Anne Fadiman’s book, The Spirit Catches You and You Fall Down, explicitly illustrates the cultural divide between a Hmong family, the Lees, and the physicians treating their daughter, Lia Lee, at the Merced Community Medical Center. Lia first begins to experience seizures when she is about three months old. This is initially when the conflict arises between the physicians and the Lees. In contrast to Lia’s Western medicine diagnosis of epilepsy, her parents interpret epilepsy, or quag deb peg in the Hmong language, as both a serious and dangerous disease and a sign of distinction, indicating that she could potentially become a shaman (Fadiman 20-21). On the other hand, the physicians are continuously trying to prevent and treat Lia’s seizures,
In The Spirit Catches You and You Fall down, Anne Fadiman reflected on ways in which cultural dissonance can have detrimental consequences for those who are caught in the midst of two cultures. In this influential story, the cultural and language barriers between Lia Lee’s family and her doctors caused Lia’s life to be negatively impacted due to improper diagnosis and treatment. The Lees preferred traditional and spiritual treatment that clearly differed from the doctors’ Westernized treatment. Through a constant battle between proper treatment and the Lee parent’s compliance, this caused Lia to live in a persistent vegetative state for the majority of her life.
At only three months old, Lia became having what Western Medicine calls epilepsy. However, her family diagnosed her with quag dab peg which translates as “the sprit catches you and you fall down.” This became a huge cross-cultural misunderstanding. The US medical doctors could not open their eyes to the Hmong culture and the Lees could not understand their Western Medicine. The Hmong believed that when Lia’s older sister slammed the door at Lia’s hu plig ceremony which
In the documentary, “The Split Horn: Life of a Hmong Shaman in America,” portrays the journey of an immigrant Hmong family battling to maintain their cultural traditions alive in the United States. In the Hmong culture, it is believed that every individual has seven souls and if they have an illness, for example sickness, it means that their soul has departed or taken by evil spirits. Hmong people believe in Shamans, who are gifted and respected people who can make contact with their ancestors and return the lost souls of people. In this documentary, the main character Paja Thao is a shaman who is challenged by American customs to keep his cultural Hmong traditions alive and pass it down to his children. Paja becomes sick because he feels like his children don’t care about the Hmong tradition anymore because they don’t participate in his rituals and realizes his children have assimilated to the American culture. The different ways one can look at Paja’s illness is by acknowledging the Hmong culture and by looking at the perspective of the biomedical world.
In the book, The Spirit Catches You and You Fall Down, Anne Fadiman explores the cultural collision between the Hmong Lee family and their American doctors. Along with the culture clash, the social stigma against the Hmong family brings to light a lot of the systematic, moral, and ethical issues that can arise in our healthcare. Ultimately, the combination of the cultural clash in medical perspectives, the underlying social stigma, the inadequate treatment, and the miscommunication hindered the proper diagnosis and recovery of led to the demise of the Hmong child. However, many of the problems could have been easily avoided or resolved with more patience, objectivity, and most importantly, cultural competence. Cross-cultural methods and approaches should be taken to accommodate for the diverse patient population in our communities.
Religion, culture, beliefs, and ethnic customs can influence how patients understand health concepts, how they take care of their health, and how they make decisions related to their health (U.S. Department of Health & Human Services, 2015). As a nurse, it is important to understand that not every patient shares the same healthcare beliefs. A nurse must be able to perform his or her duties without judgement and care for each patient with respect for their own unique set of beliefs and morals. In this paper, the Puerto Rican culture will be discussed, from family units to religious and cultural beliefs, as well as how Western Medicine fits into their healthcare.
Over the progression of the book the view points and relationships between the Lees and the doctors develops slightly. The medical staff was not prepared with a translator or a cultural understanding of the Hmong and how their beliefs would not match up with their medical practices. “Not only do the Hmong fail resoundingly to improve the payer mix- more than eighty percent are on Medi-Cal- but they have proved even more costly than other indigent patients, because they generally require more time and attention, and because there are so many of them that MCMC has to hire bilingual staff members to mediate between patients and providers” (Fadiman 25). This theme in the story was immensely eye opening for all of the cultural gaps that exist throughout the United States. The solution to this problem is for both sides standing on opposite sides of the gap to take the time to bridge the gap together. In order for this to work both cultures need to first build the relationships and establish a sense of trust between each other. Then, they need to be empathetic towards each other. In this case it is not where you are sympathetic for someone who does not understand the new culture around them, but you put yourself in their shoes and try to understand the difficult circumstances that are in front of them to help close the gap and not make it
The Hmong traditions, beliefs and ways of life were often compromised at the hands of American society. Cultural insensitivity is prevalent throughout the Hmong’s journey with the American health care system. Between 8 months and 4.5 years Lia was in the hospital seventeen times and made more the one hundred visits to ER and paediatric clinic. The health care system failed to attempt to understand the Hmong language and culture, which lead to the Hmong adapting their cultural traditions and familiarities to please
In The Spirit Catches You and You Fall Down, Anne Fadiman introduces the reader to the Hmong culture and to the Lee’s family experience with western medicine. Throughout the book it talks of the past interactions of the Hmong and Americans, showing reasoning why the Hmong already mistrust Americans and western medicine.
“The Spirit Catches You and You Fall Down” by Anna Fadiman tells the story of Lia Lee, a Hmong child with epilepsy, whose life could have been different if only her family was caught up in western medicine. This book reveals the tragic struggles between a doctor and patient because of lack of communication.
The author was trying to show how the difference between two cultures can influence in health care. The author showed how the difference between illness and disease also affects the forms of treatment. It is important to recognize the patient’s cultural beliefs because this may help us to recognize how effective the given treatment can be and in what ways we can enhance the treatment without sacrificing the patient’s cultural beliefs. The author also showed how both the parents and the doctors care about Lia but what they thought was best for Lia varied. The doctors thought that the parents were harming the treatment by not being compliant and the parents thought that the doctors were hurting Lia by giving her so much medicine.
The case of Lia Lee can be used holistically to showcase the negative effects which a culture and language barrier can produce between doctor and patient. It can reveal how communication and cultural sensitivity can aid in medical practice. Nevertheless, Lia’s case also shows the need for doctors and healthcare practitioners to learn more of about a culture so that treatment may be administered smoothly and without complete comprehension of the patient and their
Dr. Galanti provides insight into the relationship between cultural diversity and heath care providers. Dr. Galanti’s briefly states the difference between “stereotype and generalization”. The author recognizes that generalization may be a key factor used by workers in the health care community to bring awareness and a better understanding of cultural differences among patients. The article explains that although cultures differ in values, traditions, and beliefs, there are questions (the 4’C’s of culture) that may open up the line of communication, between provider and
In her book, The Spirit Catches You and You Fall Down, Anne Fadiman describes the story of the Lee family and the frightening task they had to to undergo to provide their daughter with medical aid. The Lees along with the other thousands of Hmong immigrants, tried to understand the and navigate the complex and sometimes confusing healthcare system in 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.
Instead of living with the other Ban Vinai staff, Conquergood immersed himself into the camp and went to great lengths to observe and understand the Hmong way of life. Although he had a great respect for shamanism and performance art before this assignment, Conquergood continued to learn and incorporate the Hmong rituals into treating and providing health care solutions (Fadiman, 1997, p. 36). It is Conquergoods remarkable cultural sensitivity that allowed him to effectively communicate with Hmong refugees and create a successful health care delivery