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 …show more content…
Jeanine Hilt, a social worker, made it her mission to engage the Lee family and was, “...the only one who had actually asked the Lees what they thought was the cause of their daughter’s illness” (Faidman, 1997, p. 32). There are several examples throughout the book of ways Jeanine tried to increase her knowledge of the Hmong culture by engaging with the Lee’s, asking questions to increase her understanding, and working together with them as they cared for Lia. She is mentioned in the ethnography as frequently being at the Lee’s home and at the hospital when Lia was there (Faidman, 1997). Her involvement and effort to understand the Lee’s led to a close, trusting relationship with the family in both a professional and personal …show more content…
Exploring multiculturalism is, “...a reflective process whereby practitioners demonstrate an intentional drive to continually broaden their cultural understanding and pursue a personal journey of multiculturalism” (Munoz, 2007). The lack of exploring multiculturalism was demonstrated near the end of the ethnography, when Faidman interviewed one of Lia’s doctors, Neil Ernst. When asked if he wished he had done anything differently in regard to Lia’s care, “He answered as I expected, focusing not on his relationship with the Lees but on his choice of medication” (Faidman, 1997, p. 272). If Neil had truly been trying to develop his cultural competency and explore multiculturalism, his answer to that question should have reflected his desire to learn more about the Hmong belief systems and how they influence patient care. He went on to say, “...when there is a very dense cultural barrier, you do the best you can, and if something happens despite that, you have to be satisfied with little successes instead of total successes” (Faidman, 1997, p. 272). This shows some acknowledgement of cultural factors, but no evidence of knowledge gained related to how to honor a patient’s cultural beliefs. Eventually, the cultural competencies at MCMC and around the country evolved and improved; however, there were many missed learning opportunities in the case of Lia