A very powerful book I have used in premedical classes for years is called, “The Spirit Catches You and You Fall Down.”

It is a painful, poignant and, ultimately, tragic story of the illness of a child of a Hmong immigrant community in northern California.

The child had epilepsy and was under the care of a team of expert pediatricians and neurologists for many years. But there was an ongoing clash of cultural misunderstandings between her extended immigrant support group, family and the team of “experts” providing her health care.

All sides were well-intentioned, loving people who saw the same set of facts differently. And, as is often the case when cultural gaps exist, the patient was the one who suffered.

In this case, the Hmong community viewed epilepsy and seizures as a divine gift, not a medical issue.

In some cultures, epilepsy is a mark of being favored by God. Therefore, they were not at all interested in making sure the child took the medicine as needed.

As the seizures progressed and went untreated, the child began to show signs of severe and irreversible brain damage.

No amount of linguistic translation seemed to make a difference in either the cultural expectations or the devastating outcome that proved to be inevitable.

Often in health care, we mistakenly think that if we can just find a translator to help us with patients who are not English speakers all of our decisions and outcomes will be better and the process will go more smoothly.

Yet I have learned that it is not about literal translations, but about learning to read the culture in which one serves and lives.

In the classic television series, “Northern Exposure,” Dr. Joel Fleischmann was a Jewish physician from the Northeast who found himself practicing medicine in a remote small village in Alaska with an odd and humorous collection of residents.

He was often out of his cultural element, yet his openness to learning new ways enabled him to relate to an environment foreign to the one in which he was trained.

Cultural differences are often simply more than differences in language or national identities.

In this country, for example, rural southerners may have different world views, language quirks and expectations of the health care system than a sophisticated urban resident.

Hispanics may have a different set of needs than urban blacks, while urban blacks may have a different set of understandings than immigrant Muslims.

We are a melting pot, historically and today. I think it is our strength and challenge in the health care environment.

To deliver adequate health care, we need to remove ourselves from a public policy debate that has become a political quagmire.

Our job is to give the best health care that we know how to provide to the human being before us. Period. No other option is acceptable.

The economics of that are for the voters and politicians to decide. Our historic mandate is to be agents of healing. That has not changed in a millennium and it is my hope it never will.

It is only when a practitioner learns to “read the culture” can our patients’ needs be met.

It means that, despite our own cultural assumptions and backgrounds, we need to make a modicum of effort to learn about the cultures and expectations of our patients.

We need to know a bit about Muslims, Jews, Native Americans, Mediterraneans (like my own), as well as Hispanics and blacks — and we must learn how cultural forces shape and define our patient’s lives.

It is all too easy to project our own background and experience to that of the patient. But disastrous outcomes are almost a given.

We can do better. If we practice with open minds and a bit of effort to learn about our patient’s lives, the worse outcomes can be avoided.

Michael Attas is a local doctor, a medical humanities professor and an Episcopal priest. Email him at Michael_Attas@baylor.edu.