Cultural Diversity In The Spirit Catches You And You Fall Down

“In the Spirit Catches You and You Fall Down”, Anne Fadiman explores the subject of cross cultural misunderstanding. This she effectively portrays using Lia, a Hmong, her medical history, the misunderstandings created by obstacles of communication, the religious background, the battle with modernized medical science and cultural anachronisms. Handling an epileptic child, in a strange land in a manner very unlike the shamanistic animism they were accustomed to, generated many problems for her parents. The author dwells on the radically different cultures to highlight the necessity for medical communities to have an understanding of the immigrants when treating them.

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

We can see that there was a misunderstanding between the Lee’s and the doctor. Both parties explained the view on Lia’s case but from a biased perspective within their own culture. Lia's doctors strongly opinionated to treat her disease with medication, however her parents felt that being given medication would restrict with the spiritual healing given by a Hmong shaman.

In Hmong’s, they have their own traditional beliefs in which they hardly ever alter due to a different atmosphere. Some of the Hmong beliefs are they prefer traditional medicine, are culturally active, host ritual ceremonies, and are spirituality influenced. In the book The Spirit Catches You and You Fall Down, refers to the Hmong culture and their beliefs on medicine while their baby Lia Lee, is suffering from epilepsy in which they have a hard decision. Traditional Hmong’s have their own medicinal beliefs which they obey prior to obtaining Western medicine. The gulf between Western medicine and Hmong health beliefs is an impossible abyss. Also, The Spirit Catches You and You Fall Down describes the life of Hmong refugees assimilating to

The Lees believe that for an illness to be cured the soul has to be called back through the ritual sacrifice of animals such as chicken and pig. That is, they believe in the “Shamanistic ritual performed by a trix neeb in which an animal is sacrificed and its soul battered for the vagrant soul of a sick Person” (Fadiman, 1997, p.100). According to Lia's father Nao Kao “Sometimes the soul goes away but the doctors don’t believe it…The doctors can fix some sickness that involve the body and blood but for us Hmong some people get sick because of their soul, so they need spiritual things. With Lia it was good to do a little medicine and a little neeb” (Fadiman, 1997,p.100). The medical care that the doctors at Merced were providing was without animal sacrifices therefore the Lee’s believe that it could not make their daughter well.

Kind of like in the book “the spirit catches you and you fall down,” by Anne Fadiman. Fadiman described how the Hmong’s and the doctors had different point of views; because of their differences in culture and the language barrier they had trouble communicating and understanding one another. In the Banes family, Jackie was responsible for understanding and pursuing treatments for her grandmother. These treatments were not so easy for Jackie to understand, and often there has been a lack of communication

One of the largest challenges Americans are facing today is coming to an agreement on the issue of immigration. Based on readings from Ruane and Cerulo and Fadiman, evidence of tensions between Americans and immigrant groups has spanned generations, affecting the way our culture perceives and reacts to “the Other,”1(167) cultures outside of our Western thought that we fail to understand due to continuous preconception and unrecognized self-entitlement as the ‘in-group.’ This segregation only continues the relentless cycle of economic and social barriers between an ‘us’ and a ‘them.’ The grand conflict between the Hmong versus the medical staffs in The Spirit Catches You and You Fall Down highlight the ethnocentrism that incurs blind

Anne Fadiman wrote this book to document the conflict between cultural barriers and how they affect medical issues. In this book, Lia Lee is a Hmong child was has epilepsy and battles cultural medical differences. The main struggle in this story is the conflict between the doctors and parents because they cannot seem to get on the same page. While writing the book, Fadiman stated that there was a “clash of cultures”. (Fadiman, preface) Meaning, there are two different sides to the story and the problem has not be solved.

The Lees, a Hmong family, came to the United States in the 1970s as refugees from Laos, and lived in Merced, California. Unlike most immigrants, the Hmong population was less amenable to assimilation. The traditional health beliefs and practices of the Hmong population were disputed by the practices of Western medicine. This became very event when the Lees took their three-month-old daughter, Lia Lee, to the emergency room in Merced. Lia was diagnosed with epilepsy a disease that had two different meaning among the Hmong population and Western medicine.

At 7:09 p.m. Lia Lee was born on July 19, 1982, at Merced Community Medical Center in California. Her family was Hmong descendant, a refugee from Laos that relocate themselves in America, California. The family was culturally oriented, but language limited. They cannot express themselves in another language except their cultural dialect. After Lia birth, Dr. Thueson noted that she was a “healthy baby” with the weight of eight pounds and seven ounces. Besides her weight, Lia’s assessment of a newborn infant’s heart rate, muscle tone, color, respiration, and reflexes was right within

This ethnocentrism is evident when Linda ponders her own cultural insensitivities towards the lu Mien culture, reflects on her own cultural assumptions about pain infliction with regards to immunizations, and wonders whether it is child abuse concurrent with the American law, however; keep in mind, it is a normal practice in lu Mien culture to burn children (Hachen, n.d.)

All communication is cultural. It draws on ways we have learned to speak and give nonverbal messages. We do not always communicate the same way from day to day, since factors like individual personality, mood, and the context of the situation interact with the variety of cultural influences we have internalized that influence our choices. Communication is interactive, so an important influence on its effectiveness is our relationship with others. Do they hear and understand what we are trying to say? Are they listening well? Are we listening well in response? Do their responses show that they understand the words and the meanings behind the words we have chosen? Is the mood positive and receptive? Is there trust between them and us? Are there differences that relate to ineffective communication, divergent goals or interests, or fundamentally different ways of seeing the world? The answers to these questions will give us some clues about the effectiveness of our communication and the ease with which we may be able to move through conflict. The challenge is that even with all the good will in the world, miscommunication is likely to happen, especially when there are significant cultural differences between communicators. Miscommunication may lead to conflict, or aggravate conflict that already exists, or in the sad of case of girl developing epilepsy and both her parent’s Hmong culturally clashing with her Western medicine

Language barrier was a major factor that served to extend the boundary existing between the two cultures. Some of the utterances made by the doctors were interpreted right but were understood wrongly (Swartz 2). This resulted in a worsened discernment of the American doctors by the Lees and Hmong as an entity alike. In the case of an emergency, the Lees needed to contact an ambulance, but could not communicate with the hospital. This necessitated the involvement of their learned nephew, who would call an ambulance. The interpretation process would at times limit the effectiveness of the message intended by either party. For instance, when Lia was undergoing critical care in MCMC, the Lees needed to be comforted, a process which had to be done by an interpreter. Before the final discharge, miscommunication between Lia’s mother and the doctors had her think that the nurses disconnected medicine tubes off Lia in order to give it to some other patient; a mean act. In the same incident, Lia’s father was made to sign a letter of discharge for Lia, which would happen in two hours. However, he understood this as a letter to guarantee death in two

In Hmong culture seizures are not recognized much as a physical illness as it is spiritual in nature and quab dab peg which translates to, the spirit catches you and you fall down, describes the group of symptoms experienced by Lia in the Hmong culture. The Lee’s were both happy and sad about Lia’s seizures. In Hmong culture seizures are considered to have special powers and usually become Shamans, but at the same time the Lees were worried about their child’s health.

The case study of Lia Lee is interesting and serves as a cautionary tale as it explores the consequences of cultural misunderstanding. In this case both the parents and medical staff sought the same thing; they both wanted Lia to have a positive outcome. Unfortunately, both groups had distinct ideas regarding how to achieve the common objective. This division was rooted in each sides individual cultural beliefs.