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The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (FSG Classics) Paperback – April 24, 2012
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“Superb, informal cultural anthropology--eye-opening, readable, utterly engaging.” ―Carole Horn, The Washington Post Book World
“This is a book that should be deeply disturbing to anyone who has given so much as a moment's thought to the state of American medicine. But it is much more . . . People are presented as [Fadiman] saw them, in their humility and their frailty--and their nobility.” ―Sherwin B. Nuland, The New Republic
“The Spirit Catches You and You Fall Down changed how doctors see themselves and how they see their patients. Anne Fadiman celebrates the complexity and the individuality of the human interactions that make up the practice of medicine while simultaneously pointing out directions for change and breaking readers' hearts with the tragedies of cultural displacement, medical limitations, and futile good intentions.” ―Perri Klass, M.D., author of A Not Entirely Benign Procedure
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Anne Fadiman’s book is really engaging and just draws the reader in. Although “The Spirit Catches You and You Fall Down” touches on so sensitive subjects, Anne Fadiman manages to illustrate the cultural differences so starkly that I ended up feeling sympathetic to both the western medical community that was trying to treat Lia Lee as well as Lia’s family and her community. It’s written far more like a dialogue between author and reader than a narrative.
I work as a nurse I often think of this book when I watch a new mom stuff cotton in her ears, put a towel over her head before going outside, reject the hospital food in favor of broth and chicken brought in by family, or politely remind me over and over “No ice in the water please!”. I honestly think this book should be required reading for doctors, nurses, social workers, foster parents, etc.
The culture expressed by the Hmong people is vastly different from that of Western culture, and even most Eastern culture and neighboring Asian countries. For example, there is a passage in the book that explains common gestures and social interactions that are considered inappropriate to the Hmong: “Doctors could also appear disrespectful if they tried to maintain friendly eye contact (which was considered invasive), touched the head of an adult without permission (grossly insulting), or beckoned with a crooked finger (appropriate only for animals). It was important to never to compliment a baby’s beauty out loud, lest a dab (an evil spirit) overhear and be unable to resist snatching its soul
The Hmong community in Merced, California are in desperate need of translators. Not only language translators, but more importantly, cultural translators. They need cultural liaisons to not only guide them through western culture, but to educate westerners about their culture. One thing I thought was very poignant, was a quote by a psychologist at Merced Community Outreach Services, by the name of Sukey Walker. She found a way to interact and communicate with the Hmong that was better than any of her American counterparts. She detailed one of her keys to success : “I have one rule. Before I do anything, I ask ‘Is it Okay?’”
This is a very real book. It is very heartbreaking, and very true to life. There was no happy ending or easy solution to the problems in this book. However, there is a certain amount of optimism expressed here, and it made me very hopeful and eager to see these cultural barriers deconstructed.