The Spirit Catches You and You Fall Down

Culture defines the lifestyle of human beings in various ways. However, this has affected the health of people in the long run due to adherence to these cultures. “The spirit catches you and You Fall Down” by Anne Fadiman explores the repercussion s associated with the various cultures existing in the different human populations. In this book, cross-cultural impacts on the field of medicine as a result of ethics are examined. This is addressed through the story of Lia Lee, a small Hmong child who was suffering from epilepsy. As a contrast to the rest of the children who were born in a filthy environment without assistance, Lia is born in a modern hospital with the prospects of a better life as compared to other kids from her community (Fadiman 1997).

Nonetheless, Lia experiences seizures by the age of three. According to the western medics, the seizures were a disaster and the failure to manage them a concern. However, according to the parents, the seizures had a different meaning as they viewed epilepsy as a peculiar disease and lee as the identified host of this force. They argue that the seizures empowered Lee to see things that the rest of the people couldn’t. This condition entails one of the challenges facing the health sector as it was viewed in a different manner with regard to culture. The Hmong community, based in California, tackles the conflict that exists between holistic medicinal customs of the Hmong community and the modern medicine. A dilemma exists which needs to be resolved.

The Hmong, habitually a closely-knitted and fierce people, were less agreeable to adaptation as compared to other immigrants. This was due to their steadfast adherence to the beliefs and rituals of their forefathers. As a result, to achieve mutual relationship between their traditions and the modern medicine, then the contemporary medicinal remedies require to be integrated with the traditional medicinal cultures that are essential to the well being of the population whenever they are ill. The encouragement of the sick to have faith in the recuperation program also forms part of the integration. Thus, a working relation and information of the various cultures with regard to the health care requires to be developed. According to their beliefs in spirits, the Hmong community created their own medical annotations about the sick. This prompted the application of practices that were best familiarized to them. Lia’s parents were no different from the rest of the conventional Hmong community as they believed in their cultural prescriptions. Thus, whenever Lia passed out or lost consciousness, the parents alleged that it was simply as a result of Lia loosing “…her soul” (Fadiman 1997).

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The parents were convinced that the slamming of a door during the welcoming ceremony of Lia was the primary source of the epilepsy. They argued that as the door slammed, a force engulfed her and this led to her soul getting lost. In their view, the medication administered by the Western general practitioners was inconsequential as it would not alter anything. Moreover, they believed that the Dilantin, Phenobarbital and Tegretol were administered messily. The utilization of traditional doctors and animal sacrifices by Lee Nao in the treatment of Lia’s sickness does not amuse the physicians. This necessitates the removal of Lia from her biological parents and her placement in the custody of a foster parent. Lia’s foster mother develops affection for Lia’s biological parents. It is rather ironical that Lia’s foster mother entrusts Lia’s biological mother with her own family while she proceeds to take Lia for medication. Even with a sound system of medication, the management of the seizures is not guaranteed.

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The parents and the hospital personnel were the main determiners of the direction which Lia’s life would take. The chances were high with regard to Lia’s life and the condition she was in. The communication between the parents and the hospital personnel, and the cultural diversity that existed would be merged so as to treat Lia’s rigorous seizures and related sicknesses. While it is evident that the stakes in the school atmosphere are hardly a matter of life and death, still, the potential of students entirely depends on the social interactions that exist between their age mates, their teachers/educators and the intellectual content presented to them. Thus, the influence a child encounters at a tender age plays an essential role in defining the future life of that child. Lia’s case acts as an example of the repercussions associated influences from parents, culture and beliefs.

The two physicians taking care of Lia are pediatricians who endeavored to obtain consent from Lia’s parents to put an end to the seizures since Lia’s infancy. As much as they revere the love shown by the parents to their daughter, they are compelled to petition the court to separate Lia from them. This was due to the denial of consent by Lia’s parent to the physicians to treat her seizures. Lia’s sickness hurts them as they could have saved the situation early enough. After the separation incident, Lia’s parents continue to avail their non-responsive, peaceful and well- dressed daughter for medication (Fadiman 1997). It is ironical that Foua comforts the physicians when their own child becomes sick with leukemia. The capacity to span continents, civilizations and cultures are shown in both families’ affection for their off springs.

