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The Spirit Catches You And You Fall Down By Anne Fadiman

1648 Words7 Pages

In The Spirit Catches You and You Fall down, Anne Fadiman reflected on ways in which cultural dissonance can have detrimental consequences for those who are caught in the midst of two cultures. In this influential story, the cultural and language barriers between Lia Lee’s family and her doctors caused Lia’s life to be negatively impacted due to improper diagnosis and treatment. The Lees preferred traditional and spiritual treatment that clearly differed from the doctors’ Westernized treatment. Through a constant battle between proper treatment and the Lee parent’s compliance, this caused Lia to live in a persistent vegetative state for the majority of her life.
The language barrier that the Lee’s faced at Merced hospital was discouraging, …show more content…

As Francesca Farr put it, “our view of reality is only a view, not reality itself” (p. 276) is something neither the Hmong or western culture realized or understood. From the doctor’s view, they thought their medical worldview was the only method in approaching healthcare because of their advanced education and training (p. 76). These doctors assumed their authority was to be respected, their help would be appreciated, and their treatment be utilized. At one point, Neil and Peggy Ernst even talk about how the Lee’s never thanked them for the care of Lia. This truly portrays that the Lee’s didn’t feel that they needed to be thanked because they felt the doctors at MCMC did nothing to help their daughter. I feel that this led to the Ernst’s becoming fed up and “burnt out” on helping them and eventually resulted in lack of care for Lia. This relates to what Brown said in her article about doctors becoming burnt out and how it could hurt patients as well. The doctors rarely attempted to understand or relate to the Hmong culture of medicine and they viewed the Lee’s as stubborn and ignorant. One doctor even went to the extent of saying that the easiest way to treat a Hmong patient was with a bullet to the head, hence the name of chapter 6 “High-velocity transcortical lead therapy.” From the Lee’s perspective, they thought the traditional Hmong worldview was the only way to approach life. Even after coming to America, they resist assimilation by continuing to speak Hmong and honor Hmong traditions and religion. On page 208, Fadiman says “Indeed, as George M. Scott Jr., has observed the Hmong have responded to the hardships of life in the United States ‘by becoming more Hmong, rather than less so.’” When coming to America most cultures begin to become mainstream with ours, whereas it seemed completely opposite for the Hmong. The doctors

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This book proved that in the end, neither way of thinking was completely wrong or completely right. Both the medical community and the Lees should have sought out ways in which they were able to better come to an agreement. For instance, the medical community could have tried to find a translator for the Lees which could have helped them both determine proper medical procedures. They also could have decided to learn more about the Hmong culture to have some understanding of where the Lees were coming from and avoid any barriers for them to better treat Lia. A big drawback that the medical community made was having a pessimistic outlook to Lia’s critical condition.

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“The Spirit Catches You and You Fall Down” by Anna Fadiman tells the story of Lia Lee, a Hmong child with epilepsy, whose life could have been different if only her family was caught up in western medicine. This book reveals the tragic struggles between a doctor and patient because of lack of communication. When Lia was around three months old, her older sister Yer accidentally slammed a door and Lia had suddenly fallen into the floor. This is the first recorded time that Lia was experiencing an epileptic shock.

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‘The spirit catches you and you fall down’ was published in 2012 by essayist and reporter Anne Fadiman. This introductory book review analyzes the way in which different cultures perceive illnesses and diseases. It focuses on the story of the Lees a Hmong family, who moved to the United States and experiences difficulties with language, culture and biomedicine method of healing, which contradict to Hmong’s way of healing. The chapters describe the differences between the ways childbirth is conducted in Hmong society compared to the western society. As well as the struggle the Lees family has with the cultural differences in diagnoses and treatment of their ill daughter.

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The author of this book is called Anne Fadiman. It is based on a story of a Hmong child known as Lia Lee who suffered from epilepsy. The demise of this condition shows the harm that can be contributed by absence of cross-cultural communication especially in the area of medicine. At the age of three months, the elder sister to Lia known as Yer banged a door which caused Lia to have the first seizure.

