...Praise for The Spirit Catches You and You Fall Down “Fadiman describes with extraordinary skill the colliding worlds of Western medicine and Hmong culture.” —The New Yorker “This fine book recounts a poignant tragedy…It has no heroes or villains, but it has an abundance of innocent suffering, and it most certainly does have a moral…[A] sad, excellent book.” —Melvin Konner, The New York Times Book Review “An intriguing, spirit-lifting, extraordinary exploration of two cultures in uneasy coexistence…A wonderful aspect of Fadiman’s book is her even-handed, detailed presentation of these disparate cultures and divergent views—not with cool, dispassionate fairness but rather with a warm, involved interest that sees and embraces both sides of each issue…Superb, informal cultural anthropology—eye-opening, readable, utterly engaging.” —Carole Horn, The Washington Post Book World “This is a book that should be deeply disturbing to anyone who has given so much as a moment’s thought to the state of American medicine. But it is much more…People are presented as [Fadiman] saw them, in their humility and their frailty—and their nobility.” —Sherwin B. Nuland, The New Republic 3/462 “Anne Fadiman’s phenomenal first book, The Spirit Catches You and You Fall Down, brings to life the enduring power of parental love in an impoverished refugee family struggling to protect their seriously ill infant daughter and ancient spiritual traditions from the tyranny of welfare bureaucrats and intolerant...
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...Critical Analysis of a Literary Work By Debbie Cresta Submitted to, Brian Foxworth, in partial fulfillment of HCE604 Ethics for Nurse Leaders Regis University December 5, 2013 Critical Analysis of a Literary Work When looking over the topics of choice, one book stood out among the rest. The ethical dilemma was clearly spelled out for anyone to see. Things are not always what they seem to be, they are not often black and white and at times require that we take our time to really examine our choices and how we come to reach them. Although there are many ethical dilemmas within the content of the story and some may be very hard to pin down, finding just one specific health care ethical issue to talk about can be considered a daunting task. First we must understand that the word ethics means different things to different people and that in reality its very definition can describe their own version of moral philosophy. It is conceivably much harder to understand the issues between what is right and what is wrong, the problems that may exist between ethics and morality, one’s integrity and the many existing belief systems. It is not as simple as black or white or what constitutes good behavior as oppose to bad. We must remember that one man’s poison may be another’s choice of practicing healing methods. We must remember that we live in world that has vast cultural belief systems, ethical values, and religious beliefs, therefore we must practice our western medicine without...
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...Grand Canyon University: HLT 324 V November 15, 2014 Abstract The importance of knowing your culture and where you come from can help you understand other people’s culture. This can also aid in improving how you work and what you can do. Being aware of what you are will also help prevent chaos between the patient and healthcare staffs. Being aware and mind sufficient will help one to open one’s eyes to see things in a different perspective such area where nutrition is at a high-risk. Researching the different cultural problems and identifying solutions will assist the writer to comprehend their way of life and lifestyles. High Risk Nutritional Practice There are many health care risks that we are unaware of. We need to research and figure out what we need to do. How do we prepare others in a high-risk nutrition situation? The healthcare physicians will continue to look forward to discuss the cultures that are identified and the solutions to their various problems. Chinese Heritage The Chinese heritage is a culture that is difficult to determine their health risk factors. One case the writer believes to be a high health risk among the Chinese heritage is smoking in the men and teenagers. Smoking has killed millions of people each year and yet these numbers are still rising. The second high risk factor known to the Chinese culture is drinking alcohol. Alcohol consumption has known to increase in men than women. Chinese women do...
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...family. He snarls at Janovich's sermon. At his house, in an immigrant-dominated neighborhood, people throng for the after-funeral lunch. Downstairs in the basement, Walt's grandkids look through an old army chest and see pictures of Walt during the Korean War and a medal. They quickly put them back and shut the chest as Walt passes through. Upstairs, he walks slowly and grumpily through the crowd and refuses help from his grand-daughter, Ashley (Dreama Walker). He goes outside with his dog, Daisy (probably the only creature he seems to like), and sees guests going into the house next door, which is inhabited by a Hmong family. He spits in disgust. He catches Ashley smoking in the garage next to his car. She asks him about it and he tells her it's a 1972 Gran Torino. Rather inappropriately, she asks about stuff she can have when he dies. He stalks off, wordlessly. A Hmong kid from next door, Thao Vang Lor (Bee Vang), comes over to ask for jumper cables, but Walt insults him and slams the door in his face. Father Janovich comes over to speak to Walt, but Walt demands he call him "Mr. Kowalski". Janovich tells him that Dorothy had asked him to look after Walt after she passed. Dorothy wanted Walt to go for Confession. Irritated, Walt confesses that he only went to church because of Dorothy and has no interest in attending Confession to...
