...Anne Fadiman explores the delicate nature of cross-cultural medical care in her book “The Spirit Catches You and You Fall down,” a title taken from the Hmong phrase “qaug dab peg,” an interpretation for epilepsy and its spiritual connections with the evil spirit (“dab”). Through her deep dive into the world of the Hmong people and their interactions with American medicine, her research combined with the personal story of the Lee family and their experience navigating the complicated system of eastern medicine, exposes the difficulties that so often occur when two very different cultures approach healthcare. Fadiman follows the Lees, an immigrant family who relocated to Merced, CA after conflict in Laos forced them out of their home. The book...
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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 Spirit Catches You and You Fall Down" It is difficult enough to go to the emergency ward with a family member and speak the same language as the staff. The admitting nurse wants all insurance information, another nurse/secretary asks for injury/illness history and, meanwhile, the person who needs to see the doctor is waiting in pain. The stress mounts and communication becomes harder. Now, take that same scenario when someone in the ER does not speak the language or know the culture of the patient. It not only severely complicates the process, but endangers the person needing the care. The Spirit Catches You and You Fall Down by Anne Fadiman is the tragedy about three-month-old Lia Lee, from Laos, who unfortunately was one of these cultural misunderstandings. This book had a significant impact on educational and healthcare concerns regarding the need for cultural understanding in medical care. Whether the changes will be enough remain open to question. Anne Fadiman, a freelance writer, was introduced by chance to the Hmong community through a friend working at a California hospital. It took her several months to be accepted enough to talk with the Hmong leaders, where she heard Lia Lee’s tragic story. She felt it was necessary to show the point of view of both the patient (and family) and the doctor, since cultural medicine is such a complicated issue. Fadiman succeeds in showing the challenges, frustrations and misunderstandings from these two perspectives. That is...
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...I am so sorry that you are in the hospital and I wish I could be there for you. However, I researched on your behalf Puerto Rico’s customs, culture and their healthcare. In the United States, Hispanics, are considered a minority. Puerto Ricans are simply and subculture of the Hispanic community. In the novel, “ The Spirit Catches You and You Fall Down”, Lia Lee, was considered a minority, as well. Her subculture group was the: Hmong. In this novel she is experiencing some of the same struggles you are such as absence of cross-cultural communication with medical advisors. Puerto Rican people prefer to be called “Boricua” which means family of the land whom are noble and valiant to the Lord. Since, you are a minority, Cross-cultural communication will be rathe difficult for you....
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...The Spirit Catches You and You Fall Down by Anne Fadiman is a book about the 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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...When it comes to personal health and illness rarely do we link cultural traditions and beliefs as the culprit. Typically our society views health and illness as a cause and effect subject. If we get sick it is because our body encountered something that it could not stave off. If we are healed it is because we were able to treat a specific illness with the appropriate cure. Our society does not take into consideration external factors such as cultural traditions and beliefs as causes or cures to today’s health issues. While it may be true that many health issues can be directly correlated to specific circumstances, there exists a deeper fundamental reason why we get sick and how we maintain our health. At least a part of that reason is our belief system and our belief system is formed by our culture and traditions, therefore it only makes sense that our cultures and beliefs directly impact our health. Proof that beliefs and traditions have an impact on health can be found in the interviews of the two subjects discussed in this paper. Although not the same beliefs and traditions are present in both interviews, both interviews show a direct link between the beliefs gained from culture and tradition that existed within that individual’s generational era and the impact of those beliefs on the long term health of that individual. The first interviewee, Jerry, is a 76 year old male currently suffering from his second occurrence of lung cancer. Jerry was a habitual smoker...
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...Baseball Magic - In the article "Baseball Magic" by George Gmelch, it talks about how players and their rituals they perform before a game. The whole idea is to show how two different cultures, American Baseball and the Trobriand Islanders both have the same idea same idea. That idea being that if you change,your way of doing something it ultimately ruin you. Keeping things the same will keep your luck the same. The article talks about rituals, how Dennis Grossini, a Detroit Tiger pitcher, would do everything the same on game day. Dennis would wake up at the same time, eat lunch at the same time, in fact he would eat the same lunch. All this was to win the game, he think that if he lives every day the same way he did the day he won. That the outcome will always be the same. Some may think that this is just stupid, but in reality it may work. By touching your hat or shirt, it relines your hand to where it was when you threw the strike. A ritual for me that in high school before we went on stage to do a play we would all have to jump up and hit the sign above the backstage door. The article also talks about taboo, to where players cannot say a certain word or it will break the luck of another player. The one mentioned in the book is when people say "no-hitter" around the pitcher, it there for makes him throw horrible from then on. In theater people say "break a leg" instead of good luck. Taboo for me is every time I slam on breaks or almost get in a wreck. I say the words...
