Analysis Of The Spirit Catches You And You Fall Down

The Spirit Catches You and You Fall Down (1997) is an ethnography written by Anne Faidman. It tells the story of Lia Lee, a Hmong girl with severe epilepsy, and her family’s journey with managing the condition and the cultural barriers that posed great challenges in Lia’s care. Lia was diagnosed with epilepsy at age 1. It was her family’s opinion that the condition was a spiritual gift. Lia’s parents, Nao Kao and Foua, were wary of the American medical system, preferring to treat Lia in the Hmong way. Under the more spiritually focused care of her parents, Lia continued to have severe seizures; at the age of 4 ½, she slipped into a coma that would last the rest of her life. This book serves as a testament to the importance of cultural competency

“In the Spirit Catches You and You Fall Down”, Anne Fadiman explores the subject of cross cultural misunderstanding. This she effectively portrays using Lia, a Hmong, her medical history, the misunderstandings created by obstacles of communication, the religious background, the battle with modernized medical science and cultural anachronisms. Handling an epileptic child, in a strange land in a manner very unlike the shamanistic animism they were accustomed to, generated many problems for her parents. The author dwells on the radically different cultures to highlight the necessity for medical communities to have an understanding of the immigrants when treating them.

The Celebration of Misfortunes In chapter eight of Anne Fadiman’s The Spirit Catches You and You Fall Down, the author describes her arrival in Merced in 1988 and the awkward interactions she has with the Hmong community. Fadiman meets a psychologist named Sukey Walker who helps her realize that by being respectful and having a good translator she could earn the trust of the Hmong community. Fadiman brings a translator named Max Ying Xiong to her meetings with the Lees which helps her gain trust because her translator was related to the Lees through marriage.

The story of Lia Lee in The Spirit Catches You and You Fall Down, by Anne Fadiman, explores many struggles people experience when faced with a life-threatening medical conditions. But for Lia and her family, they had added barriers of being immigrants who speak no English, who cannot find jobs, and were exiled from their own country. Ones of the biggest factor against the Lees are Western medical practice versus Easten, and any non-dominate culture, medical practices. “…the accounts of the American health care system that had filtered back to Asia were not exactly enthusiastic. The limited contact the Hmong had already had with Western medicine in the camp hospitals and clinics had done little to instill confidence, especially when compared to the experiences with shamanistic healing…”

The Spirit Catches You and You Fall Down by Anne Fadiman is about the cross-cultural ethics in medicine. The book is about a small Hmong child named Lia Lee, who had epilepsy. Epilepsy is called, quag dab peg1 in the Hmong culture that translates to the spirit catches you and you fall down. In the Hmong culture this illness is sign of distinction and divinity, because most Hmong epileptics become shaman, or as the Hmong call them, txiv neeb2. These shamans are special people imbued with healing spirits, and are held to those having high morale character, so to Lia's parents, Foua Yang and Nao Kao Lee, the disease was both a gift and a curse. The main question in this case was could Lia have survived if her parent's and the doctors overcame

We can see that there was a misunderstanding between the Lee’s and the doctor. Both parties explained the view on Lia’s case but from a biased perspective within their own culture. Lia's doctors strongly opinionated to treat her disease with medication, however her parents felt that being given medication would restrict with the spiritual healing given by a Hmong shaman.

In addition, relying on a doctor who does not share the same beliefs as one does can become fearful. Trusting the doctor for full treatment is necessary but when from a different cultural background it can prevent them on trusting them. According to a research article, Cross- Cultural Medicine a Decade Later, clearly states “when the basic belief structure of biomedicine and another set of health beliefs differs radically, problems and frustrations almost inevitably arise” (Barker, 1992, p.249). The central purpose of the research was to show whether or not health beliefs between patient and doctor differs will they find it difficult to interpret the symptoms and treatment variations to accommodate their beliefs. However, the doctor having faith in one’s health beliefs can sometimes be beneficial for the patients because they’ll be fully understood and not misjudged as being crazy. As stated by the author, for the article Chinese Health Beliefs of Older Chinese in Canada, “the findings support the previous prescriptive knowledge about Chinese health beliefs and illustrate the intergroup socio-cultural diversity that health practitioners should acknowledge in their practice” (Lai, 2009, 38). Like the Chinese, Hmong’s too first go to their shaman for traditional treatment rather than going to the doctor; to them an illness and their healing is more of a spiritual thing that

According to the Hmong culture a shaman helps to cure the soul. A doctor cures biological problems. As we learn throughout this class there is a difference between an illness and a disease. An illness or a disease may have the absence of the other. In most cases an illness can be present without a disease. In the case of Lia there was a presence of both Illness and disease. If txiv neb and the American doctor would have balanced their practices and learned from each other this would have affected the way the Lees thought about medicine. I believe that faith plays an important role in Lia’s case if the doctors would have understood the way that txiv neeb thought and vice versa the lees would have trusted American doctors and medicine more. Learning from txiv neeb would have also helped the American doctors in other cases when treating Hmong by understanding their culture. It is important for the doctors to understand the Hmong culture and specifically the way that a txiv neeb works because in Merced a third of the population were Hmong and used a tixv neeb as their main source of healing.

