Spirit Catches You and You Fall There

¶ … Spirit Catches You and You Fall

There were a number of different delivery systems models in place and which attempted to effect positive care for Lia Lee and her family in Anne Fadiman's The Spirit Catches You and You Fall Down. One can successfully argue that more than one model was used throughout the duration of the book for the simple fact that there were a number of barriers preventing success from any of the models due to the simple fact that Lia's family were Laos immigrants with little cultural understanding of the United States. However, it is fairly evident that the model that was initially used and used more than any others in this work of literature was the medical model. The medical model is commonly used within westernized society and is the oldest of the three traditional models (which includes the public health and the human services model, as well). The basis for this model is that the practitioner or medical professional treating a patient analyzes the patients symptoms, issues a diagnosis, issues treatment (typically based on medication) and hopefully effects a cure.

The initial medical personnel that treated Lee, Neil Ernst and Peggy Philp, attempted to utilize the medical model but encountered significant resistance along the way. It is worth mentioning that this resistance was both unintentional and intentional. The communication barriers present between the lees and these doctors prevented the former from efficaciously identifying the baby girl's symptoms and issuing a relevant diagnosis, since neither could speak the language of the other. Additionally, the medical facility that the pair worked at could not afford to hire translators. Once the medical personnel were able to assess the fact that Lee was suffering from epilepsy, several cultural barriers reared themselves to interfere with the treatment stage of the medical model. The Lees did not understand many of the specifications for adminstering the medication for Lia, and fostered an innate distrust of Westerners and Westernized medicine in general. Between their not understanding what to do and their distrust of doing so any way, Lia was never given what the doctors thought would be the proper treatment for her condition until she was taken from her parents.

For the most part, Lia's parents utilized the human services model system of help. This system considers the sick individual within the context of the surrounding world and universe around him or her. There is a great deal of emphasis placed on the environment, as well as on the need for balance within and without the individual. As such, it is noteworthy to mention that Lia's parents viewed her epileptic condition as one in which her soul had fled and was communing with forces outside of the physical and empirical world of substance. Therefore, their primary means of treatment was to deal with Lia's soul in this ethereal sort of way by utilizing conventional practices and rituals that were endemic to Laos. Additionally, because of this view of Lia's condition that was decidedly at variance with the conventional westernized view of epilepsy, Lia's parents did not necessarily view her condition as a problem initially.

Still, the help they administered considered Lia's problem in a holistic way which was in accordance with the surrounding environment. Therefore, they utilized herbs that grew outside of their home to attempt to effect natural treatments from the world around them. Many of the practices that they employed might be considered by westerners as superstition. However, they also purchased herbs from Thailand and placed them around lia in an attempt to cure her. They eventually changed her name as well, believing that doing so would somehow influence or shift her identity. Essnetially, they tried to cure Lia by focusing on external forces around her, which is in alignment with the human service model.

If I was the human services professional that was assigned to work with the Lees instead of Jeanine Hilt, I would have to explain some very basic information to them. However, in order to make this explanation, I might have to enlist the service of a translator. Certainly there are some non-profits or other sort of assistive organizations that could procure the services of a translator. Additionally, it might be necessary to ensure a translation of the medicine and the procedures that were needed to treat Lia -- the Westernized way -- on an ongoing basis in order to use these methods and curatives. Still, in my initial encounter with these people (which would be accompanied by a translator), I would convey the fact that I was cognizant of the fact that there are tremendous cultural differences between the family and their Westernized surroundings, and that I respected the family's culture and its traditions pertaining to medicine and to life in general.

However, I would also emphasize the fact that Lia was exceedingly ill, and that she had a condition which existed throughout history and which had produced a crippling effect on a number of people. I would stress the severity of this condition. But then I would also express to the family that there had been advancements in medication and in preventative treatment that made it possible to live a long and healthy life with epilepsy. In doing so, I would reinforce the idea that neither the family nor Lia had to suffer. Then I would present the family with a choice: they could either attempt to treat Lia on their own with their conventional methods, or they could fully ascribe to the westernized method of treating her. Doing both would not be an option. In helping them to make up their minds about this, I would remind them that if their methods had been effective, they would not have tried to seek external help for Lia in the first place.

Taking this approach would manifest my own core values related to employment as a human services worker. I believe that respect and empathy is key for this position. These two values are the motivation behind my prefacing the aforementioned conversation with the Lee's by telling them how much I value their own heritage -- regardless of the fact that it is at variance with Westernized culture. I believe that this sort of reassurance could help them to get over some of their hesitancy regarding the medical community and treatment practices in the United States. Additionally, there is part of my own cultural background that is at variance with that of conventional Westernized culture. I believe that this fact would assist me in dealing with other people who are not necessarily of European ancestry.