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What would it be like to come to a country and not understand anything about its health care system? To many this would be a very daunting task. Unfortunately, this is the scenario that the Lee family has to deal with in the book The Spirit Catches You and You Fall Down by Anne Fadiman. The Lee family, and the other thousands of Hmong immigrants, try to understand and navigate the complex and sometimes confusing health care system of the United States. As the book points out, the values and ideals of the Hmong culture and the United States health care system are not always the same and sometimes come into great conflict with each other. Lia Lee was unfortunately the person stuck in the middle of this great conflict.
The two Hmong cultural values that were demonstrated by the Lee family are portrayed by their belief and view about the cause and method of cure for an illness. The Lee family comes from a culture that believes in holistic healing. They have an animalistic view about health and medicine. For instance an epileptic is seen as someone who has been chosen to be a healer. Most Hmong epileptic are shamans, therefore even though the Lee’s wish that their daughter’s illness will be cured, they also have a mixture of pride because “although shamanism is an arduous calling that require years of training with a master in order to learn the ritual techniques and chants, it confers an enormous amount of social status in the community and publicly marks the triv neeh as a person of high moral character since a healing spirit will never choose a no account host” (Fadiman,1997, p.21). It is not surprising that their view about health is reflected mostly in their traditional belief in the causes and the cure of an illness. For i...
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..., p.261) With this knowledge of the culture that one works in, the health care worker can better see the differences with the cultures of the patients that they are taking care of. Hopefully this understanding will lead to less conflict and better healing.
In this book Anne Fadiman portrayed the ethnocentricity of the American culture, in which people of other cultures are judged based on the standard of American customs and tradition. This means that people are very skeptical about the things that they do not understand. A lot can be learned from the interactions that took place between the Western United States health care system and the more traditional Hmong culture. This book proved that in the end neither way of thinking was completely wrong or completely right. Compromise and understanding is the key to both cultures getting the outcome that they desire.
Jean Giddens (2013) defines culture as “a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language, or live in a defined geographical region.” (Giddens, 2013). A person’s culture influences every aspect that person’s life. Beliefs affected by culture include how someone interacts within the family, how to raise children, the types of foods eaten, the style of clothes chosen, which religion is practiced, and the style of communication (including verbal, and body language, slang used etc.) (Giddens, 2013). In addition to these beliefs, health care practices are also affected by culture. The cause
The Hmong people, an Asian ethnic group from the mountainous regions of China, Vietnam and Laos, greatly value their culture and traditions. The film “The Split Horn: Life of a Hmong Shaman in America” documents the seventeen year journey of the Hmong Shaman, Paja Thao and his family from the mountains of Laos to the heartland of America. This film shows the struggle of Paja Thao to maintain their 5000 year-old shamanic traditions as his children embrace the American culture. Moreover, the film shows that one of the major problems refugees like Paja Thao and his family face upon their arrival to the United States is conflict with the American medical system. Despite the dominant biomedical model of health, the film “The Split Horn” shows that
Cobb, Torry Grantham, DHSc, MPH,M.H.S., P.A.-C. (2010). STRATEGIES FOR PROVIDING CULTURAL COMPETENT HEALTH CARE FOR HMONG AMERICANS. Journal of Cultural Diversity, 17(3), 79-83. Retrieved from http://search.proquest.com.ezp-01.lirn.net/docview/750318474?accountid=158556
Share the story of The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures.
By every individual accepting and acknowledging that we are all different then there will be mutual respect for each other’s cultural difference. When these differences are explored in a safe, positive, and nurturing environment, they are more than simply tolerating others but that through these differences are instead commended and embraced. People become aware of each other’s difference and uniqueness such as religion, sexual orientation, race, gender, age and beliefs. When this is embraced by the health care providers then there will be improved care.
Cultural Competence is important for many reasons. First, it can help develop culturally sensitive practices which can in turn help reduce barriers that affect treatment in health care settings. Second, it can help build understanding, which is critical in competence, in order wards knowing whom the person recognizes as a health care professional and whom they views as traditional healer, can aid the development of trust and improve the individual’s investment and participation in treatment. Third, our population in the United States is not only growing quickly but also changing, cultural competence will allow us as educators and healthcare workers keep up wi...
