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The Spirit Catches You and You Fall Down (1997)

von Anne Fadiman

MitgliederRezensionenBeliebtheitDurchschnittliche BewertungDiskussionen
4,1901172,156 (4.22)317
When three-month-old Lia Lee arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, cleaved just as strongly to another tradition: that of Western medicine. When Lia Lee entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication. Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness and healing as spiritual matters linked to virtually everything in the universe, while medical community marks a division between body and soul, and concerns itself almost exclusively with the former. Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness, qaug dab peg--the spirit catches you and you fall down--and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.… (mehr)
Kürzlich hinzugefügt vonprivate Bibliothek, Twollaby, AKBouterse, Cai_Tippett, VaniceD, Seagirl207, NancyAK, FortisCookeville, ptarmigan_dreams
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From The Book Jacket :" Lia Lee was born in 1982 to a family of recent Hmong immigrants, and soon developed symptoms of epilepsy. By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance

I knew basically nothing about the Hmong people and their culture before reading this book. The author, a journalist from New York, gave me quite an education.

In the mid 1970s and through the 1980's, The Hmong people began to settle in Merced California. They were refuges of the Laotian Civil War. After the conclusion of the war, Communist forces began to oppress the Hmong, who had fought for the anti-Communist United States side.

The history of the Hmong being persecuted and pushed from one country to the next is sad. They originally came from China in the late 18th Century and spread into the mountains of Laos. Their culture is known for it's rigid, stubborn personalities-however, they are openly loving and accepting, as long as those things flow both ways.

When the Lee family arrived in California their daughter Lia was just a toddler. She was the youngest of their children, and spoiled with love and affection. Lia was afflicted with epilepsy-the Lee's knew this but they considered it a problem with her soul. They believed a dab (a spirit) had stolen Lia's soul and her shaking and falling were a direct result.

The Lee's and the Merced medical community were at odds from the very beginning. The main problem being the lack of reliable interrupters available. No other culture speaks Hmong, and the language is very difficult to translate into English. This left both sides being misinformed and frustrated over Lia's care. As time went on Lia's condition worsened and the relationship between them and the medical community deteriorated beyond repair.

I enjoyed this book, but had to stop at 4 stars. The Author delves into the history of the war(s) in Southeast Asia to the extreme. Although this was informative, it dragged way too much and had me skimming to get back to the story of Lia.

I would recommend this to anyone with interest in culture, medicine and what can happen when the lines of communication are broken. ( )
  JBroda | Sep 24, 2021 |
One of my most favorite books: Pages 250 to 261: The Eight Questions. The original version (of these questions) appeared in Kleinman et al., "Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research. Reading guide included.
1 abstimmen Doranms | Aug 18, 2021 |
I am sad that this book is over. I took my time reading the end of it because I wanted to absorb every bit of information I could. There is so much to every culture that we do not know. I could find parallels between the Hmong and my Native history that I identified strongly with. I want to re-read the book now just to see what I missed the first time. ( )
  Tosta | Jul 5, 2021 |
nonfiction (Hmong culture western medicine in the 1980s) ( )
  reader1009 | Jul 3, 2021 |
As a little girl, Lia Lee, the daughter of Hmong immigrants, made a big impression on those around her. The daughter of Hmong immigrants from Laos, she was her parents' favorite child despite her severe seizure disorder. When Lia has a massive seizure that damages her brain irreparably, she regresses into a chronic vegetative state.

Author Anne Fadiman uses Lia's sad biography to dramatize the cultural clash between "primitive" Hmong values and practices and modern Western medicine. Lia's parents, who were illiterate in all languages, did not comply with their physicians’ directives for several reasons, including their belief that Lia's issues were the result of her soul wandering away to her body. For them it followed that herbs and animal sacrifices have would have greater efficacy than anti-seizure medications. The two belief systems could not be reconciled.

My understanding is that this book is often used to teach cultural sensitivity to students of medicine and other disciplines. The book is at its best when it addresses Lia's medical condition and her family's devotion to her. Unfortunately, chapters devoted to a detailed history of the Hmong and the "Quiet War" in Laos bog the text down. Extraneous details about Lia's physicians' lives also slow down the narrative.

This is an ambitious case study that, in my opinion, did not completely succeed. However, a new edition that would update the statistics and clean up some of the language that has become offensive in the last thirty years (such as "retarded" and "harelip") would be welcome. ( )
  akblanchard | May 14, 2021 |
If tragedy is a conflict of two goods, if it entails the unfolding of deep human tendencies in a cultural context that makes the outcome seem inevitable, if it moves us more than melodrama, then this fine book recounts a poignant tragedy.
hinzugefügt von jlelliott | bearbeitenThe New York Times, Melvin Konner (Oct 19, 1997)
 
Ms. Fadiman tells her story with a novelist's grace, playing the role of cultural broker, comprehending those who do not comprehend each other and perceiving what might have been done or said to make the outcome different.
 
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If Lia Lee had been born in the highlands of Laos, where her parents and twelve of her brothers and sisters were born, her mother would have squatted on the floor of the house that her father had built from ax-hewn planks thatched with bamboo and grass. (Chapter 1 - Birth)
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"Of course, Martin had undergone an equally unseemly metamorphosis himself, from savant to bumbler.  It was as if, by a process of reverse alchemy, each party in this doomed relationship had managed to convert each other's gold into dross."  pg. 223
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When three-month-old Lia Lee arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, cleaved just as strongly to another tradition: that of Western medicine. When Lia Lee entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication. Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness and healing as spiritual matters linked to virtually everything in the universe, while medical community marks a division between body and soul, and concerns itself almost exclusively with the former. Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness, qaug dab peg--the spirit catches you and you fall down--and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.

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