The Spirit Catches You and You Fall Down: Cultural Variation in Medicine - Essay Example

These are people who do not want to blend in, but want to be independent within their own cultural group. Lia, the focus of the book, was a young Hmong girl born in the United States, with what American medicine calls severe epilepsy, and what Hmong medicine calls the spirit catches you and you fall down. For the doctors, epilepsy is a strange and horrible disease that must be heavily medicated to prevent any additional seizures. For the Hmong people, quab dab peg is both a disease, and a calling.

In Hmong culture, seizures are seen as a sign that the person can communicate with the spirit world, and has the makings of a shaman. Even if they end up not being a healer, they have a mark of distinction in their society. Seizures are not medicated, (there are no drugs for that) but respected as a time the spirit seeks the spirit world to commune with others. This is the primary area of miscommunication between the Merced doctors and Lia's family, which had a profound affect on her treatment.

The doctors at the Merced Community Medical Center (MCMC) were not much different then any other doctors in the 1980's. Very little, if anything was known about alternative medicine and few doctors were willing to suggest that osteopathic medicine might actually have merit. While working to treat Lia, they were limited by their education. There were no translators to help the doctors and Foua and Nao Kao understand one another, and there were no statutes in place to help either group realize that they all had Lia's best interests at heart.

When Lia was brought in seizing, the doctors immediately worked to stop the seizures. The doctors at MCMC had diagnosed Lia with severe epilepsy. Yet they had no way to communicate this to the parents, just as Foua and Nao Kao had no way of telling the doctors that they already knew what was wrong with Lia. Each had made their diagnosis independent of the other. Fadiman notes:Each had accurately noted the same symptoms, but Dan would have been surprised to hear that they were caused by soul loss, and Lia's parents would have been surprised to hear that they were caused by an electrochemical storm inside their daughter's head that had been stirred up by the misfiring of aberrant brain cells.

(Fadiman 28) The doctors, bound by their own code to protect and cure their patients, had to do all they could with the science they had to stop her seizures. Their culture insists that medicine is to cure diseases of the body, and that the soul is not a part of this complex system. Instead, the body is treated at the symptom level, to the point where the disease is controlled. Their medicine requires careful analysis of the body, including samples of fluids, x-rays, cat scans, physicals, and in-patient monitoring, all thins which are foreign to Hmong medicine.

While these doctors work to cure their patients, there is little time to be spent at the bedside, and much more time to be spent in the lab. Tvix neebs, or Hmong shamans, approach medicine in a far more allopathic way. They treat both the body and the spirit, although the spirit is considered the more important aspect. Some treatments are not actually performed on the patient at all; instead, they are performed on the evil dab, or spirit who has harmed the patient. Tvix neebs do not need to take samples, and do not examine the physical body (especially that of a woman).

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