The Spirit Catches You and You Fall Down

The Spirit Catches You and You Fall Down

After our discussion about traditional remedies and the role of religion in patient health, I thought of The Spirit Catches You and You Fall Down, as a too good of an example to let pass. First the book tells the story of Lia, a Hmong infant diagnosed with epilepsy. The collision of Lia's Hmong culture and her doctors Western biomedicine culture leads to Lia being placed under medical foster care after her parents do not comply with the doctor's requests.

At the center of the book, there are many issues. First, is the role of religious traditions and if it applies to a minor. Lia's parents did not want to comply with some of the western medicine because they preferred to try their cultural remedies first, saying they needed to restore her spirit.Plus in the Hmong culture, children with epilepsy are seen as sacred beings. The problem was deciding if religious beliefs applied to a minor, especially if that minor is not old enough to state their position. How do we know that the minor will adhere to the cultural and religious beliefs? This was a problem that the doctors faced. They were interested in the health of Lia but her parents opposed the western biomedicine approach. Currently in California, the law grants the freedom for parents to practice spiritual treatment for a child through prayer as along as it is in accordance with an accredited practitioner and it cannot allow to continue or cause any serious physical harm. If the spiritual treatment cannot be applied successfully with satisfying results and the parents refuse any other medical treatment, the law gives doctors the right to intervene and place the minor under medical foster care. The state acts in the welfare of the child because the minor is the most vulnerable since the child cannot define their religious stance.

Another issue, was the lack of a cultural barterer between the American doctors and the Hmong parents. The doctors, even though they had the best intentions were not educated to the customs of the Hmong culture. Anne Fadiman, the author, writes "Neil and Peggy were dimly aware of some of these remedies( or example when Lia had marks on her chest from coin rubbing), but they never asked them about them and they certainly never recommended them." The need of a cultural barterer was very much needed to build comprehension between the two cultures. In the book, Fadiman interviews Arthur Kleinman who suggests a return to a whole doctor. Doctors should not only concentrate on the science of their art but also on the humanity. It is essential for doctors to know more about their patients because it is the only way to offer optimal care.