The first, spontaneous reaction with regard to the stranger is to imagine him as inferior, since he is different from us.

The Spirit Catches You and You Fall Down by Anne Fadiman is the story of the infant daughter of Hmong refugees and how misunderstandings on both the side of the parents and of the American medical community led to tragedy. Lia Lee had severe, hard to control epilepsy. Her parents brought her to the hospital many times but were unable to communicate with the medical professionals caring for her due to both linguistic and cultural barriers. The result was that Lia did not receive the care she needed, and her family, as well as the Hmong community, were given ample reason to distrust American authorities.

The first half of this book was the amazing story of what happened. It's strength was that it was clear that from the beginning everyone wanted to do what was right. Her parents loved her and were excellent caregivers. Her doctors were dedicated and professional. Nevertheless, they spent much of the time in conflict, fatally separated by differences of beliefs and traditions. I appreciated Fadiman's telling of the story, which was both compassionate and impartial.

She lost that strength a little in the second half of the book, which detailed the history of the Hmong people and why they emigrated to the United States and why they didn't integrate in the way expected of them. In a nutshell, the US used the Hmong in their "quiet war" in Laos, bombing their villages and jungle environment into a wasteland, then leaving most of them to their fate when we pulled out of South East Asia. Many escaped across the Mekong river and settled in refugee camps in Thailand. The American government reluctantly allowing them to come to the US when Thailand shut the camps down. The Hmong didn't want to come, but there was truly nowhere else they could live. They believed that their wartime service had earned them a degree of thankfulness from the Americans, and we wondered why they were given welfare out of our tax dollars. It was a fascinating history, well-told, but in the telling she lost a little of the impartiality that had marked the first half. Maybe she had no choice; this wasn't a case of a story having two sides--we destroyed their way of life, while they fought valiantly on our side, but when the war was over we were resentful of our responsibility. And as Americans, we are often too attached to our melting pot view to allow immigrants to keep their way of life. I did agree with her views, I just felt a little preached to, which is never fun, even when you agree with the preacher. ( )

Superb. I can see why Robert Coles compares this to James Agee's and George Orwell's journalism. Excellent cross-cultural analysis of several different cultures--Hmong, medical field (including differences between clinics and hospitals), social workers, CPS, interpreters, &c.--by way of first learning why it's important to examine one's belief systems. I love the Arthur Kleinman quote at the end: "Get rid of the term 'compliance.' It's a lousy term. It implies moral hegenomy." This is a full, well-written, well-researched "narrative" and not a "case study." Reminds me why it's important to: listen, pay attention, to always question one's own assumptions, especially when dealing with another culture. But doing that is not always enough or easy. (This also parallels my thoughts on watching The Wire: there is no simple good/evil dichotomy here--people are often stuck within their institutions and thus certain belief systems without knowing it. Fadiman does a masterful job of interweaving all the different perspectives at the same time questioning her own and watching her own views change over time. Important work for therapists, social workers, of which I am. I like her discussion on the use of cultural brokers v. interpreters. ( )

Amazing book! Essential reading for all medical personnel. This deals with a traditional Hmong family and their disastrous experience with the American health care system. ( )

It was a long time ago I read this book, but I do remember it being powerful and eye-opening. Great story and well-written; I was teaching Hmong children at the time, and it gave me some interesting insights into that culture. I'll probably read it again someday. ( )

READ IT ( )