Cultural competency is defined as the "ability to consider cultural factors in the prevention and treatment of disease; includes the cultural influences on caregivers and patients" (Joralemon 2010: 137). Joralemon also goes on to say cultural competency is best understood with a negative example, "that is, by seeing what happens when culture is not sufficiently factored into the relationship between doctors and patients" (Joralemon 2010: 96). A clear example of this would be in Anne Fadiman's The Spirit Catches You And You Fall Down. The doctors treating Lia were not able to understand the Lees point of view of view and the Lees were not able to understand Western medical practices which made the situation very complicated. If cultural competency had been applied by the doctors and the Lees maybe the situation would have been much different. The Lees and doctors rarely had an interpreter with them so they could not even communicate, and if they did it would have been through a young relative. The other "language" barrier the doctors and Lee had was the Lees were not able to understand why Lia needed all of her medicine, they sometimes gave her too much or too little, "The absence of a good interpreter was only part of the communication problem.. Neither doctor could tell how much of their inability to get through was caused by what they perceived as defects of intelligence or moral character, and how much was caused by cultural barriers" (Fadiman 1997: 47). This quote does a great job at showing how big of the cultural gap was between the two. Their was no trust between the doctors and patient's family, no understanding which could be due to an actual language barrier or to a difference in the knowledge needed to understand Western medicine- both contributed to mess this story explains.