The Spirit Catches You and You Fall Down by Anne Fadiman is based on a true story that involves the collision of American and Hmong cultures. Hmong medicine consists of herbs and shamanism, a practice that interacts with the spiritual world. Meanwhile, Western medicine is based on the advancement of science and technology. This book is based on telling the story of Lia Lee and how there is a conflict between different cultures. Lia Lee, a Hmong child with severe epilepsy, receives treatment from Merced Community Medical Center on multiple occasions. However, due to language, tradition, and cultural barriers, the Lee family fails to follow Lia’s medication regimen. This causes mistrust between the medical staff at MCMC and the Lee family. Through the analysis of this book, it is seen that both parties failed in demonstrating proper doctor-patient communication, and this led to the downfall of Lia’s health. Fadiman concentrates on cultural collision and language barrier.
A cultural collision occurs when there is an opposing view that conflicts with another. During the birth of Lia, Foua wanted to take the placenta home and bury it. The Hmong believe that a person’s soul travels until it reaches the placenta, where it reunites with its ancestors. However, the doctors at MCMC thought Foua wanted to eat the placenta and burns it to prevent the spread of Hepatitis B. Medical workers should treat each other with respect and be mindful of individual differences (Hebenstreit 2017). To understand these differences, the workers at MCMC should have been understanding and respectful of the Hmong culture. Instead, Foua was mistreated and was unable to conduct the Hmong tradition of Lia’s placenta, a potential cause of Lia’s epilepsy. In the situation of Lia’s epilepsy, MCMC believes that modern medicine would be effective in silencing the symptoms if taken regularly. A flaw in this book was that it does not mention why the Lee family was reluctant to give Lia some of her medications. Fadiman failed to mention a specific reason why the Lees were rejecting certain medications and only giving specific ones. The Lee family believed that Western medication was killing Lia because of all the side effects. This causes the Lee family to resort to their cultural practices because they were unable to understand the effectiveness of the medications.
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Within the medical field, it is important to earn the trust of patients. This includes a proper introduction, a review of what has happened (symptoms), an explanation of the procedure and treatments, and a follow-up. A doctor-patient relationship is important because it can impact the effectiveness of the treatment regimen. If the doctor-patient relationship is poor or if communication fails to get through, the success of the treatment plan will be rendered useless. In the spirit catches you and you fall down; Fadiman was able to display the poor relationship between MCMC and the Lee family. Hmong families who seek medical attention were often faced with hostility (Sen 2013). Although MCMC is knowledgeable in treating epilepsy, they failed to find a translator for the Lees. It was clear that there wasn’t any proper communication, yet, the workers failed to acknowledge their mistakes. Not only does this lead to mistrust in the medical component, but since the workers also failed to be mindful of their cultural differences, the Lee family had no reason to believe that they cared for Lia’s health (Thorburn 2012). There was no proper communication due to the language barriers, which led to Lee’s mistrust of the work ethics of MCMC. The workers should never have expected the Lee family to follow the medication regimen if they can’t read the instructions.
The lack of communication between the doctors and the Lee family caused child neglect. The medications that the doctors prescribed were meant to be taken on a regular basis. Since the Lee family failed to comply, they put Lia’s health at risk. The doctors also did not understand the Hmong remedies that were used on Lia and believed that Foua couldn’t provide the care needed. This caused Neil and Peggy to file a report to child protective services and placed Lia in foster care. Unlike how the book portrays the Lee family, the parents loved Lia a lot. In traditional families, the daughter is often neglected, and the son is valued. For this situation, Lia was showered with love and affection from both her parents. Nao Kao, her father, valued Lia to the point where he rushed her to the hospital and was eager to bring her home. Nao Kao wanted to watch over his daughter from their house, where they are most comfortable. It was unfortunate that the family had lost Lia once before due to accusations of child neglect.
The Spirit Catches You and You Fall Down educated society on medical complications with cultural differences and language barriers. This book taught lessons on why it is important to make sure patients understand the proper regimen and to thoroughly explain the treatment they are receiving. Although the Hmong is reluctant to western medicine, proper education should still be given. The community is constantly receiving immigrants every day. It is important for the medical team to get to know their culture and intertwine it with modern medicine.
Works Cited
- Hebenstreit H. The National Association of Social Workers Code of Ethics and Cultural Competence: What Does Anne Fadiman's The Spirit Catches You and You Fall Down Teach Us Today? Academic oup. 2017 Mar 4 [accessed 2020 Mar 28]. https://academic-oup-com.proxy.wexler.hunter.cuny.edu/hsw/article/42/2/103/3061730
- Fadiman A. The spirit catches you and you fall down. Farrar Straus & Giroux Inc; 2007.
- Sen A. Postcolonial yearning: reshaping spiritual and secular discourses in contemporary literature. Place of publication not identified: Palgrave Pivot; 2013 [accessed 2020 Mar 31]. https://link-springer-com.proxy.wexler.hunter.cuny.edu/content/pdf/10.1057%2F9781137340184.pdf
- Thorburn S, Kue J, Keon KL, Lo P. Medical Mistrust and Discrimination in Health Care: A Qualitative Study of Hmong Women and Men. Springer Link. 2011 Nov 25 [accessed 2020 Mar 28]. https://link-springer-com.proxy.wexler.hunter.cuny.edu/article/10.1007/s10900-011-9516-x
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