The Spirit Catches You and You Fall Down: The clash of two cultures, a Hmong youngster, and her American doctors Author: Anne Fadiman
The Spirit Catches You and You Fall Down is a book by Anne Fadiman that focuses on the difficulties that result when two cultures collide and their firsthand experience of the Hmong community with the American healthcare system. Fadiman narrates the tale of Lia, a young patient with a chronic illness, her family, her doctors, and the medical system to which they are meant to entrust Lia's life. Other than that Fadiman brings out the social and political beliefs amongst the Hmong and its influence on their relationship with the American medical system. Anne Fadiman finds her inspiration from Lia's story and intends to be the voice of the Hmong community and the American doctors to the world in a bid to get a permanent solution for such other cases that happen all over the world. Fadiman maintains the reader's attention throughout the book due to her precise attention to continuity and pooling together societal themes that reflect the world today.
When Lia’s family moves to America, their lives change in a significant way. The exodus of the many changes begins when Lia is born in a foreign country. What follows throws the Lee family off guard once Lia experiences seizures and the family gives in to the American health system. The health system is governed by some standards referred to as the National Standards for Culturally and Linguistically Appropriate services whose objective is to deals with breaking the barriers of communication and help in improving the quality of health care (Kaakinen, Coehlo, Gedaly, & Hanson, 2015).On considering the (National CLAS standards), the standards are adhered to when a language translator is provided to assist Lia’s parents, and the doctors communicate. The standard adhered above is the standard that requires that language assistance is offered to persons with little or no understanding of English at no cost (Kaakinen, Coehlo, Gedaly, & Hanson, 2015)
Disregard for the National CLAS standards resulted to negative implications on Lia's illness. Some of the possible causes that could have led to her irreversible coma include the language barrier that is deeply existent between the doctors and her parents.Also, language barrier is seen as a possible factor that leads to delayed diagnosis for Lia.it contributes to the many unfruitful visits to the hospital and inaccurate information collected from her parents by the doctors leading to uncertainty amongst them. Furthermore, miscommunication also resulted to Lia getting incorrect dosages for her prescribed medication affecting her recovery. (Fadiman, The Spirit Catches You and You Fall Down: A Hmong child, her American doctors, and the collision of two cultures., 2012)
Our family believes in taking people to the hospital in case of any illness. We believe in the doctors and the medication given. We are well informed on conditions such as Seizure disorders and do not take it as if one has been possessed with the spirits and understand why it should be treated at an early age. On the other hand, the Lees believed Lia was the chosen one that is why they hesitated in taking her to the hospital. They believed the medication made her more ill.
Lia's condition got worse because her parents are too rigid to adapt to the American culture, and the doctors fail to understand the culture of the Hmong community. They change medication without giving any explanations to the parents thus making them lose their trust in the system. They take the child to be government property for some time which makes her parents feel as if their rights are undermined leading to resistance and conflict between the parties. Lia's treatment is interrupted and delays her recovery process. Perhaps, if both cultures had been more accommodative of each other, Lia would have gotten a chance to live past the disorder.
In my opinion, Fadiman manages to collectively bring out some of the challenges that face major Health care systems in the world. The book elevates some emotional aspects when Lia is taken away from her parents and taken to foster care. Through the book, I am disappointed by the doctors. More so because they ought to have been professional since they had the upper hand in understanding the situation and position Lia's parents were in at that moment. From my view of point, the doctors are negligent and lack to practice thoroughness in their duty. I fail to understand how the doctors allow Lia;s parents to administer medication to Lia without first confirming that the parents fully understand how to administer the dosages.
Lia’s parents are not to fully blame for Lia’s fate. In their defense, they have just moved to a different country where the culture is undeniably different .despite the culture shock they are seen to accept to give the American health system a try, but the American doctors make it hard for them to trust the system. I also feel that the medics and social services workers were too hard on the parent. Instead of taking their child away without an explanation they should have tried to reason out with the parents by trying to treat the child from their angle.
. Reading this story, I feel that as a medical student there is need to understand how cultural differences can affect the way a patient is treated. Schools should come up with more case studies so that the students can see the importance of not ignoring these cultural differences. It is also essential for medical students to be taught how to work with interpreters in a situation they needed to understand what is affecting a particular patient. I also feel that the book has alerted me on the consequences of failing to practice professionalism and diligence in my course of work as a nurse to whom patients entrust their lives.
References
Fadiman, A. (2012). The Spirit Catches You and You Fall Down: A Hmong child, her American doctors, and the collision of two cultures. New York.
Kaakinen, J. R., Coehlo, D. P., Gedaly, R., & Hanson, S. M. (2015). Family Health Care Nursing: Theory, Practice, and Research. Philadelphia: F. A Davis Company.
