Anne Fadiman struggles to find the answer to who is responsible for Lia Lee’s health in her book, “The Spirit Catches You and You Fall Down.” The book describes the clashing of both the medical community within Merced, California, and a Hmong refugee family, the Lees, cultural beliefs. The Lees daughter, Lia Lee, is plagued with a severe case of epilepsy, or qaug dab peg in Hmong, as a child and is administered to the Mercy Medical Center Merced, or MCMC, a hospital in Merced, California. The doctors there go through many struggles in order to work with the Lee family, as they are faced with cultural and language barriers that they must overcome in order to ensure Lia is in good health. The Lees do not feel that they are in the wrong, for their …show more content…
Patients were people who came to the doctors with hope of getting cured and if they did not listen to the doctor, then they would be deemed a bad patient. The doctors of the MCMC community did not ever try to get to know their patients emotionally, so they did not care who they were trying to help. For example, “(quote from when dr was complaining how many other patients he has).” A large amount of the patients at the hospital were Hmong, “(quote about how many Hmong were in hospital).” Yet, an interpreter was not hired until years after Lia had started going to MCMC regularly. The doctors would hope a janitor would be on staff to roughly translate for them what medications their Hmong patients should take to become healthy once more. Their ignorance led to many misunderstandings, leading the Hmong community as a whole to not trust the MCMC hospital. “(quote/paraphrase about the Hmong not trusting the hospital).” The hospital did spend lots of their time trying to get their ideas across via stickers and calendars they provided to their patients that could not understand English, but all of that extra effort would not have been needed if they had hired a full-time interpreter. The MCMC hospital did not think it mattered if they could or could not have a deep meaningful conversion with their Hmong patients, otherwise they would have fixed this communication problem as soon as it
The Spirit Catches You and You Fall Down (1997) is an ethnography written by Anne Faidman. It tells the story of Lia Lee, a Hmong girl with severe epilepsy, and her family’s journey with managing the condition and the cultural barriers that posed great challenges in Lia’s care. Lia was diagnosed with epilepsy at age 1. It was her family’s opinion that the condition was a spiritual gift. Lia’s parents, Nao Kao and Foua, were wary of the American medical system, preferring to treat Lia in the Hmong way. Under the more spiritually focused care of her parents, Lia continued to have severe seizures; at the age of 4 ½, she slipped into a coma that would last the rest of her life. This book serves as a testament to the importance of cultural competency
The Spirit Catches You and You Fall Down is non-fiction text where Faidman discusses Lia Lee’s case, a girl with epilepsy or quag dab peg, and how her family goes about treating her disease by mixing traditional Hmong ways and modernized American ways. From three months, Lia’s seizures began. It is viewed as both a blessing and a curse because it is dangerous but also an indication of future
Putting the advice of Sukey Waller to use was an incredibly helpful step and recruiting May Ying to be the “cultural broker” and interpreter for Fadiman really led to substantial progress. Closer collaboration between the departments of the hospital may have led to a more prompt address by such a route. One wonders why Sukey Waller was not consulted sooner.
Merced's population was a one fifth Hmong and since MCMC offered the Medi-Cal plan which was a government funded service for people who couldn't afford health insurance, which most Hmong could not. More than eighty percent of the Hmong who obtained care were receiving free health care. The government only pays for so much, so the hospital has to pick up the rest of the bill. MCMC didn't have the money to hire interpreters, so as a makeshift they hired bilingual Hmong as lab assistants, nurse's aides, and transporters. Sometimes even these people weren't around and the Hmong children who attended English school were used as the translators. Even if the children and the makeshift workers could translate it would never be perfect for most medical English terms have no equal in Hmong, and it is awkward for children to ask such questions as "Do you want to take him of life support?" Questions like that should never have to be asked by a child. Foua and Nao Kao were illiterate and spoke only Hmong, so there problems were destined from the very beginning. They never understood what the doctors told them unless there was some sort of translator available. When a translator wasn't available they would sign without knowing what for, because they believed that in America if they didn't sign they would be deported or punished. Lia's parents were farm people they didn't know anything about
Many years ago, an epileptic Hmong girl named Lia Lee entered a permanent vegetative state due to cross-cultural misunderstanding between her parents and her doctors. An author named Anne Fadiman documented this case and tried to untangle what exactly went wrong with the situation. Two key players in her narrative were Neil Ernst and Peggy Philp, the main doctors on Lia’s case. As Fadiman describes, “Neil and Peggy liked the Hmong, too, but they did not love them… [W]henever a patient crossed the compliance line, thus sabotaging their ability to be optimally effective doctors, cultural diversity ceased being a delicious spice and became a disagreeable obstacle.” (Fadiman 265) At first glance, this statement seems to implicate Neil and Peggy as morally blameworthy for a failure to be culturally sensitive enough. However, upon further inspection of the rest of the book, it becomes clear that Neil and Peggy’s failure to be more culturally sensitive to their Hmong patients was caused by structural issues in the American biomedical system. To prove this point, this paper will first present a background to Lia’s case, then discuss possibilities for assigning blame to Neil and Peggy, then show evidence for the structural issues in American biomedicine, before finally concluding.
