The Spirit Catches You and You Fall Down by Anne Fadiman - Essay Example

? Psychology Grade 7th Feb, Introduction: Anne Fadiman the of the book “The spirit catches you and you fall down”, narrates about a Hmong child, her American doctors and the collision of cultural differences. The experiences of Lia, the epileptic Hmong child is told in tragic and intimate details. Fadiman learns the significance of understanding the patient’s culture, while others do not learn. Understanding the culture of a patient aids in proper treatment for the patient (Fadiman, 1998). The book has a protagonist, who is Anne Fadiman, who identifies herself with the Hmong when researching and writing the book, and the antagonists who create an obstacle for the protagonist. The antagonists are the Lees, who are bound by their cultural beliefs, and, the American doctors, who refuse to accept and accommodate the patient’s culture as integral and vital in the treatment of the patient. Fadiman’s book is based on the clash between the American culture and the Hmong culture (Fadiman, 1998). The book, the spirit catches you and you fall down, guide the medical practitioners as well as the social workers in carrying out their duties. It requires the nursing, medicine, public health and social work practitioners to always understand the patient’s cultures without being biased or ethnocentric. The spirit catches you and you fall, in relation to social nursing and public health: The spirit catches you and you fall down guides the medical practitioners as it is relevant in giving guidelines in cross-cultural relationships. The book is relevant to the profession of social work and public health. It illuminates the shortcomings of the medical practitioners in the line of their duty when faced by a complex cultural obstacle through the American doctors who were treating the three- month old epileptic Lia Lee at the hospital in Merced. The book also puts light on how cultural clash can retard medical practice or a patient’s treatment. According to Fadiman (1998), cultural miscommunication made Lia Lee’s case to be tragic. The two parties, the doctors and the parents both wanted what was best for the child, but their ideas about what caused the illness differed a lot as well as their opinions on the type of treatment. The doctors ascribed the diseases to the misfiring of the cerebral neuron, while the parents attributed the disease to the spirits. The doctors advocated for anticonvulsants as treatment, while her parents wanted animal sacrifices. By shedding light on such cultural miscommunication, social workers and public health professionals are enlightened on the need to understand a patient’s cultural background as vital in the treatment of the patient (Spector, 2008). Fadiman uses the literal piece to show the battle between Lia’s parents and the Merced doctors to emphasize the need for sensitivity to the different aspects of other cultures and stop feeling superior over other cultures (Lieberman and Lester, 2003). The relevance of the book is to show that there is some need to include the patient’s cultural idea alongside their medical treatment. In the Lee case, a little neeb or soul, and a little medicine, would have helped little Lia. In the social work and public health profession, there is always need for compromise as it makes problems to be solved. The Merced doctors sought after helping and healing the body, while the parents wanted to help the soul. Alongside the medical treatment, the doctors needed to understand and give room for the Hmong concept of the soul. Lee’s trust on Jeanine Hilt: In The Spirit Catches You and You Fall Down, Jeanine hilt was the only American who completely won the Lee’s trust. Jeanine Hilt is a social worker and she made Lia her personal cause. She truly cared for the Hmong and fought against the medical establishment with all her capability on behalf of Lia (Fadiman, 1998). Jeanine Hilt made it her business to understand the Hmong and accept their cultural concept of the soul, unlike other medical practitioners. She also treated them like equals and called them by their names. Lia’s main doctors, Neil Ernst and Peggy Philip, for example, were ready to understand the Hmong culture, but, they did not understand the soul concept in healing diseases. According to the doctors, the bottom line was about life and saving the body. In this way, they failed to earn the Lee’s trust, unlike Jeanine Hilt who identified herself with the concept of the soul. Most physicians at the Merced Community Medical Centre never considered understanding the Hmong culture. In the book The Spirit catches you and You Fall, Jeanine Hilt is used to portray the need for social workers and public health practitioners to give room for a patient’s culture concepts in the treatment of the patient. This develops trust in both parties and compromise can be reached, which is essential in communication (Spector, 2008). The different ideas and concepts arising concerning a patient should not be ignored. A social worker is supposed to act as a bridge between the