The Spirit Catches You And You Fall Down

Alvord Practiced at Gallup Indian Medical Center where she stood out from her peers. She realized that all of her peers are Anglos and she was the only Native American. Although she is Native American she is not seen as such from her Native American Patients because of her modern medical practices. Alvord felt conflicted for her Native American background by practicing western medicine. She realizes that trust is the most difficult aspect when having Native American patients. Since the doctors are mostly Anglos it is difficult to communicate to the Navajo patients. Alvord realized this conflict and bridged the patient-physician gap by speaking Navajo and touching the patients. Since Navajo’s believe in touching, singing and feeling as a major

During the reading of this book, I felt that Fadiman did an excellent job of balancing the hero and villains so to speak between western medicine views and those held by the Hmong. Practicing empathy for the Hmong and their strife’s but at the same time recognizing the tribulations of the healthcare providers.

This book addresses one of the common characteristics, and challenges, of health care today: the need to achieve a working knowledge of as many cultures as possible in health care. The Hmong population of Merced, California addresses the collision between Western medicine and holistic healing traditions of the Hmong immigrants, which plays out a common dilemma in western medical centers: the need to integrate modern western medicinal remedies with aspects of cultural that are good for the well-being of the patient, and the belief of the patient’s ability to recuperate. What we see is a clash, or lack of integration in the example of the story thereof. Lia, a

The Hmong have been known to mistrust Western medicine and practices, instead preferring their own healers who would respect their wishes and followed very strict rules of conduct while also being very attentive, staying by their side for hours while Western doctors will only see patients for a few minutes and ask a lot of private questions. Also, the Hmong view epilepsy, also know as qaug dab peg, as a religious and holy experience, yet the Dr. murphy who diagnosed Lao Lee with epilepsy officially only sees it as a medical problem that can be suppressed with medication. So Lao Lee’s parent struggle with respecting that doctors regimen of medication to help her condition, because Lao Lee could be seen as a very respected spiritual leader in

The doctors did not try to understand the viewpoints of Nao Kao and Foua and instead reduced their thoughts and feelings to being inferior. Nao Kao and Foua did not understand what the doctors were doing to their child, let alone understand the instructions that the doctors were giving them. The doctors did not try to understand the Lee’s culture and what they were going through. Instead, the doctors proceeded to help Lia in the way that they saw fit. Western medical practices were more invasive than Nao Kao and Foua were accustomed to. I was angry with the Lee’s about the treatment that they were receiving from the doctors. There was no communication with Nao Kao and Foua. When Child Protection Services were brought in and Lia was taken away from Nao Kao and Foua I was astounded. I did not understand why Lia’s doctors believed that Child Protection Services was necessary. It seemed that if the doctors had taken the time to listen to Nao Kao and Foua about their concerns and not just rely on interpreters to give them information one way, everything would be fine. However, I realized that child abuse and neglect was much more complicated than I had

This book is certainly an eye opener. I always knew that culture played an important part in one’s everyday experience, but I never imagine it to be so extensive and tragic. When Dan Murphy stated “when you fail one Hmong patient, you fail the whole community”(p.253), I believe that he meant that as other Hmong families hear about Lia’s family tragic experience, they too feel the fear and disappointment caused by the health system of modern society. When another Hmong family has a sick child, they will hesitate to bring their child to the hospital because of the thinking that they may be forced to go against their cultural regimes. I think that whole Hmong family will neglect analyzing the Lia’s situation, and again run from the thinking that

Fadiman’s The Spirit Catches You and You Fall Down addresses experiences and decisions we may all relate to in some degree through the point of view of a journalist. It offers a different perspective and insight that has been used as an acceptable resource on cultural competence. As a passive reader, our understanding of cultural competence has grown more humanistic, because we feel the healthcare provider’s frustration and their concerns becoming more salient, while we see how a breakdown in communication, can have heartbreaking results as felt by the Lees. I think the book’s by-product is a lesson in cultural competence that can educate health care, but it is also a story that is much more dynamic as it reflects upon the sociopolitical struggle of the Hmong Chinese, xenophobia, and reminds us of a dark period of time in American history, the Vietnam War. This story, sadly, highlights the struggle of refugees, their decision to assimilate or not, which is unfortunately still relevant to this day. At some points in the book, I was immediately making connections between the Hmong Chinese and the current crisis of Syrian refugees of today. This story nonetheless is a riveting account of the life of Lia Lee and her family struggling to understand their daughter’s epilepsy through Western medicine, and the compassionate, but overtaxed providers of her care, which give us an honest glimpse into the medical world.

