Ethical Analysis of Independent Reading of The Spirit Catches - Book Report/Review Example

Ethical Analysis Order No. 362552 February ‘10 Ethical Analysis The spirit catches you and you fall down; A Hmong child, her American doctors, and the collision of two cultures. Introduction The Spirit Catches, a book by Anne Fadiman was published in 1997. The book is about the struggles of a Hmong refugee family and their interactions with the health care system of Merced, California. It is a novel based on the clash of two cultures, the Hmong culture and the American culture. The subtitle of this book: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, in a nutshell gives us an idea of the story of the book. In the story a little Hmong girl is diagnosed as having epilepsy. However her parents believe that it is caused by spirits and they try to cure her illness in their own Hmong ways and not with Western medicines leading to a huge misunderstanding between them and the doctors. Anne Fadiman in the course of her story provides us a vivid and detailed history of the Hmong in Laos. She explores their involvement in the Vietnam War and their struggles in America. She also explains why the Americans, especially the doctors, feel the way they did about the Hmong culture The book is a thought-provoking book with a well-told story. Lia Lee born was born to a family of recent Hmong immigrants in 1981, and soon developed epilepsy. She had her first seizure when she was just three months old. Her parents then believed that this was because her soul had been frightened after her sister slammed a door. They refer to her seizure as qaug dab peg which means “the spirit catches you and you fall down”. However in 1988 she was declared brain dead as a result of overmedication, misunderstanding and culture clash. The story is truly relevant to the practice of medicine and cross-cultural relationships. Americans are believed to have a sense of superiority when it comes to culture. However, Fadiman even though an American looks at it in a totally different perspective. This book is significant as it looks at various social and cultural issues. It can be used as a basic guide for those who want to study the Hmong. It forces one to reflect upon issues which are often taken for granted. Fadiman’s sympathy towards the Hmong is evident in the book but she presents the issues from the perspectives of both the medical community and the family. The book has often been cited by medical journals and in lectures as an argument for the need for greater cultural competence. The book has proved to be useful to medical, pharmaceutical, and anthropological students in the US. Ethical and moral issues The main ethical and moral issue in the book is about Lia Lee who has epilepsy and the cross culture conflict that comes in the way of her treatment. Other issues explored in the book include broader themes such as the Hmong culture and their customs, the involvement of America in the war in Laos and immigration problems. The issue of ethnocentrism plays a big role in the book. Ethnocentrism is the belief that one’s own culture is superior to others. In the book one often sees the Hmong culture with all its superstitions and beliefs clashing with the scientific knowledge and medicines of the American doctors. The book while it focuses on the clash of cultural beliefs and practices explores some fundamental issues connected with humanity and the progress of science. Fadiman weaves a story around the conflict of and struggle of the Lees and the American doctors and brings into focus issues of culture, history, moral ethics and spiritual beliefs. By describing the experiences of Lees during the war in Laos and as immigrants in the United States she brings into focus the larger context of the history of the Hmong struggle and the cross cultural conflict. “Medicine was religion ….. In fact, the Hmong view of health care seemed to me to be precisely the opposite of the prevailing American one, in which the practice of medicine has fissioned into smaller and smaller sub-specialties, with less and less truck between bailiwicks. The Hmong carried holism to its ultima (Fadiman, 1997). These words, found in the beginning of the book, effectively set the tone of the book. When Fadiman visits Lia’s parents’ apartment she finds Lia, alive and lovingly cared for by her parents even though she has been declared brain dead two years ago by her American doctors. The Lees could not even communicate their daughter’s sickness to the doctors as they did not speak English. According to them the seizure were caused by spirits. It was only after several seizures that Lia was taken to the doctors and was diagnosed as suffering from epilepsy. The doctors believed that Lia’s condition was biological in origin and could be treated with drugs. In the next four years the doctors changed Lia’s anticonvulsant prescriptions 23 times. The Lees doubt the effects of these multiple prescriptions and refused to administer the drugs. Lia was then placed in foster care by the doctor attending on her. A few months later Lia suffered a massive seizure that left her brain dead and her parents take her home. When Fadiman visited them to investigate the story, the Lees were organizing an elaborate pig sacrifice hoping to reunite Lias soul with her body. The parents believed that her soul had fled her body on account of the seizures. The