The Spirit Catches You And You Fall Down

For example, Dr. Adrian Chan is a second-year neuropathology fellow at New York University Langone Medical Center. As an IMG from Beijing, Dr. Chan has experience with the challenges of acculturation and emigration. “Only the best of the best get to come to America” he tells me during one of our friendly conversations. He then goes on to acknowledge the fact that many Americans perceive Asians as very “polite, hard-working” and often “keep to themselves” (Personal Conversation, 2009). This observed facet of Asian culture can be a hindrance to Asian physicians who need help in an American cultural setting. Often their silence is perceived as indirectness (Piercy et al, 2005) or aloofness. In order to effectively treat physician-patients, both the hospital administration and mental health clinics should acknowledge and provide empathy for difficulties wrought by a physician-patient’s ethnic background.

I feel that Anne Fadiman narrated the story of Lia Lee’s and her family’s life in intimate and tragic detail. The Spirit Catches You and You Fall Down is a poignant depiction of the struggle between loving parents, hard-working medical professionals, and a very precious child caught in the middle of a tug-of-war. Ms. Fadiman very distinctly illustrates how the collision of two cultures indirectly led to the demise of a little seven- year old girl.

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.

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

This prejudice is another strong concept, as the American doctors continued to underestimate, disrespect, and undermine Foua Yang (mother) and Nao Kao Lee (father) and their Hmong way of life. Vice versa, the Lees would refuse doctors’ orders in administering medicines. Ruane and Cerulo hit it right on the nail when describing prejudice,(20) which is a prejudgment directed towards members of certain social groups, as a feeling associated with immigrant groups, those that contain individuals who have left their homelands in pursuit of a new life in a new country. There is a clear indication of an in-group vs. an out-group, as it is noted from Second Thoughts, “an in-group carry unrealistically positive views of their group. At the same time…share unrealistically negative views of the out-group.” The cultural barriers are built due to “the one-sided relationship,” of knowledge only found in the unyielding West, with the prominent racial discrimination found among the white, English-speaking doctors and their intimidate dismissal of the existence of any Hmong medical practices/knowledge. The application of assimilation (20) is important to the in-group, as they simply believe that the immigrants will come to embrace the same values and customs of their new ‘homeland.’

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 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.

The Spirit Catches You and You Fall Down, by Anne Fadiman, is the story of two very different cultures lacking understanding for one another leading to a tragedy due to cultural incompetence. Today in America there are very many different cultures. Health care providers need to be aware of cultural diversity and sensitivity when caring for patients. If a health care provider is not sensitive towards a patient’s culture it can cause a relationship of mistrust to form, lead to barriers in the plan of care, and increase health care cost. The current guidelines to promote cultural competence in the clinical setting include completing a cultural diversity self-assessment, identify the need of the population served, evaluate barriers in the community and practice, educate staff to cultural diversities, schedule longer appointments, clarify limitations, and identify alternatives offered (Cash & Glass, 2014).

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.

1. Do you think the author was evenhanded in her presentation of Hmong culture and medical culture?

In The Spirit Catches You and You Fall Down, there are many different intercultural misunderstandings. A Hmong girl’s life was forever changed because of these misunderstandings and some things could have easily been avoided, had each side taken the time to better understand the other.

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.

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.

This book, as narrated by the author, Anne Fadiman, is about the true story of the life of an epileptic Hmong child named Lia Lee, and her refugee family’s interactions with the American health care system. This child endures agonizing grand mal seizures which ultimately and unfortunately, as a result, led her to become vegetative for the rest of her life. However, the central idea of this story is not entirely about Lia’s severe epilepsy, but how cultural boundaries had prompted to the obstruction of her treatment. Compliance had a major effect on Lia’s life between the doctors and her family, in which this argumentative battle is a way of implicitly revealing the differences in Western and Eastern medication, how the patient is perceived

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.