Throughtout the later chapters of When The Spirit Catches You and You Fall Down, Fadiman describes how the Homong play a large role in the population of Merced, but are not considered in the city’s day to day life. This brings to light the strong ties of their own community of the Homong. During this time of the book Lia has become more stable from when she had her major sezirue but the brain damage from her grand mal becomes more apparent. Lia’s father, Nao Kao, continuously uses the Homong medicine just as he has in the past which shows that he wants her health to return to a somewhat normal state. In his view he sees a contradicting image that occurs between the Western medicine preformed by the medical doctors versus the Homong traditional medicine practices.

So far, I have learned that regardless of the Hmong cultural beliefs and difficulties they love their daughter. Everything is knew for them, different country, and culture, which makes it more difficult for them to adjust. They caring and loving people because had the courage to introduce a stranger to their home. It must be very hard for the Foua and Nao Kao to follow the doctor’s rule because their cultural beliefs are really strong. Although they are doing their best to make things smooth and help their daughter. Coming from a different country where people have live most of their life it is very had to fit in. Everything is different and at times you get frustraid because you are away from your whole family.

The belief that an individual's attitude and actions should be understood along with their ethnicity. Fadiman demonstrates the lifestyle of the Hmong culture in America will it is being interfered with the Western Health philosophies, which is displayed with Lia's parents and the American doctors they are working with. While Lia's parents believed in " a little medicine and a little neeb", but were very worried that allowing their daughter to get treated medically would limit the effectiveness of their spiritual healing. However, as the doctors purely saw Lia's illness as a neurological disorder and that it could be potentially be controlled and save her

My take away from the book “The Spirit Catches You and You Fall Down” as I progress through the pharmacy curriculum and into practice is that I must be aware of my patient’s cultural background. Help my patient overcome social determinant barriers such as language, education, and others that could prevent patient’s from accessing to quality care. Through out the curriculum I will be exposed to multiple rotation settings and involvement with different ethnic population. My take away from this book will help me effectively associate with my patient in term of respect and sensitivity when it comes to cultural differences. In my future practices, the examples from this book will help me able to communicate effectively with my patient so I can

When the culture of the Anishinaabe, or Ojibwe, people were suppressed when colonization began in the Americas, their medical practices were as well. In an effort to preserve the Ojibwe culture as well as establish effective treatment options for people living on reservations as well as members of Ojibwe communities, Anishinaabe cultures should be incorporated into the clinical setting.

There were many examples in which the healthcare team showcase empathy and cultural sensitivity for Lia’s parents. First, the doctor accepted the parents to practice their rituals and even let them administrated their own medicine to their child. In addition, the doctors and nurses did not press charges after Nao Kao had pushed her against the wall.

As I eat dinner with three generations at table, live up to the expectations of being the oldest child, and tend to my frail grandparents, my Vietnamese heritage permeates my life. It has also given me a unique perspective on medicine. Although western medicine focuses on reducing suffering and retracting treatment toward the end of one’s life, for example, many Vietnamese people would view this as a betrayal of the patient. Thus, living in and internalizing a dual culture helped me recognize the paramount importance of identity in health and healthcare. Such realization has refined my purpose in medicine to be focused on care for the individual rather than just treatment of physical ailments.

When one thinks of “traditional” African healing, images of tribal healers or witchdoctors covered in stereotypical garb, holding elaborately decorated sticks, dancing around a fire and chanting are likely among the first things that come to mind. There is a misconception that “traditional” African healing is static and synchronic and attributes all illness (mental and physical) to ancestors and witches. However, “traditional” African healing has been influenced by what is typically considered western biomedicine and continues to change. For centuries, while the colonizers stole resources and priceless artifacts from African nations, they left behind techniques typically associated with western biomedicine; in true colonizer fashion, they also adopted some aspects of “traditional” African healing and interwove it with western biomedicine. By examining the interactions between practitioners of “traditional” African healing and those of western biomedicine,