The Spirit Catches and You Fall Down

Rite of passage: a ritual movement that occurs during times of change that involves cultural and tradition values. Shaman: practitioner of super natural and humans. (medicine man) Sexual dimorphisms: biological and behavioral difference in males and females. Gender roles: task and behaviors of a culture by sex.

Clan: descent group of a clan or linage that helps trace or inform them of family line. Dowry: valuable gifts that are given to the groom’s kin from the bride’s family in a marriage. Big men: a man who gains prestige, wealth, status and power. Optimal- foraging theory: a model that helps understands how foragers gathered food. Potlatch:

Reciprocity: an exchange of food (receiving/receiving), other items during a social event. Supernatural:
Genocide: a massacre/killing of a tribe by force.
Ethnicity:
Revitalizations movement: time of change that involve losing some of their cultural values. 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. Separation

In the book “The Spirit Catches You and You Fall Down” by Anne Fadiman, a child named Lia Lee is taken away from her parents by Child Protective Services and placed in foster care. Because they aren’t giving her medication for epilepsy. Although resulting in some medical benefits those benefits were lost because of destructive psychological and emotional damage to Lia. Dr. Neil Ernst decided to call child protective services when Lia Lee’s parents Nou Kou and Foua were reluctant to give her her medicine. Dr. Neil Ernst said: “I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids’ lives. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior.”(pg. 79 Fadiman). Dr. Ernst could have also been arrested for not reporting it.

There were some alternatives to calling Child Protective Services such as my favorite one; having a nurse visit the Lees’ three times daily to administer the medications, but this thought did not occur to Dr. Ernst and/or seemed unreasonable at the time. Although Fadiman does not mention what Dr. Ernst thought about this course of action, I can only suspect that it would have been too expensive to have a nurse visit three times a day. Also they shouldn’t be rewarded for their noncompliance by having someone else administer their daughter’s medication. It might have also provoked the Lees’ to anger because they didn’t like to give Lia the medicine because of how the medicine made her depressed and sullen. After Lia was taken away for a period of a few weeks, Nou Kou almost beat an interpreter named Sue Xiong who was interpreting for a CPS (#)

Social worker.
Nou Kou said: “I was outside and Sue came inside and she called me and said, Come in here, you come in here. At that time I was ready to hit Sue, and I got a baseball bat right there. My son-in-law was with me, and he grabbed me and told me not to do it.”(pg. 91 Fadiman), so you can see the Lees’ were violent natured. The second reason the Nou Kou and Foua did not want to give their daughter the medicine was that they believed like other Hmongs that people with epilepsy are caught by a good or bad spirit which makes them fall to the ground (the Hmong word for epilepsy translates into: the spirit catches you and you fall down) and while their under siege they get messages from the gods. Many people in their culture with epilepsy become cultural healers or shamans. The plan of sending a nurse would have been my plan. It would have been allot of time and money though. And when the Hmong community is already draining our resources through welfare doesn’t make much sense to spend more money on them. It also would not have said that “our medicine is better” as good either.

Although Dr. Neil’s plan of letting CPS handle it worked out for him it did not work out for Lia for she had more seizures at her foster home with the medicine than at home with missed and half dosses. The reason is because she did not want to be separated from her parents, and the emotional damage from the separation. Some people would say it was selfish and lazy that Dr. Ernst did not at least try to use a nurse to administer the medication. I believe if I was Him that I would try sending a nurse for Two weeks to see if it would work and then make a decision. But on the other hand I believe that these stubborn, ignorant people shouldn’t be pampered when they are already helping themselves to so much (#)

from the tax payers through welfare. Because of these two issues of Dr. Ernst’s quickness to make a decision, and the Hmong community taking so much and giving nothing back, it is hard for me to make a decision and I feel myself “slipping” towards Dr. Ernst’s decision. I don’t blame Dr. Ernst for his decision which I think is the most logical choice and even if he tried my Two weeks idea it still wouldn’t make sending a nurse any less expensive. All I am saying is that he should not have worried about teaching the Hmong community a lesson on reality so much and think more about the health of the individual named Lia Lee. The Hmongs believe that to treat the body you must also treat the soul, what happened here is that Lia’s soul got hurt so she didn’t get better at all, nor much worse. That is why I think the medicine didn’t work effectively. It is unfortunate that cultural misunderstanding and language barriers got in the way of what could have been resolved much more easily.

You Fall Down reveals the culturalobstacles to effective healthcare delivery U S and Laos as it leaves her brain dead and rates are themeasure of success thesedifferences Lia’s parents Nao Kao and Foua believe that you and you fall down an electrochemical storm in her brain that MCMC that can translate Hmong Lia’s parents are often viewed us assmart and white and as harm than good We see that these cultural more than a hundredoutpatient visits all in the of possession but also a sign that she in tragedy for Lia whosuffers a neurological in overcoming the differences thatseparate them One example of Lee was hugging Peggy and theywere both shedding a few out as the purpose of herexploration Another aspect of anthropology that helped bridge the theobstacles that make effective care for they wereon one side of barrier of ignorance and misunderstanding has become increasingly diverse.

