The Spirit Catches You And You Fall Down By Fadiman
Book Review: The Spirit Catches You and You Fall Down
Tim Merlino
Drexel University
November 2017 The patient-doctor relationship recognizes transference affects as a bi-directional relationship which affects the way a health care provider treats a patient and the way the patient responds to treatment (Zinn, 1990). Fadiman’s book examines different problems in the culture of American medicine by highlighting a tragedy centered around a Hmong immigrant family and their sick child, Lia, in California (Fadiman, 2012). The story also highlights some important lessons to be learned by the American health care system to avoid future incidents like described by Fadiman and to ultimately apply cultural competency in public health (Fadiman, 2012).
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Community outreach and involvement is essential. Some of Lia’s providers including her social worker, Jeanine, made efforts to better understand Lia’s family and the Hmong population (Fadiman, 2012). For instance, Jeanine showed many instances of empathy for Lia’s family and the Hmong which was recognized and appreciated (Fadiman, 2012). Jeanine had a chronic illness and she showed true affection for Lia (Fadiman, 2012, p. 113). Additionally, Jeanine avoided being patronizing and talking much about western medicine when interacting with Lia’s family which helped their relationship (Fadiman, 2012). An article by Bahr discusses importance of community outreach and involvement in the treatment of heart attack patients (Bahr, 2017). Bahr found heart attacks have beginnings which can be identified and acted upon at the community level before reaching the hospital (Bahr, 2017). Bahr’s article describes a community intervention in the past which improved heart attack survival rates by sixty-two percent by increasing bystander and community participation (Bahr, 2017). A different evaluation by Lachance showed programs which emphasized self-participation and health literacy by utilizing community health workers showed positive patient outcomes (Lachance, 2017). Utilizing community health workers in the Hmong population could be beneficial population as they suffer from being stuck in low-wage jobs (Fadiman, 2012, p. 206). Additionally, this approach would be more of a mutual assimilation between the health care system and Hmong culture rather than a one-way assimilation, which the Hmong have historically resisted in both China and America (Fadiman,
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