Spirit Faidman, Anne. (1998) the Spirit Catches

Spirit

Faidman, Anne. (1998) The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giroux.

The title of Anne Fadiman's book on the implications of multiculturalism in modern nursing sounds more like a religious testimony than a textual asset to the modern nursing profession. However, Faidman tells a tale of Biblical proportions, and the emotional nature of The Spirit Catches You and You Fall Down is epic in its intensity. Moreover, the title is indeed descriptive, for it encompasses in its scope not simply faith, but also functions as a description of the symptoms of epilepsy that affects the patient at the book's core. The title describes how the parents of the patient viewed the symptoms of their child, in direct contrast to the representations of the modern medical system in America, whom treated this young child of recent immigrants. (Faidman, 1998)

The main theme of Faidman's book is that, for doctors and nurses, simply being medically and technically competent at one's profession is not enough, when healing a patient in general, but particularly a patient from a culture different from one's own and the mainstream of current American cultural life. The epileptic in question, Lia Lee was born in 1981 to a family of Hmong immigrants. Most of the Hmong like Lia Lee's families were refugee families who supported the losing side in Laos, from whence the Lees came during the 1970's.

Spirituality is and was at the core of the lives of most Hmong families, and they have tended to resist efforts to integrate their culture into the community, in comparison to other immigrant groups from Southeast Asia. During no point of the medical treatment of Lia Lee was this spiritual aspect ever taken into consideration or acknowledged as valuable and important in the family's emotional survival under different circumstances. Despite the fact that even in our own community, the need for linguistic translation for recent immigrants is stressed when discussion of medical terminology, no effort was made to translate the culture of Lia Lee into terms comprehensible and relevant and meaningful, spiritually and emotionally as well as linguistically, to the parents of the girl.

A second major theme of the book is that making such an effort to translate the culture of the patient into comprehensible terms, and to translate one's own medical culture and ideas into cultural terms comprehensible to the patient is critical to ensure that the patient receive appropriate care. The Lee girl's pediatricians, Neil Ernst and his wife, Peggy Philip, never saw themselves simply as the product of another tradition, of Western medicine, but of the representations of scientific truth. By viewing the situation not as one of translation but of right and wrong, no communication across cultures was possible.

However, this book is not so culturally relativist that it sees no wrongs and rights in the situation. The third dominant theme of the book is the nature of the injustice done to the young girl by the medical system in the name of modern medicine. When Lia's doctors saw her seizures as problem in her neurology, and prescribed anticonvulsants and her parents called her epileptic affliction "the spirit catches you and you fall down," and made use of animal sacrifices with the best intentions to heal her, neither enough follow-up, medically speaking, was conducted in a culturally sensitive fashion towards the end of her treatment, nor was their any effort made not to scare the Lees by the terminology and technology of modern medicine.