The Spirit Catches You and You Fall Down
In The Spirit Catches You and You Fall Down, Anne Fadiman introduces the reader to the Hmong culture and to the Lee’s family experience with western medicine. Throughout the book it talks of the past interactions of the Hmong and Americans, showing reasoning why the Hmong already mistrust Americans and western medicine. Following World War II, the Hmong culture was rejected and ridiculed by the Chinese for not assimilating with their culture, causing many to move to the U.S. Upon arrival, they were still ridiculed, harassed, and violated. In the Hmong’s eyes, they deserved respect and welfare for their sacrifices in the war.
The Hmong practice traditional healing and sacrifices and saw America as a place they could continue doing so. Soon, they learned that American doctors did not respect their traditional beliefs in medicine and saw western medicine as the “right way.” Doctors grew angry that their Hmong patients would not agree with their treatments. The Lee’s are one of many who experienced this first hand.
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Her parents saw this as qaug dab peg, “the spirit catches you and you fall down,” that Lia’s soul was scared out of her. In their eyes the seizures were sacred as she could be chosen as a ‘tvix neebs’ or ‘shaman.’ Although still worried, they took Lia to Merced Community Medical Center. Lia was diagnosed with epilepsy. The Lee’s wanted to do half western medicine as well as half traditional healing to try to get Lia’s soul to return, but they were unhappy with the side effects from the prescribed medications. Therefore, they would not give Lia her full complicated order of
In a healthcare setting you will see different cultures that will come and go. It is very important to know how to deal with each culture so that you can help them while still making sure they are comfortable. Native Americans have many different characteristics because of the different tribes from all over the world. Healthcare providers should be familiar with them so they know how to distinguish them if needed. While knowing their characteristics they should also know how to interact with Native Americans as well since their culture is a lot different than ours, we want to make sure that we don’t disrespect them.
Lia’s parents spoke the Hmong language, which was a barrier during the treatment of Lia Lee. During the hospital stay at Merced County Medical Center, the doctors tried to explain the procedure of her treatment and provided the medications to cure Lia’s epilepsy. But since Lia’s parents had language barrier, the doctors and Lia’s parents were confused on the medications of what is supposed to be given for the betterment of Lia Lee. They even tried to send a nurse to their home to help with the medication regime. They soon realized that her parents did not want to give the medications to Lia.
Many of the Hmong (including the Lee family) immigrated from their Thai refugee camp to America in the late seventies. The book is mainly about the Hmong culture and healing beliefs colliding with “modern” American medicine. The Lees want to heal Lia spiritually with a Txiv neeb (spiritual healer), and don’t really want to use and medicine provided by their doctors. At the beginning of the book Fadiman explains why the Hmong prefer a Txiv neeb over a doctor. She writes, “Txiv neebs were polite and never needed to ask questions; doctors asked many rude and intimate questions...
“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.
It wasn’t until a couple of seizures later that the hospital understood that that the baby was suffering from seizures. Lia was to begin a strict regime of medication which was to limit the number of seizures. Because the Lee’s did not fully understand the medication and saw the epileptic seizures as part of the divine, the Lee’s did not stick to the medication as prescribed. What follows are a series of seizures, hospitalizations,
“Their seizures are thought to be evidence that they have the power to perceive things other people cannot see, as well as facilitating their entry into trances, a prerequisite for their journeys into the realm of the unseen” (Fadiman 21). Known as the quag dab peg ‘when you fall the spirit catches you’ are said to be the “most treasured possessions a person can have” (Fadiman 22). Which was considered to be a calling to become a host of a healing spirit. The author kept up to date through Lee’s tragic experience with translation complications, inequality and culture shock. Little did she know that she would be witnessing a “collision” as one doctor called it.
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Family and group solidarity are important to the Hmong, yet they were forced to split apart during their journey to America. The Hmong also partook in ceremonies, dances, and sacrifices that were important to them and their religion, however, the doctors and other people were wary of these practices and didn’t condone them, especially when it came to patients such as Lia Lee. Lee’s doctors were constantly giving her shots, medicine, and feeding her through tubes. Her parents didn’t approve of this at all and thought that the medicines they were giving her was what was killing her.
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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.