author uses this story to graphically illustrate the two cultures that come into conflict. Each culture is shown as having absolutely no understanding of the other culture. The Hmongs culture is principally based on a set of beliefs and superstitions they use everyday to fight illness and other things. Here the author says in the early part of the book, "Although the Hmong believe that illness can be caused by a variety of sources - [...] by far the most common cause of illness is soul loss" (Fadiman, 1997 ). The American doctors want the Hmong to use American medicines whereas the Hmong have no knowledge of these medicines. As the two cultures come into conflict there are errors and misunderstanding and Lia has to pay the price in the end. The author uses her own recollections, folk stories and beliefs, religious and medicinal practices to describe the Hmong. Here she writes, “The history of the Hmong yields several lessons that anyone who deals with them might do well to remember. Among the most obvious of these are that the Hmong do no 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 culture, even those more powerful than their own, are superior, and that they are capable of getting very angry (Fadiman, 1997). She further writes that they are resistant to change. "European immigrants came to the United States because they hoped to assimilate into mainstream American Society. The Hmong came to the United States for the same reason they had left China in the nineteenth century: because they were trying to resist assimilation" (Fadiman). Fadiman also believes that spirituality and myths play a large role in Hmongs lives. This she reiterates throughout the book. According to her the Lees are not concerned about their daughters epilepsy, but are more concerned about the fact that her illness is due to a spiritual condition. Lias parents are shown as being inconsistent with giving Lia her medication prescribed by the doctors. They believe that since an evil spirit has taken away their daughter’s soul, she must be treated with neeb, or the healing spirit. They believe that too much medicine will interfere with the neeb. Hence the medicines must be given in small quantities and not according to the prescription. This proves to be a difficult situation for the American doctors. Fadiman believes that the things went wrong because there was no true understanding on the part of either the Lees or their doctors and also the various agencies that were involved in Lia’s case. The customs and beliefs on all sides were deeply entrenched. The author’s argument here is that a better understanding of the Hmong culture might have helped the American doctors to prevail over the familys resistance to science and make them cooperate. One instance in the book points out to the fact that had both the parties involved in the clash had understood each other better, things would have been different. In this case the parents refused to give to their daughter a drug which they thought would harm her. At this point one of Lias doctors got a court order to put her in foster care. The year’s separation proved to be extremely stressful for the child. This could have been avoided had both the sides understood each other. Fadiman also argues that the Hmong are "differently ethical." Here Fadiman says she is surprised at the creative ways in which illiterate Hmong elders cheat while writing their drivers tests. Further, she says that the Hmong in order to get certain benefits blatantly lie about things like their age, marital status or physical conditions. This trait is inconsistent with the fact that the Hmong are generally considered to hospitable and straight forward. The author explains this by saying that the Hmong were oriented towards the group, not the nation. Conclusion Finally it can be said that The Spirit Catches you is an extraordinary book where the author uses investigative journalism style to knit together various issues. That there is a multicultural clash is evident in the events described in the book. A young Hmong girl suffering from epilepsy is taken to an American hospital. Both the parents and the doctors feel that they are doing the right thing to save the girl. The parents blame the hospital for the damage caused to the girl’s brains. Things might have been different if the parents had complied with the doctors’ instructions earlier on. Both the sides failed to understand each other and each other’s culture as well. To put it succinctly the author argues that the Hmong consider illness as spiritual matter and link it to the soul while the medical doctors differentiate between body and soul and consider only the body. The story shows how cross-cultural conflicts regarding medical practices and miscommunications can lead to tragic consequences. Anne Fadiman when she discussed Lia with the medical anthropologist Arthur Kleinman, he observed “You need to understand that as powerful an influence as the culture of the Hmong patient and her family is on this case, the culture of biomedicine is equally powerful. If you can’t see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else’s culture?" This then is the central focus of the book. References 1. Fadiman Anne (1997), The spirit catches you and you fall down; A Hmong child, her American doctors, and the collision of two cultures, Farrar, Straus and Giroux; 1st edition (September 30, 1997) Read More