¶ … Spirit Catches You and You Fall Down is a book by Anne Fadiman about cross-cultural communications, or lack thereof, in the American health care system. The book is about a child named Lia Lee. Lia Lee was the first in her family to be born in the United States. Her parents are Hmong, which is a hill tribe that was settled mainly in Laos and which helped the American government during the War in Vietnam. The Hmong were displaced and persecuted, and thus afforded refugee status. This book is about how the immigrants spoke no English, had different values toward health care, and were therefore excluded from receiving the quality of care needed. As a result, their daughter was taken away from them and eventually Lia Lee became a vegetable and recently died.
When Lia Lee was an infant, she had her first epileptic seizure. However, doctors misdiagnosed the disease at first. Their misdiagnosis could have been a serious problem. Therefore, the book is also about medical malpractice to a certain degree, although the author focuses more on cultural issues. The Spirit Catches You And You Fall Down is now widely read and appreciated by many health care workers and others who care about cultural concerns.
Epilepsy is called qaug dab peg in the Hmong culture. Qaug dab peg is relatively common and treated as a spiritual condition by the Hmong (p. 21). The title of the book...
21). This is because the disease is related to a bad spirit that steals a person's soul, and the person has a seizure as a result. The author of the book tries to get the readers to understand that the Western model is not the only way of viewing a disease. It is equally as valid to think that the spirit is taken by an evil spirit. However, it is something different altogether to deny a child treatment. The family is shown as being too afraid of the Western medical system to allow their daughter to use surgical procedures. This is why the state took control of the child and put her in foster care. Had the family been able to understand the doctors were trying to help her, the outcome might have been different.
The Lee family did not like knowing their daughter was not being seen by a shaman and was seeing doctors instead. It is remarkable that even though there was a large Hmong community, no one found a translator for the family. Drugs like ampicillin and Dilantin were recommended to control seizures but the family did not want to use these or other drugs to counteract symptoms. Lia Lee's seizures became more frequent and the family could not ignore the problem. After the parents took the child back to the hospital, the health care team tried to do the right thing but it…
