| The Spirit Catches You and You Fall Down | |
|---|---|
| Author(s) | Anne Fadiman |
| Country | United States |
| Language | English |
| Publisher | Farrar, Straus and Giroux |
| Publication date | 1997 and 1998 |
| Media type | Print (Hardback & Paperback) |
| Pages | 352 |
| ISBN | ISBN 0374525641 ISBN 978-0374525644 |
| OCLC Number | 47352453 |
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures is a 1997 book by Anne Fadiman that chronicles the struggles of a Hmong refugee family from Sainyabuli Province, Laos,[1] the Lees, and their interactions with the health care system in Merced, California.
On the most basic level, the book tells the story of the family's second youngest and favored daughter, Lia Lee (Romanized Popular Alphabet: Liab Lis[2]), who is diagnosed with severe epilepsy, and the culture conflict that obstructs her treatment.
Through miscommunications about medical dosages and parental refusal to give certain medicines due to mistrust and misunderstandings, and the inability of the doctors to have more empathy toward the traditional Hmong lifestyle or try to learn more about the Hmong culture, Lia's condition worsens. The dichotomy between the Hmong's perceived spiritual factors and the Americans' perceived scientific factors comprises the overall theme of the book.
The book is written in a unique style, with every other chapter returning to Lia's story and the chapters in-between discussing broader themes of Hmong culture, customs, and history; American involvement in and responsibility for the war in Laos; and the many problems of immigration, especially assimilation and discrimination. While particularly sympathetic to the Hmong, Fadiman presents the situation from the perspectives of both the doctors and the family. An example of medical anthropology, the book has been cited by medical journals and lecturers as an argument for greater cultural competence, and often assigned to medical, pharmaceutic, and anthropological students in the US. In 1997, it won the National Book Critics Circle Award for General Nonfiction.[3]
Contents |
The Hmong religious belief in shamanistic animism asserts that malevolent spirits are constantly seeking human souls, especially those of vulnerable or unloved children. In Hmong culture, epilepsy is referred to as qaug dab peg (translated in English, "the spirit catches you and you fall down"), in which epileptic attacks are perceived as evidence of the epileptic's ability to enter and journey momentarily into the spirit realm. In Hmong society, this ability must be used to help others. Qaug dab peg is often considered an honorable condition and many Hmong shamans are epileptics, believed to have been chosen as the host to a healing spirit, which allows them to communicate and negotiate with the spirit realm in order to act as public healers to the physically and emotionally sick. In addition to these beliefs, Hmong also have many customs and folkways that are contradicted by those of the American mainstream and medical communities; for example, some Hmong traditionally perform ritual animal sacrifice and because of very specific burial traditions and the fear of each human's many souls possibly escaping, the traditional Hmong beliefs do not allow for anyone going through invasive medical surgery.
In the U.S., the medical community rarely has ways to communicate with people of cultures so radically different from mainstream American culture; even a good translator will find it difficult interpreting concepts between the two different cultures' world-concepts. American doctors, unlike Hmong shamans, often physically touch and cut into the bodies of their patients and use a variety of powerful drugs and medicines.
New England Journal of Medicine article 1 [1]
New England Journal of Medicine article 2 [2]