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The Spirit Catches You and You Fall Down (1997)

by Anne Fadiman

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Showing 1-5 of 86 (next | show all)
Such a sad, unfortunate account of two cultures colliding with ensuing misunderstandings resulting is tragedy. There is much to be learned from this account. I found the description of Hmong culture fascinating and find it disturbing that relocation to the US will likely erode away a culture that had managed to survive in the remote regions of Asia. ( )
  Cricket856 | Jan 25, 2016 |
A very interesting look at an unfamilar culture. ( )
  Jen.ODriscoll.Lemon | Jan 23, 2016 |
A very interesting look at an unfamilar culture. ( )
  Jen.ODriscoll.Lemon | Jan 23, 2016 |
An incredibly powerful and heartbreaking book about the cultural clash between western medicine and non-western cultural practice. This book tells the story of Lia Lee, a Hmong child suffering from epilepsy. The book is about what happens when two cultures clash and the devastating consequences on the life of a sick child and her family. This book is a must read for anyone in the health care field and highlights the importance of cultural approaches and understanding in the treatment of an increasingly diverse patient population ( )
  JenPrim | Jan 15, 2016 |
I found parts of this book fascinating and all of it well-written, but (while I appreciate that it was relevant in explaining the Hmong attitude to the US) the chapter on the war in Laos was not so interesting to me. There were also large sections dealing with general Hmong experiences and anecdotes about lack of assimilation which I found a distraction from the main story. The writer did make me sympathize with Lia's parents to an extent, but I struggled throughout with an inability to understand their resistance to learning English. I struggled also (and I think this was part of the point) to work out whether, when an interpreter was present, the interpreter interpreted badly or the Lees only pretended to understand or the Lees understood but decided to disregard what was being said or what?? There were times when this was about something very simple. Also, if the Lees rejected Western medicine, why did they keep taking Lia to the hospital. (I appreciate that my Western bias is coming out here...) ( )
1 vote pgchuis | Aug 26, 2015 |
Showing 1-5 of 86 (next | show all)
If tragedy is a conflict of two goods, if it entails the unfolding of deep human tendencies in a cultural context that makes the outcome seem inevitable, if it moves us more than melodrama, then this fine book recounts a poignant tragedy.
 
Ms. Fadiman tells her story with a novelist's grace, playing the role of cultural broker, comprehending those who do not comprehend each other and perceiving what might have been done or said to make the outcome different.
 
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If Lia Lee had been born in the highlands of Laos, where her parents and twelve of her brothers and sisters were born, her mother would have squatted on the floor of the house that her father had built from ax-hewn planks thatched with bamboo and grass. (Chapter 1 - Birth)
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"Of course, Martin had undergone an equally unseemly metamorphosis himself, from savant to bumbler.  It was as if, by a process of reverse alchemy, each party in this doomed relationship had managed to convert each other's gold into dross."  pg. 223
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Genre: non-fiction

Summary: A child of a family of Hmong Immigrants to the US has epilepsy, and cultural misunderstanding contributes to overmedication, culture clash, and a tragic result for the young girl.

Commentary:
The group read this along with Linda Voigt's "Bodies," an excerpt from article on Medieval Model of the Humours

The group responded enthusiastically to the Fadiman book, especially its fair-minded and balanced presentation of both the Hmong and the American medical perspectives on the case of epilepsy patient Lia Ly.

While there was much sympathy for the devastation wrought by the language barrier when two such different cultures collide, there was a sense that things have improved, at least a little, in health care facilities over the past twenty years. "We have learned something" was said a couple of times, referring to the need for intercultural understanding.

The materials on the humours -- which were thought to control bodily health, personality, and one's position in the world -- was a revelation to some participants. I had included it to make the point that, until the 17th century, the Western European model of the body and its functions, the psyche, and the relation of the individual to the cosmos, would be as alien to modern Americans as the Hmong model is.

After the first session in which individual difference was emphasized, this session on cultural differences seemed a logical development in the seminar themes. Many participants commented in later sessions how much The Spirit Catches You meant to them -- how it helped them step back from a cross-cultural therapeutic encounter to assess whether they were really understanding what was going on or what the client was trying to say. (Kathy Ashley, Maine)
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Amazon.com Amazon.com Review (ISBN 0374525641, Paperback)

Lia Lee was born in 1981 to a family of recent Hmong immigrants, and soon developed symptoms of epilepsy. By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, overmedication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty--and their nobility."

(retrieved from Amazon Thu, 12 Mar 2015 18:06:27 -0400)

(see all 4 descriptions)

When three-month-old Lia Lee Arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents were part of a large Hmong community in Merced. The Hmong, traditionally a close-knit and fiercely people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians cleaved just as strongly to another tradition: that of Western medicine. When Lia Lee entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication. Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness and healing as spiritual matters linked to virtually everything in the universe, while medical community marks a division between body and soul, and concerns itself almost exclusively with the former. Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness, qaug dab peg--the spirit catches you and you fall down--and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.… (more)

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