The Spirit Catches you and You fall Down is a true story about the life of a young Hmong girl named Lia Lee who came to America with her family in 1980 because of a war in her native country of Laos and it's surrounding nations. The story is told by Anne Fadiman, who spent many years of her life researching both Western medicine and the cultural practices of the Hmongs. This story illustrates a clash between the two, with a frail, sick child in the middle of the battle. It is clear to me that neither the doctors who cared for Lia or her parents and family who dealt with her serious condition since birth, wished Lia harm, and even Fadiman herself stated, following Lia's death, that "both Lia's family and her doctors had the best intentions" (Sacramento Bee website).
The most unfortunate aspect of the story of the Lia and the Lees was the lack of cultural competency of the American doctors. Had they been more culturally aware and understanding of the Lees and their beliefs it may have made their (the Lees') experience less traumatic and stressful. There's a good chance it would have improved Lia's quality of life as well because she would have received consistent treatment for her epilepsy, resulting in less severe long term effects.
The best evidence of applied medical anthropology from this book was the presence of the author, collecting, analyzing and organizing information and putting it into words, in an attempt to educate the public about the dangers of lack of cultural competency. Lia's story is a powerful example of what can go wrong in the medical community when cultural differences in health and disease are not taken into consideration. Translators were available, often English speaking family members (Joralemon, 2010: 28) who were meant to help with communication between practitioners and patients of different cultures, however there were limitations due to concepts and terminology that could not be easily translated.
Overall there was not much effort made by the healthcare providers to communicate with the Lees or try to figure out how to best resolve the obvious problems with providing effective medical care to the Hmongs and other minorities. There were no real efforts made to consider why the Hmongs were so resistant to treatment and why the Hmongs actually considered the treatment more of a crisis than the disease (Joralemon, 2010: 52) or to try and understand their practices and beliefs, as a reason for their resistance. Ideally, an applied medical anthropologist would be hired prior to the Hmongs coming to America and consider what factors of their culture would make medical care in America challenging. They would then help to implement programs within the healthcare community that would best benefit both the Hmongs and the healthcare providers.
The Lees were provided with unlimited access to healthcare because of their socioeconomic status. Because they received public aid, Lia's many trips to the ER and stays in the hospital cost the family nothing, and her care may have cost a total of more than $250,000 (Joralemon, 2010: 254).
Critical medical anthropology was not evident in the book. There was no education of community members to help them recognize and understand differences. Healthcare providers tried to change the mind of the Lees and other Hmong families rather than try to learn about their culture. This lead to serious gaps in communication that impacted Lia's overall care, as well as that of other ethnic group members. Critical medical anthropologists are social activists and there was no support for the Hmong families in the book.
The most unfortunate aspect of the story of the Lia and the Lees was the lack of cultural competency of the American doctors. Had they been more culturally aware and understanding of the Lees and their beliefs it may have made their (the Lees') experience less traumatic and stressful. There's a good chance it would have improved Lia's quality of life as well because she would have received consistent treatment for her epilepsy, resulting in less severe long term effects.
The best evidence of applied medical anthropology from this book was the presence of the author, collecting, analyzing and organizing information and putting it into words, in an attempt to educate the public about the dangers of lack of cultural competency. Lia's story is a powerful example of what can go wrong in the medical community when cultural differences in health and disease are not taken into consideration. Translators were available, often English speaking family members (Joralemon, 2010: 28) who were meant to help with communication between practitioners and patients of different cultures, however there were limitations due to concepts and terminology that could not be easily translated.
Overall there was not much effort made by the healthcare providers to communicate with the Lees or try to figure out how to best resolve the obvious problems with providing effective medical care to the Hmongs and other minorities. There were no real efforts made to consider why the Hmongs were so resistant to treatment and why the Hmongs actually considered the treatment more of a crisis than the disease (Joralemon, 2010: 52) or to try and understand their practices and beliefs, as a reason for their resistance. Ideally, an applied medical anthropologist would be hired prior to the Hmongs coming to America and consider what factors of their culture would make medical care in America challenging. They would then help to implement programs within the healthcare community that would best benefit both the Hmongs and the healthcare providers.
The Lees were provided with unlimited access to healthcare because of their socioeconomic status. Because they received public aid, Lia's many trips to the ER and stays in the hospital cost the family nothing, and her care may have cost a total of more than $250,000 (Joralemon, 2010: 254).
Critical medical anthropology was not evident in the book. There was no education of community members to help them recognize and understand differences. Healthcare providers tried to change the mind of the Lees and other Hmong families rather than try to learn about their culture. This lead to serious gaps in communication that impacted Lia's overall care, as well as that of other ethnic group members. Critical medical anthropologists are social activists and there was no support for the Hmong families in the book.