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Showing 1-10 of 713 reviews(Verified Purchases). See all 1,018 reviews
on July 8, 2007
Anne Fadiman tells the story of little Lia Lee, a Hmong-American child with epilepsy, and weaves together the woof of parental love and biomedical treatment with the warp of Hmong and American cultures. This book brings into focus how extensively cross-cultural transitions impact both the approaching and approached peoples. In an interview in 2001, Fadiman explains what drew her so deeply into this book, "Yes, it is about an epileptic Hmong toddler, but it is also about many other things. . . I started pulling on a slender thread, the thread that was Lia Lee, the small sick child . . . I pulled on the thread and the thread became a string and the string became a rope, and then I tugged really hard on the rope and I discovered that it was attached to the entire universe."

Fadiman alternates chapters about Lia with chapters on the history and culture of the Hmong people. Interwoven in Lia's story is the story of her people. The parallel can be drawn that the spirit catches the Hmong people with wars and threats of assimilation, and in response the Hmong eschew resistance and migrate. Most of Merced's Hmong population came to the U.S.

Lia's parents wanted "a little medicine and a little txib" (p. 110.) While medical care at MCMC was provided at no charge, Lia's family spent large sums on buying amulets, having a tvix neeb perform ceremonies, and sacrificing chickens, pigs, and even a cow. Foua would grow herbs and make special concoctions both for feeding to Lia as well as bathing her. The author was privileged to be present when the family sacrificed a pig in their living room in order to seek her wandering soul and bring it back to Lia.

From the doctors' perspective Neil Ernst said, "I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids' lives" (p. 59.)

The Spirit Catches You and You Fall Down was both thought-provoking and emotionally rewarding. It is recommend for those who enjoy a well-told story, as well as those working in public health fields, interested in cross-cultural transitions, or who have special interest in the Hmong people.

Anne Fadiman discussed Lia Lee with medical anthropologist Arthur Kleinman. His observations brings out the crucial point (p. 260), "You need to understand that as powerful an influence as the culture of the Hmong patient and her family is on this case, the culture of biomedicine is equally powerful. If you can't see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else's culture?"

Where is Lia Lee now? In a Newsweek article in 2005, then 22 year old Lia was still in a persistent vegetative state, still cared for at home by her careful and loving mother.
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on July 28, 2014
This book was recommended extra reading for cultural competence in one of my nursing school textbooks. It is not like you have time to read extra books while you are in nursing school. However the brief review in my textbook captured my attention enough to look it up on Amazon. It is among the most memorable books I have read. The communities of people who fought on the U.S. side in Laos during the Viet Nam war were displaced to the United States. This girl was born within one of these communities with a seizure disorder. The Hmong words for a seizure meant, "The spirit catches you and you fall down." Children with seizure disorders are seen as holy, and elevated to special status in the community. In the U.S., the medical community, in huge contrast, saw this as a grave illness, which pretty much bewildered the family and community of the girl. The author researches the situation from birth through the child being taken out of the home, through deterioration in foster care. I found correlations to my experience as a nurse, even within the local community, where many people distrust the intentions of the medical community, and the people in it who are genuinely trying to help, but often end up doing more harm than good. It is an excellent book for anyone in a caregiving occupation.
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on August 7, 2015
I read this while I was a Master of Public Health student to get a better perspective on working with immigrants and refugees, and it provided a fantastic perspective. There were many barriers to healthcare for non-native speakers that I hadn't considered, and this knowledge was very helpful when I started volunteering with a refugee group.

I'm sure it would also be beneficial for anyone in a social service field (social work, etc).

Beyond the insights it provided, it was a pleasure to read, and was very well written.
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on February 5, 2014
This book shows very clearly, by what was said, just how far our medical understanding and compassion has come since the 1980s.

I felt this book was extremely emotive and there were times when I really felt like shaking the doctors at the time because of what I perceived as an almost deliberate action on their part to make a people of a different culture and belief system to bend and acquiesce to that of the Western world. I found myself sympathising very strongly with Lia and her family, but I also felt for the medical people in spite of their reported behaviour and approach to not only this family, but also to other Hmong families.

