The Spirit Catches You And You Fall Down Essay

In addition, relying on a doctor who does not share the same beliefs as one does can become fearful. Trusting the doctor for full treatment is necessary but when from a different cultural background it can prevent them on trusting them. According to a research article, Cross- Cultural Medicine a Decade Later, clearly states “when the basic belief structure of biomedicine and another set of health beliefs differs radically, problems and frustrations almost inevitably arise” (Barker, 1992, p.249). The central purpose of the research was to show whether or not health beliefs between patient and doctor differs will they find it difficult to interpret the symptoms and treatment variations to accommodate their beliefs. However, the doctor having faith in one’s health beliefs can sometimes be beneficial for the patients because they’ll be fully understood and not misjudged as being crazy. As stated by the author, for the article Chinese Health Beliefs of Older Chinese in Canada, “the findings support the previous prescriptive knowledge about Chinese health beliefs and illustrate the intergroup socio-cultural diversity that health practitioners should acknowledge in their practice” (Lai, 2009, 38). Like the Chinese, Hmong’s too first go to their shaman for traditional treatment rather than going to the doctor; to them an illness and their healing is more of a spiritual thing that

The doctors assuming the Lee were giving their daughter her medications, were surprised to not see levels of the medications in her blood. Dan Murphy who was one of Lia’s doctor questioned the parents and he learned that due to their cultural beliefs, Lia’s parents have not been administering her with the proper medicine. Where Lia’s mother believes she is doing the right thing for her daughter, Murphy has sympathy for the mother and told Fadiman “I remember having a little bit of awe of how differently we looked at the world”. A key feature of the Hmong is that they have no interest in being rule, do not like to be told what to do, and are rarely persuaded by the customs of other culture. The mistrust and open hostility between the medical staff and the Lee family seemed to overshadow Lia’s disease. Both side obviously loves Lia and wants her healthy but neither was willing to compromised and meet half way.

What do you think of traditional Hmong birth practices (pp. 3-5)? Compare them to the techniques used when Lia was born (p. 7). How do Hmong and American birth practices differ?

With the loud noise of a slamming door the family believed that Lia’s spirit had been frightened and left the body causing the sickness she was experiencing. The family saw the seizures as an illness of some distinction. In the Hmong culture epileptics often become shamans. The chapter goes on to tell the child’s story about multiple trips to the Hospital Emergency Room. It speaks about the lack of communication surrounding the child’s symptoms. The family is unable, and the medical team unaware of the lack of communication about medical dosages. The doctors have no idea about parental refusal to give certain medicines due to mistrust, misunderstandings, and behavioral side effects. The doctors do not attempt to develop more empathy with the traditional Hmong lifestyle or try to learn more about the Hmong culture. The dichotomy between the Hmong's perceived spiritual factors and the Americans' perceived scientific factors comprises the overall theme.

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.

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.

1. The client system, in this case the Lee family, defines Lia’s seizures as both a spiritual and physical ailment. According to Fadiman (1997), “…the noise of the door had been so profoundly frightening that her soul had fled her body and become lost. They recognized the resulting symptoms as qaug dab peg, which means ‘the spirit catches you and you fall down’”(p.20). To the Lee family, Lia’s condition was as revered as it was frightening. While a person with qaug dab peg was traditionally held in high esteem in the Hmong culture, it was also terrifying enough that the Lee’s rushed Lia to the emergency room more than once in the first few months

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).

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

Lia Lee was a Hmong infant born with epilepsy. Lia’s parents were immigrants to a Western nation. However, the parents held tightly onto traditional beliefs from their native country. The incongruent belief structure of the East and West created difficulty when the two systems collided in an effort to care for Lia Lee. Specifically, when the drug therapy prescribed for Lia Lee was not followed by her parents. Subsequently the child’s medical team contacted child services, which lead to Lia’s removal from her family. The result of the cultural misunderstanding was fragmented family. In addition to fueling the distrust of the western healthcare system by an already marginalized community.

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.

This entry book” spirit catches you and you fall down” is talking about the cultural conflict between the Hmong's culture and American culture. These differences are brought by the strong beliefs in the Hmong's culture, and the difficulties to accept a new culture. There is a lot of misunderstanding/conflicts between these two cultures in the book. Usually, when the doctors are trying to convince the Lee's family about Lia's treatments, the Lees are stuck in their ways and really hard to accept what the doctors have to say about their beloved daughter. They believe in their own ways, even if it is helpful or not. They refuse to accept the doctors' ideas, and because the treatments that the doctors give are based on the scientific experiences, so the doctors believe that the Hmong's ideas are unreasonable or even stupid .However, when the culture conflicts face the love, these cultural differences become meaningless, which lead me to think that love is the only way that bring these cultures to connect.

Anne Fadiman had the difficult job of conveying history and traditions of an entire group of people in only a few hundred pages. To the Hmong, epilepsy is not black and white. Rather, it is a gift from a higher power and can only be managed in a specific way with the help of a txiv neeb. Healing often includes the sacrifice of animals, such as chickens and cows. The Hmong call seizures quag dab peg, which translates to the title of the book.

Anne Fadiman shows how different the Hmong culture is from American culture and the transition they have to go through. The food in Hmong culture can be seen in the story of Lia Lee’s birth at Merced Community Medical Center. The rituals followed in terms of food were very different from what they were used to. Foua (the mother) was offered ice water after the birth but the Hmong believed that any cold food consumed postpartum makes the blood thicker in the womb which does not allow it to flow freely (Fadiman, 9). The Hmong have specific foods to eat after childbirth which is also very different from American culture. Foua specifically ate steamed rice, boiled chicken with five special postpartum herbs (Fadiman, 9). They also abide by special rules within the culture to ensure the health and safety of their child such as drinking water with a key boiled in it because that is believed to unlock the birth canal (Fadiman, 5). The Hmong culture views things in a spiritual way while in America things were a bit more straightforward. The Hmong put an emphasis on everything around them such as giving birth in a home, burying the placenta, and not doing this or that because something bad will happen to the baby or its soul will be lost (Fadiman 8-11). While in America, the doctors incinerated the placenta because it could potentially spread Hepatitis B which is a simple fact that they could back up with science. The Hmong views are based on what they’ve learned while living among each other and their beliefs are true to them so their baby can be happy and healthy. Seeing how things are done in America make it seem more like a culture-shock. The history of the Hmong shows that their culture and fate flows deep in tradition. Their history consists of a mixture of wars and small periods of peace. They fought with China over time and they do not like to be bossed around. They either flee, fight or