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...misunderstandings between cultures and the importance of cultural competence. The story focuses on a Hmong refugee family from Laos living in Merced, California when one of it’s younger members, Lia, is diagnosed with epilepsy. The Hmong people believe they are protectors of their own souls and that people afflicted with epilepsy have a sacred ability to travel to the spirit realm to protect their spirit from the dab, or malevolent spirits. Because of this, Hmong epileptics are seen as people to be revered fighting a noble battle. This conflicts with western medicine and created a war between Lia’s doctors and family that kept her from receiving the care she needed. At four years old, Lia developed status epilepticus and hit her head. She went into septic shock in the hospital and suffered brain-death. Her parents chose not to remove her from life support. The overarching theme of The Spirit Catches You and You Fall Down was that lack of cultural competence can kill. Fadiman wrote, “I have come to believe that her life was ruined not by septic shock or noncompliant parents but by cross-cultural misunderstanding” (p.262). Lia’s parents almost never followed the doctor’s...
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...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. I did not expect the story to end with Lia Lee in a persistent vegetative state. I was very excited when I first started the book, but I soon became rather depressed with the lack of compassion of people towards the Hmong in general throughout the book. I am not certain whether I am now more culturally aware now, but I was very frustrated by the lack of respect given to the Hmong by the people in the city of Merced and the doctors and nurses comments about the Lees. Three Major Themes Evident in the Book: A: Cultural Understanding An important thread running throughout this book is cultural understanding. Americans, including the medical professionals in Merced and Valley Children’s Hospital are depicted as very insensitive to the ways of the Hmong people. Anne Fadiman, while acutely aware of the physicians’ frustrations in providing medical care for those individuals with very radically different worldviews was able to at least urge the physicians to acknowledge the families realities. The Hmong have been fighting against many different peoples over centuries, being forced from their beloved China into Laos, then into Thailand, and then the United States. The Hmong people throughout history have had little need to assimilate to other cultures because they have lived...
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...course website. 1. What do you think of traditional Hmong birth practices (pp. 3-5)? Compare them to the techniques used when Lia was born (p. 7). How do Hmong and American birth practices differ? 2. Over many centuries the Hmong fought against a number of different peoples who claimed sovereignty over their lands; they were also forced to emigrate from China. How do you think these up-heavals have affected their culture? What role has history played in the formation of Hmong culture? 3. Dr. Dan Murphy said, "The language barrier was the most obvious problem, but not the most important. The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference" (p. 91). What does he mean by this? 4. The author says, "I was struck...by the staggering toll of stress that the Hmong exacted from the people who took care of them, particularly the ones who were young, idealistic, and meticulous" (p. 75). Why do you think the doctors felt such great stress? 5. Dr. Neil Ernst said, "I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids' lives. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior" (p. 79). Do you think the Hmong understood this message? Why or why not? What do you think...
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...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 during infancy. Her family’s opinion was that the condition was a spiritual gift. Lia’s parents, Nao Kao and Foua, were wary of the American medical system, preferring to care for Lia in the Hmong way. Throughout the considerable conflict surrounding her care, Lia continued to have seizures; at the age of 4 ½, after a particularly devastating episode of status epilepticus, she slipped into a persistent vegetative state that would last...
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...THE STATE OF HMONG-AMERICAN STUDIES (A BIBLIOGRAPHIC ESSAY) By Mark E. Pfeifer, PhD Director, Hmong Resource Center, Saint Paul Editor, Hmong Studies Journal Introduction In the newly published volume Hmong/Miao in Asia, Chiang Mai: Silkworm Books, co-editor Nicholas Tapp provides an insightful essay “The State of Hmong Studies: An Essay on Bibliography” which traces the temporal development of research on the Hmong and assesses some of the key works within the interdisciplinary realm of Hmong Studies. Tapp’s essay is very valuable as an overview of the growth of Hmong Studies research based in Asia. Unfortunately, the sections of his piece pertaining to Hmong-American Studies, are, as he himself acknowledges, dated as they are heavily focused on publications from the 1980s and early 1990s. It is the purpose of the present short essay to provide the reader with an assessment of recent developments in Hmong-American Studies and some insights about certain research areas that need further development in the field. Health and Medicine Hmong-American Studies research has grown dramatically since the early 1990s. The Hmong Resource Center library in Saint Paul now possesses more than 150 dissertations/theses and 450 journal articles pertaining to HmongAmericans (as opposed to Hmong in Asia and other countries). The vast majority 1 of these works have been published since 1994. There are certain fields within Hmong-American Studies that have seen very important...
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...For Hmong who maintain their traditional beliefs in America, the scientific worldview and Western medicine, have challenged their entire means of understanding the world. Likewise, Hmong beliefs have done the same to Western medical practice. The coexistence of sacred space and medical space has created a need for mutual understanding of worldviews. Through stories drawn from Symonds and Fadiman, it is possible to see how Hmong practice has created a therapeutic myth that closely resembles American medical practice of sickness and health. Through analysis of these two worldviews, I will demonstrate how Hmong cosmology and American medical practice are closely related in the story of Lia Lee. For the Hmong, the shaman plays a crucial role in...
