The Spirit Catches You and You Fall Down

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 or quag dab peg is said to mean “a soul stealing dab; peg means to catch or hit; and quag means to fall over with one’s roots still in the ground, as grain might be beaten down by wind or rain” (Fadiman, 1997). The Lee family belonged to the Hmong tribe, which was the basis of their differing beliefs in comparison with modern medicine. Lia’s parents believed that when she was three months of age, she had been startled when her older sister, Yer, slammed the door of the Lee family’s apartment. This resulted in Lia’s first seizure which her parents believed made Lia particularly fit for divine office. The Hmong believed epileptics became shamans or medicine men and

Lia Lee born and raised in America, but brought up as a Hmong, faced health issues specifically epilepsy. Her parents who practice the Hmong culture had a different view on how to handle Lia critical condition. Hmong did not believe in traditional medicine but believed in Txiv neeb, person with a healing spirit. Not only do they believe in a person with healing spirit to help cure their illness but also consider epilepsy as power; “Their seizures are thought to be evidence that they have the power to perceive things other people cannot see, as well as facilitating their entry into trances, a prerequisite for their journeys into the realm of the unseen” (Fadiman, 1998, p.21). Right at this moment is where you can tell conflict is going to occur.

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.

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.

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.

Anne Fadiman struggles to find the answer to who is responsible for Lia Lee’s health in her book, “The Spirit Catches You and You Fall Down.” The book describes the clashing of both the medical community within Merced, California, and a Hmong refugee family, the Lees, cultural beliefs. The Lees daughter, Lia Lee, is plagued with a severe case of epilepsy, or qaug dab peg in Hmong, as a child and is administered to the Mercy Medical Center Merced, or MCMC, a hospital in Merced, California. The doctors there go through many struggles in order to work with the Lee family, as they are faced with cultural and language barriers that they must overcome in order to ensure Lia is in good health. The Lees do not feel that they are in the wrong, for their

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

Rhetorical Analysis on The Spirit Catches You and You Fall Down Kelsey Carter North Idaho College Author Note This paper was prepared for English 102, Section 09, taught by Audrey Cameron. Rhetorical Analysis of The Spirit Catches You and You Fall Down

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

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 Spirit Catches You and You Fall Down is only one example of many that shows how cultural differences affect health. Cultural differences such as variations in beliefs, preferences, behaviors, recognition of symptoms, and expectations of care because of one’s culture, are some factors that influence decision making and consequently, health outcomes.2 For example, the Hmong’s cultural beliefs include respecting the patient’s privacy by not asking personal questions, asking them to undress, or take blood samples,

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.