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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, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit and fiercely proud people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, 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)
A great, if heartbreaking book. The author presents a relatively impartial history of how a group of thoroughly committed and well meaning people are caught together in a situation that somehow trumps all their good intentions. It has history, culture, folklore, humor, medicine and humanity. Highly recommended ( )
Grin recommended this book to me after we had a conversation about different cultural perspectives re medicine and wellness. If you have any interest in global health and/or how the US health care system treats immigrants and refugees, this is a must-read. Anne Fadiman's a brilliant writer, and in this book she takes a personal interest in the Hmong family on which the story is based, so it's an especially moving account vs. what you might read about medical anthropology in a journal or magazine. ( )
Well-researched and well-written. I'd probably give this 3.5 stars. I learned quite a bit about the Hmong culture and history, and a smidge about the US medical establishment, too. ( )
Author researches a Hmong family in California with an epileptic daughter and their experience with US Health care system, shows culture and doctors care deeply for child with radically different approaches to treatment. Also touches on racial, economic prejudice combined with low literacy as barriers to allowing the two approaches to become complementary. Fadiman is also a superb essayist, this is an outstanding book. ( )
This book deals with the culture clash between Hmong refugees from Laos in the same time period and American doctors called upon to treat their epileptic child. Well-written, fascinating, and compassionate to both points of view. March, 2012 ( )
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.
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)
Quotations
"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
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, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit and fiercely proud people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, 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.
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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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