This book is a very dense and intense read but is certainly worth the effort made. The afterword left the reader with a sense of hope and joy which was very much needed. It was both a sad and a happy book. Words really don't do it justice. It really needs to be read from cover to cover to be able to appreciate what was going on for all parties. I certainly don't regret reading this book and I would recommend it to adults who have an interest in learning about other people, their culture and beliefs.
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on March 15, 2015
This book is one of the most fulfilling books I have read in a very long time. It centers around the life of a young Hmong child, Lia, and the hardship her and her Hmong family face in the American health system. Their story is told by the prospective of Anne Fadiman, the author, who worked closely with the Lee family to document their struggles in the American healthcare system. Their young daughter, Lia, was diagnosed as having severe epileptic seizures that severely impacted her development and cause strain for her parents and her team of doctors. This book is more than just the story of a family struggling with a sick child. It is a story about how the American healthcare system lacks the education it needs to deal with other cultures traditional health practices. This book will prompt you to think about how the healthcare and healthcare education system can be changed to better suit the needs of all of it's patients, from all walks of life and all unique cultural backgrounds.
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on July 27, 2015
The book is a major accomplishment and it will remain a classic for decades to come. There already are hundreds of very emotional reviews of the book. I would like to stress couple points. The main point of this book is that it stimulates an ongoing debate. The major drawback of the book is that it remains inconclusive and it wears out the reader, perpetually drowning them in detail and data, especially close to the end, when it becomes obvious that so much new data was produced since the original first edition of this book. The amount of data collected and presented in the book is a proof of the author's honorable commitment to the cause. On the other hand, the inability to see at what point the data became too overwhelming for readers indicates that the author somehow cared more about the issue than about the book itself. Everybody should read this book.
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on September 29, 2009
By the time more than two hundred people have reviewed a book and a hundred and seventy people have given it five stars, adding one's own two cents to the mix seems almost beside the point. Yet the significant minority who have written highly negative reviews seem to call out for response. Besides, I happened to love the book and want simply to share that fact.

I knew nothing about the Hmong before reading this book and, from it, learned a lot about their history and traditional culture. I don't think there is any need to fear that readers of this book will imagine all Hmong to be like the ones Fadiman depicts, any more than, if I wrote a book about my Sicilian-immigrant great-grandparents (who probably had more in common with Fadiman's subjects than one might at first suspect) people would think it revealed much about Italian-Americans, or Italians in Italy, today.

This book is "woven" out of two main strands: alternate chapters tell the story of the family whose daughter has major epilepsy, and alternate chapters describe the history and culture of the Hmong. Each strand is brilliantly done and as the book progresses each sheds light on the other.

But there is a class of readers to whom I would recommend this book even if they have no interest in the Hmong, and that is anyone who cares about medicine in general and the state of health care in today's America in particular. I am an articulate, educated native speaker of English and I've had frustrating experiences. When I was seven I was in hospital with severe asthma. I was alone in the room when a nurse came in with what I now know was an intravenous bag, on its large metal rack, with tubes and needles dangling from it. I had never seen IV before and had no idea what this was. I asked the nurse; she said she was going to give me a blood test. She inserted the needle into my arm, wrapped a bandage around it, and walked out of the room. This terrified me: I knew very well that a blood test involves inserting a needle for about one minute. Why did the woman lie? Too busy? Too arrogant or stupid? I am fortunate today to have an excellent doctor but in the past I've had no shortage of this sort of "just obey and don't ask questions" attitude.

Now imagine that I am a relatively uneducated American and I'm in a village in Laos with my child, who suddenly becomes gravely ill. I don't understand a word anyone is saying, but they're bringing my child some strange boiling liquid. Do I pull my child away, refusing to let other people do potentially harmful stuff to her? Or do I trust them because there's at least a chance that it might help her, and doing nothing is the greatest risk at all?

But here is what Mrs. Fadiman's book shockingly reveals: the American doctors were sometimes more wrong than the girl's parents were. At least one of the medicines which her parents refused to give her really did turn out to be harmful to her. When the parents had custody of her and took care of her in their own way she flourished--who knows whether she would still be well now if they had been able to keep her?

