In the novel The Spirit Catches You and You Fall Down, the author Anne Fadiman describes the non-fictional story of a young Hmong girl and her experiences with American doctors as she seeks treatment. Lia Lee suffers from epilepsy but is caught in the cultural clash between her family and American doctors. The novel incorporates major themes that relate to public health, such as cultural competence amid different cultural beliefs and modern medicine. The conclusion of the novel depicts the consequences from a lack of cross-cultural communication and reveals weaknesses of modern Western medicine when it comes to treating patients in a way that aligns with their own beliefs. This is a relevant public health issue in America today, where we have …show more content…
It has additionally tarnished Asian American immigrants as aliens and polluting threats to the health and welfare of the nation.2 As a result of unconscious biases, Lia is already at a disadvantage; first by her illness, and then by her classification as an Asian American. Culture plays a major role in the novel as each chapter shares some aspects of Hmong culture. This includes food, language, family style, and structure. Those deeply rooted in the Hmong culture have beliefs that the cause of disease is spiritual and can be further cured through their traditional forms of healing and rituals. As one can expect, these values against medical procedures and beliefs about origins of disease and conditions conflict with those of modern Western medicine. This has created conflict and misunderstandings through a lack of communication between medical practitioners and …show more content…
These boards can then identify areas of improvement and design solutions that will be culturally competent. The concept of community engagement, viewed through its multiple lenses, is rooted in social justice and community change processes. In the 1997 Centers for Disease Control and Prevention (CDC) publication Principles of Community Engagement, community engagement was defined as “the process of working collaboratively with groups of people who are affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being.”4 This educational background in understanding cultural perspectives is an important concept in working towards positive change in minority communities. An interesting quote that I believe summarizes this whole scenario is from William Osler. Osler is one of the founding physicians of Johns Hopkins
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
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.
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.
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.
In the book The Spirit Catches you and you Fall Down, ethnocentrism can also be seen. Throughout the book the family and the doctors have different ideas of medicine/healing techniques are often disagreed on. It’s important for the doctor to see that biomedicine has its own intentions of saving patient through standard procedures and beliefs. Understanding those terms will shed some light on the culture of the patient, which has their own intentions, beliefs, and rules as well. Breaking down ethnocentrism to find an agreement is a good goal to accomplish in order have successful prognosis and healing. In addition, shedding the ethnocentrism will allow the doctors to see the different cultural beliefs and not judge right away. Although, some cultural remedies may not always work, it’s wrong for people to have the mindset of ethnocentrism without even considering their beliefs first.
Union between two quarrelsome objects can be the most amazing creation in certain situations, take for instance, water. Originally, water was just hydroxide and hydrogen ions, but together these two molecules formed a crucial source of survival for most walks of life. That is how marriage can feel, it is the start of a union that without this union the world would not be the same. A Hmong mother, Foua took it upon herself to perform a marriage ceremony for the author of “The Spirit Catches You and You Fall Down”, Anne Fadiman. In this miniscule event, two cultures with completely conflicting ideas came together to form a union. In this union, an American was celebrating an event in a Hmong way, truly a collision of two cultures.
Traditional Hmong’s believe in their Shaman rather than western doctors, they choose to detain their treatment by hosting their rituals to save them. A shaman is “a person who acts as intermediary between the natural and supernatural worlds, using magic to cure illness, foretell the future, control spiritual forces, etc” (dictionary.com). Hmong individual’s have a belief that ancestral spirits, including the spirits of shamans, are reincarnated into the same family tree. Hmong consider being a shaman an honor because they carry the duty of helping mankind according to Hmong mythology. Differences between Hmong traditional beliefs and Western biomedical beliefs create a lack of understanding. Negative health care experiences result in Hmong community members’ mistrust and fear of Western medicine. However, when there’s mistrust between a doctor and a patient there could be lack of treatment because of the differences between our ...
Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.)
This book addresses one of the common characteristics, and challenges, of health care today: the need to achieve a working knowledge of as many cultures as possible in health care. The Hmong population of Merced, California addresses the collision between Western medicine and holistic healing traditions of the Hmong immigrants, which plays out a common dilemma in western medical centers: the need to integrate modern western medicinal remedies with aspects of cultural that are good for the well-being of the patient, and the belief of the patient’s ability to recuperate. What we see is a clash, or lack of integration in the example of the story thereof. Lia, a Hmong child with a rare form of epilepsy, must enter the western hospital instead of the Laotian forest. In the forest she would seek out herbs to remedy the problems that beset her, but in the west she is forced to enter the western medical hospital without access to those remedies, which provided not only physical but spiritual comfort to those members of the Hmong culture. The herbs that are supposed to fix her spirit in the forest are not available in the western hospital. The Merced County hospital system clashes with Hmong animist traditions.
In “The Spirit Catches You and You Fall Down” by Anne Fadiman, the whole story revolves around Lia, the thirteenth child of Lee family. Lee family was a refugee family in USA and Lia was their first child to be born in US. At the time of time of birth, she was declared as a healthy child but at the age of three it was founded that she is suffering from epilepsy. In the words of western or scientific world the term epilepsy mean mental disorder of a person and in Hmong culture, epilepsy is referred to as qaug dab peg (translated in English, "the spirit catches you and you fall down"), in which epileptic attacks are perceived as evidence of the epileptic's ability to enter and journey momentarily into the spirit realm (Wikipedia, 2014)
Tradition is defined in the dictionary as the handing down from generation to generation of the same customs and beliefs. The Spirit Catches You and You Fall Down, I believe has two main topics addressed: the traditions of the Hmong people, and the dangers of being unable to communicate. The misunderstanding of these two consequential points, I believe caused the majority of conflict that arose.
The Spirit Catches You and You Fall Down by Anne Fadiman is a nonfiction book that brings to light the clash of Hmong culture and Western medicine in Merced, California. Anne Fadiman tells the story of a Hmong immigrant family, the Lees, and the unfortunate condition of epilepsy that their daughter Lia suffers from. Throughout the book the reader sees great conflict inflicted on medical practitioners due to the Lee’s own cultural beliefs and the frustration suffered by the family due to miscommunication. Anne develops the story by giving a detailed background of the Hmong peoples’ lifestyle in their indigenous land of Lao, how it contributes to their beliefs, and their struggle to understand and accept Western practices.
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An individual’s culture and belief may significantly impact the type of services they require. In addition, it may affect the time, place, and method in the delivery of health care
Cultural blindness can lead to misconceptions and the inability to treat patients efficiently. Culture, religion, beliefs, values, social economic standings, education, mentality, morals, and treatment are all different from person to person, community, and groups. These barriers can be overcome by treating each patient as a unique individual and seeking to learn about cultural beliefs and differences, without reservations or pre-judgments but with an open and willing mind. These inhibiting barriers can be crossed through acceptance and commonality can be established. Through Patient-centered communication and attentiveness to the patients’ interpretation, discussion of lifestyle and treatment choices in an open and non-judgmental manner, and understanding of patient views, concerns and information needs can lead to cultural sensitivity and appreciation (Dean, R,