Rating: 
Summary: Culture versus Medicine
Review: Subject: Your Amazon.com Order
From: orders@amazon.com
This is much more than a book about Lia Lee, a Hmong girl born with
epilepsy in Merced, California in the early 1980s to a family of
refugees. It is also the story of the Hmong culture and the
difficulties encountered when its members try to navigate the medical
system with a seriously ill child. This is a tragedy without anyone to
blame--a story of ordinary people trying to do the right thing, about
cross-cultural misunderstanding resulting in disaster.The title of
the book comes from the words the Hmong use to describe epilepsy--they
believe that a spirit grabs someone causing the person to fall
down. Needless to say, the medical personnel trying to deal with this
kind of belief system, frequently without interpreters, were often at
a loss as to what to do. Reading this book, I realized the
monumental task involved in teaching Hmong refugees, who hold many
animistic beliefs, about our culture and technology. These were people
with only an average of 1.6 years of education in their native
country. (Vietnamese refugees had an average of 12.4 years of
education before coming to the U.S.). Compared to other Merced County
residents, 18% of whom were receiving public assistance, 79% of the
Hmong were on assistance when this book was written, putting
tremendous strain on the county resources. The Hmong had to be
taught some of the most basic things, such as do not use the toilet
water to wash food; the refrigerator door needs to be closed; fires
cannot be built in the middle of a floor; ask before taking a
neighbor's fruits, flowers, or vegetables. Fadiman said that, 17
years later, the Hmong used American appliances but still spoke only
Hmong, celebrated only Hmong holidays, and knew far more about current
events in Laos and Thailand than they did about what was going on in
the United States. Unlike European immigrants who had come here to be
assimilated, the Hmong had come here because they were resisting
assimilation at home--they actually came here to preserve their Hmong
ethnicity. In the case of Lia Lee, cultural interpreters, not just
translators, were needed in order to have both the Americans and the
Hmong understand each others' cultures. Lacking this service, the
medical personnel in Merced, were unable to work within the Hmong
belief system. Our western medicine focuses on life, while the Hmong
believe that the sould is of equal- or more -importance. The mind-body
dichotomy does not exist in their culture. They see natural and
supernatural healing as "complimentary rather than
contradictory". I learned so much from reading this book, and
would heartily recommend it to others. I did not give it five stars
because it got a little bogged down and repetitive, at times, in
giving the Hmong background.
Rating:
Summary: The invisible wall
Review: First of all, I have experienced similar frustrations myself, in dealing with patients of other cultures. Despite professional interpreters, it seems that there is an inpenetrable wall between members of some inmigrant cultures and US healthcare providers.
This book narrates one such conflict, between the parents and family of a little Hmong girl, affected by severe epilepsy, and the doctors and nurses at a teaching hospital in Mercer, California.
Sometimes without interpreters, sometimes with interpreters, the failure to "get through" to the family frustrated the chronically overworked residents of Mercer Hospital. The failure of the doctors and staff of Mercer Hospital to understand and agree with the family frustrated in turn the family of the little girl. Every single interaction between the two cultures, Hmong family on one side, and American medical establishment on the other, is interpreted by each side in the worst possible light.
There is a sense of inpending tragedy in the narrative, and as it is intertwined with the story of the Hmong people, and their exodus from Laos, one family's tragedy is inextricably merged with the tragedy of a people.
I learned from this book, but, unfortunately, I am not optimistic that I can communicate better with people with such different world views.
A must read by any member of the health professions that deals with non-European minorities. (And who doesn't nowadays?)
Rating:
Summary: Fascinating and frustrating
Review: Anne Fadiman manages to tell both sides of an extremely complicated story in this book, that of the struggle between a traditional Hmong family with a sick child and the scientific outlook of American medical doctors. The author deftly points out shortcomings of both sides (as well as the validity of both), particularly focusing on the communication problem between the two. She reserves ultimate judgment for the "real" culprit: unwillingness to understand the "other", something all too common in society.
Additionally, it is a fascinating account of Hmong culture, something I knew nothing about before reading this book. The accounts of Hmong immigrants and their culture reveal a unique and miraculously intact "lump" in the much-discussed "melting pot" of America.
Finally, reading this book made me painfully aware, as a white American, of my own personal biases and "truths" that I sometimes take for granted as universal. As globalization becomes the norm, this book is invaluable.
Rating: 
Summary: When culture and medicine collide
Review: Anne Fadiman's "The Spirit Catches You and You Fall Down" is an engaging read that describes the trials of a Hmong family dealing with their daughter's illness, the American doctors who try to help her, and their cultural collisions. Fadiman uses a Hmong storytelling tool, "speaking of all kinds of things," to provide a rich account of Lia Lee incorporating history, mythology and folklore, anthropology, psychology, politics, and more to give the readers a greater understanding of the culture of Lia and her family and how they came to America. Her narrative is not only culturally sensitive (to both the Hmong and the Western doctors) but also fair. It is impressive in its depth and noble in its efforts to advocate "cultural brokering" in medicine. Fadiman's writing style is informative, compassionate, and very thought-provoking. This book is a must read for anyone interested in culture and medicine and is an important work, especially in a world where cultures meet and often collide.
Rating:
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.
Rating:
Summary: The need for empathy
Review: As a student looking to go to medical school, I found this book to be an eye opening experience. It really points out the need for empathy for other cultures, languages and religions in the medical establishment. Although I know I am more open minded than most pre-med students, I think that anyone who reads this book can develop an appreciation for culture and religion as it relates to health and healing. It is a great read and I recommend it for all pre-med students.
Rating:
Summary: Sometimes Prejudice Isn't Evil, Only Ignorant
Review: I may be too optimistic, but I've grown to believe that bigotry isn't always practiced by bad people, but often by good people ignorant of cultures other than their own. This was certainly the situation in the case that Anne Fadiman writes about. People from two cultures, each believing they are correct, clash and a small child gets caught in the middle. Prejudice begins to break down in the light of true communication. Unfortunately for this child, true communcation was too big of a hurdle to cross. Fortunately for the reader, we can learn from reading about this experience. This book will touch your heart and open your mind. The lessons learned within its pages will stay with you. This book is worth purchasing.
Rating: 
Summary: Hmong American reader here
Review: This book is a must read. It is thought provoking, educational and hard to describe. I kept wanting to place judgement on the doctors, then I wanted to place judgement on The Hmong families, when really there was no judgement to be placed. This book is about cultural issues that impacts many lives. I liked the fact that Anne Fadiman didn't seem to have an agenda, she told the facts as they happened and as she saw it, without her own prejudices. With so much prejudice in our society I think this book might help us each be a little more tolerant.
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