The Spirit Catches You and You Fall Down
The book, “The Spirit Catches You and You Fall Down”, by Ann Fadiman is novel about a Hmong child, Lia Lee, her family, and western medicine. This book explores the very different lives of the Hmong culture in contrast to the western culture, specifically the Hmong shaman medicine and the western medicine. It is also a window into the grayer area of child abuse. The book is written in such a way that the reader is able to view the problems from every point of view and empathize with each character.
Lia was the first child in her family to be born outside of Laos, she is the thirteenth child and at the beginning of the book she is the youngest. Her birth was very different from the type of births her other siblings experienced, for example her mother didn’t deliver her by herself, she was assisted in the MCMC hospital by the staff and doctors. The placenta was not kept and buried like it traditionaly was done in Laos but instead the hospital burned it. To the Lee’s Lia was a beautiful and perfect child. She was spoiled from the very beginning, showered with affection like most Hmong children are; yet when her older sister Yer slammed a door in their apartment three months after Lia’s birth all the more did Lia become the center of her parents’ attentions. Lia started having seizures that very day, diagnosed by her parents as a soul disease, but later diagnosed by Doctor Neil as epilepsy. The Hmong viewed such diseases with pride and concern, they revered it in its spiritual qualities, as given to their shamans.
This contrasting view in Lia’s diseases would lead both the medical staff at MCMC and her family down a very rough and unnecessary road. The Hmong usually distrust western medicine due to how it is perceived by the people. They don’t understand the idea of giving blood or surgery; all they embrace from western medicine usually are the needle and prescription drugs. The Lee’s are no different, when Lia was first taken into the ER she was administered drugs for pneumonia and not the epilepsy she had fallen into, the second time allowed doctors to see that she indeed had a form of epilepsy and they began her on a therapy drug. Over the course of 3 years Lia was administered a cocktail of drugs that were essentially being properly handled by her parents. The doctors began to see a decline in her developmental capabilities and came to the conclusion it was because her parents were not giving her the right dosage or drug for ailment. Other factors played into this as well, the fact that the Lee’s liked their child to be obese as a sign of health in their culture but detrimental to her according to her doctors.
Doctor Neil and his wife finally came to the conclusion that they needed to fix this problem that they needed to report the Lee’s to child services. Though Neil could not shake the thought that his lack of care in the beginning could have been what brought Lia to the state she was headed. The husband and wife team still went through and reported the Lee’s, resulting in the placement of Lia in the Korda’s care, which given the circumstances and the parties involved may have been the best for Lia. The Korda’s took genuine interest in the care for Lia and even took interest in her family, allowing weekly visits and befriending the family. The Korda’s took extra care to educate her parents on her drug regimen and to try and understand them. Both families found a common ground in the care for Lia.
The author was also introduced to the family and gained much information on the situation with Lia but also about Hmong culture. Foua, Lia’s mother, wanted to explain what Hmong culture was and how different it was from America, she did so in hopes that Fidamen’s book would reach the medical professionals and others involved with immigrants of Hmong background.
I can understand the doctor’s frustrations but also the frustrations on the family’s part. I don’t know all that much about the Hmong culture besides what is presented in this book, but from what I have gained it is a culture that is firmly centered on the relationship between the spirit and the body and how the two work together. The Hmong are so intent on the medical practices here in America because of central medicine plays in their daily lives in their own culture.
If I had one of Lia’s siblings in my classroom and they talked about the problems they were facing at home I would probably report it, due to how little the children would be able to tell me about the situation and how accurate the accounts were. To some extent the situation would be distorted and only lead to me think that the abuse was caused by something else. Yet the parents are not typical abusers and this situation like many others in this scene are not black and white cases of abuse. One could argue neglect but the neglect was due ignorance and non-compliance, as well incompetency on the medical staffs part. But I think that by giving this situation over to the Korda’s care that Lia’s life was given a better outcome than the one she was inevitably headed. She was given a better chance at life and also able to retain a relationship with her parents. Her parents were also able to gain friends in this terrible situation and better understand Lia’s needs. This whole case could have been avoided in certain aspects and yet Lia was saved to an extent. Both her loving parents and people who knew about her condition and how to appropriately care for her.
This sort of problem will always have a lot of “what if’s” and unresolved tensions on all parties. These situations of abuse are harder to label as abuse because of how much gray area is present. I don’t think there is an easy answer, but I think there is a better response from every person involved.
Ms. Smith 