The Spirit Catches You and You Fall Down by Anne Fadiman

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.

Perhaps the greatest problem faced throughout this tale was that of miscommunication. The Merced Community Medical Center or MCMC for short was the place where Lia was being treated. This hospital was the Merced county's only hospital and unlike most rural county hospital it is state of the art, ."..42,000-square foot wing ... that houses coronary care, intensive care, and transitional care units; 154 medical and surgical beds...."3 This was a teaching hospital made up of interns mostly, but also with some great doctors like Peggy Philp and Neil Ernst. Peggy and Neil are married and have children. They graduated together at the top of their class, and have created quite a practice for themselves. Although MCMC is a great rural hospital, it also has the same problems as most rural hospitals do which is the health care crunch, where most of the money goes to the urban hospitals and then the leftover money is spread among th...

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...es, and the Hmong would be more likely to listen to them, because they had helped someone else in their community.

In conclusion, three things could have solved the cross-cultural problems between the Hmong and the American doctors. The doctors should have had more compassion toward the Hmong people, who have been discriminated and put down for very many years. They should have been more understanding toward the Hmong's belief and worked with and not undermine it. Lastly to compromise in all aspects in a relationship no matter what kind is a two way street, and if one party does not respect the other then the feeling will be reciprocated. You have to come to a middle ground or everything will fall apart like in Lia's case.

End Notes

1. Anne Fadiman, The spirit catches you and you fall down, (New York, Farrar 1997)

2. Ibid

3. Ibid

4. Ibid