The diagnostic testing that MCMC professional deemed necessary to assess Lia’s progress was continually challenged throughout her care. Foua Yang and Nao Kao believed most of the procedures were unnecessary and did not understand the importance of the testing. A challenge for healthcare professionals when dealing with disapproved medical procedures and methods in Lia’s situation is the repetitive testing needed to review Lia’s progress. The blood sampling that occurred at every medical visit was viewed as unnecessary and threatening to Foua Yang and Nao Kao because, “Most Hmong believe that the body contains a finite amount of blood that it is unable to replenish, so repeated blood sampling, especially from small children, may be fatal” (Fadima, 33). Medical professionals overlooked a very important aspect of the Hmong culture, which is the soul, and the wisdom of shaman Txiv. Prayer is often used in the United States as a healer and according to the Hmong culture,  “Txiv neebs knew that to treat the body without treating the soul was an act of patent folly” (Fadima,

The Spirit Catches You and You Fall Down is a book by Anne Fadiman about a Hmong family (the Lee’s) that moved to the United States. It deals with their child Lia, her American doctors, and the collisions of those two cultures. In Fadiman’s unbiased book I learned that there are many cultural differences between Hmong and Americans concerning opinions, stubbornness, and misunderstandings.

In the book “The Spirit Catches You and You Fall Down,” author Anne Fadiman presents a character who suffered from epilepsy as a Hmong child who born on July 19, 1982, in Merced, California. Being the fourteenth child of Foua Yang and Nao Kao Lee, Lia Lee was their favorite daughter. They spoiled her and treated her like a princess; believed that her epilepsy marked her as special; and that she might someday become a shaman, which is a person regards as having access to. Because of their belief, the Lees were both concerned and proud of Lia. They brought her to the Merced Community Medical Center (MCMC) for treatment, Meanwhile, they also practiced traditional healing that involved call back her soul using tvic neeb.

Child abuse and neglect is severely frowned upon in America. To abuse and neglect a child means that a parent has broken their promise to love and care for their children. Parents should not be able to take care of a child if their physical, mental or social wellbeing are in danger. Before reading The Spirit Catches You and You Fall Down by Anne Fadiman, I thought that I had a somewhat solid grasp of what child abuse meant and how a person should respond if they suspected that a child was being abused or neglected. I saw child abuse and neglect as a black and white picture where there was either care being provided for the child or the child was in danger. However, after reading The Spirit Catches You and You Fall Down I realize that the topic

1. The client system, in this case the Lee family, defines Lia’s seizures as both a spiritual and physical ailment. According to Fadiman (1997), “…the noise of the door had been so profoundly frightening that her soul had fled her body and become lost. They recognized the resulting symptoms as qaug dab peg, which means ‘the spirit catches you and you fall down’”(p.20). To the Lee family, Lia’s condition was as revered as it was frightening. While a person with qaug dab peg was traditionally held in high esteem in the Hmong culture, it was also terrifying enough that the Lee’s rushed Lia to the emergency room more than once in the first few months

Lia is born of a loving Hmong family, and just three months into her life, begins to reveal epileptic symptoms. According to the Hmong community, the condition is curable, and the presence of spirits in such a patient’s soul is considered a blessing. However, American doctors in a community medical center fail to understand and appreciate Lia’s parents’ approach to the child’s disease, and are only interested in saving this child’s life. As the conflict develops, it becomes apparent that the child will not be healed; but this is not without the doctors realizing the importance of compromise. In this book, Anne Fadiman claims, “I have come to believe that her [Lia’s] life

In ‘The Spirit Catches You And You Fall Down’, Lia, a Hmong baby girl, is born to a Hmong family living in California as refugees away from their war torn land in Laos. In Laos the Lee’s where farmers and lived in the country according to their Hmong traditions and beliefs. In California they barely understood the language, much less Western culture or medicinal practices. In Hmong tradition, illness was seen as a spiritual problem rather than a physical problem and a Shaman that practiced spiritual ceremonies and used natural remedies was sought to prevent or cure certain illnesses and/or diseases; so when Lia suffered her first seizure at the age of 3 months and was taken to Mercer