The Spirit Catches You and You Fall Down

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Summary: Journalism vs Literature: a metaphor
Review: Anne Fadiman's well-documented examination of a case of the essential differences in cultural beliefs - medicine of the Western mode, Shamanism of the Eastern mode - and the moment by moment revelation of what tragedy can come in the wake of those blocks between the two makes for a rich experience of soul searching. The Hmongs are a tribe of wandering Asians, literally without a home for centuries, not unlike gypsies, but with a set of values that are based on the spirit world. This report (and I use that term with respect because this book is written as a documentary not a novel) is centered on one family coincidentally transposed to Merced, California where their daughter struggles with epilepsy - a treatable chronic disease in the eyes of well-meaning Western medicine; a natural manifestation of a spirit entering and leaving the human form in the Eastern shamanistic approach. Fadiman relates her case without condemning either mode for the grievous outcome of a brain-dead vegetable and in taking such a courageous stance she allows us to draw our own conclusions about the larger issues of life and death and what makes the universe understandable.

That the book is written without lyrical style or flexible liquid language for this reader keeps it out of the category of great literature. A good reporter she is, a talented stylist she isn't. But the overall effect of the story makes its own indelible case. Recommended reading for medical students and nursing students.....as well as physicians out there who have lost touch with the inexplicable.

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Summary: the spirit catches you and you fall down: a hmong child, her
Review: Ann fadiman has done it. This book is the best book that i have ever read in my spear time. It was so good that it caught my every attention. I love this book so much that i can't stop reading it. This book tells you how everything all begin and how it ends with some sad and happy ending. When i read this book i felt like i was in the story and go with Anne everywhere she goes. This book was so good that i recommend all my teachers to read it and all my friends and relatives. Anne no one has done it better then you. This is a two thumps up book. This is the best book ever. This book also tells you the differents between two cultures and there ways of life.

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Summary: Excellent cultural reading but just OK as a reread
Review: It's not a surprise that this book is required reading for certain courses in med school. You learn not only how the healthcare system works but how it affects a very insular culture that we know virtually nothing about in the US--the Hmong. You won't be bored--Fadiman writes with intense description and skill--and come the last few pages, you are enlightened. In the end, however, it's not a book that you feel you must reread over again. You've basically read a case history/documentary--do you really need to read it once more? Read it, learn something about culture, and then pass it on, or donate it to your local university, where you will make some med students very happy.

In all, a fascinating, well written piece of work that i feel many Americans should read (given the state of ignorance in the US), but it's not necessary as a permanent fixture in your library.

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Summary: Culture versus Medicine
Review: Subject: Your Amazon.com Order From: [e-mail] is much more than a book about Lia Lee, a Hmong girl born withepilepsy in Merced, California in the early 1980s to a family ofrefugees. It is also the story of the Hmong culture and thedifficulties encountered when its members try to navigate the medicalsystem with a seriously ill child. This is a tragedy without anyone toblame--a story of ordinary people trying to do the right thing, aboutcross-cultural misunderstanding resulting in disaster.

The title ofthe book comes from the words the Hmong use to describe epilepsy--theybelieve that a spirit grabs someone causing the person to falldown. Needless to say, the medical personnel trying to deal with thiskind of belief system, frequently without interpreters, were often ata loss as to what to do.

Reading this book, I realized themonumental task involved in teaching Hmong refugees, who hold manyanimistic beliefs, about our culture and technology. These were peoplewith only an average of 1.6 years of education in their nativecountry. (Vietnamese refugees had an average of 12.4 years ofeducation before coming to the U.S.). Compared to other Merced Countyresidents, 18% of whom were receiving public assistance, 79% of theHmong were on assistance when this book was written, puttingtremendous strain on the county resources.

The Hmong had to betaught some of the most basic things, such as do not use the toiletwater to wash food; the refrigerator door needs to be closed; firescannot be built in the middle of a floor; ask before taking aneighbor's fruits, flowers, or vegetables.