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In her book, Fadiman explores the cohesion that exists between the cases of flourishing cross-cultural associations as legitimate friendliness. As much as Fadiman employs an impartial tone in the manner she presents her work, she noticeably seems to have affection for Foua and Nao Kao, Lia’s parents. Furthermore, the author expresses her warm feelings for the Merced Hmong population as she is able to outline particulars concerning this community. The lee family expresses their love for Jeanine, the social worker. Their affection for Jeanine is substantiated by the manner in which they called her, ‘the daughter of America’. This enabled them to converse effectively and efficiently with her. Dan, the young inhabitant who has compassion for the local Hmong society, lives in harmony with the Lee family. He also avails eminent medical care for the sick Lia (Fadiman 1997). Despite the pressures that existed during that period; the processes associated with the hospital and the intense tension related to the emergency room atmosphere, Dan was still there for Lia. This is a typical Hmong individual as they oftenly assume best intentions regardless of the baffles connected to each others actions or statements. On the other hand, physicians Neil and Peggy, who are treating Lia, make comments that are inconsiderate and disapproving about the Hmong in general and the family of Lee in particular yet, they meet frequently. In this case, the author highlights that affection and friendliness may result to a cyclical impact. Sociability leads to a more successful cooperation and contact, which enhances the friendliness feelings. This in turn increases the value of the communication leading to strong connections between individuals.

As much as affection determines the relationship between individuals, it is evidently not sufficient. This is substantiated by the manner in which Martin, the poetic nurse, interacts with the Hmongs. Regardless of his profound respect for Hmong customs and the hard work shown by the Lee family, he still relates inelegantly with them. Another instance where Fadiman expresses legitimate affection among the cross-cultural associations is when a cultural broker is enlisted. This cultural agent is not only a broker but also an individual who is engaged in the negotiations of cultural diversities and is able to present perspectives (Fadiman 1997). The working and association between the Lee family and the hospital was made easy by the involvement of Jeanine. This is shown during the time which the family was making prior plans to return Lia home from the hospital. The narrator finds a barrier in trying to access the Lee family and other Hmong individuals until she employs the assistance of May Ying. The background of May Ying formed the basis in which her services were sought by the author. She was at ease in both Anglo-American culture and among her kinsmen, the Hmong population. On the other hand, Jeanine solicits the assistance of Lia’s sister, who is reasonably Americanized, to converse with the family of Lee.

The book highlights that thriving cross-cultural endeavors was achieved over a long period of time, and willingness and patience contributed to this achievement. The author had encountered fruitless efforts until she enlisted the assistance of May Ying. However, this did not spell an instant victory for her as she used to spend long periods of time listening, sitting and chatting. The lee family could not welcome and accept Jeanine immediately as they had their own doubts. This was due to the fact that Jeanine was an agent of the very State that intended to keep Lia. Nonetheless, the family gave Jeanine a chance to demonstrate her intentions and she did not fail. The efficiency needed in the hospital atmosphere actually resulted to a greater inefficiency. The period taken to sit in the company of an able translator and harsh issues, which required to be handled in a calm way, could have averted enormous suffering, pain and confusion in the long run. Consequently, this would have saved the mind of Lia. Neil and Peggy failed to root for this approach of interaction and instead, ended up utilizing coercive procedures. The repercussion of this was the broadening of the rift between the Hmong population and the Merced County (Fadiman 1997).

Fadiman’s description of the Hmong community as “differently ethical” is baffling. The author is astonished at the innovative methods by which the not so conversant Hmong seniors cheat on the printed part of their tests. In addition, she states that the Hmong blatantly lie about their physical status, marital status or ages as a way of obtaining particular benefits. Realizing that this deceitful practice is not in agreement with the generally simple and hospitable Hmong, Fadiman comes to the astonishing conclusion that Hmong were “differently ethical”. The orientation of the Hmong was directed towards the faction and not the nation. In spite of the author’s feelings towards the theory of customary relativity, it should be understood that apart from age, which has a minimal impact because most Hmong are not familiar with their dates of birth, this community has similar ethics, just like the rest of the human population. The human nature in them makes them to lie and cheat hence, are no different from the rest of the human beings. The author in this context intends to express dishonesty as a survival response since this is not tolerated by the Hmong as a community.

By evaluating and reflecting on the issues presented in this book, a tremendously productive experience is obtained. Fadiman does not propose that the treatment of the epilepsy should not have taken place. Instead, she intends to engage the reader into thinking about the improvements that need to be implemented in the healthcare sector to cater for individuals with a different dialect. The author also emphasizes that medical nurses are familiar with the fact that patients don’t lie on their own in bed. The participation of culture, history and family all play a crucial role in the healing process of a patient. This encompassing model functions and nurses are presented with a great opportunity of being part of other families. As such, they are expected to provide sufficient and effective care for their patients and them.

Lia’s parents were illiterate according to the Western standards as they did not know how to read, speak English or write. Their knowledge of health care and medication involved spiritual advisors, sacrifices and trances. Without edifying advisors or translators, the medical physicians attempt to educate Lia’s parents on the American medication. The story of Lia helps to highlight the consequences of cultural diversity and its impacts on the health sector. “Family spirits” are hidden conflicts, past experiences and concerns that define the way individuals perceive contemporary issues and play a role in the final decisions made by individuals. In Lia’s case, the traditional beliefs and culture sealed her fate and the ghosts are factual thus, need to be honored.

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