A. Fadiman’s “The Spirit Catches You and You Fall”

Anne Fadiman, in her book The Spirit, Catches You and You Fall Down, tells the story of a child whom doctors and nurses treated from convulsions. The book revealed the conflict between the child’s parents and the health care specialists of a medical institution in the United States. This writing evidenced the emergence of strong misunderstanding that resulted from the prevalence of a cultural conflict, which emphasized the need to consider cultural features in the treatment of a patient.

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The child was the victim of misunderstanding and was sent to a foster family even though the girl’s parents believed that they were acting in her best interests when not following the recommendations of the doctors. This book describes the devastating consequences of an inability to establish a dialogue between cultures, even when both parties believed they were doing the best they could. The book by Anne Fadiman disclosed that it is necessary to appreciate the diversity, take into account the dynamic behavior of relationships of people from different cultures, and to be able to adapt to the cultural diversity.

One of the main reasons for the cultural dissonance that took place in the story was connected to the lack of knowledge by the hospital staff about the culture and beliefs of the Hmong people. The Hmong from Laos arrived in the US after the Fall of Saigon, which they supported, as well as the Americans, did (Fadiman 1998, 138).

The attempts by the US government to resettle them in the country have not been successful, and in a short period, they moved independently and started to live in small ethnic communities. The Hmong people strongly believe in spirits, and these beliefs directly affect their perceptions of health. When in a hospital in California, the American physicians needed to furnish care to the little girl from a family of Hmong (Lia Lee), they failed to do so for several reasons. The girl suffered from epilepsy, but her parents perceived it as the manifestation of the fact that their daughter was possessed, which was not regarded as something dangerous in the culture of these people (Fadiman 1998, 28).

On the contrary, Lee’s parents hoped that the presence of the spirit in the child would allow their daughter to become a healer in the future. Thus, the cultural differences in the views of doctors and patient family proved insurmountable, since none of the parties was able to communicate and reach an agreement. Moreover, the attempts to hospitalize the girl was perceived as a violent separation of the girl from her parents, and Hmong regarded the distressing diagnosis, which was determined by the doctors, as a magical curse. As a result, little Lia did not receive the appropriate treatment and fell into a coma.

Further, the book provided another perspective on cross-cultural communication, which is the execution of power in case of ineffective interaction. The staff of the hospital did not provide a translator who could enable health care specialists to communicate with the family more effectively. Therefore, the language barrier did not allow the family to express their concerns and share their attitude to the proposed treatment. The nursing personnel made rather unethical remarks about the communication barrier with the Lees but executed their power over the final decision-making.

They did not provide sufficient and understandable information about the proposed care plan and medications; consequently, they did not ensure that the parents of the girl were knowledgeable about the course of treatment and its possible implications (Fadiman 1998, 90). This was a sign of their authoritative power in the case of miscommunication. As discussed earlier, the parents believed that the seizures their daughter had were not a worrying signal but the inability to discuss it with the medical staff of MCMC resulted in their reluctance to give the prescribed medication to the girl, which was an essential condition for the girl’s recovery.

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Therefore, it would be reasonable to wonder whether it was the parents’ fault solely that their daughter was given to the foster family and did not receive the necessary treatment. The parents were anxious about the reactions of the girl when she was on medication and decided to stop the treatment (Fadiman 1998, 58). Nevertheless, they were deeply concerned because her condition was deteriorating, but their religious beliefs persuaded them to do so. Consequently, it was the MCMC’s fault that they were unable to accommodate the family correctly.

Apart from that, when being unaware of the Hmong’s culture, the doctors did not know that their religion required a holistic approach to healthcare and some of the practices required by the American health care setting were inappropriate for these people. For instance, their culture stated that not only the body of an individual should be cured but the soul as well. The book stated that according to their religion, “to treat the body without treating the soul was an act of patent folly” (Fadiman 1998, 33).

Also, the family believed it was not appropriate to conduct x-rays and take blood tests or get naked in front of a health care specialist. Thus, the parents were at the crossroads because the condition of their daughter was explained by their culture as a possession by a Shaman, though, they saw their child was feeling unwell, but the practices required by the doctors were alien to them. Moreover, the culture of the family implied a belief in xiv neebs (Fadiman 1998, 4).

Despite their effort to communicate this belief to the medical staff, they were unable to do so as the language barrier and miscommunication have worsened the situation. However, if the nursing personnel were more open-minded and tolerant, they would have been able to explain to the parents that the idea of the presence of the need in a child was erroneous and was highly dangerous for the child. Consequently, the specialists of MCMC did not put enough effort to overcome the cultural and communicational gap to provide the best of care to the patient. Nevertheless, technically they did everything that was required of them.

In conclusion, the number of immigrants from different countries and cultures has significantly increased over the past 30-40 years, and the story of Lia evidenced the necessity of effective cross-cultural communication. In this connection, the doctors, as well as workers of other areas, have to deal with people who have different cultural values and specific backgrounds. In big cities, which are centers of intense intercultural contacts, health care specialists are required to be culturally competent. Researches undertaken by medical anthropologists become increasingly important. Thus, cultural competence is a necessity in the globalized world as it implies the preparedness to listen and understand another person.

Reference List

Fadiman, Anne. 1998. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. London: Macmillan.

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"A. Fadiman's "The Spirit Catches You and You Fall"." StudyCorgi, 3 Oct. 2020, studycorgi.com/a-fadimans-the-spirit-catches-you-and-you-fall/.

1. StudyCorgi. "A. Fadiman's "The Spirit Catches You and You Fall"." October 3, 2020. https://studycorgi.com/a-fadimans-the-spirit-catches-you-and-you-fall/.


StudyCorgi. "A. Fadiman's "The Spirit Catches You and You Fall"." October 3, 2020. https://studycorgi.com/a-fadimans-the-spirit-catches-you-and-you-fall/.


StudyCorgi. 2020. "A. Fadiman's "The Spirit Catches You and You Fall"." October 3, 2020. https://studycorgi.com/a-fadimans-the-spirit-catches-you-and-you-fall/.


StudyCorgi. (2020) 'A. Fadiman's "The Spirit Catches You and You Fall"'. 3 October.

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