Fadiman said that, 17years later, the Hmong used American appliances but still spoke onlyHmong, celebrated only Hmong holidays, and knew far more about currentevents in Laos and Thailand than they did about what was going on inthe United States. Unlike European immigrants who had come here to beassimilated, the Hmong had come here because they were resistingassimilation at home--they actually came here to preserve their Hmongethnicity.

In the case of Lia Lee, cultural interpreters, not justtranslators, were needed in order to have both the Americans and theHmong understand each others' cultures. Lacking this service, themedical personnel in Merced, were unable to work within the Hmongbelief system. Our western medicine focuses on life, while the Hmongbelieve that the sould is of equal- or more -importance. The mind-bodydichotomy does not exist in their culture. They see natural andsupernatural healing as "complimentary rather thancontradictory".

I learned so much from reading this book, andwould heartily recommend it to others. I did not give it five starsbecause it got a little bogged down and repetitive, at times, ingiving the Hmong background.

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Summary: Not only for doctors or those interested in multiculturalism
Review: I knew almost nothing about the Hmong when I started this book. It almost immediately sucked me in, and I couldn't put it down. While I desperately wanted to know what would happen with Lia, I really enjoyed the history/background chapters. I don't think the book would have been nearly as good without them. Those chapters read just as fast the narration of the main story, and I actually found myself wanting more detail about the history of the Hmong. This book opened me up to a whole other world I really didn't know existed, and I felt for everyone in the story. Just about the time you feel yourself taking sides, like thinking "Why didn't the doctors pay more attention to the family?" or "Why couldn't the family manage to give the medicine?", Fadiman shows it just isn't that simple. I would recommend this book to anyone.

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Summary: gripping, informative story of mutual culture shock
Review: A truly gripping story detailing the collision of Western medicine and Hmong culture. You probably know about the Hmong, but in case not, they're mountain tribespeople who fought a shadow war for the CIA in the 70's in Laos, were brought here afterwards, and settled mainly in Merced, CA. They maintain a set of animistic beliefs which most Westerners would dismiss as outlandishly irrational, and the clash between this belief system and the belief system which is implicitly propounded by allopathic Western medicine caused a series of terrible misunderstandings over a span of a few years that culminated in the brain-death of an epileptic Hmong girl. All the dramatis personae in this tragedy, just about everyone involved, was well-meaning and committed. With the very best of intentions, the different _premises_ held by the various parties involved caused events to lurch forward, painfully, towards the grim conclusion. It's a stark reminder of the difficulties that arise when people talk at each other from different frames of reference. These difficulties have hardly been ameliorated by the surface sheen of similarity slapped onto the countries of the world by MTV, McDonald's, Coca-Cola, CNN, Hollywood, etc. Really thought-provoking -- makes you think about what it means to be open-minded, and what it means to be an American. As a bonus, the writing is top-notch, and Fadiman is wonderfully sensitive and non-judgmental of both sides. See Fadiman's other book Ex Libris for more of her excellent writing. Also, those interested in having their perspectives widened by a story such as 'The Spirit Catches You...' might also consider 'Catfish and Mandala' by Andrew X. Pham, which is the story of the author's long personal road to finding Vietnam, his family, and himself.

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Summary: A sensitive exploration of the clash of two cultures
Review: Anne Fadiman's book, The Spirit Catches you and You Fall Down, is an outstanding look at the tragedies that can ensue when two cultures-the Hmong and the medical/biotechnical- that cannot possibly understand each other clash over something as important as a child's life.

Lia Lee, the Hmong baby this story is about, is brought to the emergency room in the clutches of a grand mal seizure. So begins her family's journey through the depths of the American medical system as doctors attempt to cure her disease. While the doctors have diagnosed her, little do they understand that the parents have done the same, believing that she has the disease where the spirit catches you and you fall down, caused when a dab, or evil spirit, scares the soul from a child. Both sides begin a fierce battle, with their own knowledge and with each other, to ensure that Lia's health remains intact. Thus, while the doctors attempt to regulate medication levels; Lia's family attempts spiritual and cultural healing ceremonies.

