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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 are often referred to as a "Stone Age" people or "low-caste hill tribe. " She's a fantastic storyteller, keeping the reader always wanting more, and at the same time, shows humility and a willingness to engage with difficult issues. Lia becomes a collection of symptoms, not a person with a rich cultural and social history. Last Updated on May 5, 2015, by eNotes Editorial. The Lees insist Lia be sent home to live with them. When America pulled out of Vietnam, a Communist government in Laos persecuted the Hmong, and many fled the country in fear of their lives. Researched in California, her 1997 book, The Spirit Catches You, examines Hmong family with a child with epilepsy, and their cultural, linguistic and medical struggles in America. To refuse to accept the punishment would be a grave insult. What the Hmong historically suffered is devastating to read about. Chapter 11 the spirit catches you and you fall down book. Approximately 150, 000 Hmong fled to Thailand after the war; their prewar population in Laos had been between just 300, 000 to 400, 000. They took Lia to Merced Community Medical Center, a county hospital that just happened to boast a nationally-renowned team of pediatric doctors. Lia lived with the Korda family for ten months, during which time Dee Korda scrupulously followed the complicated drug protocol and became devoted to the difficult but lovable Lia. When I entered "Lia Lee" into Google to see what ultimately happened to her (she died in 2012, at age 30), Google sidebar stated this: "Lia Lee.
By following one Hmong family in California as they struggle to care for their epileptic daughter, we see how difficult it can be to assimilate, especially when there are strong differences in the culture of healing. I was especially interested in this book because I traveled to Laos a couple of years ago, and had the opportunity to visit a Hmong village in the mountains above Luang Prabang. This détente looked good on the surface, but masked an unfixable wound to the relationship between the Lees and their daughter's doctors. Brilliantly reported and beautifully crafted, The Spirit Catches You and You Fall Down explores the clash between the Merced Community Medical Center in California and a refugee family from Laos over the care of Lia Lee, a Hmong child diagnosed with severe epilepsy. One perspective is that of her family, who believed that epilepsy had a spiritual rather than a medical explanation, and who had both practical difficulty (as illiterate, non-English speaking immigrants to the U. ) He also informs them of his own planned vacation beginning that night. The story was gripping, and so was the background (and Fadiman did a great job of interspersing the two so as to build tension, and so that neither aspect of the book ever got boring). Fadiman explores the complicated system of rituals and beliefs that govern traditional Hmong life. Then in 1975 the Hmong found themselves on the wrong side of the argument when the communists took over Laos, and they began to get the hell out of Dodge, to coin a phrase. The Spirit Catches You and You Fall Down - Chapter 11 Summary & Analysis. I don't have the answers but I think it is cruel to expect a person to leave behind all of their cultural beliefs and traditions. The author says, "I was the staggering toll of stress that the Hmong exacted from the people who took care of them, particularly the ones who were young, idealistic, and meticulous" (p. 75). "Once, several years ago, when I romanticized the Hmong more (though admired them less) than I do now, I had a conversation with a Minnesota epidemiologist at a health care conference. Their fears became so visual and vivid for me. As Fadiman makes painfully clear, cultural misunderstanding was the primary culprit in Lia's medical tragedy.
Well, contrary to Western "wisdom" rats are extremely clean animals and these ones, coming from the pet store, they were not carrying disease. The camp was the largest Hmong settlement in history, with over 40, 000 residents at its peak. The Lees at one point acceded that they would be willing to use a combination of therapies both from their culture and their recently adopted culture, but would the physicians have complied to it as well? More than 10, 000 Hmong said no to both choices and fled to Wat Tham Krabok, a Buddhist monastery north of Bangkok. Lia is placed in the care of a foster family. He is clever and resourceful, able to fight and escape rather than be captured or forced into an undesirable situation. At age three months Lia had had her first epileptic seizure—as the Lees put it, "the spirit catches you and you fall down. " The spinal tap they administer is particularly upsetting to Foua and Nao Kao, who believe the procedure will cripple her. The Lees left northwest Laos, spent time in a Thai refugee camp, and eventually ended up in California, where Lia was born. This is the heartbreaking story of Lia, a Hmong girl with epilepsy in Merced. 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. Stream Chapter 11 - The Spirit Catches You and You Fall Down from melloky | Listen online for free on. Again, who was right?
What are the most important aspects of Hmong culture? How does the greatest of all Hmong folktales, the story of how Shee Yee fought with nine evil dab brothers (p. 170), reflect the life and culture of the Hmong? The different levels of engagement the Lee family had with various westerners was particularly telling, and explained a lot about the wildly varying opinions people had formed.
