The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

Anne Fadiman

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'The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures' by Anne Fadiman is a poignant exploration of the clash of cultures and beliefs that ensued when a young Hmong girl named Lia was diagnosed with severe epilepsy. Through a mix of storytelling, history, and cultural insights, the author delves into the challenges faced by both the Hmong immigrant family and the California doctors involved in Lia's care. Fadiman skillfully presents the complexities of the situation, shedding light on the misunderstandings, communication failures, and deeply rooted cultural differences that impacted the child's medical treatment.

The narrative of 'The Spirit Catches You and You Fall Down' is structured to provide a comprehensive view of the story, alternating between recounting the history of the Hmong people and detailing Lia's journey through the medical and foster care systems. Fadiman's writing style is empathetic, thought-provoking, and deeply researched, offering readers a glimpse into the struggles faced by both the caregivers and the family as they navigate the complexities of Western medicine and traditional Hmong beliefs in the pursuit of healing for Lia.

Writing/Prose:

The writing style is a blend of journalistic and narrative, effectively intertwining personal stories with factual information to convey the complexity of the cultural clash.

Plot/Storyline:

The plot revolves around the experiences of a Hmong family in America, highlighting the cultural misunderstandings between them and Western medical practitioners, particularly concerning their daughter Lia's epilepsy.

Setting:

The setting includes both the Lee family's life in Merced, California, and the cultural backdrop of Hmong history and immigration.

Pacing:

The pacing fluctuates throughout the book, alternating between detailed cultural history and urgent medical drama.

If Lia Lee had been born in the highlands of northwest 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 fathe...

Genres:

nonfiction

medical anthropology

cultural studies

Topics:

hmong culture

epilepsy

western medicine

communication barriers

immigration and refugee experiences

cultural competence

cultural clash

miscommunication

Notes:

The book focuses on Lia Lee, a Hmong child with epilepsy, and the cultural clash between her family and American medical professionals.

The Hmong people view epilepsy as a spiritual issue, believing that it is caused by a lost spirit, rather than a medical condition.

Lia's parents struggled to communicate with her doctors due to language barriers, which led to misunderstandings about her treatment plan.

The Hmong rely on traditional healing practices and shamans, which conflicted with the Western medical approach that prioritized medication.

Lia's treatment involved a rapidly changing regimen of anti-convulsants, which her parents did not fully understand.

The book highlights the difficulties faced by refugees in adapting to a new culture, including navigating the complexities of the healthcare system in the U.S.

Fadiman's writing emphasizes the good intentions of both the Hmong family and the medical professionals, despite the tragic outcome.

Cultural differences played a significant role in the mismanagement of Lia's care, including differing views on compliance and treatment.

The story illustrates the broader implications of cultural understanding in medical practice, which is even more relevant in today's diverse society.

Fadiman conducted extensive research and interviews to portray both sides of the narrative fairly.

Sensitive Topics/Content Warnings

Triggers include discussions of severe medical conditions, cultural misunderstandings, and a tragic outcome for the main character.

From The Publisher:

Now with a new Afterword from the author

Winner of the National Book Critics Circle Award for Nonfiction

The Spirit Catches You and You Fall Down explores the clash between a small county hospital in California and a refugee family from Laos over the care of Lia Lee, a Hmong child diagnosed with severe epilepsy.

Lia's parents and her doctors both wanted what was best for Lia, but the lack of understanding between them led to tragedy. Winner of the National Book Critics Circle Award for Nonfiction, the Los Angeles Times Book Prize for Current Interest, and the Salon Book Award, Anne Fadiman's compassionate account of this cultural impasse is literary journalism at its finest.

Lia Lee 1982-2012

Lia Lee died on August 31, 2012. She was thirty years old and had been in a vegetative state since the age of four. Until the day of her death, her family cared for her lovingly at home.

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1 comment(s)

swebud854

Incredible

9 months

This book truly helped me better understand why miscommunications can't always be talked out of. It reminded me that, as humans, we're all living in our own little worlds hoping that the worlds of those around us remain comprehensible

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About the Author:

Anne Fadiman was born in New York City and was raised in Connecticut and Los Angeles. After graduating from Harvard, she worked as a wilderness instructor in Wyoming before returning to New York to write. She has been a staff writer at Life, editor-at-large of Civilization, and editor of The American Scholar. Fadiman is also the author of Ex Libris and At Large and At Small, and the editor of Rereadings. She now lives with her family in western Massachusetts and serves as the Francis Writer-in-Residence at Yale.

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