Will, Celeste, Maggie, Shauna

Critical Reading Report

EDUC 300-M

November 2017

The Spirit Catches You and You Fall Down

The Spirit Catches You and You Fall Down focuses on Lia was a young girl whose life

changed dramatically at an early age when she began suffering from epilepsy. Her condition

stirred up a cultural debate between the western medical doctors and Lias family, of Hmong

culture, when they failed to adequately communicate clearly and effectively to treat her

condition. While modern medicine had one theory on how to treat her epilepsy the family had

another, believing that her condition was really a spiritual happening. Due to the lack of clear

communication and effort to care for one anothers cultures and work towards a mutual

understanding to help Lia, her life was full of traumatic events until her early death. The Spirit

Catches You and You Fall Down, demonstrates the clashing of cultures that can be prevented

through communication and empathy.

The life of Lia has never been easy, she was a young child with epilepsy whose condition

started when she was three months old. At this point in time her older sister, Yer, had shut the

door in Lias face and therefore triggering her first seizure. While their parents believed that the

door had caused her soul to flee, her doctors had an entirely a different viewpoint. When Lia first

arrived at the hospital she received treatment, however the treatment that she had received that

had little to no effect due to two reasons. The first reason being that her family did not trust

modern medicine, or anything that was not closely related to their culture. Secondly, doctors
were not able to truly discover what her condition was until several months after she had been

brought to the hospital. One of the main reasons that she suffered was because there was little to

no language translation available between the doctor and Lia's parents. As previously discussed,

her parents were very much against anything that was not part of their Hmong culture. With this

resistance her parents either did not fully understand the doctor's orders and/or refused to honor

them. This would end with Leah receiving inadequate treatment which would lead to devastating

effects. Some of these effects entail more severe seizures as well signs of mental retardation

becoming apparent.

While the system tried to help through the aid of her social worker, Jeanine Hilt, the aid

was too little too late. She taught Foua how to administer the medicine that Lia needed for her

condition. However, after four short months Lia endured a very severe seizure and had to stay in

the hospital for additional fourteen days. Two months after this instance she had another massive

seizure which left her brain dead. Because being brain-dead many doctors assumed that she

would not survive, and she could return home. This unfortunately was a clear sign that doctors

had given up on Lia.

Modern medicine had failed Lia, while not all the blame can be placed on modern

medicine quite a bit can. Modern medicine was supposed to be there to help Lia no matter what.

However, this was not the case, the case was that Lias doctors were unable to convince the

Hmong culture that they were to be trusted and not feared. Furthermore, modern medicine did

not assimilate to help to merge the two ways of healing together. In the Hmong culture they were

far more spiritual while modern medicine was far more analytical, if they came together and

decided on a middle ground where both sides were taking a step closer to the other, instead of

them constantly bashing heads, then they would have increased Lias chances of survival and
therefore would have been far better off. What the doctor should have done from the beginning

was to get a translator, preferably one among the Hmong culture, who could explain the different

processes to the parents adequately and therefore help to relieve any sense of stress or uneasiness

that they had about modern medicine. If they would have gotten this translator, then maybe they

could have influenced the parents to follow the doctor's recommendations rather than to Simply

ignore them and to default back to their traditions. However, because the two cultures were

unable to assimilate, they inevitably were the leading causes of Lias death.

The Hmong Culture saw Lia Lees illness as a spiritual happening. They believed that her

severe epilepsy was caused by her spirit fleeing her body, making her collapse into epileptic fits.

The western doctors tending to Lia Lee, however, diagnosed her with epilepsy; they wanted to

treat her in the same fashion they would treat a western patient. Dan had no way of knowing

that Foua and Nao Kao had already diagnosed their daughter's problem as the illness where the

spirit catches you and you fall down. Foua and Nao Kao had no way of knowing that Dan had

diagnosed it as epilepsy, the most common of all neurological disorders (Fadiman 28). The Lee

family relied on their cultural and spiritual beliefscooperating became difficult for the family

because the doctors refused to compromise to the degree that the family wanted. While the

doctors perpetuated the conflict through miscommunication and misrepresentation, the Lee

familys refusal to use the medicine that had been prescribed to the extent the doctors requested

and encouraged demonstrates the familys unwillingness to accept or trust the western doctors

insight. This rejection shows that the Hmong family refused to assimilate to the western culture

that may have benefited their daughter. This emphasizes the necessity of empathy and

compromise between cultures.

 Foua Yang, the father of Lia, described the compromise his family was willing to do,

stating, The doctors can fix some sicknesses that involve the body and blood, but for us Hmong,

some people get sick because of their soul, so they need spiritual things. With Lia it was good to

do a little medicine and a little neeb, but not too much medicine because the medicine cuts the

neeb's effect. If we did a little of each she didn't get sick as much, but the doctors wouldn't let us

give just a little medicine because they didn't understand about the soul (101). In accepting

some of the recommended medicine, Foua believed that he was compromising an appropriate

amount. However, in claiming that a little medicine and a little neeb would help his daughters

health problems, Foua was neglecting the fact that the doctors recommended amount is the

necessary treatment that has been studied, tested and proven to be the best possible treatment for

an ill patient. The Lee family wanted to compromise, but under their own premises. In wanting

to reduce the medicine their daughter took for the effects of neeb to work, they were

undermining the factual evidence that the doctors were working under: In the Lee familys

unwillingness to compromise to the extent the doctors recommended, the Lee family was

showing their unwillingness to assimilate to the culture of the western doctors.

