The Spirit Catches You And You Fall Down By Anne Fadiman

The author of this book is called Anne Fadiman. It is based on a story of a Hmong child known as Lia Lee who suffered from epilepsy. The demise of this condition shows the harm that can be contributed by absence of cross-cultural communication especially in the area of medicine. At the age of three months, the elder sister to Lia known as Yer banged a door which caused Lia to have the first seizure.

‘The spirit catches you and you fall down’ was published in 2012 by essayist and reporter Anne Fadiman. This introductory book review analyzes the way in which different cultures perceive illnesses and diseases. It focuses on the story of the Lees a Hmong family, who moved to the United States and experiences difficulties with language, culture and biomedicine method of healing, which contradict to Hmong’s way of healing. The chapters describe the differences between the ways childbirth is conducted in Hmong society compared to the western society. As well as the struggle the Lees family has with the cultural differences in diagnoses and treatment of their ill daughter.

As Fadiman wrote, “Doctors on the late shift in the emergency room had no way of taking a patient’s medical history, or of asking such questions as Where do you hurt?” (25). The fact that Lia’s parents could not understand English contributed to her not getting better since the doctors assumed that they would give her the medications as prescribed which they did not. A quote of Fadiman that says it all, “Over time, her drug regime became so complicated and underwent so many revisions that keeping track of it would have been a monumental task for a family that could read English. For the Lees, it proved to be utterly confounding” (45).

Several chapters in this book are devoted to Hmong’s history, cosmology and the multiple challenges they have faced while trying to settle in the United States. According to Fox (2005), Western medicine is a more reliable and effective way of curing diseases as compared to the traditional, and old-fashioned cultural methods, such as sacrificing pigs and chicken as depicted by the Hmong Lee family. I think that a better and more profound understanding of diverse cultures and their beliefs will play a key role in enabling Western doctors to overcome cultural resistance towards science. Consequently, they will have a more cooperative attitude towards the patients, which will likely change the ancient beliefs as held by some patients. Besides, the societies should not fully trust the cultural healing modalities.

The Spirit Catches You and You Fall Down by Anne Fadiman, explores cultural competence, ethics in medicine, and the provision of culturally competent health care in the United States by following a family of Hmong culture in their struggles with mainstream U.S. society and healthcare. Fadiman has implemented her studies to highlight the differences between Hmong and Western practices and perspectives on health care, illness, spirituality, and the body. Through her extensive research, Fadiman is able to express cultural differences and the impact ignoring this crucial piece can have. Healthcare in the U.S. is described as the best in the world, but Fadiman is able to highlight the weaknesses this healthcare system has in regards to culturally

Have you ever thought about how difficult it might be to go into a different country knowing absolutely nothing, not even language, and something horrific happened to you or anyone in your family?  Don’t you think you would feel so powerless, so helpless, so clueless? This happens commonly and it has never had any attention brought to it, at least not until 1998. Anne Fadiman wrote a book entitled, The Spirit Catches You and You Fall Down. This demonstrated a collision of two complete opposite cultures, but they both have the same goal to help the child get better.

Another critical element is the difference of the two culture in addressing illness. The Hmongs have a Shaman who comes in their home, spends time with the family and the patient. Shamans treat their patient’s spirit as well as the body and can make an immediate diagnosis. The American medical system very different in so many aspects that Fouya and Nao Lee is having a difficult time accepting

If a doctor however was given the chance to save Lia’s life and failed, they would be blamed for it. There was a feeling amongst the Hmong that because American doctors were so different than the Hmong medical system they were used too, they were more likely to cause harm than restore it. The Lee’s were no different in their judgment of American doctors, throughout the book it was clear that they cared about Lia very much and wanted the seizures that plagued her to stop, but their knowledge of medicine and health clashed with Western medicine and caused the seizures to increase rather than decrease. On the other side of the spectrum stood the American doctors who were more to blame than the parents for Lia’s permanent vegetative state. They didn’t adhere to simple the Hmong culture that would gain the Lee’s respect and understanding.

Puerto Rican Culture Religion, culture, beliefs, and ethnic customs can influence how patients understand health concepts, how they take care of their health, and how they make decisions related to their health (U.S. Department of Health & Human Services, 2015). As a nurse, it is important to understand that not every patient shares the same healthcare beliefs. A nurse must be able to perform his or her duties without judgement and care for each patient with respect for their own unique set of beliefs and morals. In this paper, the Puerto Rican culture will be discussed, from family units to religious and cultural beliefs, as well as how Western Medicine fits into their healthcare. Explain the culture.

On September 17, 1951, Cassandra Peterson was born. Although her family eventually relocated to Randolph, Kansas, she was born in Manhattan, Kansas. Prior to Turtle Creek Reservoir flooding the Kansas Randolph region, she was raised there. She attended General William J. Palmer High School when the family relocated to Colorado Springs. She graduated from High School in 1969 and during the course of her education, she had her mother, who owned a costume shop, make whatever outfits she desired in her size, and wore them to school.

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.

For more than three decades Hmongs have migrated to America, longing for a new enhanced life. Even if it meant they would have to learn a new culture, values, and language. Hmongs left their past, and journeyed on to develop a new future. The religion in North Asia will be discussed as well as the reason why some no longer practice the religion. Three main points that will be addressed will be when they first arrived to America.

Within the Hmong culture there is great emphasis on symmetry, balance, and complementary sections in bodies, society, and cosmos. Additionally, the soul must be kept in balance to maintain good health; sadly, the soul of Lia was not kept in good health which lead to severe, poorly-treated epilepsy. The medical mistakes and lack of precise communication ultimately lead to an untimely death of Lia; however, between both parties dealing with Lia’s epilepsy, the severity of her illness could have been prevented if both parties took Eliade’s perspective on sacred space into account during treatment. Sacred space, in terms of Eliade’s perspective, is one of the most critical, cherished topics that defines his paradigmatic model for religion. The

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.

In Anne Fadiman’s book, The Spirit Catches You and You Fall Down, two cultures clash with each other in the struggle to save Lia Lee, a Hmong child refugee with severe epilepsy. Although Lee and her family live in the United States, and thus receive medical care from Westerners, her family believes that Lee’s condition is sacred and special. The following miscommunications, both culturally and lingually, between the American doctors and the Lee family leave Lia Lee in comatose at the end of the book. However, Lia Lee could have been saved if the Lee’s had a better understanding of the American doctors’ intentions, and the American doctors understood the Hmong culture. Essentially, the tragedy of Lia Lee can be attributed to the clash of American and Hmong cultures at both the surface and sub-surface level.