Lia lee, a little Hmong girl, has a severe case of epilepsy. She is the daughter of Nao Kao and Foua lee who are among the many Hmong refugees that fled to the U.S. The Hmongs are very simple and proud people. They take pride in the fact that they have never been ruled by anyone. Even though they have been driven away and separated many times they always seem to find themselves and their culture, never seemingly adapting to the major culture. Even when French missionaries settled in their area and brought their western ideals, medicine, religion, and values they never really accepted them. Fadiman stated in her book that in reality, “no Hmong is ever fully converted” (35).
The Spirit Catches You and You Fall Down by Anne Fadiman is about the cross-cultural ethics in medicine. The book is about a small Hmong child named Lia Lee, who had epilepsy. Epilepsy is called, quag dab peg1 in the Hmong culture that translates to the spirit catches you and you fall down. In the Hmong culture this illness is sign of distinction and divinity, because most Hmong epileptics become shaman, or as the Hmong call them, txiv neeb2. These shamans are special people imbued with healing spirits, and are held to those having high morale character, so to Lia's parents, Foua Yang and Nao Kao Lee, the disease was both a gift and a curse. The main question in this case was could Lia have survived if her parent's and the doctors overcame the miscommunication, cultural racism, and the western way of medicine.
She heard about the Hmong through a friend, and so she spent 4 years living in Merced, California and another 5 writing this book. She attempts to stay fairly neutral in her writing, though through her time with the Lees, she confesses that her writing may appear biased toward the Hmong culture rather than toward the Americans. However, in the end she could not blame one side or the other for the unfortunate tragedy of Lia, who got hit in the cross-fire between these two cultures. Her theoretical view is a type of cultural relativism. Neither the Hmong nor the Americans could emerge as the better culture. She does not address any questions about direct unethical practices. The Hmong did not practice human sacrifices, and the animals they did sacrifice were theirs. She does seem to believe that every culture has its weak and strong
As part of my Culture, Health and Illness class, I undertook a critical analysis of the book “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures” by Anne Fadiman. This book was published in 1997, and documents the struggle of a Hmong family from Laos in communicating with and understanding the American health system.
This essay will be evaluating the question: how did language and communication play a role in shaping what happened to Lia? Also, it will look at if Fadiman points out ways in which communication practices between doctors and patients could be improved. These were important in the book, The Spirit Catches You and You Fall Down, because they shaped what would happen to Lia in the end. The evidence we will look at will include the facts that the doctors and the Lees couldn’t understand each other, the hospitals didn’t have enough interpreters for everyone, and that the Lees did not trust hospitals or doctors in the first place because of their culture.
Cultural competence is a skill essential to acquire for healthcare providers, especially nurses. Cooperating effectively and understanding individuals with different backgrounds and traditions enhances the quality of health care provided by hospitals and other medical facilities. One of the many cultures that nurses and other health care providers encounter is the American Indian or Native American culture. There are hundreds of different American Indian Tribes, but their beliefs and values only differ slightly. The culture itself embodies nature.
As nurses entering the medical field understanding the culture of our patients is crucial to proper care. Each culture has their own set of beliefs and values that are shared among groups of people which influences personality, language, lifestyles, house hold, level modesty, social standings, foods, health treatment and identity. Culture affects how people view health and illness; dictating when, where and what type of medical treatment they will receive and who will be their care provider.
There are many main ideas and themes in the book “The Spirit Catches You When You Fall” by Anne Fadiman. I and my group discussed three themes and specific main points that we all thought was important to take from the book. Some of the main points that we discuss is Hmong culture/family, language barriers, and epilepsy. I will talk about the main points, a brief reflection on the doctor’s take on this situation and the theme sometimes you can’t control the outcome of situations.
Understanding cultural differences not only improves the effectiveness of the treatment the patient receives, it is also help the nurse to prevent negliency of care. It is impostant to maintain a curiosity about each patient no matter how much we know abouth that person's culture.