¶ … Spirit Catches You and You Fall Down
I believe Anne Fadiman was trying to prove that it is possible to work through tough cultural barriers by showing the mistakes of Lia Lee's doctors. By showing these examples, and also giving examples of how culture can work together, Fadiman is trying to prove that the American medical system needs to have other socially accepted avenues of therapy to work alongside of conventional medicine. The health issues faced by the Hmong Lee family, both from patient's point-of-view and the family's point-of-view are affected by their adaptation to the United States and their feelings toward health care and health care providers. It is hard to know what Lia Lee thought of her epilepsy since the audience never hears her voice an opinion on the matter. It is crystal clear, however, what the Lee family thought the health issue was: quag dab peg, roughly translated in English means "The spirit catches you and you fall down." Essentially, Lia's parents felt that her spirit was startled by a slamming door, it then briefly left her body, which was then snatched by an evil spirit; startled her spirit and then she "fell down" into an epileptic edpisode.
In several instances throughout the book, the author narrates the fear and confusion towards Western medicine. In refugee camps throughout Thailand, Hmong tribes readily believe that American doctors take too much blood from patients (believed to cause death among Hmong tribes), after you die doctors take out the brains, and that when Hmong people die they are cut up into small pieces and put into tin cans to be sold as food. Hmong are so suspicious of American healthcare because their own shaman, or medicine men, do not touch those they care for, do not cut into them, do not examine people while naked, and do not heal those of the opposite sex from themselves. In fact, most of the routine medical procedures, examinations, medications and surgeries performed by Western doctors are most definitely viewed as harmful or threatening to Hmong; which is why such stout resistance is met by nurses and doctors when anything needs to be done to the patient.
Hmong are a very stubborn people, who value family above all else, and who demand that outsiders earn respect before it is given to them. The reason for this is that Hmong people have never actually had their own country to do what they wanted and practice their beliefs as they wanted. It seems that they are always fighting with someone just to be left alone, and in the end, the only support they had was from their own families and tribes. This is why whenever important decisions must be made; all members of the family are included in the decision-making. Everyone is important, and no one is left behind. This feeling of family definitely contributes to the motivations for not giving Lia her medication as prescribed. As someone who readily second guesses my doctor's opinion, and will question what that recommendation means for me personally, I definitely see where the Lee family was coming from. However, the situation was fraught with difficulties from the beginning because Lia was a child, and it seemed that both sides of Lia were blinded to her best interests by this fact. Parents are always hyperprotective of their children, and doctors are put under stress because they are legally bound to not mess up and make a mistake with children especially. However, there was also the fact that the Lee's were experiencing firsthand the side effects of the medication, and the huge language barrier (the Lee's could not read English) was further confusing them. Almost the whole time, even with an interpreter, they did not know what to give her and when because the medicines and schedules kept changing, they did not understand what it was supposed to do or understand the dosages because there is no Hmong interpretation for Western medical terms (or measurements or clock times). It was just a very difficult situation that seemed to be getting worse in the eyes of the Lee family.
As far as the numerous healthcare providers that the Lee family saw for Lia, I wholeheartedly disagree with how they treated the family. Instead of being culturally sensitive, and maybe doing some research and background reading, they decided to act like typical Americans where they felt...
Spirit Catches You and You Fall Down by Anne Fadiman is a groundbreaking book about cross-cultural communication in health care. The book is about Lia Lee, who was the first in her Hmong family to be born in the United States. Her parents spoke no English. When Lia Lee was three months old, she had her first seizure. Due to misdiagnosis, a string of unfortunate events prevented Lia Lee from
The family would certainly have been more comfortable if the hospital made more of an effort to understand their culture and beliefs. The Lees were treated as if they were indignant and unresponsive to the needs of their child which was not the case at all. The hospital could have enlisted the help of affluent Hmong natives who have become more accustomed to American traditions. This person could have helped
Within this clash of cultures, the Lee family did not know how to cope with the medical system in place to help Lia and her epilepsy. When they refused to give her the medications, Lia was removed from the home and placed in foster care. When the foster care parents gave her the prescribed medication, her condition worsened in several important ways. The foster parents believe that Lia's parents realized
Spirit Faidman, Anne. (1998) The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giroux. The title of Anne Fadiman's book on the implications of multiculturalism in modern nursing sounds more like a religious testimony than a textual asset to the modern nursing profession. However, Faidman tells a tale of Biblical proportions, and the emotional nature of The Spirit Catches You and You Fall Down is epic in its
Yet the nightmare continued, because the communication problems were not resolved. During the next four years, her anticonvulsant medicines were changed about 25 times, which would have been hell for any family. The Lees questioned the value of so many prescriptions, especially with their Hmong mindset, and did not follow directions. Of course, this was exacerbated by the fact that they did not understand the dosages. The doctors inaccurately concluded
They cannot ignore the socioeconomic issues of adversity so often present and, where necessary, need to act as advocates, mediators and social brokers (Compton, Galaway, & Curnoyer, 2005). The concern is that the issue of healthcare for culturally diverse individuals is so complex, there are no exact rights and wrongs. For example, in Fadiman's book, no person(s) can be said to be ultimately correct or incorrect in his/her behavior or
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