Mrs. Fadiman interviews the various doctors extensively. Most of them emerge as fiercely intelligent, thoughtful people who are examining their own mistakes. One of them points out the harmful assumptions behind a lot of the language used--"compliance", for example. It reduces the patient to a child, or the subject of a tyranny, from whom nothing is expected but obedience.

Finally, this book asks us to ponder a difficult political problem. How much freedom should parents have over the raising of their own children? The parents in this book had their child taken away because they were not giving her the medicines prescribed by the doctors. Was this just? It seems to me that the government, in this case, did either too little or too much. If they had taken the child away for good, then perhaps, with consistent application of the prescribed medicines, she would have done well. If they had left her with the parents entirely, then she still might have done well (remember the parents are demonstrated to have been right more than once about their daughter's health on occasions when the doctors were wrong) and at least the parent-child bond would not have been violated as horribly as it in fact was. But the shuttling of the little girl back and forth between her parents and other families was inexcusable.

All in all, a thought-provoking, balanced, and humane book, worth reading by anyone who cares about health, culture, family, folklore, and the human condition.

And by the way, I despise political correctness and although I am living a genuinely "multi-cultural" life, most trendy talk about 'multi-culturalism' makes me run in the opposite direction. This book is a model of how to talk about the clash between two cultures in a way that is neither condescending (on either side) nor superficial or politically-loaded.
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on October 8, 2012
I read Anne Fadiman's The Spirit Catches You and You Fall Down for the first time a decade ago, when it was required reading for an Asian American history class I took in college. It had such a profound effect on me that I decided to revisit it last weekend. I had to purchase it again because I have misplaced my old copy after moving several times since college.

Fadiman's book focuses on the heartbreaking case of Lia Lee, a Hmong-American child with epilepsy, which, according to her parents happens when "the spirit catches you and you fall down." It explores the conflict between Lee's family and the Western medical and social services systems in Merced County, California in the 1980s. While minor aspects of this story seem specific to the 1980s, the story is otherwise a timeless, balanced example of the tragic consequences of cultural misunderstanding.

It was an eye-opening book for me, even though I was not a young child nor was I from a sheltered background when I read it for the first time. A decade later, I relate to this book a little differently from the way I did when I was 20. My sympathy for the Hmong parents versus the Western doctors (and their degree of culpability) has changed over the years, but the book's lessons of cultural sensitivity and personal autonomy are no less important.
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on December 8, 2012
I ordered this book from Amazon because it was a required reading for my Ethics course in Marriage and Family Therapy. I believe our instructor's main objective in having to read this was to learn about culture sensitivity.

Before reading this book I have never heard anything about the Hmong culture. The writer does a good job at getting into the Hmong's way of thinking and how coming over to American can be quite a culture shock.

The book skips around a lot which can be a good or a bad thing depending on the style of reading you like. For example, one chapter will talk about the Hmong culture itself while the next will talk about the specific Hmong family and the chapter after that many jump to something different. This can be good because we are continually being fed information about the Hmong culture while reading the story, however, it may come across confusing to the reader. I personally would have rather seen a few chapters at the beginning explaining the Hmong culture and then delve into the story of Lia Lee and her family without any interrupting chapters.

I would probably give this a five star, however besides the problem mentioned above, i also found this book to be repetitive when it came to describing the Hmong culture. For example, the issue of animal sacrifice comes up countless times throughout which I found unnecessary. It would have been easier just to have a section describing the Hmong's practice of animal sacrifice to give us an understanding and after that only bring it up in the story when it is part of the actual story.

There are many things that can be taken from this book such as culture sensitivity, how even those with good intentions can mess things up, and how shocking it can be to adjust to one culture and then become part of a culture that is entirely different.

The story itself is based on a true story that has apparently had a strong impact on the medical world. For this I give the author much credit. I also give her credit in her sensitivity discussing the topic and how she was able to engage the interest of the reader when telling the story.

I recommend this book for those that will be working with diverse populations whether it be in the medical field, field of psychology, or any other such field.

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on July 23, 2017
insightful. As a future physician assistant I learned a lot about the emotional struggles that cultural differences and language barriers can cause. It opened my mind a little more than it was before.
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