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
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.
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
This prejudice is another strong concept, as the American doctors continued to underestimate, disrespect, and undermine Foua Yang (mother) and Nao Kao Lee (father) and their Hmong way of life. Vice versa, the Lees would refuse doctors’ orders in administering medicines. Ruane and Cerulo hit it right on the nail when describing prejudice,(20) which is a prejudgment directed towards members of certain social groups, as a feeling associated with immigrant groups, those that contain individuals who have left their homelands in pursuit of a new life in a new country. There is a clear indication of an in-group vs. an out-group, as it is noted from Second Thoughts, “an in-group carry unrealistically positive views of their group. At the same time…share unrealistically negative views of the out-group.” The cultural barriers are built due to “the one-sided relationship,” of knowledge only found in the unyielding West, with the prominent racial discrimination found among the white, English-speaking doctors and their intimidate dismissal of the existence of any Hmong medical practices/knowledge. The application of assimilation (20) is important to the in-group, as they simply believe that the immigrants will come to embrace the same values and customs of their new ‘homeland.’
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.
I feel that Anne Fadiman narrated the story of Lia Lee’s and her family’s life in intimate and tragic detail. The Spirit Catches You and You Fall Down is a poignant depiction of the struggle between loving parents, hard-working medical professionals, and a very precious child caught in the middle of a tug-of-war. Ms. Fadiman very distinctly illustrates how the collision of two cultures indirectly led to the demise of a little seven- year old girl.
The doctors assuming the Lee were giving their daughter her medications, were surprised to not see levels of the medications in her blood. Dan Murphy who was one of Lia’s doctor questioned the parents and he learned that due to their cultural beliefs, Lia’s parents have not been administering her with the proper medicine. Where Lia’s mother believes she is doing the right thing for her daughter, Murphy has sympathy for the mother and told Fadiman “I remember having a little bit of awe of how differently we looked at the world”. A key feature of the Hmong is that they have no interest in being rule, do not like to be told what to do, and are rarely persuaded by the customs of other culture. The mistrust and open hostility between the medical staff and the Lee family seemed to overshadow Lia’s disease. Both side obviously loves Lia and wants her healthy but neither was willing to compromised and meet half way.
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
The Spirit Catches You and You Fall Down is the story by author Anne Fadiman, which explores the clash between a small county hospital in California and a refugee family from Laos over the care of Lia Lee, a Hmong child diagnosed with severe epilepsy. Lia’s parents and her doctors both wanted what was best for Lia, but the lack of communication between them led to tragedy.1The lack of communication due to cultural misunderstanding, mistrust, lack empathy, and poor health literacy led to care being comprised for Lia, which also affected both her parents and healthcare providers.
Lia Lee was a Hmong infant born with epilepsy. Lia’s parents were immigrants to a Western nation. However, the parents held tightly onto traditional beliefs from their native country. The incongruent belief structure of the East and West created difficulty when the two systems collided in an effort to care for Lia Lee. Specifically, when the drug therapy prescribed for Lia Lee was not followed by her parents. Subsequently the child’s medical team contacted child services, which lead to Lia’s removal from her family. The result of the cultural misunderstanding was fragmented family. In addition to fueling the distrust of the western healthcare system by an already marginalized community.