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First, she could have made herself fit into the Hmong culture and be part of them then look like perceiving the American doctors medical healing to be a behavioral side effect and mistrust that could not heal their daughter (Westby, p.132). Then she could have went ahead and finding all the relevant information about her culture and why they are so spiritual and naïve of going for medical treatment for her sister Lia Lee. Secondly, she could have gone into the American hospitals and tried to find out why they believe in medicine much and not spiritual healing and thus she could have gotten enough information which could have made her a better anthropologist. The methods she majorly used to gather her data as sources for writing her book were reading of the medical journals thus medical anthropology and listening to several lectures that build her

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This blatant disregard to the Hmong’s perception of lab work shows that their distrust in doctors is well placed. Had the situation been explained, as with the baby’s family (51) they may have been more willing to accept treatment. The Hmong people have little to no knowledge to how western base medicine works, thus can only speculate on how it works from what they observe. The language barrier adds another level of confusion, for even if time was taken to explain procedures, there is still the lack of producing an adequate, understandable and accurate translation. In this passage, the lack of information causes the Hmong people to conjure up explanations for what the American doctors practice, obvious from the title, “Do Doctors Eat Brains?”.

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It was a federal grant used to establish “an integrated mental health delivery service utilizing Hmong healers and western mental health providers” (Fadiman 2012). The program was successful and treated 250 patients. In one case, the traditional healer, the txiv neeb, was able to heal a man with a swollen penis. Another case, the txiv neeb was unable to heal his patient with gall bladder problems, but was able to help assist the patient in consenting to surgery. During the mid-1990’s, cross-cultural training emerged slowly in medicine.

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The Hmong became frustrated with the American medicine as seen when the author says that it was typically Hmong for patients to appear passively obedient only to later ignore everything they had supposedly assented to after they left the hospital. It therefore stressed the doctors who considered the Hmong as the most difficult patients. This was well brought out by a doctor who said that the only easy way to treat the Hmong people was with a bullet in their head known as “high velocity transcortical lead therapy” (63). Lia was equally difficult to the point that nurses would pray she is not admitted any time she fell epileptic. The uncooperative nature of the Lees made Lia be taken away from them

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1302 Words | 6 Pages

Nao Kao did not understand why his daughter was tied down, revoking more of his trust in the health care system he kept removing them. This is a perfect example of how easily communication and trusting nurse-client relationship could have prevented this misunderstanding and ambiguity. Peggy and Neil prescribed numerous medications for Lia over the course of her hospital visits. Nao Kao and Foua did not speak or read English, leading her to keep seizing because she did not have enough Phenobarbital in her blood, “Foua and Nao Kao, of course, had no idea what the labels said” (p.46). American doctors believed decreasing the risk of the seizures as more important, and the Lee’s viewed Lia’s nature and personality as more significant.

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Have you ever thought about how difficult it might be to go into a different country knowing absolutely nothing, not even language, and something horrific happened to you or anyone in your family?  Don’t you think you would feel so powerless, so helpless, so clueless? This happens commonly and it has never had any attention brought to it, at least not until 1998. Anne Fadiman wrote a book entitled, The Spirit Catches You and You Fall Down. This demonstrated a collision of two complete opposite cultures, but they both have the same goal to help the child get better.

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Over the progression of the book the view points and relationships between the Lees and the doctors develops slightly. The medical staff was not prepared with a translator or a cultural understanding of the Hmong and how their beliefs would not match up with their medical practices. “Not only do the Hmong fail resoundingly to improve the payer mix- more than eighty percent are on Medi-Cal- but they have proved even more costly than other indigent patients, because they generally require more time and attention, and because there are so many of them that MCMC has to hire bilingual staff members to mediate between patients and providers” (Fadiman 25). This theme in the story was immensely eye opening for all of the cultural gaps that exist throughout the United States. The solution to this problem is for both sides standing on opposite sides of the gap to take the time to bridge the gap together.

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