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...The Spirit Catches You and You Fall Down Each culture has their own set of beliefs, values, and traditions. When two cultures come in contact with one another, a few things can happen. The most ideal situation is cultural integration, where both cultures can coexist with respect and acceptance of the other one. On the other hand, cultural assimilation can occur where the minority group/culture comes to adopt and resemble the dominant group. The worst case is a cultural clash. Conflicts can arise from the different cultural values and a lack of effort by either one to truly understand the platform of the other group. A similar cultural collision between a Hmong family and their American doctors is demonstrated in Anne Fadiman’s book called The Spirit Catches You and You Fall Down. This book examines how this culture clash impacts the...
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...“The Spirit Catches You and You Fall Down” Reader’s Guide Directions: Read the captioned book. Then answer the questions contained in this study guide. Post your completed document to the appropriate assignment box on the 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...
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...Reflection Paper 1 Reflection Paper Reflection Paper 2 Overall Impression of Book: 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. 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...
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...Literary Reviews Laura Miller of Salon write, “Indelible . . . Much like Ann Fadiman’s The Spirit Catches You and You Fall Down, this is a heroic work of cultural and medical journalism. With it, Skloot reminds doctors, patients, and outside observers that however advanced the technology and esoteric the science, the material they work with is humanity, and every piece of it is precious.” In Miller’s review of “The Immortal Life of Henrietta Lacks,” she focuses almost solely on the aspect of Henrietta’s family and the injustice done to them. She lightly mentions what these cells have done for ethics and medical research but how most importantly Skloot was able to tell a story from “the Lackses’ perspective.” I agree wholeheartedly with this statement and I do not believe this book would have been near the success that it is without including the Lackses’ side of this story of unjust ethics and racism in the medical and research field....
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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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...The Spirit Catches You and You Fall Down Book Review by Jerry Cyccone The book I chose to review, “The Spirit Catches You and You Fall Down: A Huong Child, Her American Doctors, and the Collision of Two Cultures”, by Anne Fadiman, is a non-fiction narrative about the collision of cultural relativism and medicine. The book describes the struggles faced by the Lees, a Hmong family that emigrated from Laos in 1980, to the city of Merced, California. The story revolves around young Lia Lee, the second born from her parents and a sufferer of epilepsy. Difficulties arise when barriers in communication, culture, and religion surface between American physicians and Lia’s parents over Lia’s treatment. These barriers, further enhanced by both side’s ethnocentric beliefs and failure to work together, resulted in creating a series of events that would eventually determine the fate of poor Lia Lee. Lia had her initial seizure at the young age of three months old. In an unfamiliar country and not fluent in English, yet concerned by Lia’s seizure, the Lees brought Lia to Merced Community Medical Center. From the beginning, the inability of both Lia’s parents and the doctors to communicate with each other, made it almost impossible for Lia to even be diagnosed properly. In fact, the first diagnosis of Lia was that she was suffering from a “bronchial infection” (p. 26). Yes, Lia did have breathing issues, but because of the language barrier, the doctors didn’t realize until...
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...The Spirit Catches You and Fall Down discusses many important topics, such as cultural humility and the consequences of miscommunication. The following is a brief response to some of the key topics discussed in the book (Fadiman, 1997). Explanatory Model of Illness: Definition of the Explanatory Model of Illness: An explanatory model of illness is a model that focuses on how the patient understands his or her illness and the factors that are involved. Two Examples of the Explanatory Model of Illness in the Book: The first explanatory model of illness is seen with the Hmong. The Hmong believe in a spirit called the Dab. They believe that many illnesses occur because of the Dab. For example, it mentions in the book that if a woman did not give...
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...In the Novel “The Spirit Catches You and You Fall Down” by Anne Fadiman the doctor and Hmong relationship seems to be improving because the doctors are finally letting the Hmong use traditional healing techniques. However, the only reason the doctors are agreeing to this is because they believe she is going to “die anyway”. In my opinion this is crude and an inhumane way of the doctors to think and then allow the family to follow the traditions. Instead of trying to explain to the family the gravity of the situation through a cultural interpreter or finding an anthropologist is explain issue they ignore it. They ignore it by essentially giving up understanding the family and their perception of the events, allowing them to try their best to save her for her only to die, meanwhile the doctors new of this the whole time. While I understand where the doctors were coming from wanting to appease the family, I still do not...
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