The Spirit Catches You And You Fall Down Analysis

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

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

When some Hmong children arrived at the hospital, doctors were extremely concerned about the lesions left on the abdomen and arms of their pediatric patients. The doctors ended up contacting Child Protective services on several occasions claiming child abuse (Fadiman, 1997). Within the Hmong culture, however, this was acceptable because the lesions came from coin rubbing. Coin rubbing is a “traditional healing art,” (Fadiman, 1997, p.64) that was to help heal the soul. Lia’s parents also wanted to bring in a shaman, Hmong soul healer, to aid in Lia’s treatment of her disease. Hospital staff completely denied the request. However, when Lia had experienced severe brain damage, her family was told by several doctors that there was a good chance that she was going to die. In the Hmong culture, that was a large insult. Two Hmong woman commented on this from their Hmong culture point of view:

According to the Hmong culture a shaman helps to cure the soul. A doctor cures physiological 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 neeb and the American doctor would have balanced their practices and learned from each other, this would have positively affected the way the Lees thought about modern medicine. I believe that faith plays an important role in Lia’s case, and 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 Lia’s case and in other cases when treating Hmong patients 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. A txiv neeb takes the time to be with a patient while a doctor would only spend 15 minutes with them. A txiv neeb could have learn how to perform CPR in case it was ever

Chapter 1 goes through the traditional birthing methods and traditions of the Hmong people. One of the most significant traditions is burying the placenta. The placenta has to be strategically buried in a specific spot under the homes dirt floor or when the person dies its soul has to travel back to the placenta. This chapter also introduces the characters Nao Kao and Foua Lee. Nao is husband and father of 13 children (some of which died at an early age). Foua is the mother and wife.

Medical professionals could not understand why the Hmong were so combative with procedures. Many nurses found the Hmongs to be stupid. Lia’s doctors Neil Ernst and Peggy Philp had discovered burns and lesions in various stages of healing on Lia’s body. Unaware of an Asian healing treatment of coin rubbing, Ernst and Philp called Child Protective Services. Just one of many instances that many Western doctors never made an attempt to understand a set of cultural believes that were strongly held

One of the biggest hurdles between the Lee family and MCMC doctor’s was their variation of belief’s involving medicine and culture. Hmong’s are very spiritual people, often believing illness can cause soul loss.

The Hmong cultural/religious belief in shamanism animism claims that wicked spirits are continually searching human souls, mostly those of defenseless or unappreciated children. For the Hmong culture, epilepsy is known as qaug dab peg which means, "the spirit catches you and you fall down" in English (Fadiman, 1997, p.3, 4). Epileptic episodes are seen as affirmation of the epileptic's capability to enter and

Each and every culture is unique in it’s own way. From cultural practices, beliefs, values, biases, attire, to past history and experience, our world is shaped in many dissimilar ways. The book “The Spirit Catches You, & You Fall Down” highlights how diverse the Hmong people are compared to that of American people. In this paper, I will examine the impacts of multiculturalism within the Western health care system, particularly, how the care Lia and her family received after fleeing their home in Laos was incongruent with their traditional beliefs and values.

In The Spirit Catches You and You Fall Down author Anne Fadiman states her opinion about Lia Lee: "I have come to believe that her life was ruined not by septic shock or noncompliant parents but by cross-cultural misunderstanding." (1, p.262) I agree with this assessment. Fadiman does an excellent job of exploring all the many heart-breaking ways that the Lees and their doctors struggle with cultural issues. The Lee's and their doctors all wanted the very best care for Lia throughout every stage of her illness, but they could never quite agree as to what that encompassed. All too often each side thought they knew what was best and would work against the other to the detriment of Lia.

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.

I have to admit when I first read “The spirit catches you and you fall down” I thought it would be pretty boring turns out its one of the most interesting books I have ever read. The cultural conflicts can apply to anyone and knowing a little bit more now what the Hmong people have actually gone through can make everyone develop a great amount of respect for the culture. The Lee family continuously went full force colliding with the American ways in order to protect their traditions so they could preserve their culture. Unfortunately, in the end it didn’t help them but that was all they knew considering the fact that that the doctors at MCMC hospital didn’t really go out of their way to explain procedures it only makes sense for the Lee family to revert back to what they know in their traditions.

In addition, doctors can learn how to establish a trustful relationship with Haitians by observing healing ceremonies preformed by Voodoo priests. Through this learning process, western doctors will begin to understand the importance of non-western methods for the treatment of Haitian’s illnesses. According to McCabe (2007), the acknowledgement and acceptance of non-western interpretations and techniques is paramount to the process of treating ethnic minority clients. Since traditional healers are acknowledged in their community as being a trusted spiritual healer it is critical for healthcare practitioners to understand the role of the traditional healers in counseling, health promotion and education.

From an Indigenous person of Canada’s perspective, there is more to healing someone from an illness than focusing only on the body. They believe that there must also be a focus on the individual’s spirituality (Keightley et al., 2011, p. 240). A doctor, who practices modern western medicine, places their focus on the physical body and follow a specific scientific process that depends on the illness being cured (Keightley et al., 2011, p. 241). These different approaches to medicine are based on the philosophies and beliefs that a person has, and can often raise debate in certain medical situations. The death of Makayla Sault raised a conflict between traditional medical practices, and western medical practices.