The Spirit Catches You and You Fall Down by Fadiman

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Table of Contents

Introduction
Main Text
Conclusion
Works Cited

Introduction

When travelling abroad and visiting poor countries, the traveler might sometimes witness sights that contradict with the usual perception of normal life conditions. After watching people in remote districts still believe that psychic illnesses can be cured by the local healer, the person would return home while deep down in feeling a relief that in his country such situation is unimaginable.

If the person feels the need to participate in educating the people of the necessity of a professional medical aid, he might do so, but if the attempts fail, he would also return home thinking about how the world is different. But what if the aforementioned events take place not in a rural district of Laos, but in a modern day California. What if the person who watches the resistance of using contemporary medicine, is the doctor responsible for the health of a sick child?

Such dilemmas might be related to the clash of culture, but what are the options when there is someones life affected by wrong decisions and cultural influences. In the book The Spirit Catches You and You Fall Down (1997) by Anne Fadiman, the author shows such cultural dilemmas by telling the story of the struggles of Hmong family and the girl Lia Lee, who was diagnosed with epilepsy, and the clashes of cultures during her treatment in Merced, California. This paper analyzes Fadimans book in terms of the different conflict moments and their management based on the books narration of Lia lees fate.

Main Text

In the situation described in the book, the case might be radical, but it enlightens an existent problem and an existent question. Who is to blame? Is it the family whose believe takes roots in an ancient culture which states that, diseases are caused by fugitive souls and cured by jugulated chickens? (Fadiman 61) Or is it bad communication by the doctors who pressed to care for too many patients in the time available may fail to explain adequately the reasons for their recommendations and drug prescriptions, the possible side effects and what to do about them, and the potential consequences of not following the prescribed remedy or preventive. (BRODY)

Portraying the different health system opinions it is hard to accurately transfer the authors opinion on the outcome of their integration. On the one hand, there is an apparent obvious lack of knowledge in Hmong family which resists accepting the treatment, and at the same time a certain feel of idealization can be trace in authors description of their ideals.

The author wrote:

Hmong do not like to take orders; that they do not like to lose; that they would rather flee, fight, or die than surrender; that they are not intimidated by being outnumbered; that they are rarely persuaded that the customs of other cultures, even those more powerful than their own, are superior, and that they are capable of getting very angry. (Fadiman)

On the other hand, she might be agreeing with the doctors who thought that, Hmong taboos against blood tests, spinal taps, surgery, anesthesia, and autopsies-the basic tools of modern medicine-seemed like self-defeating ignorance. (61)

In that sense, the responsibility can be divided, an approach that can seem controversial based on Fadimans book, as the whole theme and the moral of the story cannot examined without bias toward Lia Lee. The breakdown between culture and health care is a matter of misunderstanding which combined by the lack of spoken English can lead the doctor to and the patient blaming each other. (68)

In addressing the means by which this conflict can be solved, it can be agreed that the responsibility of the doctors is greater in that sense, where cultural difference is a factor that should not be ignored. Analyzing a research conducted to examine treating cultural differences in primary care, the results show that, ignoring cultural differences can affect the interaction between the doctor and the patient at least in two ways.

Doctors who do not address the issue of cultural differences, in the case such difference occurs, the process of consulting the patient can be negatively affected. The doctors themselves are influenced by their culture and their medical perspective, but the extent of this influence is left unexamined. (Wachtler, Brorsson and Troein 115) In that sense, increasing the awareness of the doctors to the cultural issue could help solving cross-cultural problems in health care.

In the light of the aforementioned, Fadimans book is better perceived not as the story of pointing to the one responsible in the occurred situation, but rather as a fact, a situation and an existent problem that should bring awareness about its existence. It is the fact of the unawareness that made the doctors frustrated by the differences in worldview.

This frustration initially put the doctors in a no-win situation. In that sense, there is an interesting position of Roger Fife, a family physician who served his residency at MCMC in the early eighties (Fadiman 76). Can his approach to comply the demands of Lees family be considered ethical? Can the doctor say, Its your body and you are free to with it whatever you want, while the medical background points toward doing whatever is right. Other doctors do not.

The issue of ethics can be rather controversial in that matter. For example, a doctor can devote his time only to patients who do comply with HIS orders. In that sense, a reply of conscientious allergist who refuses to treat patients with asthma who do not follow his recommendations is understandable.

He explains:

I dont want anyone dying on my watch, Id rather devote my time to patients who do their best to prevent asthma attacks. (BRODY)

The position of this doctor can be understandable, as he cannot take the responsibility of someones conscious ignorance, especially if the matter concerns adults. However, what is the responsibility of a child who is thought to have her spirit caught.

According to Fadiman this responsibility is an issue that should be addressed and solved. Looking at the title of the book, it can be assumed that choosing an excerpt of Hmong tradition, it is not as much reference to Hmong perception of the disease, as much as it is an emphasis on the helplessness of the little girl was put into that situation.

Summarizing the reflection of reading Anne Fadiman, it can be said that the given story is insightful and representative. For a country like the US, which has an enormous flow of emigrants from different parts of the world who bring their culture with them, it is an existent problem. Based on a research previously mentioned, cultural difference is not treated in GP consultations with immigrant patients. (Wachtler, Brorsson and Troein) It should be pointed to the dramatization of the case in Fadimans book, where the story itself is a dram, but it can be sensed that devoting most of the book to the cultural background of the Hmong is an attempt to implement a certain stereotype of immigrants.

Conclusion

It is rather questionable on why showing all of Hmong traditions, such as capturing women for brides, or the differences of legal perceptions. In that sense, Fadiman is generalizing, as it cannot be assumed that most of the immigrants are so traditional in holding to their culture in a foreign country. Nevertheless, the book is a beneficial reference to cases of cross-cultural studies. Its most beneficial aspect is in providing a valuable argument for considering the cultural aspect when consulting in multi-cultural environment. Another point of interest can be found in the portrayal of Hmong traditions, where it could serve as a basic guide to look inside a different culture, traditions, and world views.

Works Cited

BRODY, JANE E. Personal Health; Just What the Doctor Ordered? Not Exactly. 2006. The New York Times. Web.

Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. 1st ed. New York: Farrar, Straus, and Giroux, 1997.

Wachtler, Caroline, Annika Brorsson, and Margareta Troein. Meeting and Treating Cultural Difference in Primary Care: A Qualitative Interview Study. Family Practice 23.1 (2006): 11115.

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The Spirit Catches You and You Fall Down by Fadiman

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