The Spirit Catches You

Some of the Hmong people had to learn English and how to read and write. In their village, they never had to learn how to read or write because of their background and their religion. The Hmong people feel that their culture and values still play a major role in their daily lives. Many Hmong communities rely on the shamans for religious and spiritual support. Without the shamans, the Hmong culture would be incomplete and slowly diminish.

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.

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

Structural Causes of Cultural Insensitivity in Anne Fadiman’s The Spirit Catches You and You Fall Down

4. There were many people affected by the Lia’s seizures and the cultural clashes that ensued. I will focus on the two that seemed most significant. The first people who were affected were her family, namely her parents. Nao Kao and Foua were obviously distressed that their youngest daughter was having these seizures. The Hmong in general are excellent parents, providing their children with an extraordinary amount of love and attention (Fadiman, 1997, p. 22) and I can’t even imagine the amount of grief the Lees dealt with as they watched Lia’s soul slip away during those several tumultuous years of her life. Because the Lees blamed the medical system for the end result of Lia’s vegetative state, they became increasingly angry people, Nao Kao in particular. Fadiman tells us how angry he was several times in the book, angry enough to try to steal Lia away from the hospital (p. 213). While Foua more evenly tempered than her husband, she did show severe signs of depression and even suicide when Lia was first taken away from them and placed in

The Spirit Catches You and You Fall Down is the story by author Anne Fadiman, which explores the clash between a small county hospital in California and a refugee family from Laos over the care of Lia Lee, a Hmong child diagnosed with severe epilepsy. Lia’s parents and her doctors both wanted what was best for Lia, but the lack of communication between them led to tragedy.1The lack of communication due to cultural misunderstanding, mistrust, lack empathy, and poor health literacy led to care being comprised for Lia, which also affected both her parents and healthcare providers.

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

I absolutely believe that the author was evenhanded in her presentation of the two cultures. Throughout the book it was clear that she tried to look at everything from as many perspectives as possible to accurately portray the Hmong culture and medical culture.

The Lees believe that for an illness to be cured the soul has to be called back through the ritual sacrifice of animals such as chicken and pig. That is, they believe in the “Shamanistic ritual performed by a trix neeb in which an animal is sacrificed and its soul battered for the vagrant soul of a sick Person” (Fadiman, 1997, p.100). According to Lia's father Nao Kao “Sometimes the soul goes away but the doctors don’t believe it…The doctors can fix some sickness that involve the body and blood but for us Hmong some people get sick because of their soul, so they need spiritual things. With Lia it was good to do a little medicine and a little neeb” (Fadiman, 1997,p.100). The medical care that the doctors at Merced were providing was without animal sacrifices therefore the Lee’s believe that it could not make their daughter well.

“In the Spirit Catches You and You Fall Down”, Anne Fadiman explores the subject of cross cultural misunderstanding. This she effectively portrays using Lia, a Hmong, her medical history, the misunderstandings created by obstacles of communication, the religious background, the battle with modernized medical science and cultural anachronisms. Handling an epileptic child, in a strange land in a manner very unlike the shamanistic animism they were accustomed to, generated many problems for her parents. The author dwells on the radically different cultures to highlight the necessity for medical communities to have an understanding of the immigrants when treating them.

The first time Lia was brought into the hospital it was hard for the doctors to understand the Lee families beliefs. Jeanine Hall was the only person that took into consideration their beliefs and values. Hall was Lia’s social worker

The Hmong are a group of people who originally lived in the mountains overlooking Laos, China, Vietnam, and Thailand-- though most have since emigrated to other countries and areas due to political conflict. They have valued self-sufficiency and resisted authority throughout history, as they have constantly been the minority and often seen as the Other and persecuted for being such. Still, many have managed to survive and preserve much of their culture, such as religious beliefs and shamanic healing practices.

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.

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.

Health protection in health care is an individual going back to his original state wellbeing where he/she used to function properly with the absence of disease and preventing any exacerbations. In restoring health, the America family uses modern medicine; example going to DR’s appointment, clinics, admissions, therapies may be needed as well. Meanwhile Hispanic and Hmong families in their interviews only had a couple of Western medicine in attempting to restore optimum health, even though they rely mostly on combining alternative medicine and different healers or folk medicine. Hmong is non-compliant with to western medicine and would only sign up for this in the case of an emergency. According to Hmong family who refuses modern medicine, mentioning too much of a disease process would entail you inviting sickness into your body. (“Promoting cultural sensitivity “n.d.). This may seem disadvantageous to both families and the heath community as evidenced by Hmong father who is not wanting to relay his TB signs and symptoms to his ER DR with the fear of being massaged, cupped, poked, or spooned. The Hmong beliefs do use religious Shamans to heal and as a stepping stone to getting permission in reaching modern medicine. On the other hand, the Hispanic Family in their interview are using most of the modern medicine, herbs treatments, and other medicine, candles burning