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The Spirit Catches You and You Fall Down by…

The Spirit Catches You and You Fall Down (1997)

by Anne Fadiman

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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 |
A fascinating look at how cultural differences can lead to misunderstandings and tragedies, both large and small. A Hmong family flees the violence of Laos and along with many other refugees, settles in California. The Hmong culture values the collective over the individual; they believe in spirits and traditional/cultural medicines and practices. When the Lee family has a young baby with epilepsy, their beliefs clash with those of Western medicine. The book tells their story with understanding and sympathy.

The book also tells about the history of the Hmong people, and is very well researched. It is written in an engaging style. While the life of the Hmong people has changed -- generations have grown up educated in the U.S. -- the story of culture clash remains relevant. ( )
  LynnB | Jun 23, 2015 |
A little Hmong girl who has seizures is taken to the hospital for treatment. It is the clashing of two cultures and two very different belief systems.

I was amazed that people even survive in this country without knowing how to read or write the language. The Hmong hold so tightly to their own culture that there is no place for any other at all. In this case, it's really sad - with no one really interpreting between the family and the doctors. The living conditions for these refugees is beyond belief, so many people and so little space. You feel for the Hmong, because they are mainly used to providing for themselves off the land, and they really don't have a chance to do that in this country.

A fascinating book. ( )
  bookwormteri | Mar 11, 2015 |
I found myself riveted to this story and though it was heartbreaking at times, I was fascinated and did not want to put it down. Disclosure here: I have 2 points of personal interest in this, from both the medical and the sociological perspectives: I have been a teacher in a school for physically and developmentally disabled kids, for over 25 years. I have had many students over the years with seizure disorder (aka, epilepsy), from the very mild to the very severe, and am familiar with the names of several of the medications mentioned in this story, as well as the manifestations of the various types of seizures, not to mention the controversies about some of them. I also have a degree in sociology although I have never worked in that field. I have occasionally wondered, over the years, if I should have gone into sociology or anthropology instead of education as cultures and cultural differences have always been a real interest of mine. I live in Toronto, one of the most multi-cultural cities in the world and have come face to face in my class and school, with some of the very issues that Fadiman illuminates in this book (language barriers, cultural customs and beliefs, etc).

This book is an exceptionally well-researched and fair presentation of both sides of the story, without getting bogged down in either sentimentality or bias. The story itself is really heartbreaking but although it was written nearly 20 years ago, it is surely a tale that repeats itself day in and day out, everywhere that immigrants live and the locals can't learn to be open-minded enough to see the whole picture, the whole person. People are a sum of their cultures, beliefs, and traditions and each of those aspects is essential to successful communication and acceptance. Fadiman spent years in the writing of this story and how she managed to gain the access and trust of the very many people involved, is remarkable. Her footnotes throughout the book are excellent for explaining and expanding on certain words, concepts or facts. But she also took the time, at the end of the book, to outline in almost 20 pages, her further notes on her sources for each chapter. She also has 2 pages at the end on Notes on Hmong Orthography, Pronunciation and Quotations, which was not actually necessary but still tremendously interesting. There are over 10 pages of Bibliography and 2 and a half pages of Acknowledgements. Such a thorough and wonderful labour of love - I highly recommend this book and think that even if one comes to it without my own personal points of interest, it is highly readable and gripping. ( )
  jessibud2 | Feb 22, 2015 |
A young Hmong girl in California with severe epilepsy is caught between her family's Hmong culture and the culture of a modern medical facility with its doctors. I wasn't sure I would like it at first, but Fadiman (quickly becoming one of my favorite authors) presents the dilemma with such an even hand. She sees both sides of the issue, and doesn't come out and preach one over the other. Truly a thought-provoking book. ( )
  tloeffler | Aug 9, 2014 |
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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)
"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.

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)

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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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