The Spirit Catches You And You Fall Down - Book Report/Review Example

Running Head: THE SPIRIT CATCHES YOU AND YOU FALL DOWN The Spirit Catches You and You Fall Down Anne Fadiman’s The Spirit Catches You and You Fall Down is a book essentially about two clashing cultures, the American medical culture and the Hmong culture. Foua and Nao Kao are from the Hmong community that has migrated to the United States with their child Lia Lee, as a result of running away from the Quiet war in Laos. Fadiman tells a story about Lia Lee, a child who was diagnosed with epilepsy by her American doctors while her parents believed that her ailment was because their child, Lia Lee was possessed by spirits, which they referred to as ‘qaug dab peg’ which in English translates to, the spirit catches you and you fall down. Their different approaches and beliefs to Lia Lee’s condition, the miscommunication between the parents and the doctors, partly because of the language barrier, and her parents’ refusal to administer the medication leads to worsening of the condition that leaves Lia Lee brain dead. Since the Hmong culture believed that illness was practically a matter of spirituality and sacrifices, they did not take their daughter to the hospital for diagnosis. It was only after several seizures that they decided to take her to the hospital. The American doctors diagnosed Lia with epilepsy and gave her medication to manage the condition. The parents reluctantly agree to administer the medication but over the next four years, the anticonvulsants do not take effect as the doctors keep changing her prescriptions. This causes Lia Lees parents to doubt the effectiveness of the medication and consequently refuse to administer the drugs to Lia. This decision makes the American doctors take action against Lia’s parents and place Lia in foster care where she could be given the drugs and hopefully get better. However a few months after returning home, Lai has a massive seizure that leaves her brain dead. With death imminent, the doctors allow her to be taken home by her parents, who were still hopeful that they would be able to unite Lia’s soul with her body and hence were organizing a pig sacrifice that was part of the Hmong’s rituals for uniting souls to their bodies. There is an evident cultural dissonance in regards to the Hmong’s view of sicknesses as tied to their culture and the American medical culture. The Hmong tie sicknesses to spirituality and believe that sicknesses are a result of an individual’s soul leaving its body and keep wondering after being possessed by spirits. In order to unite the wondering spirit with its body, the spirit has to be appeased by offering pig sacrifices to the spirit so that it can leave the body that it has possessed. Because of this cultural belief, the Hmong do not take their patients to medical doctors who believe in science and modern medicine. The Hmong believe that an epileptic would eventually become a shaman. ‘Hmong epileptics often become shamans’ (p. 21). The medical community in the United States believes in science and medicine to cure and heal any ailment or disease. They believe that sicknesses are a result of an invasion of the body by antibodies that bring about the disease. There is a strong belief in medication and surgery in an effort to cure almost all diseases that are curable and / or manageable. Unlike the Hmong culture, which does not believe in medication or any form of invasive surgery, the American medical community relies on doing blood tests, performing different forms of surgery, in an order to detects, diagnose and fix medical problems. Some of the methods especially the invasive surgery that the medical community in the United States uses is considered to be disrespectful by the Hmong culture. When Lia had a massive seizure, she was taken to Valley Children’s Hospital in California where the doctor gave her more heavy medication that caused her serious brain damage that may have caused her to be brain dead. ‘They just took her to the hospital and they didn’t fix her. She got very sick and I think it is because they gave her too much medicine’ (Fadiman, 1997). The doctor also ordered for Lia to get a spinal tap to check if the sepsis had passed into her spine without asking for consent form her father. This made Nao Kao, Lia’s father very angry because such an invasive procedure is considered as disrespectful by the Hmong community. While Lia’s father was very angry with the doctor, the doctor believed that he was undertaking a medical procedure that would enable them find what had caused the massive seizure that saw Lia be pronounced brain dead and try to find a solution to the medical problem. Intercultural communication is important since the world is becoming a global village as technology is advancing. The chances of different cultures interacting are extremely high because our sense of distance and space are constantly changing. By understanding other people’s cultures a, their basic beliefs and practices, we are able to avoid misunderstandings and at the same time we give respect to other people’s culture. It can well be assumed that the doctors who were treating Lia were ignorant of the importance of intercultural communication because it was later discovered that none of the medical interventions with Lia’s parents took place in the presence of an interpreter. The language barrier may have been a major cause in the misunderstandings that ensured between Lia’s medical doctors and her parents who did not believe in modern medication. If the doctors who were treating Lia were sensitive to the Hmong culture and had taken the effort to look in to their beliefs concerning health, they would have been able to find reasons to Lia’s parents’ uncooperativeness with the medicine they were given to administer to their daughter and the doctors would have otherwise avoided the sad situation when they