The Spirit Catches You Analysis

“Health is influenced by culture and beliefs” (NRS-429V, 2011, p. 1). In order for the nurse to properly care for the patient, she must know and understand the patient’s culture. “Cultural care is a comprehensive model that includes the assessment of a client’s cultural needs, beliefs, and health care practices” (NRS-429V, 2011, p. 1). It is not enough to just know where the patient lives or where he came from. The nurse must embrace the concept of cultural competence and cultural awareness. This requires not only the awareness of the cultural beliefs and values of their patients, but also

Language barrier was a major factor that served to extend the boundary existing between the two cultures. Some of the utterances made by the doctors were interpreted right but were understood wrongly (Swartz 2). This resulted in a worsened discernment of the American doctors by the Lees and Hmong as an entity alike. In the case of an emergency, the Lees needed to contact an ambulance, but could not communicate with the hospital. This necessitated the involvement of their learned nephew, who would call an ambulance. The interpretation process would at times limit the effectiveness of the message intended by either party. For instance, when Lia was undergoing critical care in MCMC, the Lees needed to be comforted, a process which had to be done by an interpreter. Before the final discharge, miscommunication between Lia’s mother and the doctors had her think that the nurses disconnected medicine tubes off Lia in order to give it to some other patient; a mean act. In the same incident, Lia’s father was made to sign a letter of discharge for Lia, which would happen in two hours. However, he understood this as a letter to guarantee death in two

“Between the ages of eight months and four and a half years, Lia Lee was admitted to MCMC seventeen times and made more than a hundred outpatient visits to the emergency room and to the pediatric clinic at the Family Practice Center.” The Lee family was a regular visitor at the hospital but it did not make thing between the Lee family and the hospital any easier. There was many issues between Lia’s family and the Merced hospital staff. Many of these issues steamed from many different areas of things. Between the Lee’s a Hmong family and the American doctors at Merced Hospital there were several cultural differences on what both parties wanted. Cultural difference was not the only thing they did not see eye to eye on there was also a huge language barrier between the Lee family and the workers at Merced hospital.

Many live under the assumption that those who come to the United States want to become Americanized and assimilate to the melting pot our culture has formed into. This is the populations ethnocentric belief, which is the belief that the ways of one’s culture are superior to the ways of a different culture, that wants others to melt into the western ways. In Ann Faidman’s The Spirit Catches You and You Fall Down, Faidman fails to completely remain objective when demonstrating how cross-cultural misunderstandings create issues in the healthcare field, specifically between the Hmong and western cultures that created dire consequences between the Lee’s and their American doctors. Faidman uses her connections with the Hmong and the doctors who cared for them in order to disclose the different views, beliefs and practices the Hmong and Western cultures practiced. With her attempt to be culturally relative to the situation, Faidman discusses the series of events and reasons as to why the Lee’s faced the fate that they did and how it parallels to the ethnocentrism in the health care system.

When parents apply religious or cultural beliefs concerning spiritual healing, faith healing, or preference for prayer over traditional health care for children, concerns develop. This dilemma is unraveled in Anne Fadiman 's true story, The Spirit Catches You and You Fall Down, where the study of cross cultural medicine holds a significant value in all profession. The book chronicles the vast cultural differences between mainstream Americans and the Hmong, and how language and cultural barriers affected Lia 's treatment. To understand the Lees we really need to understand the Hmong culture.

In a perfect world, race, ethnicity and culture would have no negative effect on the medical care we receive, yet problems do arise and it affects the quality of care the patient receives. Language barrier, poor socioeconomic status, and poor health literacy also contribute to health care disparity. For Lia, it was more than her skin color, it was all of the above, her parents did not speak English and they were illiterate. They had trouble understanding the American healthcare system, had trouble or little interest in adjusting to or understanding the American culture. They didn’t work, which in addition to cross cultural misunderstanding, helped contribute to animosity between the Hmong and the host community, because some in the Merced area did not like or appreciate the fact that some Hmong did not work and relied on welfare to make ends meet. All these factors, contributed to the poor quality of

The case study of Lia Lee is interesting and serves as a cautionary tale as it explores the consequences of cultural misunderstanding. In this case both the parents and medical staff sought the same thing; they both wanted Lia to have a positive outcome. Unfortunately, both groups had distinct ideas regarding how to achieve the common objective. This division was rooted in each sides individual cultural beliefs.

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.

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 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.

In the book, The Spirit Catches You and You Fall Down, it addresses one of the more common challenges and characteristics of health care today: the demand of working with as many cultures as possible to meet the demands that our country has. The Hmong population of California where the family is residing addresses the collision between western medicine and traditional healing practices of the Hmong immigrants. There are so many different cultures residing amongst us in the United States today and we need to be able to cater to all cultures not just the most abundant one. What we see is a barrier, or lack of combination in the example of the story by Anne Fadiman. In the book, Lia, a Hmong child with a rare form of epilepsy, must enter the

Anne Fadiman wrote this book to document the conflict between cultural barriers and how they affect medical issues. In this book, Lia Lee is a Hmong child was has epilepsy and battles cultural medical differences. The main struggle in this story is the conflict between the doctors and parents because they cannot seem to get on the same page. While writing the book, Fadiman stated that there was a “clash of cultures”. (Fadiman, preface) Meaning, there are two different sides to the story and the problem has not be solved.

The main purpose of this article is for the nurses to provide a successful caring for the minority. Hmong are one of the largest minority group to lived in the United States. In order for the health professional to provide care for them. As Torry Cobb said, they need to be aware of the “history, culture, social structure and belief systems” of the Hmong people. The health care providers need to respect the Hmong American medical practices because they believe in their own use of traditional medication and using the shaman will help heal their spirit and physical illness. They also do believe in the western medication, but sometimes they don’t have confidence in the health care system because of their beliefs and practices. In addition to that,

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,

With regard to adapting care to the cultural context of a Native American patient, two theoretical nursing perspectives would be useful. The first is the meta-theory of critical theory, which is concerned with addressing and overcoming unethical power relations in the nursing situation (Oudshoorn, Ward-Griffin, & McWilliam, (2008); and under this umbrella, the second is Leininger's middle-range theory of cultural care, which is specifically concerned with surmounting cultural barriers in the nursing situation (McFarland & Eipperle, 2008). The critical theory perspective would help the nurse remain attuned to power discrepancies in her relationship with the Native American patient; this is absolutely crucial, because a Native American patient may be far more sensitive to what he perceives as acts of domination than patients from the dominant culture. Complementing this broad view, Leininger's theory provides a more specific framework which the nurse can use to assess her patient in order to make sure that she is taking a full holistic account of the patient and refraining from imputing her own cultural views onto the patient. This theory isn't predictive in nature, but it will help the nurse develop the frame of mind necessary for providing "culturally congruent care" (McFarland & Eipperle, 2008, p. 48) for the Native American patient. The middle-range theory can help the nurse bridge the simple social-cultural gap, while the meta-theory