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...Hmong Culture vs Western Medicine: A Social Constructionist Analysis Throughout Lia Lee’s medical journey, both her doctors and her family struggled to understand one another’s behavior resulting in misunderstandings, alienation, and distrust between the two parties. The social constructionist perspective and related theories on human behavior, such as symbolic interactionism, can be used to analyze the complicated and confusing relationship between the Lee family and the Merced County Medical Center doctors. The social constructionist perspective, as defined in the book Human Behavior and the Social Environment, states that “people construct meaning, sense of self, and a social world through their interactions with each other,” Hustchison, 2019, p 52....
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...Promoting Cultural Sensitivity A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos U.S. Department of Health and Human Services Centers for Disease Control and Prevention Hla dej yuav hle khau; Tsiv teb tsaws chaw yuav hle hau. “When you cross a river, take off your sandals; when you emigrate from one country to another, take off your hat.” –Hmong Proverb Promoting Cultural Sensitivity A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos Female elder. © Frank Carter. U.S. Department of Health and Human Services Centers for Disease Control and Prevention 2008 For Additional Information For more information or for a list of available guides, please contact: Division of Tuberculosis Elimination National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention 1600 Clifton Road, NE, Mailstop E-10 Atlanta, GA 30333 Phone: (404) 639-8120 Web site: http://www.cdc.gov/tb Suggested Citation Centers for Disease Control and Prevention. (2008). Promoting Cultural Sensitivity: A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos. Atlanta, GA: U.S. Department of Health and Human Services. 2 Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Intended Audience . . . . . . . . . . . . . . ....
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...Hmong World View and Social Structure According to Durkheim (1961), the source of what we regard as sacred or religious lies within our own image. The deities and spirits we pay respect to are but "society transfigured" for in the final analysis we only worship our society. It is society which is both the cause and the expression of religious sentiments through regular ritual representations (Aron, 1967: 53) These rights constitute beliefs enacted for the purpose of preserving a sense of belonging for the participants and maintaining them together as a group. They not only tie the members of the group to each other "but also to the past and the future generations" (Cohen, 1871: 180). Religious ideas, in the words of Bachofen (Leaf, 1979: 118), define fundamental relations in society, showing internal structures similar to the actual behaviour or the believers. The supernatural order is in general based on the social relationships of the group. It validates and regulates these relationships, thereby conserving the social orders. In this paper, I will discuss the social organisation of the Hmong of Laos and Thailand in relation to their religious beliefs in order to see if the two spheres mutually interact to maintain the broader social system. It has been said that ancestral spirits are no more than "a projection of the authority system of the living - the lineage elders elevated to a supernatural plane" (Keesing and Keesing 1971: 309). How true is this of the Hmong? I will...
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...Gran Torino Film Analysis Norma J Morehead Intercultural/International Communication 10 June 2012 Cultural conflict and popular culture are two experiences in life that assist in defining intercultural communication and how its influence affects our daily intercommunication. Cultural conflict is inevitable as we live out our daily lives in the identities we have selected for ourselves, the identities relating to our ethnicity and in those identities others have selected for us. These identities are bound to conflict with another individual’s identities which is why there is a need for understanding what intercultural communication is and how it can be enhanced becomes vital to peaceful living around the world. Popular culture is a reference point for information used to determine who we want to be, who we are, and what we want in life. Popular culture has its good attributes and its bad attributes, both shape our society. Popular culture as it relates to television, video games, music videos and print media has a negative reputation because it is driven by money. There are characteristics of popular culture that are positive and enrich the lives of individuals such as the fine arts; the symphony, theatre, and museums. In a free society we are fortunate to have a choice. We are a free society and we want to remain a free society which makes the need for successful intercultural communication that much more important to achieve. Released in 2008, the film Gran Torino...
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...Online Business Expansion Plan for Clovis Transit A1. Online Business Viability Clovis Transit is a public transportation agency located in the San Joaquin Valley of Central California. Clovis Transit provides two types of transportation – fixed route and paratransit. The fixed route service is called Stageline and runs regular routes throughout the city of Clovis proper and into some portions of the neighboring town, Fresno. The paratransit service is called RoundUp and provides service to disabled residents of the city. Clovis Transit is considered a mid-sized transit agency and provides approximately 300,000 trips per year. The city brands itself in the western motif with the goal of maintaining a small-town feel and personality while still serving a population of just short of 100,000 citizens. Passengers who use Clovis Transit fall into three main categories: low income, student, and disabled riders. These riders are considered “transit dependent” which means they have no other choice for transportation beyond the bus and therefore marketing has remained a low priority. The City of Clovis maintains a website that provides access to all its departments including Transit. The Transit department’s website currently contains basic information about the services offered and various forms and documents that can be downloaded by the user. Because the department serves two distinct customer groups, regular fixed-route transit riders and disabled citizens, there is an opportunity...
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