Intercultural Misunderstanding In 'The Spirit Catches You And You Fall Down'

Being a Hmong-American in the United States was hard. Growing up in a community that was full of Americans, and being in a private school in my early years, (consisting mostly of Americans and little diversity) was difficult. In that kind of environment, I never saw each person differently. The characteristics that I saw were our skin color, and another distinction that I saw was our religious and cultural backgrounds. I started to lose touch of my own culture and identity as a Hmong-American girl. My family told me that in the stages of my toddler years, I used to be good at speaking my native tongue until I started school.

The Hmong were well known for being a self-sufficient people producing their own food, making their own weapons, hunting their own game including birds, monkeys, deer, wild pigs, tigers, and more. They fished, gathered fruit, wild vegetables, and honey. These individuals were farmers and have very intimate relationships with the natural world(pg 120). Foua Yang grew up in a mountainous clan such as this. She had revealed that everyone in her village performed the same tasks therefore causing no class system. “Since no one knew how to read no one felt deprived by the lack of literacy.” They believed that anything of importance that the children needed to know could be learned through spoken word or by example. The elders were essential for teaching the younger generation among many things how to hold sacred their ancestors, play the qeej, conduct a funeral, how to court a lover, how to track a deer, and how to build a

Language barrier was a major factor that served to extend the boundary existing between the two cultures. Some of the utterances made by the doctors were interpreted right but were understood wrongly (Swartz 2). This resulted in a worsened discernment of the American doctors by the Lees and Hmong as an entity alike. In the case of an emergency, the Lees needed to contact an ambulance, but could not communicate with the hospital. This necessitated the involvement of their learned nephew, who would call an ambulance. The interpretation process would at times limit the effectiveness of the message intended by either party. For instance, when Lia was undergoing critical care in MCMC, the Lees needed to be comforted, a process which had to be done by an interpreter. Before the final discharge, miscommunication between Lia’s mother and the doctors had her think that the nurses disconnected medicine tubes off Lia in order to give it to some other patient; a mean act. In the same incident, Lia’s father was made to sign a letter of discharge for Lia, which would happen in two hours. However, he understood this as a letter to guarantee death in two

     The Hmong had trouble adapting to American life. With no driver’s license or bank account, they had to make a living doing whatever they could. Not knowing the language in a foreign land doesn’t help either. The Hmong women adapted much more quickly than the men did because of the fact that they interacted more with English-speaking people. While the men were at work, the women were spending time interacting. The Hmong men also refused to change more that the women did. This shift of power caused a lot of changes in Hmong households. What even caused more of a power shift was the fact that the Hmong children learned about the culture easier than the women did. Instead of the father having control over the family like it was back in Southeast Asia, the children now had the upper edge. The children could communicate, interact and even drive with Americans. You could see a 16-year-old Hmong

Most Hmong fear western medicine because of a lack of understanding, and a refusal to try to understand. The Lees had the importance of the medicine that was given to them explained to them many times, but they still believed that their thoughts about medicine and disease were far superior. In contrast, the Americans also refused to even attempt to understand the Hmong culture; even though slightly adapting to their medicine would have likely made the Lees much more compliant. This general misunderstanding of the other culture is best summarized by Fadiman, saying,

One of the largest challenges Americans are facing today is coming to an agreement on the issue of immigration. Based on readings from Ruane and Cerulo and Fadiman, evidence of tensions between Americans and immigrant groups has spanned generations, affecting the way our culture perceives and reacts to “the Other,”1(167) cultures outside of our Western thought that we fail to understand due to continuous preconception and unrecognized self-entitlement as the ‘in-group.’ This segregation only continues the relentless cycle of economic and social barriers between an ‘us’ and a ‘them.’ The grand conflict between the Hmong versus the medical staffs in The Spirit Catches You and You Fall Down highlight the ethnocentrism that incurs blind

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 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.

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

All communication is cultural. It draws on ways we have learned to speak and give nonverbal messages. We do not always communicate the same way from day to day, since factors like individual personality, mood, and the context of the situation interact with the variety of cultural influences we have internalized that influence our choices. Communication is interactive, so an important influence on its effectiveness is our relationship with others. Do they hear and understand what we are trying to say? Are they listening well? Are we listening well in response? Do their responses show that they understand the words and the meanings behind the words we have chosen? Is the mood positive and receptive? Is there trust between them and us? Are there differences that relate to ineffective communication, divergent goals or interests, or fundamentally different ways of seeing the world? The answers to these questions will give us some clues about the effectiveness of our communication and the ease with which we may be able to move through conflict. The challenge is that even with all the good will in the world, miscommunication is likely to happen, especially when there are significant cultural differences between communicators. Miscommunication may lead to conflict, or aggravate conflict that already exists, or in the sad of case of girl developing epilepsy and both her parent’s Hmong culturally clashing with her Western medicine

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 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.

The Hmong are a clan based, patriarchic culture. Within the clans there is much diversity, with each clan having its own group identity and traditions. The language has a long oral history and very new, 1095’s, written form. The family structure consists of multiple generations in one household, with the elder male being the main dissension maker. The nurse must be familiar with generalities of the Hmong culture and be able to ask patients and their families of the cultural beliefs and decision making.

Guideline one knowledge of cultures was not met. An example of this guideline not being met in the ethnography was when a Hmong patient came to the Family Practice Center and complained of a stomach ache, what they were actually complaining of was “the entire universe was out of balance,” (Fadiman, 1997, p. 61). If the health care provider knew more about the Hmong culture he or she could have asked more questions to decipher what was truly going on in the patients life.

Ethnic, Religious, & Cultural factors impact a woman’s experience during pregnancy and childbirth. In providing care for the pregnant woman that have differing cultural beliefs and practices, healthcare providers should be aware of patient’s beliefs and the influence they might have on the pregnancy and childbearing. It is the patient’s right to be cared for within the context of their cultural beliefs and it is the practitioner’s responsibility to influence health care to optimize the health of the pregnant patient. . If the healthcare & culture are not congruent the well being of the patient is at risk. Three particular cultural & ethnic groups whose views on pregnancy and childbearing differ from the “normal” western society’s views are