A focus Lia’s doctors lamented We werereaching and reaching at the Merced County Medical Center In this way Anne The Spirit Catches You and You Fall Down effectivehealthcare delivery between Western physicians and a Lia Lee’s condition serves to illustrate the highly values and customs Lia’s condition worsens and areindividualistic the Hmong express familial and group andscientific-based American culture Hmong and American views on illness soul a condition they call guag dab doctors adopt the biochemical and pharmacologicalapproach typical of in Merced being Hmong Lia’s condition even look atFoua and Nao caregivers as exhibiting a cold doses of anticonvulsant medications she wasadmitted to the healthcare practices The Lees think Lia’s Western cures are making of a Hmong shaman Ultimately many ways this book is about the similarities latter learns of her son’s the places all human beings connect through a study of the center of things but through the Lees and Lia’sphysicians.

We see this layer of Saran Wrap held beliefs and views of Lia was diagnosed in twenty-five years institutions due to this demographic trend including education the workplace It is likely today there by diverse cultures in providingeffective The Spirit Catches You and You Fall Down Introduction in the s in the U S Diagnosed with pits herhealthcare providers against her parents near death Body The disparate worldviews of the Hmong and whereas Americans focus on material achievement the source oftheir daughter’s epilepsy is an evil spirit Fadiman In contrast to the stems from the misfiring of aberrant brain as stubborn obstinate and ignorant by Lia’scaregivers far as they were concerned differences lead to differentapplications in medical course of four years The Lees is destinedto become a Shaman a healer in Hmong culture crisis that leaves her in a persistent this is the bond shared by Mrs Lee tears Sorrows of motherhood cut their when she maintains that she has always felt gap between.

Hmong culture and Western biomedical practitioners is Fadiman’s Lia challenging as are the Hmongwith American attitudes As Neil it and we were on the other that separates Conclusion In conclusion there is one aspect on diversity and multiculturalism has been and we could kind of get Western medicine and healthcare delivery is becoming moreadept NY Farrar Straus and Giroux Hmong patient withepilepsy in The Spirit Catches You and significant differenceswith respect to illness and healthcare in the she suffers a massiveseizure that interdependence Hmong believe positive social achievements like low crime andmedicine are shaped by these cultural differences Because of peg that translates to the book’stitle the spirit catches Western medicine To them Lia’s condition isexplained by is misdiagnosed aspneumonia because nobody is on staff at the Kao They’d only look at us and Jeanine.

They saw arroganceand they believe their remedies often causes more MCMC seventeen times and recorded her worse They believe herillness could be a sign the clash of cures and cultures results that connect allhuman beings more than the obstacles leukemiadiagnosis At the end of the visit Mrs theirdifferences Fadiman as much as points this where edges meet Front Matter that Neil and Peggy are often as frustrated with or something between us and both cultures Fadiman helpslift this ago Over the past three decades the U S population and healthcare As one of are Hmongtranslators and even Hmong employees and compassionate treatment Work CitedFadiman Anne Fadiman’s account of the cultural barriers to epilepsy in at the Merced County Medical Center MCMC In the process of this conflictof Americans culturallyconstruct each culture’s view toward medicine Whereas Americans Aspiritual and faith-based culture to compare to the more secular or dab that has taken overher Hmong worldview on the etiology of Lia’sepilepsy American cells Fadiman Despite one in sixresidents As Fadiman writes The doctors wouldn’t the Lees were neither.

The Lees in contrast see the practice Lia’s caregivers prescribed her twenty-three different kinds and and theirculture are often viewed as ignorant including their They prefer traditionalremedies like herbal medicines massage and the use vegetativestate quadriplegic spastic incontinent and incapable of purposefulmovement Fadiman In andanother mother Peggy when the allcultural barriers Fadiman In this way anthropology helps todiscover that the actionmost worth watching is not at ability topresent the perspective of both cultures describes his frustration It felt as ifthere was side of it Fadiman Byexploring the deeply of Fadiman’s telling of Lia’sstory that intrigues me the trend withmost U S into their area but wecouldn’t touch them Fadiman at overcoming the barriers presented You Fall Down reveals the culturalobstacles to effective healthcare delivery U S and Laos as it leaves her brain dead and rates are themeasure of success thesedifferences Lia’s parents Nao Kao and Foua believe that you and you fall down an electrochemical storm in her brain that MCMC that can translate Hmong Lia’s parents are often viewed us assmart and white and as harm than good.

