Spirit Catches You and You

¶ … Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman. Specifically, it will discuss the role of ethnocentrism in the book. "Ethnocentrism" is the belief that your culture is "better" or "superior" to other cultures and that cultural standards are universal. It is often the wedge that keeps people from many cultures from blending into a cohesive unit, and in "The Spirit Catches You," it is quite common to see how the Hmong, with their culture of beliefs and superstitions, and American doctors with their medicines and science would clash and never see eye-to-eye.

The Spirit Catches You" is the story of a Hmong family, the Lees, and their young daughter Lia. Lia is diagnosed with epilepsy, which the Hmong call "the spirit catches you and you fall down" disease. The story graphically illustrates two cultures that meet head on - with each one having absolutely no understanding of the other. The Hmong's entire culture is built on a series of beliefs and superstitions that they use nearly everyday to combat illness and appearance. For example, the author notes early in the book, "Although the Hmong believe that illness can be caused by a variety of sources - [...] by far the most common cause of illness is soul loss" (Fadiman 10). Thus, the Hmong use spiritual and holistic approaches to their daughter's health problems because it is all they know. The American doctors, on the other hand, want the Hmong to use American medicines and treatments, and the Hmong have no idea what these treatments are, or how they will benefit their daughter. What happens as the two cultures collide is a comedy of errors and misunderstanding, except that it is not funny, and Lia pays the price in the end.

Lia was diagnosed with epilepsy at only eight months of age, but from the first, her diagnosis was difficult because the Lees spoke no English, and there were no Hmong interpreters at the hospital in Merced, CA, where they lived. Finally, they encountered a doctor, Dan Murphy, who actually understood their needs, and they had a family member accompany them to translate. Murphy kept Lia in the hospital three days, and gave anti-seizure medicine to her parents, and this routine continued throughout her infancy. She would seize, the parents would take her to the hospital, the doctors would prescribe anti-seizure medicines, and the parents would either misunderstand the prescription, or make up their mind it was doing more harm than good, and stop giving the medicine.

The American doctors and social workers who began to treat Lia and then know her well were frustrated with the Lees. They knew the continual seizures were harming Lia and her development, and they were beginning to angry with the family who seemed to think they knew more than the doctors about treating their child's disease. One of the doctors on the case, Peggy Philp said, "I remember wanting to shake the parents so that they would understand'" (Fadiman 56). In fact, her fellow physician and husband, Neil Ernst, and also on the case, sent notices to the Health Department and Child Protective Services about the Lees and their continued lack of understanding and non-compliance with Lia's medicines. The doctors felt not giving Lia her medications was akin to child abuse, and in fact, in early 1985, Lia was removed from her parents and placed in foster care by the state. It is not surprising that the doctors recommended this, for in their minds it was the only way to save Lia from the ignorance of her parents. However, it just made matters worse for everyone concerned.

Lia remained away from her parents for a year. She was re-diagnosed with a rarer form of epilepsy, and her medications were changed to those that even her parents could administer. Throughout the ordeal, the culture clash is so difficult it is hard to read. The Lees do not trust the one Hmong interpreter, and will not allow her in their home. They have little understanding from the medical community, most of who have numerous encounters with Hmong patients, but do not know anything about them, and have not taken the time to learn. Medical training is all about treating patients who understand, there is little training for the patients who are not "normal," and so the medical community is ill prepared to deal with other cultures. The American doctors were saddened by Lia's condition, which deteriorated to a vegetative state after a two-hour long seizure, but they never took the time to understand how to really communicate with the Hmong. Even the social workers did not really know how to communicate with them. Much of the clash of cultures was due to lack of a common language, but even more was due to arrogance and sheer ignorance. The social workers and doctors could not conceive of people who did not read, did not know how to tell time, and could not understand even basic commands, even if they were translated effectively. The Hmong were from a poor, agricultural culture, and things Americans take for granted were unknown to them. It is especially sad that a little girl like Lia was the one who was caught in the middle, and that so many people did not learn anything from her story. Her story proves that two cultures can learn from each other, but they have to want to learn, and many of the people in Merced did not want to learn about the Hmong, they only wanted to blame them when they did not conform to "normal" Western culture.