The Spirit Catches You and You Fall Down by Anne Fadiman

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The third chapter reveals that Lias parents have already diagnosed her disease as the spirit catches you and you fall down. They were convinced that it was because of the soul loss during the seizures. They would certainly be surprised to hear that it was a common neurological disorder caused by an electrochemical storm inside Lias brain. The difficulties that were provoked by the language barrier lead to the serious misunderstanding. Knowing the exact symptoms of their daughters illness, the Lees were unable to tell about them. However, the inability to express themselves in English is not a serious problem for the Hmong. Their beliefs played an important role in Lias illness. They considered that medications are fine but Lia will not be able to recover without special amulets, animal sacrifices, chants and the help of a shaman. They wanted to create a balance between traditional medicine and spiritual beliefs of their society. The conclusion of this story is tragic because Lia had a septic shock that led to the persistent vegetative state. Nevertheless, the Lees family had a clear concept of their daughters illness. Their love and care helped her to extend her life while well-trained doctors saw the only method how to cure her and after several feeble attempts released her to die at home. Despite their professional care, Lia had the worst outcome of her illness.

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All in all, on the one hand, the author tell the story of the most basic cultural conflict when the immigrants are seen as aliens in the society that is new for them and this fact stimulates them to struggle for their rights, dignity and the desire to preserve their customs and traditions. While the new society estimates the immigrants as the danger, they try to make their own way in this new world, remaining certain cultural values. On the other hand, this struggle is only a part of the major conflict. Lias disease reveals that there is also more significant confrontation. It is the collision with the Western medical culture that has its own language and traditions.

Actually, the disease of this Hmong girl caused a clash between two oppositions: the rationalism of Western medical service and the spiritualism that embraces every issue of the Hmongs culture. Medical language focuses only on different scientific terms that help doctors to diagnose people but this language excludes the notion that is extremely important to the Hmong. The author of the book supports the idea that the language barrier is not a huge problem while the confrontation between rationalism and spiritualism can lead to much more significant consequences that result in misunderstanding between two cultures.

Another important question that this book raises is the necessity of appropriate cultural competence within the members of medical service. Providers should pay attention to the patients health beliefs and foresee the potential influence of culture on the assistance they should receive. Doctors should try to apprehend correctly how patients understand their illness and suggest possible ways of treatment that coincide with their cultural beliefs. The example of the Lees family shows that they do not simply struggle with the USA medical system but also defend and uphold the principles of their culture that seemed strange and unusual for Western people but rather effective for Lias health.

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