medical professionals and the community involved. Cultural misunderstandings between the Lee family and the medical team: The Spirit catches you and you fall illuminates various cultural misunderstandings between the Lee family and the medical team. Fadiman shows how the medical team handled or mishandled the case of the epileptic Lia, and her family. The Lees having migrated to Merced in 1980 from Laos had their cultural practices which were different from the American medicine practice (Fadiman 1998). This led to a misunderstanding between the medical community and the Hmong family. Language barrier was very apparent requiring translators. The crisis was beyond the language barrier but revolved around understanding social and religious customs. There was absolute cross- cultural failure at both levels. The Lees wanted to unite the child’s soul with the body using their cultural ways while the doctors were concerned with the body hence prescribing anti- consultants. Language barrier also played a critical role in causing the crisis, and the doctors did not explain fully to the Lees of what was happening to make them understand. It is quite obvious that the Hmong people are not accustomed to taking orders and losing, they are never intimidated because of being outnumbered and rarely are they persuaded to adopt other customs or culture. The fact that they were being patronized by the American doctors to an extent of putting Lia into a foster home made the crisis all the worse. A compromise in this case would have given equilibrium and maybe Little Lia would have been saved. The care of patients and Professional collaboration: Social work advocates for the skills for social consultation, health planning for marginalized populations and interdisciplinary research (Bratch, 1969). The research programs and graduate teachings emphasized by social workers in public health schools help in the care of patients. The background research about the patient is done which is very vital in the treatment of patients. Social workers try to understand the patient’s background and cultural practices. The public health practitioners focus mainly on the well being of the patient by administering proper medical treatment. In the Lees’ case, the medical team tried to have their way in administering treatment to Lia, while the social worker, Jeanine Hilt, went way off to even understand the cultural and soul concept of the Hmong (Fadiman, 1998). The medical doctors did not give room to the practice of the Hmong culture but forced their American medical culture on the Hmong parents. The professional can collaborate on a team, agency or policy level setting. The collaboration of medical professionals and social workers significantly expand the research, teaching and service opportunities of the social workers in the medical field (Bratch, 1969). Social workers provide the social facts and empirical research which cannot be provided through scientific research alone. For example the social workers and the medical team should have made the Lees understand the need to continue giving Lia her medicine instead of leaving it to them alone. All the multi agencies involved should work jointly with the patient and the relatives to ensure that proper guidelines are being followed and are being administered. Jeanine Hilt worked well with both the medical team and the Lees using their daughter May, as her interpreter, thereby involving the family members fully. Conclusion: The Spirit catches you and you fall creates a platform for the frustrating cross- cultural crisis that took place in Merced, California. Differences in cultural practices and language barrier hindered proper treatment to be administered on Lia Lee. Both her parents and the medical team were up bent to give her what was best for her, they both contributed seriously to her vegetative state. Anne Fadiman illuminates the problems arising in the social work and public service as a result of diverse cultural beliefs and practices. The spirit catches you and you fall down provides an example of what takes place daily in health care. There is a lot of assumption by doctors and health care practitioners about the patients and their families. Mostly, ignorance is presumed, leading to assuming a paternalistic attitude in relation to health care. Health care practitioners in some cases fail to explain the decisions that the patients face, the repercussions of each decision, and, any alternatives in line with the recognized procedures. References. Bratch, N. (1969). The contribution of public health social work in Academic departments of community medicine. The milbank memorial fund 47(1) 73-89. New York: Blackwell publishing: Fadiman, A. (1998). The spirit catches you and you fall down: a Hmong child, her American doctors, and the collision of two cultures. North point press: Farrar, Straus and Giroux. Lieberman, A., Lester, C. (2003). Social work practice with a difference. New York: McGraw- Hill. Spector, R. (2008). Cultural diversity in health and illnesses (7th ed.). New Jersey: Prentice hall. Read More