Fadiman discusses this further, describing an interaction she had with an epidemiologist.

Fadiman was expressing her frustration toward the doctors and their hesitance in accepting the

compromise proposed by the Lee family. The epidemiologist responded to Fadimans critiques

saying, "Western medicine saves lives" (276). Fadiman reflects on the epidemiologists

statement, suggesting that in her admiration of the Hmong culture and her agreeance with

Dwight Conquergoods philosophy that suggests healthcare should act as a barter-system that

compromises to the degree in which the family is comfortable, which she has ignored the due to

the unrelenting fact that Western medicine is one-sided (276).

 Western medicine has been proven to help patients, while neeb has not been supported

with any true evidence. While it is highly important to maintain spirituality and cultural practice,

refusal to layer neeb on top of the prescribed medicine demonstrates that the Lee family was

hesitant in their compromises. Because the Western doctors and the Lee family did not share

cultures or an understanding of each others culture, they were unable to find a compromise that

satisfied both parties. This created conflict and a truly traumatic experience for Lia and her

parents. The Lee family did not assimilate to Western medicine, and therefore, suffered

emotionally and spiritually.

During Lias life, she was bounced back and forth between modern medicine and the

medicine of the Hmong cultural. Since this happened for the duration of her life, she never fully

got the health care that she deserved to help her with her disease. The cultural barrier that was

put into place hindered Lia because the doctors did not want to learn about the Hmong culture,

and what the family believed which therefore affected her care throughout her life. The doctors

wanted the Lee family to give their daughter only modern medicine and to not use the Hmong

cultures medicine. Eventually, the family performed a healing ceremony on Lia. Lia became

brain dead, but her family still took care of her until she her death. In the end, the family did not

like or want to use the modern medicine pushed in their direction. The family chose to use their

cultures way to treat her disease, and they were happy with their decision.

Throughout the book, the American Western culture did not get along with the Hmong

culture. The Lee family came over to America to have a better life with their children and for

themselves, which was unsuccessful regarding Lias health care. Anne Fadiman tells the story of

the Lee family trying to get their daughter who has a disease healthy. By telling this story,

Fadiman is showing the world how difficult it is to communicate with people from other
cultures. This difficulty in communication can add more problems to an already scary situation.

In the Lee family, the sad reality was that their daughter is was suffering from life threatening

seizures, and no one knew how to treat her because the doctors and family could not

communicate properly. Looking back on this whole story, the doctors could have learned how to

communicate, at least slightly, with the Hmong culture, and they could have tried to understand

how important it was to the Lee family to keep in touch with their cultural traditions to treat

disease. If they would have taken this small effort, then it could have been very possible that Lia

could have been given a beneficial mix of modern medicine along with the Hmong ceremonies

that her parents preferred to save her.

While Lia and her family suffered a sad fate in the loss of her life, a lot was to be learned.

When one culture is not appreciated, or respected miscommunication and lack of a basis of trust

there is no common ground to establish an end goal. It caused Lia to lose her battle with epilepsy

as she became brain dead and was left with no more options but to go home and wait out the rest

of her life. The doctors failed to care for the family and Lias need by contributing a translator or

any effort to understand their cultural beliefs through asking for through information. The

Hmong culture refused to give in and part-take in modern medicine that may have saved Lia

because their beliefs and traditions were not respected or valued. While both parties were busy

focusing on their own individual goals the common goal, the goal to help and save Lia, was

over-looked resulting in tragedy for the family. Had the doctors and families met with a

translator, worked to understand and trust one another the outcome may have been different for

Lia. The Spirit Catches You and You Fall Down, demonstrated clearly the idea that when

cultures clash in ways that nobody cares to learn, change and adapt from unnecessary events that

could happen when they are not addressed and prevented through communication and empathy.
Working Together: Quotes from the Authors:

When our group first meet we decided that your efforts would be the most efficient if we

were to split up the workload and each focus on a particular part of the book. After we gained all

the information that we could we meet again to merge our ideas. In the end our group worked

well together to achieve the end goal that we desired. -Will

Our group worked together by first discussing the novel and what we thought the author

was trying to convey. This allowed us to express our individual opinions, as well as create a

collaborative thesis that encompassed all our thoughts. We then each took a section of the paper

and developed our specific ideas. Finally, we put our final projects together and edited them into

a fluid piece. Celeste

I believe that our group worked very well together. We met a handful of times to discuss

what we wanted our paper to look like. We were able to split the paper evenly amongst ourselves

so that the workload was fair between everyone. It was nice to work we everyone, especially

since we all were able to agree what we wanted our end goal to be! - Maggie

I was an add-in to the group later during the formation of the paper. Therefore, I was not

present in the initial meeting over the essay. They seem to have done a successful job in breaking

apart the book into sections that flowed well together, matching the same concepts. My

contribution was assisting and editing the final product as well as forming the introduction and

conclusion of the book into a final product. - Shauna