The Spirit Catches You and You Fall Down | 
 enlarge | Author: Anne Fadiman
Publisher: Farrar, Straus and Giroux
Category: Book
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Rating:  224 reviews
Sales Rank: 131
Media: Paperback
Edition: 1
Number Of Items: 1
Pages: 352
Shipping Weight (lbs): 0.7
Dimensions (in): 8.2 x 5.5 x 1.1
ISBN: 0374525641
Dewey Decimal Number: 306.461
EAN: 9780374525644
ASIN: 0374525641
Publication Date: September 28, 1998
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Amazon.com Review
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."
Product Description
Winner of the National Book Critics Circle Award for Nonfiction
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 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 aand 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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| Customer Reviews: Read 219 more reviews...
 School Mandated January 8, 2009
I read this book as a requirement of nursing school, but I thoroughly enjoyed it... It will captivate anyone with a heart/soul. I might even read it again later in my career- I really enjoyed the exposure to cultural competence.
 Health care must account for personal cultural beliefs January 7, 2009
I am a PhD student in Sociology and just read this book as a requirement for my assistantship work in a hospital. The Spirit Catches You and You Fall Down is a very interesting case study of the intersection of the US health care system (including its workers and clinicians) and people of different spiritual and national backgrounds. The US health care system is rigid and believes in a singular biomedical model of medical healing, and this book shows that this view does not allow room to include the complexities of the other dimensions to a person. For example, the Hmong described in this book do not see a difference between mind and body. Therefore, taking care of the body without respect to the mind is not complete healing. I know that medicine in our society aims at saving physical lives at the cost of all else, and often the individual beliefs are neglected.
I think this book also highlighted that some hospitals do have adequate interpreters or offer these services to patients. It surprised me that the local hospital in the book did not have proper Hmong interpreters when such a large proportion of the city residents were Hmong. In this book, I did value the efforts at practicing excellent medicine (from their own view) of the doctors and how they did go out of their way to fight for the life of Lia.
It's too much for people in the health profession to know the cultural beliefs of every one of their patients, so I think it is important to spend time at the first meeting to open the doors of discussion and ask the patient or client what her/is cultural and spiritual views are and keep a constant dialogue throughout the healing process.
Must read! December 30, 2008
I love this book! It was about a vietnamese immigrants whose daughter had epilepsy. It was a clash of cultures and looks into one major flaw of our healthcare system. The main theme language and cultural barriers that can create roadblocks to getting proper medical care. One feels for these parents and I don't think I could ever be as patient a parent as they were under these difficult circumstances. Highly recommend!!
Catch the Spirit December 29, 2008
Reading this extraordinary book has helped me retrieve a significant part of my soul. A deep gratitude to the author for the tremendous sensitivity, involvement and work required to write such a thorough anatomy of the limits of communication for which the Hmong culture versus the American, and epilepsy versus "normalcy" are such strong metaphors.
One of the most remarkable books I've read December 29, 2008
I don't keep many books for my permanent library, but this is one of them. It is a remarkable study of the meeting, misunderstanding, and ongoing struggle for harmony between Western ways and the unique culture of the Hmong people. The title story is only part, though a major one, of the book; a young Hmong girl became epileptic, and the long-running encounter of her family with Western medical traditions, hospital procedures, and cultural assumptions, occupies the greater part of the text. The story shows in many poignant ways how good intentions could not overcome radically different world views. Just how great the misunderstanding was (on both sides), can be glimpsed by an example: the author refers to "...the kind of blind spot that made a Merced health department employee once write, about a child from a family that views the entire universe as sacred:
Name: Lee, Lia
Principla Language: Hmong
Ethnic Group: Hmong
Religion: None"
The Hmong are animists, regarding all things as having spirits, especially animals...so, the characterization of them as having no religion is laughable--but also tragic. The outcome of this young girl's affliction was similarly tragic...not only for her, but for her family, her doctors, and the Western friends who tried in various ways to be helpful.
I strongly recommend this book to anyone who wants a brilliant example of how cultural assumptions and misunderstanding can play out in damage and pain to people on all sides of the interaction. It is sad but not pointless to consider a book such as this; it can only prove instructive and will ultimately help any number of people to better understand and coexist together.
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