The Spirit Catches You And You Fall Down Analysis

Directions: Read the captioned book. Then answer the questions contained in this study guide. Post your completed document to the appropriate assignment box on the course website.

Lia Lee born and raised in America, but brought up as a Hmong, faced health issues specifically epilepsy. Her parents who practice the Hmong culture had a different view on how to handle Lia critical condition. Hmong did not believe in traditional medicine but believed in Txiv neeb, person with a healing spirit. Not only do they believe in a person with healing spirit to help cure their illness but also consider epilepsy as power; “Their seizures are thought to be evidence that they have the power to perceive things other people cannot see, as well as facilitating their entry into trances, a prerequisite for their journeys into the realm of the unseen” (Fadiman, 1998, p.21). Right at this moment is where you can tell conflict is going to occur.

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

Many years ago, an epileptic Hmong girl named Lia Lee entered a permanent vegetative state due to cross-cultural misunderstanding between her parents and her doctors. An author named Anne Fadiman documented this case and tried to untangle what exactly went wrong with the situation. Two key players in her narrative were Neil Ernst and Peggy Philp, the main doctors on Lia’s case. As Fadiman describes, “Neil and Peggy liked the Hmong, too, but they did not love them… [W]henever a patient crossed the compliance line, thus sabotaging their ability to be optimally effective doctors, cultural diversity ceased being a delicious spice and became a disagreeable obstacle.” (Fadiman 265) At first glance, this statement seems to implicate Neil and Peggy as morally blameworthy for a failure to be culturally sensitive enough. However, upon further inspection of the rest of the book, it becomes clear that Neil and Peggy’s failure to be more culturally sensitive to their Hmong patients was caused by structural issues in the American biomedical system. To prove this point, this paper will first present a background to Lia’s case, then discuss possibilities for assigning blame to Neil and Peggy, then show evidence for the structural issues in American biomedicine, before finally concluding.

The Hippocratic oath (document4) is an oath all doctors take to this day. It is a pledge that all doctors take to promise that they intend on giving their patients the greatest care possible. The oath asks doctors to vow that they will be honest and confidential with their patients “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it nor will I make a suggestion to this effect… Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice….

Anne Fadiman struggles to find the answer to who is responsible for Lia Lee’s health in her book, “The Spirit Catches You and You Fall Down.” The book describes the clashing of both the medical community within Merced, California, and a Hmong refugee family, the Lees, cultural beliefs. The Lees daughter, Lia Lee, is plagued with a severe case of epilepsy, or qaug dab peg in Hmong, as a child and is administered to the Mercy Medical Center Merced, or MCMC, a hospital in Merced, California. The doctors there go through many struggles in order to work with the Lee family, as they are faced with cultural and language barriers that they must overcome in order to ensure Lia is in good health. The Lees do not feel that they are in the wrong, for their

In Hmong culture seizures are not recognized much as a physical illness as it is spiritual in nature and quab dab peg which translates to, the spirit catches you and you fall down, describes the group of symptoms experienced by Lia in the Hmong culture. The Lee’s were both happy and sad about Lia’s seizures. In Hmong culture seizures are considered to have special powers and usually become Shamans, but at the same time the Lees were worried about their child’s health.

The United States is faced with multiple health disparities within the country that encompass many challenges for individuals when it comes to the fairness and access to health care. A health disparity is defined as the inconsistency of treatment between two different groups of individuals. Treatment that could be different could be seen as different care due to age, race, ethnicity, culture, or current socioeconomic status (Koh et al., 2012). Treatment may be harmful for individuals as a result of miscommunication that may be perceived the wrong way. Individuals with low health literacy do not understand the purpose of particular drugs or the name of one’s condition, which can further leave an individual vulnerable to harm. Individuals may sign consent they do not fully understand, and will receive unwanted care and procedures (Clark, 2011). Healthcare providers need to be aware of an individual’s level of understanding before harming the individual with irreversible procedures.

Culture plays a major role in the spirit catches you and you fall by Ann Fadiman. Every chapter shares some aspect of Hmong history and culture: food, clothing, language, family structure, birthing rituals, and so on. The Hmong traditionally lived high in the mountains of Laos, where they practiced agriculture and subsisted primarily on rice, vegetables, herbs, and occasionally pork and chicken if the family could afford it. They believe most diseases have a spiritual cause that can be alleviated through traditional forms of healing such as rubbing the skin with coins, creating a vacuum by igniting cotton soaked in alcohol under a tiny cup, or drawing disease out with an egg. A tvix neeb, or shaman, could conduct more powerful healing; such a figure is thought to be able to get rid of evil spirits called dabs and retrieve lost souls. Certain aspects of Hmong culture, such as taboos against medical procedures, often conflict with the western culture of medicine, resulting in communication issues. Other aspects, such as utilizing animal sacrifice in shamanic ceremonies, to heal have led to conflicts with the American doctors to the point that rituals were banned in hospitals. Lia lees outcome was preventable if communication between both Hmong

One of the remedies used for Lia for her epileptic episodes was her parents would rub her skin with coins, elicit sickness with an egg, and or call in a tvix neeb a shaman granted power from Shee Yee. A lot of which back in the day did not have any correlation with western medicine and doctors. Many of the procedures done on patients were taboo in Hmong tradition. Because of the power structures of many Hmong families doctors would have to go through so much more to do simple tasks. Such as drawing blood, according to Hmong culture a person only has so much blood and when drawn it will shorten the person's lifespan. This went with many of the procedures done deteriorating the relationships between Hmong patients and

What would it be like to come to a country and not understand anything about its health care system? In The Spirit Catches You And You Fall Down, Anne Fadiman brings to light the conflicts between a Hmong family’s cultural beliefs, and that of the traditional western medical beliefs of the American doctors they come into contact with. Fadiman shows the consistent tug of war between the Hmong culture and the Western American medical practice. The Lee family comes from a culture that believes in holistic healing. They have an animalistic view in regards to health and medicine. The cultural barriers between the two eventually leads to the detrimental fate of the Lee’s daughter Lia.

The United States is known for its melting pot of cultures, which creates one of the most contentious issues in the medical world which is the clash of cultures. The book we read “The Spirit Catches You and You Fall Down” is a great example of how a miss communication and struggle between cultures which lead to a very dismal end. The difference in beliefs cause constant issues in communication, even though both want what is best.

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 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 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.