The Spirit Catches You, and You Fall Down and Social Intercultural Issues
The Spirit Catches You, and You Fall Down depicts the tale of Lia Lee, an epileptic Hmong kid whose sad death highlights the risks of a lack of cross-cultural dialogue in the medical sector. The book spends a significant amount of time detailing Hmong history. Hmong people were expelled from China for refusing to integrate the country’s culture and then made their way to the Laotian highlands. As the Vietnam War destabilized the region, the Hmong were forced to fight for the US government in the so-called “Quiet War,” an oxymoron. The book describes how communist troops demolish their towns, pushing the Hmong to risk their lives to make it to America.
Nao Kao and Foua Lee, Hmong refugees, have settled in Merced, California, with their families. Their daughter Lia is born, and tragedy strikes: she has epilepsy and regular seizures. Lia’s therapy is hampered by Nao Kao and Foua’s inability to converse in English, making communicating with her physicians hard. Everything happens when Lia’s pediatrician, Neil Ernst, becomes frustrated with her lack of communication and places her in a foster home. Things get much worse since Lia’s foster mother, Dee Korda, and her social worker, Jeanine Hilt, are ni people. As soon as Lia is isolated from her family, her health worsens. She’s suffering significant seizures regularly by the time she gets home, and her growth has slowed dramatically. A considerable take subsequently renders her legally brain-dead. This case forces Nao Kao and Foua to pick up the pieces and put their lives back together. Despite their efforts to make Lia as comfortable as possible—keeping her alive for decades longer than the doctors anticipated—Nao Kao and Foua are badly upset by the event, blaming Lia’s physicians for her daughter’s predicament. And, strangely enough, we’ll leave it there.
But the book also touches on critical cultural and historical processes concerning the Hmong culture. Of course, one of the main questions is fundamental. It is about what role history has played in the formation of Hmong culture. On page 13, it says that the Hmong’s history has been a continuous series of brutal scrimmages. For as long as records have been kept, interspersed by brief calm times, few and far between. The Hmong have repeatedly reacted to persecution and assimilation demands by fighting or moving. This pattern has been repeated in ages and locales, and it appears to be a genetic feature. Page 15 also mentions that the Hmong people were allergic to all kinds of authority. This expresses the freedom-loving nature of this culture.
The concept of “fish soup” in Chapter 2 is essential for understanding the Hmong culture, and for a good reason. Kiga herself talks about this from an interesting point of view. In a French lesson, a Hmong student took 45 minutes to give a 5-minute presentation on making fish soup (Fadiman 25). According to the professor, the Hmong are known for their fish soup. To talk on a wide range of topics, as the phrase goes. It is frequently used at the start of the oral narrative to remind listeners that the world is full of things that may not appear to be connected. No event occurs in isolation – this is likely where the disconnect with biomedical culture begins; people are unwilling to listen to their side to validate what they believe and feel is the problem. Biomedicine informs patients that they are incorrect; they must remove their errors to improve.
According to Dr. Dave Schneider, the language barrier is the most visible but not the most severe issue. The most significant problem was the cultural divide. There is an immeasurable difference between dealing with them and everyone when interacting with the Hmong. He got this impression because of the above-described feature of the Hmong people. Freedom-loving and unusual, they were quite alien and strange to other inhabitants of their region. Even to a greater extent, Westerners can say the same.
In the situation described in the book, when Child Protective Services took Lia away from her parents, this is wrong. A child should not be taken away from his family unless his family intends to harm the child deliberately. However, she is taken away because of the xenophobic social institution (Fadiman 63). By removing a child from the Hmong culture from this family, the institution of social guardianship destroys his nature. Instead of such a brutal way, one should try to adapt the whole Lia family along with their child. It would be necessary to find a methodology for communication and learning and mutual cultural integration.
It is the above allows that when the doctor fails one Hmong patient, they fail the whole community. The Hmong are a minority; they are culturally unique and highly protective of their customs and culture (Fadiman 36). The culture and traditions of their people are concluded precisely in their families, clans, and individual members. That is exactly what is meant because the entire Hmong line suffers as one having lost one.
In chapter 18 — Life or the Soul, you can find an example of incorrect treatment. Social worker, Francesca Farr, worked with her Hmong him to ensure the patient took the medication needed to cure tuberculosis. However, it did not consider the cultural and internal context of the Hmong culture, which is why it was not effective. Modern approaches to the treatment of representatives of other cultures suggest this type of interaction. Respect and cultural tolerance are critical in such a matter.
Fadiman, Anne. The Spirit Catches You and You Fawn: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus and Giroux, 1998.