The Spirit catches You

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.

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

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,

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

The Lees, a Hmong family, came to the United States in the 1970s as refugees from Laos, and lived in Merced, California. Unlike most immigrants, the Hmong population was less amenable to assimilation. The traditional health beliefs and practices of the Hmong population were disputed by the practices of Western medicine. This became very event when the Lees took their three-month-old daughter, Lia Lee, to the emergency room in Merced. Lia was diagnosed with epilepsy a disease that had two different meaning among the Hmong population and Western medicine.

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 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.

According to the Hmong culture a shaman helps to cure the soul. A doctor cures biological problems. As we learn throughout this class there is a difference between an illness and a disease. An illness or a disease may have the absence of the other. In most cases an illness can be present without a disease. In the case of Lia there was a presence of both Illness and disease. If txiv neb and the American doctor would have balanced their practices and learned from each other this would have affected the way the Lees thought about medicine. I believe that faith plays an important role in Lia’s case if the doctors would have understood the way that txiv neeb thought and vice versa the lees would have trusted American doctors and medicine more. Learning from txiv neeb would have also helped the American doctors in other cases when treating Hmong by understanding their culture. It is important for the doctors to understand the Hmong culture and specifically the way that a txiv neeb works because in Merced a third of the population were Hmong and used a tixv neeb as their main source of healing.

We can see that there was a misunderstanding between the Lee’s and the doctor. Both parties explained the view on Lia’s case but from a biased perspective within their own culture. Lia's doctors strongly opinionated to treat her disease with medication, however her parents felt that being given medication would restrict with the spiritual healing given by a Hmong shaman.

I enjoyed this book very much and consider it to be one of my favorites, mainly due to the interesting events in the ward revolving around disease. It was interesting how Donaldson explained the illnesses, symptoms, and medicines along with their purposes, without sounding like a textbook. The Lassa Ward was definitely informative, but personally, I wish the author would have included more description on the conflict in Liberia. The battle was brought up frequently, however, I felt as if his explanations as to what was happening were somewhat redundant. Most of them were constantly repeating that President Bush wouldn't send troops. Donaldson also informed us on some cultural beliefs that the Sierra Leoneans hold. For instance, the children were afraid of white people, because they thought they were ghosts, considering it is not often that they see somebody of another race. Additionally, I can connect the book to my personal life and the world that I live in. When Dr. Conteh leaves the ward in Ross's hands, Ross gets a massive load of responsibility placed upon him. He is now in charge of keeping the ward in tact while trying to save multiple patients lives. A large amount of responsibility comes with babysitting, so I can relate to Ross when I am left alone with my brothers and sisters. While babysitting I have to keep a close eye on my siblings, so that they can stay safe. In Ross's case he must pay attention to his patient's symptoms and treatment. Another way I can connect to the book is on page 75, when Ross wonders if coming to Kenema was courageous and an extremely dumb idea. Usually, I have many regrets whether it is over how much I studied or spend my summer days. Even though my decisions typically aren't as deadly, I still tend to make some impulsive decisions that can cause harm in the long run.

The intercultural misunderstandings start at birth. When a child is born, Hmong women want their placenta, so that they may bury it. In Laos, this is perfectly normal, but in the United States, most doctors find this strange. Since this is not something regularly practiced in the U.S., when a Hmong woman asks for her placenta, most doctors say no. The few that do agree to give them the placenta pack it in a plastic bag or some other container that degrades the importance of the Hmong culture. Many doctors assumed that the women wanted to eat the placenta. This is wrong, but they would never know because they never took the time to ask. If the doctors had asked why they wanted the placenta, they would easily find out that it’s important to the Hmong culture because their soul and afterlife depend on it.

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.

I found the book to be extremely troubling. Next to slavery, the holocaust, and treatment toward Native Americans; this has been one of the top horrifying acts of humanity I’ve come across. The events surrounding the 'Rape of Nanking' are only a part of the story but have become related to those leading up to the construction of one of the most notorious research labs known- Unit 731. However, what was done to the inmates was only the beginning. The biggest travesty was soon to come by way of the U.S's reaction- after the war was over, U.S occupational forces lead by Douglas MacArthur struck a deal that would help shield the doctors, nurses and other medical personal involved with these horror from much deserved accountability. Some had gone