In order to understand the history that leads to this unique story, Fadiman discusses the role of the Hmong and how the Lee family came to be in Merced, California. She has undertaken thoughtful and in-depth interviews with everyone involved in the story, from Lia's parents to the doctors and social workers involved in the case.

Overall, I think this is a wonderful book and will be enjoyed by anyone with an interest in the conflicts faced by those in our health systems.

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Summary: Fadiman offers culturally sensitive insight into Hmong
Review: The author does an admirable job of exploring not only Hmong culture, but American culture as well. It's a testament to her work that she made me, an American reader, see my own culture with the eyes of an outsider.

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Summary: Different Interpretations
Review: I thought that this was a wonderful book. It opened my eyes to see that there are different ways of interpreting language in many different cultures. Throughout the book, I tried to put myself into the shoes of the doctors and also the family. I don't know what else there was to do. The language barrier was difficult to get around. No one is to blame, everyone did what they thought would be the best for Lia. At points of this book I was frustrated. I kept asking myself the "what if" question. What if they had not given her so much medication? Would that of improved her situation or not? I think that the doctors and the family asked themselves the "what if" question throughout the book. I feel that I gained a lot about culture in this book. Before reading, I never realized how difficult it would be to go to another country that does not speak your language and get medical care. This would be a huge learning experience and a frustrating one for doctors and the family. The family and the doctors always had the same goal throughout the book and that was whatever was best for Lia. The lack of communication and understanding is what stood in the way. I feel that Anne Fadiman did a wonderful job!! I felt for the most part this was a very deep eye-opening book. Some of the parts in the book I felt were slow, but the rest of the book made up for it. I hope that everyone has a chance to read this, especially if you are going to visit another country.

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Summary: The Spirit Catches You and You Fall Down
Review: This is the second time I have read the book The Spirit Catches You and You Fall Down, by Anne Fadiman. This book provided an excellent background to my cross cultural class for a trip we will be taking to Thailand. This book demonstrates many emotional aspects pertaining to life including pain of having a child taken away and the sadness of losing someone dear to you. Through all these emotions, the reader becomes acquainted with the Lee family and experiences both their triumphs and disappointments. As an American, I found myself questioning, the Lee's views on many of the medical issues. And at times I found myself wanting to shake them in order to make them comprehend how important the American medicine is to their child's life. But other times throughout the book I completely sympathize with family and their confusion with the United States system of dealing with things. They came here to experience freedom, but they have less freedom here, then they did at home. Everything they knew and loved has been flipped upside down in this foreign land. They are forced to live on welfare in a country where all of their former views topple. The society in Hmong depends on the elderly, they are the most respected. But when they come to America, the elders must rely on the younger children for they are the ones who can translate this foreign language back into their native tongue. So many things are new and different for them. I thought this book did an excellent job of educating the reader on the culture of the Hmong. The book introduced the different practices of the Hmong as well as demonstrating how they differed with those in the American culture. The separation between the two cultures to understand how lost the Lee family must have felt in a brand new country with a completely new culture. As a student interested in pursuing a medical future, I found this book incredibly interesting and disheartening at the same time. The doctors, although knowing everything about the medical system failed to save Lia's life due to the cultural differences. In my eyes the doctors were perfectly educated in how to treat the disease. But when it came to how to help the patient and the family they were seriously flawed in their skills. It is this lack of knowledge of other cultures and how to deal with people that killed Lia. While the doctors did everything they could to help the Lee's understand the daily medication for Lia, it still must have been hard to understand such a foreign idea. Instead of trying to understand the Hmong culture and ideas of treatment and incorporating them into their own treatment. I really enjoyed reading this book. Anne Fadiman did a good job of keeping the book interesting while still managing to educate the reader about the culture of the Hmong.