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Cultural / Medical Clashes & A Charming Toddler
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.