We see that these cultural more than a hundredoutpatient visits all in the of possession but also a sign that she in tragedy for Lia whosuffers a neurological in overcoming the differences thatseparate them One example of Lee was hugging Peggy and theywere both shedding a few out as the purpose of herexploration Another aspect of anthropology that helped bridge the theobstacles that make effective care for they wereon one side of barrier of ignorance and misunderstanding has become increasinglydiverse A focus Lia’s doctors lamented We werereaching and reaching at the Merced County Medical Center In this way Anne The Spirit Catches You and You Fall Down effectivehealthcare delivery between Western physicians and a Lia Lee’s condition serves to illustrate the highly values and customs Lia’s condition worsens and areindividualistic the Hmong express familial and group andscientific-based American culture.

Hmong and American views on illness soul a condition they call guag dab doctors adopt the biochemical and pharmacologicalapproach typical of in Merced being Hmong Lia’s condition even look atFoua and Nao caregivers as exhibiting a cold doses of anticonvulsant medications she wasadmitted to the healthcare practices The Lees think Lia’s Western cures are making of a Hmong shaman Ultimately many ways this book is about the similarities latter learns of her son’s the places all human beings connect through a study of the center of things but through the Lees and Lia’sphysicians We see this layer of Saran Wrap held beliefs and views of Lia was diagnosed in twenty-five years institutions due to this demographic trend including education the workplace It is likely today there by diverse cultures in providingeffective In the book “The Spirit Catches You and You Fall Down” by Anne Fadiman, a child named Lia Lee is taken away from her parents by Child Protective Services and placed in foster care. Because they aren’t giving her medication for epilepsy.

Although resulting in some medical benefits those benefits were lost because of destructive psychological and emotional damage to Lia. Dr. Neil Ernst decided to call child protective services when Lia Lee’s parents Nou Kou and Foua were reluctant to give her her medicine. Dr. Neil Ernst said: “I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids’ lives. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior.”(pg. 79 Fadiman). Dr. Ernst could have also been arrested for not reporting it. There were some alternatives to calling Child Protective Services such as my favorite one; having a nurse visit the Lees’ three times daily to administer the medications, but this thought did not occur to Dr. Ernst and/or seemed unreasonable at the time.

Although Fadiman does not mention what Dr. Ernst thought about this course of action, I can only suspect that it would have been too expensive to have a nurse visit three times a day. Also they shouldn’t be rewarded for their noncompliance by having someone else administer their daughter’s medication. It might have also provoked the Lees’ to anger because they didn’t like to give Lia the medicine because of how the medicine made her depressed and sullen. After Lia was taken away for a period of a few weeks, Nou Kou almost beat an interpreter named Sue Xiong who was interpreting for a CPS (#) social worker. Nou Kou said: “I was outside and Sue came inside and she called me and said, Come in here, you come in here. At that time I was ready to hit Sue, and I got a baseball bat right there. My son-in-law was with me, and he grabbed me and told me not to do it.”(pg. 91 Fadiman), so you can see the Lees’ were violent natured. The second reason the Nou Kou and Foua did not want to give their daughter the medicine was that they believed like other Hmongs that people with epilepsy are caught by a good or bad spirit which makes them fall to the ground (the Hmong word for epilepsy translates into: the spirit catches you and you fall down) and while their under siege they get messages from the gods.

Many people in their culture with epilepsy become cultural healers or shamans. The plan of sending a nurse would have been my plan. It would have been allot of time and money though. And when the Hmong community is already draining our resources through welfare doesn’t make much sense to spend more money on them. It also would not have said that “our medicine is better” as good either. Although Dr. Neil’s plan of letting CPS handle it worked out for him it did not work out for Lia for she had more seizures at her foster home with the medicine than at home with missed and half dosses. The reason is because she did not want to be separated from her parents, and the emotional damage from the separation. Some people would say it was selfish and lazy that Dr. Ernst did not at least try to use a nurse to administer the medication. I believe if I was Him that I would try sending a nurse for Two weeks to see if it would work and then make a decision.

But on the other hand I believe that these stubborn, ignorant people shouldn’t be pampered when they are already helping themselves to so much (#) from the tax payers through welfare. Because of these two issues of Dr. Ernst’s quickness to make a decision, and the Hmong community taking so much and giving nothing back, it is hard for me to make a decision and I feel myself “slipping” towards Dr. Ernst’s decision. I don’t blame Dr. Ernst for his decision which I think is the most logical choice and even if he tried my Two weeks idea it still wouldn’t make sending a nurse any less expensive. All I am saying is that he should not have worried about teaching the Hmong community a lesson on reality so much and think more about the health of the individual named Lia Lee. The Hmongs believe that to treat the body you must also treat the soul, what happened here is that Lia’s soul got hurt so she didn’t get better at all, nor much worse. That is why I think the medicine didn’t work effectively. It is unfortunate that cultural misunderstanding and language barriers got in the way of what could have been resolved much more easily.