asked for the assistance of child services who took Lia away from her parents and home to a foster care for ten months and to make matters worse this action did not improve Lia’s condition which became worse almost immediately after going back to her parents and her home and thereafter getting a massive seizure that may have rendered her brain dead. Fadiman has also delved into other cultural practices of the Hmong community in regards to childbirth and practices and process that go into the birth of a child of a child in the Hmong community. The birth of Lia in the modern hospitals in America is different from if Lia was born in her country. In Laos, Lia’s would have used her hands to pull the baby from her womb while in a squatting position. She would have also labored in silence because the Hmong believed that noise from the mother during child birth would attract dabs, spirit thieves who looked for an opportunity to rob life of its value. In the even that there were complications during child birth or in the pregnancy, the Hmong would sought the help of a shaman who were believed to have the ability to enter a reverie, call upon familiars, ride a winged horse, cross an ocean inhabited by dragons and bargain for the patients health with spirits that lived within the territory of the unseen. After birth the placenta was buried under the home in accordance to the Hmong’s cultural practices in regards to birth. In contrast, Lia was born in a modern hospital where the doctors incinerated the placenta in the hospital (Fadiman, 1997). Lia’s mother did not bother to ask for the placenta because of the language barrier and the fact that they lived in a modern house with wooden floors covered with wall to wall carpet. She did not know what she would do with the placenta if she asked to be given. In the American culture, medicine and surgery would be the option to deal with any case of emergency that arose during child birth. The solutions that would be workable and effective in the medical practice in the United States would be one that is culturally appropriate so that an amicable solution that is favorable to both the Hmong and the American medical society is reached. Apart from culture in itself being a barrier to effective communication, the preconceived attitudes that we have play a big role in impeding our capacity to communicate effectively. When we use stereotypes to judge and make conclusions about other people who are not from one’s culture, are prejudiced towards other people’s cultures, are ethnocentric in believing that one’s culture is superior to another and assume that there are similarities between one’s own culture and another, we create an environment that does not allow for effective communication across different cultures. The readiness of an individual to create a bond with the alien culture can assist one adapt to the alien culture without difficulty. The American medical doctors come from a society (American) that has an open nature and therefore it would be easy for doctors to create a bond with the Hmong community so as to understand their practices especially as pertains to their belief in cross cultural medicine. This would enable them effectively understand the apprehension of the Hmong community and their defiance to cooperate with doctors. If the doctors who were treating Lia had understood that ‘What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance.’ (Fadiman, 1997) And no matter what they did, the Hmong inevitably interpreted it in the worst possible light. The doctors would be able to have a meaningful discussion in regards to epilepsy as a condition that can be managed by medication, keeping in mind what the Hmong community perceived epilepsy to be and their remedy for such a condition. The medical team in America should be able to role – take. This means that they should be able to see the world from other people’s perspective, in this case the perspective of the Hmong community. The doctor handling a Hmong patient should be able to understand how the Hmong make sense of their world and actively trying to experience what they feel. Prejudices and stereotypes are insidious. They play a major role in hindering intercultural understanding and communication. People do not realize that they have these traits in them and may act out with this in mind without realizing. It is therefore prudent for the American medical doctors to check and examine themselves for possible stereotypes and prejudices against the Hmong community who according to Bill Selvidge, MCMC’s former chief resident have been known to be the most difficult patients to handle in the United States (Lee, 2010). The clash of cultures usually happens because the cultures that are clashing are strange to the other and there is a hostility that is created because of lack of knowledge and fear of the unknown, which is a trait of human beings. The story of Lia Lee should be of concern to us especially to the medical society so as to create awareness of how intercultural communication is important especially in the field of medicine that is concerned with human life. Through the book The Spirit Catches You and You Fall Down, Fadiman brings into light the challenges the medical doctors in America face while trying to treat patients from the Hmong community. Through the story of Lia, we are able to see the mistakes that were committed that may have possibly led to the vegetative state of Lia Lee and hopefully with the awareness, especially for students in medical school, they can be able to avoid such mistakes of intercultural communication and consequently treat their patients effectively. References Fadiman, A. (1997). The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giroux. Lee, M. N. (2010). Book Review: The Spirit Catches You and You Fall Down. Retrieved December 17, 2010, from http://www.hmongnet.org/publications/spirit_review.html Read More