The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

This is not a self-published book of an indie author

After reading Euphoria by Lily King, I was in the mood to read more books along anthropological lines. King's book is a poignant novel loosely based on the life of real-life anthropologist Margaret Mead. This book, on the other hand, is completely nonfiction. In these pages, Anne Fadiman writes about her investigation into a story she had heard tell of regarding the clash between a Hmong family in California and their daughter's American doctors.

THE BLURB:

Lia Lee was born in 1981 to a family of recent Hmong immigrants, and soon developed symptoms of epilepsy. By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, overmedication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty--and their nobility."

MY THOUGHTS:

This book is sad and upsetting in a way, but it highlights such an important topic. It gives perspective on the difficult task of providing medical care to people with differing belief systems. What culturally sensitive healthcare boils down to is this: the ideology of biomedicine and whatever personal ideology the patient holds true must come together to find a solution that both parties consider acceptable. What you assume the ideal outcome should be is not necessarily what the patient came to you seeking, and it is of utmost importance to understand just what it is the patient is asking your help for. The healthcare provider may not consider the end result a total success, but it's small successes that both parties can live with that matter most in these situations.

However, the case of Lia Lee had another complicating factor. Lia was a child when she was being treated for epilepsy; with minors, there is the possibility that well-intentioned parents can be overridden if U.S. authorities believe that their beliefs are not in line with the child's best interest. 

Here is where the subject is so heartrendingly difficult. Lia's parents loved their daughter and wanted what was best for her. Lia's doctors wanted what was best for her. But their ideas of what exactly that entailed were not the same, and after a slew of miscommunication as well as a failure to compromise, tragedy ensued for Lia Lee. No one was happy with the end result. 

Apparently this book has been required reading for some medical schools and such. I think that's a great idea, and it would be wonderful for everyone in the healthcare field to read this book. It will at least help remind practitioners why it is so important to consider cultural factors when dealing with patients, in the interest of trying to avoid unhappy outcomes like the ones seen for the people in this book.

MY RATING:

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