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Hmong Vs American Medicine in the Spirit Catches You and You Fall Down

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The book is said to be without the presence of a “villain”. This is a view that can be refuted based on bias towards a certain culture or group of people. An American could say that Lia’s parents were “villains” because of the way they chose to treat their daughter, and Hmong could argue that the American people were “villains” because of the way they treated them based on their culture. To say that there is a specific villain in the book is based on a view of the characters, but in reality, they were only acting based on their personal beliefs or rules.

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A significant portion of the disagreement in the book came from Lia’s family’s failure to adhere to the regimen given to them by Lia’s doctors. Specifically, their failure to maintain the extreme agenda required in order to keep Lia’s constant seizures under control. Dan Murphy diagnosed Lia on her 3rd visit to the hospital as epilepsy, which was what the parents had already known as The Spirit Catches You and You Fall Down, and described it to them as “an

electrochemical storm inside their daughter’s head that had been stirred up by the misfiring of aberrant brain cells (Fadiman 39 PDF).” Not knowing much about medical terms they didn’t understand which became a problem later down the line when Lia’s life was put in danger because of not following the procedure they were given. This would lead some to believe that Lia’s parents didn’t care enough about Lia to follow her regime and make her better, however, Hmong are known for smothering their children with love and affection. “They felt Lia was kind of an anointed one, as a member of royalty. She was a very special person in their culture…., and so sometimes their thinking was that this was not so much a medical problem as it was a blessing (Fadiman 32 PDF).” Dan says that “Men think it is divine merely because they don’t

understand it (Fadiman 40 PDF).” Although this decision was not intended to put Lia in harm’s way, she was removed from her family’s care and put into foster care. Managing Lia’s countless seizures proved to be far to difficult for her parents to handle with the always-changing schedule, constant prescription changes from Lia’s doctors, and the language barrier between her parents and the doctors. Nonetheless, Lia’s parents chose not to follow even the instructions they did understand to their correct procedure. Lia’s parents disagreed with the doctor’s explanations about the causes and possible fixes to the issues Lia was having. Their culture altered their views on Lia’s condition and prevented them from adhering to them. In the Hmong culture, Lia’s condition was seen to have spiritual roots, and because of this, Lia’s parents believed that their own decided dosings would suffice for Lia’s condition, mixing both modern medicines along with spiritual healing. Without the full understanding of the Hmong culture and the Lee’s position as Lia’s parents, these things could lead to the idea that Lia’s parents did not care for her and were the “villains” of the book.

Neil, Lia’s doctor, found no joy in the thought of prosecuting Lia’s parents, however, he believed that Lia was in true danger while under the care of her parents. According to Dan Murphy, “Neil must have been just desperate to do something like that,” he said. “That’s the first time I’ve ever heard of a child being taken away from good caretakers. You know, it’s usually somebody who is willfully harming their child, either through extreme neglect or through actually doing them damage…. (Fadiman 93 PDF).” In the eyes of doctors, complying is shown through the action of following the given instructions. A patient is only able to abide by instructions that they fully understand. If a doctor is not sure that a patient or caretaker fully understand the instructions they are given, it can be assumed they are not going to abide by them. In Lia’s case, being Hmong, their culture is revolved around spiritual healing. When the Lee’s were given the instructions of how much medicine to give Lia, because of their culture, they chose to believe that the doctors were prescribing too much medicine, and a mixture of both modern medicine and spiritual healing was the answer to Lia’s condition. Lia’s father, Nao Kao, stated “With Lia it was good to do a little medicine and a little neeb, but not too much medicine because the medicine cuts the neeb’s effect. If we did a little of each she didn’t get sick as much, but the doctors wouldn’t let us give just a little medicine because they didn’t understand about the soul (Fadiman 113 PDF).” In the eyes of the Hmong, Lia’s family specifically, the American doctors do not understand their beliefs and because of this, they don’t treat them as they would like to be treated. They believe that American doctors don’t respect their beliefs and because of this, there is mass confusion in cases with Hmong patients which leads to confrontations.

To say that there is the presence of a “villain” in The Spirit Catches You and You Fall Down is wrong. One who believes there is a “villain” in the book is biased towards one view, whether it be siding with the Hmong or American views. Some can argue that the Lee’s were the villains because they didn’t take proper care of their daughter, and the other side says that the Americans were the “villains” for taking Lia away from her family and not attempting to understand and adapt to Hmong culture better, however, these views are shadowed with bias, and there in reality are no villains in the book.               

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