Medical Beliefs of the Hmong People Depicted in the Book, The Spirit Catches You and You Fall Down

What happens when two very different or even mutually exclusive cultural perspective are forced into contact with one another? In Anne Fadiman’s The Spirit Catches You and You Fall Down, there is a division between the shamanistic insubordinate cultural of Hmong refugees in Merced, California and the cold analytical approach of western medicine. In the early 1980s, the child of a Hmong refugee family in Merced, California is born with epilepsy, her name is Lia Lee. Anne Fadiman traces the interaction between these two cultures and Lia’s disease, she reviews that misunderstanding and miscommunication can have calamitous consequences for all involved. The author introduces many characters throughout the book and they all

The Spirit Catches You and You Fall Down, portrays two themes. First, the text refers to Hmong history and the destabilization of the region of Vietnam forcing Hmong refugees to migrate to other parts of the world but mostly the United States. Within the text is another story of a Hmong refugee family and their daughter named Lia Lee who settle in Merced California. Lia is tormented by a misfortunate diagnosis of epilepsy and faced by cultural inequality by her American doctors. Health care providers wrote Lia Lee off as a complex patient with severe communication barriers. Almost all of her admission notes contained the phrase” language barrier” (Fadiman, 2012). As she bounced back and forth between healthcare providers within the Emergency Room and pediatric visits, her doctor, Neil Ernst concurs that her parents are responsible for the communication barrier and non-compliance with prescribed treatment. Dr. Ernst deemed this as neglect and had Lia placed in a foster home but after being separated from the only people she knew, her conditioned rapidly deteriorated. Her seizures progressed in intensity and duration until one

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

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

The Spirit Catches You and You Fall Down is the story by author Anne Fadiman, which explores the clash between a small county hospital in California and a refugee family from Laos over the care of Lia Lee, a Hmong child diagnosed with severe epilepsy. Lia’s parents and her doctors both wanted what was best for Lia, but the lack of communication between them led to tragedy.1The lack of communication due to cultural misunderstanding, mistrust, lack empathy, and poor health literacy led to care being comprised for Lia, which also affected both her parents and healthcare providers.

The Hmong cultural/religious belief in shamanistic animism claim that wicked spirits are continually searching human souls, mostly those of defenseless or unappreciated children. For Hmong culture, epilepsy is known as qaug dab peg which means, "the spirit catches you and you fall down" in English (Fadiman 1997), which epileptic invasions are seen as affirmation of the epileptic's capability to enter and stay temporarily into the spirit world (unconsciousness). In Hmong

What would it be like to come to a country and not understand anything about its health care system? To many this would be a very daunting task. Unfortunately, this is the scenario that the Lee family has to deal with in the book The Spirit Catches You and You Fall Down by Anne Fadiman. The Lee family, and the other thousands of Hmong immigrants, try to understand and navigate the complex and sometimes confusing health care system of the United States. As the book points out, the values and ideals of the Hmong culture and the United States health care system are not always the same and sometimes come into great conflict with each other. Lia Lee was unfortunately the person stuck in the middle of this great conflict.

At birth, the Hmong view their newborns as a gift and extremely special. At birth, it is called “Mus Thawj thiab, “go become again” or more simple, “reincarnation,” is a traditional Hmong belief (Bankston 2000). When a child is born, they are automatically seen as a gift and reborn as a reincarnated soul. Though, if a child dies after three days of living there are “no funeral ceremonies…since the child did not have a soul yet” (Bankston 2000). The Hmong believe if the child lives past three days, their soul is present though if they die, the infant never had a soul to begin with. If the child lives past day three, then a shaman is brought in and he “evokes a soul to be be reincarnated in the baby’s body” (Bankston 2000). This is considered

“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.

Being a Hmong means their spiritual beliefs are a lot different than those of an American. For instance, a mother a Hmong child would birth her baby in their home with her own two hands. On the other hand, an American mother would birth her child in a hospital with medical staff. When Lia was born, she was born in the Merced Community Medical Center and at that point in her life she did not have epilepsy. At three months old Lia began having seizures. The seizures were blamed on her older sister because she once slammed a door and frightened Lia. Her parent’s belief was the slamming of the door scared her soul out of her body and made her lost. With an American family, this is not something they would typically believe in.

The book titled The Spirit Catches You and You Fall Down: Talks about a Hmong Child, Her American Doctors, and the Collision of Two Cultures written by Anne Fadiman. Anne Fadiman is an American essayist and reporter, who interests include literary journalism. She is a champion of the National Book Critics Circle Award for Nonfiction, the Salon Book Award, and the Los Angeles Times Book Prize for Current Interest. In the book, Anne Fadiman explores the clash between a county hospital in California and a refugee family from Laos over the health care of Lia Lee. Lia Lee is a Hmong child diagnosed with severe epilepsy, whose parents and the doctors wanted the best treatment for her, but the lack of communication cause a tragedy. The essay paper will state and explain what went wrong between Lia’s family and the doctors. The central point is a lack of understanding between them leads to Lia’s tragedy.

The Spirit Catches You and You Fall Down tells the story of Lia Lee. Lia was barely three months old when she had her first epileptic seizure. Born into a large family, her parents, Nao Kao and Foua Lee, were Hmong refugees from Laos who didn 't speak a word of English. While their culture dealt with illness through shamans or txiv neeb, Lia’s seizures were so serious that they decided to take her to Merced Community Medical Center, a county hospital that had a renowned team of pediatric doctors. However, none of those doctors spoke the Hmong language. This initial encounter gave way to a series of collisions brought on by a difference of language, a difference of religion, and a difference of world view which caused a myriad problems that resulted in a tragedy of medical and emotional proportions for Lia, her family, and her doctors. The author is painfully self-aware about her own limitations within a culture that isn’t her own yet that doesn’t stop her from exploring the issues presented in the book with incredibly gravitas.

There is not doubt that every culture perceives illness in a different ways. In the first scenario the patient is an 80 years old Vietnamese female with a diagnosis of colon cancer and receiving many visitors. Additionally, different kind of treatment has been explained but she refused the and medications as well. She remains quit and only want to be with her husband and son. All this behavior could be consider normal for a Vietnamese patient. To begin with, the Vietnamese have deferent perceptions on why they could be ill. They believe in spiritual causes, imbalances or caused by pathogens. The patient’s refusal of medications and treatment could be because a few believes that Vietnamese patient have towards western medicine (Dayer-Berenson,

All cultures throughout human history have had beliefs about the nature of disease and the means by which it originated, what it signified, and how to treat it. These definitions have evolved over the course of human existence. Nowadays, Western medicine defines disease as a consequence of a series of chemical reactions, or the opposite of a “state of complete physical, mental and social well-being” ("Constitution Of WHO: Principles”), whilst in other cultures, a disease might be the result of a supernatural phenomena and a method of treatment considered sufficient is praying in order to counteract these ‘forces’. Cultural differences may affect patients’ attitude toward the available medical care and their ability to understand the nature

Cultural factors can impact health care clients in a number of ways. Some cultures do not have faith in western medicine and may believe in alternative treatments such as prayer or herbal and traditional cures (Koutoukidis, Stainton & Hughson 2013, pp 110-115).