The Hmong see illness aand 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. Transcultural medical care. This is the first of many tragic misunderstandings caused by misinterpretation and colliding realities. Her parents, Nao Kao and Foua, were Hmong refugees from Laos who didn't speak any English. The author gives you some insight into the way she organized her notes (p. 60). Chapter 11 the spirit catches you and you fall down images. But that's not really the point of Fadiman's book: she doesn't condemn anyone, and, in fact, she points out that there isn't anyone person or group who can be blamed for what happened to Lia. Because empirical Cartesian science-based clinically-trialled peer-reviewed Western medicine IS thought to be true, not just one of several possible truths. Could this have been prevented? US doctors believed they were helping Lia, while the Lees thought their treatments were killing her. Compare them to the techniques used when Lia was born (p. 7). Lia has another seizure on the way to VCH. In a shrinking world, this painstakingly researched account of cultural dislocation has a haunting lesson for every healthcare provider.
As the medical establishment increasingly splinters into specialized groups, this book serves as a vivid reminder that the best medicine must always recognize the interconnectedness of culture, family, body, and soul. Nao Kao was generally correct in this case, but the ER would have triaged Lia immediately ahead of any other patients given her situation. Knowing she had worked with the Hmong, I started to lament the insensitivity of Western medicine. However, this time she was so sick that Nao Kao had his nephew who spoke English come over and call 911. One month later, they tried to escape again, along with about four hundred others. The doctors, in turn, can't understand why Lia's parents do not administer her prescribed medications or take the steps they view as necessary to treat Lia's condition. The doctors, the nurses, CPS workers, the Lees. Chapter 11 the spirit catches you and you fall down audiobook. Lia's life, especially her early life, was characterized by significant strife between her parents and the medical system. Others, however, preferred to stay at Ban Vinai. Dr. Maciej Kopacz thanks MCMC in a strangely courteous tone for sending an incredibly challenging patient. After two years in refugee camps, they were able to immigrate to the United States, and, like most Hmong, gravitated to the Central Valley of California. Anne Fadiman addresses a number of difficult topics in her depiction of a Hmong couple's quest to restore the soul to their child. The Hmong and their language and their culture were yet virtually unknown and entirely misunderstood in America at this time while Mia and her family knew only their own culture and language. If I couldn't get a doctor to give me five minutes of uninterrupted time, I can only imagine the experience of an indigent, non-English speaking patient who walks into the hospital with a life experience 180-degrees different from his or her physician.
She graduated in 1975 from Harvard College, where she began her writing career as the undergraduate columnist at Harvard Magazine. I can only say, I wish I could write a book like that one day. There were and are no easy answers, but there always are lessons to be learned, and a lot can be learned from this book. When the war was lost, they had to leave their country or die. Lia Lee's parents immigrated to this country in the early 1980s from Laos. It is heartening to learn that this book is being used in educational settings.
It wasn't that these Hmong hated the communists, but they got the idea that the communists were going to stop them farming in their own Hmong way. Her sympathies lie with the Lees, and perhaps rightly so; yet she isn't quite willing to extend the same empathy or generosity of viewpoint to others she comes across. While a few "privileged" families were airlifted or paid a driver to take them to Thailand, most walked. This book was amazing, on so many levels. She also talks about how it would have been impossible to write now, at least not in the same way. Unable to enter the Laotian forest to find herbs for Lia that will "fix her spirit, " her family becomes resigned to the Merced County emergency system, which has little understanding of Hmong animist traditions. On the other hand, the Lees promised to follow the new plan as prescribed. This is an eye-opening account of multiculturalism, social services, and the medical community. Was any other solution possible in the situation?
As for Foua and Nao Kao, they had little understanding of what was going on. I knew a little about this case, and before I read the book, I was certain I'd feel infuriated with the Hmong family and feel nothing but disrespect for them, and would side with the American side, even though I have my issues with the western medical establishment as well. Fadiman wrote a fascinating and sympathetic story about a culture that couldn't be much farther removed from ours in the West. Believing that the family's failure to comply with his instructions constituted child abuse, Lia's doctor had her placed in foster care. It begins with a toddler, Lia Lee, living in California in the 1980s. The narrative cites a clinical description of Lia's symptoms as "American medicine at its worst and its best. " Happily, one can now also read memoirs by Hmong authors, such as The Latehomecomer, which tracks the experiences recorded in this book closely but from a first-person perspective. Well-meaning health worker: I'm not very interested in what is generally called the truth. A veritable cornucopia of debate, dissention, and gentlemanly disagreement: Vietnam, CIA, Laos, and the debt owed the Hmong; refugee crises and how they are handled; the assimilation of refugees and immigrants; and even end of life decisions. Her medical chart eventually reached five volumes and weighed nearly fourteen pounds, the largest in the history of the hospital.
It's an eye-opener on cross-cultural issues, especially those in the medical field, but also in the religious, as the Hmong don't distinguish between the two. It shouldn't be a binary question of the life or the soul, with the doctor standing in for God.
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