The Spirit Catches You and You Fall Down

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Summary: A book you will learn from
Review: As a future physician and former tutor of Hmong students, I found this book to be rewarding on many different levels. Readers interested in the changes that take place when two vastly different cultures meet and interact will appreciate the complex story of Lia, her family, and the doctors who tried to help her. Furthermore, readers who are (or will be) health care providers can learn a lot from the experiences detailed in this book. As our society becomes more diverse, it will be helpful to know how to work with people who have different conceptions and expectations about sickness and health than our own. Lastly, Fadiman's excellent prose detailing Hmong history and culture allowed me to more fully appreciate the character of the Hmong people.

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Summary: powerful, a must read for all doctors
Review: this was an amazing book. she has capture the story so well, and you are left to make up your own mind on who's fault it is, if there is any. being a pediatrician, the story hits close to home, but i think it is a must for all provider, especially those who must interact with patients from a culture, that is not your own. a must read, you can finish it in one day, it is that engrosing.

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Summary: Medical workers, students would benefit from reading`Spirit.
Review: If only the American doctors who treated Lia Lee's epilepsy had been able to read Anne Fadiman's "The Spirit Catches You and You Fall Down," the scenario might have been different. If only Lia Lee's parents had capable interpreters or cultural brokers to escort them through teh maze of Western culture and medicine, Lia's sould might still be with her family. "the Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors and the Collision of Two Cultures" is about cultural ambivalence and miscommunication. Fadiman's book details the wreckage when two cultures are fact-to-face, but can't see eye-to-eye. Lia Lee, the infant daughter of Hmong immigrants, arrives in the Merced, Calif., country hospital in an epileptic seizure which her parents attribute to a slammed door, a spirit catching Lia and soul loss. To the doctors, who know little about the Hmong, Lia's seizures are like short circuits in her brain which can be "Fixed" with powerful drugs. But the doctors are unaware that in Hmong culture, Lia's epilepsy, though considered potentially dangerous, makes Lia distinguished and indicates a possible future as a shaman. The Hmong, like many other small indigenous groups, are circular thinkers who see universal connections in all things. The Hmong, unlike Americans, don't split the mind and body. To the linear Cartesian doctors, medical health is not to be bartered with supplications to spirits and animal sacrifices. The book also touches on the colonial politics which have created Hmong and American personality traits. For centuries, the Chinese Communists and other Asian groups have systematically tried to persecute, manipulate and dominate the Hmong. Resistance has ensured Hmong survival. The Hmong challenge to authority frustrates American doctors who aren't used to having their suthority questioned. The Hmong firmly believe that Lia's medical treatments only make her more ill and refuse to give the medications. The doctors retaliate by removing Lia from her parents' home to foster care. In fact the Lees' fears are somewhat justified _ the prescriptions end up damaging Lia beyond repair. One doctor observes, "It felt as if there was this layer of Saran Wrap or something between us, and they were on one side of it and we were on the other side of it. And we were reaching and reaching and we could kind of get into their area, but we couldn't touch them. So we really couldn't accomplish what we were trying to do, which was to take care of Lia." Fadiman aptly notes the story raised questions about what it means to be a good parent and what it means to be a good doctor. Within their knowledge and capabilities, the Lee parents and the Merced doctors did everything the could to save Lia. Fadiman's book illi\ustrates the need for future cross-cultural studies and anthropological investigations which may prevent tragic encounters such as Lia's. Medical workers who treat non-Western patients should definitely read this book. High school students could also benefit from "The Spirit Catches You" because the text allows the reader to step briefly outside American culture and become Hmong.

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Summary: Read this book!
Review: This is one of the best books on healthcare and healthcare ethics that I have read in along time. I plan to use it to begin my university course in Healthcare Ethics.

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Summary: A divine liqueur distilled from a murky cultural clash
Review: I was one of the physicians involved in the care of Lia Lee. I'm referred to in the book as the physician that first diagnosed Lia's spells as seizures. Neil Ernst and Peggy Philp, the principal pediatricians in the book, were and are good friends of mine. Having experienced Lia Lee's saga personally, and then having read the book, I can only refer to Anne Fadiman's talent as astounding. Anne walks an incredibly fine, and very well documented, line as she describes what happens when American medical technology meets up with a deep and ancient Eastern culture. My team (Western medicine) failed Lia. Never have I felt so fairly treated in defeat, and never have I felt so much respect for an author's skillful distillation of a tragically murky confrontation of cultures. Incidentally, the hospital administrator of the hospital I'm currently associated with rated the book "The best book I read in 1997". He reads prodigiously. Dan Murphy, MD

