing up they saw people who needed help walking or moving around and they saw that as being a shameful thing, so now when they are getting old they don't want to be viewed as being unable to walk because they think that other people would look down on them.  

I guess that ties in with the concept of losing face, how they see people who are old and in need of wheelchairs or walkers as being shameful.

Exactly.  

My brother-in-law, in fact, had a pinched nerve in his spine, so he had a lot of back problems but he won't see a doctor.  It hurt him to walk, sit and even sleep, and he had these pains for over ten years.  Finally when he went to see a doctor about it because he couldn't handle the pain anymore the doctor told him that he needed a surgery immediately.  My husband and I went to go see him after his surgery and he seemed better; he could sit up without pain.  

So even your brother-in-law, who isn't in the same generation as your husband's father and your friend's mother, showed signs in the belief of losing face.

Well, even though he is in the same generation as us he grew up in China until he was college-age.  So because he didn't grow up here he still has a lot of Chinese beliefs in him.  

I know that "losing face" has negative effects on the first generation of Chinese immigrants, but do you think this has any negative effects on the rest of the family, the younger generations who are more open about talking about their problems?

Yes, I think that because that generation is so against shaming themselves and their family, they don't want to talk about their problems to their doctors or even to their own relatives.  Even when they do tell their families, they don't want to mention it regularly or talk about it because they are embarrassed or they are ashamed.  

My niece, my brother-in-law's daughter, told me that she doesn't even know much about her family's health history.  She herself had to ask my husband (her uncle) how her grandfather died because her own father does not want to talk about things like that.  They never talk about it, but now she needs to know her family's medical history in order to be aware of what diseases may run in the family.  She has to know in order to be able to take care of herself and her own children.  

Losing face doesn't just affect the elderly generation; while it prevents them from receiving healthcare, it also proves to be detrimental to the future generations who don't know about their family's history of illness.  Thus, it becomes important not just for the younger generations to urge their parents and grandparents to go to the doctor when they feel pain, but to also actively seek answers as to why their family members have died and whether it was because of diseases that could possibly be passed on from generation to generation.  

LOSING FACE

The Chinese concept of "losing face" (mo meen in Cantonese) denotes the concept of bringing shame to oneself and ultimately to one's family.  Since the family is viewed to be more important than the self, personal mistakes and shortcomings "reflect badly on the entire family and cause shame or loss of face" (Braun and Browne, 1998).

Because loss of face is such an important concept to Chinese, and is taken more seriously in elderly Chinese than in more Americanized generations of Chinese, it is very likely for the Chinese elderly generations to withhold information regarding physical of mental ailments from the public eye and even from their own families.  The rationalization behind withholding information is that, by "avoid[ing] disclosing private concerns to outsiders" there is no way for others to look down on the family and therefore there is no loss of face (Braun and Browne, 1998).

However, for an elderly person to not discuss pain or sickness with one's doctor or even with one's family does not end well.  Since the elderly are more likely to still follow Chinese customs, they are more likely to see weakness as loss of face; it is the elderly who would most need the help of a doctor or physician in the event of an illness.

It is up to the younger generations to initiate conversations about disease and sickness with the elderly; because they would not speak openly about problems they may be having, the younger generations must be the ones to bring up the topics and help the elderly in receiving aid.



SOURCE:
Braun, Kathryn L., and Colette V. Browne. 1998. "Perceptions of Dementia, Caregiving, and Help Seeking among Asian and Pacific Islander Americans."  Health and Social Work 23, no 4:262-74.