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Summary: Required reading for medical professionals; a benefit to all
Review: "The Spirit" is a most incredible book. I have practiced medicine in Stockton California for 6 years, seeing or hearing from peers about Hmong patients monthly. Until reading this book, I am sorry to admit, I had little empathy for the "strange" cultural difference which make caring for the Hmong so difficult. Fadiman's book opened my eyes, and taught me the beauty of the Hmong people, their heritage, pride, and courage. She tells the story of Lia Lee who is surrounded by a family which, once understood, can only be described as exquisitely nurturing and supportive. Unfortunately, Lia Lee has Epilepsy(the Spirit). Fortunately, she has caring for her Doctors Neil Ernst and Peggy Philp, two of the finests physicians America has ever produced! They are teachers of young physicians, brilliant in book and clinical knowledge, and practice medicine with the ethics of Hippocrates and the empathy of a Priest in confessional. Their motivations are beyond reproach. The result of the clash of cultures, so beautifully presented by the author, becomes humbling to Lia Lee's physicians as well as to the reader. We are left with a new order of priorities, a new perception of right and wrong, a new understanding of the Hmong People. I strongly recommend this book. It should be required reading in all Medical Schools. It is a fine tool for teaching the beauty of America's cultural melting pot. We are made richer by learning about and understanding our neighbors. Anne Fadiman must complimented for this fine work!

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Summary: You couldn't ask for more....
Review: Anne Fadiman does an excellent job of bringing to life the history, culture and belief systems of the Hmong. I live in Merced and know many of the people who comprise the human component of the narrative. Ms. Fadamin's writing flows more like a novel than the tremendous ethnography piece that it is. Her descriptive powers and ability to write good prose give us a novel that roars along like a dime store thriller. It is a book of tremendous substance and educational value. The book's high points are the revelations about the Hmong culture. Western medicine is the vehicle or counterpoint that Ms. Fadiman uses to weave her tale. We all know Western medicine, and this isn't the important part of the story. People make the difference. This is an intensely personal book. It gives you a looking glass into the soul of the Hmong family and community members, the medical prationers, and the author herself. The latter is by no means a criticsm, because the author's deep sense of comittment to the subject and the people in the book is one of its finest features. This is also a book that reflects a great deal of hard work. Anne Fadiman is certainly not lazy. She didn't take any short cuts, and because of that we have the best historical and cultural monograph ever written about the Hmong. The fact that it is a "page turner" and flows like a river is an added benefit.

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Summary: wonderful fish story!
Review: I trained as a resident at the residency program discussed in the book. I had not started the program when the events of the book took place, but I know most of the major characters of the book. It is a difficult subject that is handled well by the author. She does a wonderful job of letting us know about all the people involved, who they are, and where they are coming from. The only criticism is that towards the end, some of the flow seems to be lost. I think this book should be required reading for everyone who works with the Hmong. I wish I had read this when I lived in Merced. I always liked the Hmong, but I never really understood them or respected them adequately until now.

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Summary: This is an exceptional piece of work!!
Review: I don't think I should be writing in here since I am a part of the book. This book was amazing! It took me two days to read it and of course I shed a few tears on the way. My sister, Lia Lee, is doing well although she will never be able to see the bright sunlight or the incredible stars that we see everyday and everynite. She is an incredible child with so much love and affection from her family and the many friends she have encountered during her hardships. I was only 7 when all this happened, but I do recall everything from the door slamming incident to the day the doctors told my family that it was okay for her to come but she will not live pass 7 days. I will never forget that week or those many years of pain my family or the doctors had to go through. This book has given me a better view of what can really happen when two different cultures have their own ways of interpreting medicine or life in general. We must understand that different cultures have different ways of curing a person and doctors have their policy they must follow. To avoid another incident like this, we must work together as a whole and not blame each other for not cooperating with one another. Lets hope this book tells us what can happen in the future if we don't work with this now. Anne did a great job on this book! My family couldn't have ask for more. She has become a great friend of my family and we are greatful for it. Anne-thank you !

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Summary: I liken this to the literary world
Review: Fadiman in a journalistic style of writing captures how different belief systems class in the world of the hmong and American medicine. What strikes me about this book is that it is translatable to the literary world. Madness is a much talked about subject in the genius of writing, but madness is run from by the Literati. The world is different now. As Alexandra Johson and others stated on memoir back in the late 90's, writing is more about having a writer with an agent, that is once was where a writer had a therapist. To wit: madness is perceived as an illness, when it used to be perceived by the writing world as a gift to the creation of art. Now in the writing world where agent matters, you get books like punctuation in Shoots and Leaves rather than about being and what it is like to BE in this day and age. And what's also true about this book and the American Medicine is that the doctor's like the literati are well meaning.