The Spirit Catches You and You Fall Down

nett Paper The tactile property Catches You and You F wholly Down By Anne Fadiman Meghan Mal oney 26 April 2013 To make the struggles that the Hmong people face living in America it is important to meet where they come from and what they obligate gone through. The majority of the Hmong people originate from the cragged country of Laos. The mountains created isolation from the neighboring cultures and cultivated a clan identity. They were incision of a society where everyone moveed to cash in ones chipsher and lived off the land. They excessively putd spontaneous tradition since they could non read or write any language.Unfortunately, in the 1960s Laos became the battlefield for the Vietnam War. The land was destroyed and the Hmong were forced to move or fight. Many evacuated while many were trained and armed by the U. S. as a secret guerrilla army. During this quantify of war, the Hmong lost all self-sufficiency, and became unfree on the U. S. for food as well as surviv al. An exodus of Hmong from Laos to Thailand was the close of many. The Hmong were hunted and forced to leave everything cornerstone. The clan identity was left behind as well for it was everyman for himself. Those that were lucky enough to make it to Thailand were faced with assimilation.The Hmong truism assimilation as an insult and a threat to their culture. In smart set to resist oppression, the Hmong took the United States promise of land and presidential term support, and moved to America. Still resisting assimilation in the U. S. , the Hmong were faced with culture shock. sensation of the biggest differences between Hmong culture and American culture is the practice of medicine. Anne Fadiman in The Spirit Catches You and You Fall Down tells this clangour as the story of Lia Lee and her American doctors. Lia Lee is a Hmong child that was born in the U. S. n July 19, 1982, after her parents, Foua and Nao Kao Lee, moved to America. She was delivered at a hospital in Merced , California they appearance Americans think is normal-on a metal table, scissors to snip the placenta, washing the mollycoddle with soap, and putting the baby in a heated box. Normal accouchement for the Hmong would be the mother pulling the baby appear herself in quiet on the dirt floor of their hut and then burying the placenta chthonian the ho theatrical role. The Hmong believe that when you die your soul will come back to get your placenta. When Lia was three months old, her sister, Yer, slammed the front doorstep in her face.Moments later Lias eye rolled up, her arms flailed over her head, and she fainted. Lias parents believe that the noise of the door had been so f sort outening that her soul fled her body and became lost. The resulting symptoms are recognized as Quag water tap Peg, The spirit catches you and you fall have. Having Quag Dab Peg gives the mortal the power to perceive things others can non see, and is a prerequisite for the expedition into the realm o f the unseen. Quag Dab Peg is considered an honor and blessing in Hmong culture. It allows the person the opportunity of becoming a txiv neeb, or spirit healer.It also confers an enormous amount of social status in the community because the txiv neeb is seen as a person of high moral character since the spirit chose them. In Hmong culture, saving face is of high importance. Foua and Nao Kao Lee brought Lia to Merced Community Medical confirm-to doe with (MCMC) after she had 20 of what Americans call raptures. At eons, the Lees believed that Lias epilepsy wasnt as much of a medical problem as a gift. The Hmong believed in shamanistic animism, which asserts that malevolent spirits are constantly seeking military personnel souls, especially those of vulnerable or unlove children.Their hope was that if the spirits refractory to keep hold of Lia, that long-term she would sustain a tvix neeb, and if she did not become a tvix neeb, then their hope was that the sickness would be short -term. The American doctors in MCMC run across the Hmong as problematic diligents and were not empathetic with the traditional Hmong spiritednessstyles. Because in that location are no interpreters, communication is always an issue, they bring lots of family members with them as well as animals, and they make loud noises. When Foua and Nao Kao arrived at MCMC Lia had stopped clutch and was coughing.The doctors were forced to as they put it practice veterinary medicine since they couldnt talk with the Lees, and treated Lia for her cough. They diagnosed Lia with early bronchiopneumonia because she exhibited those symptoms. The doctors had no way of knowing that the bronchial congestion was caused by aspiration of saliva or vomit during her seizure without trying to communicate with the Lees. The doctors put a pen and paper in front of the Lees and had them scribble on it. The doctors assumed the Lees would be able to obtain and administer the medications that the paper described in detail.In reality the Lees had no desire what they honourable signed and walked out. This same situation happened a few more(prenominal)(prenominal) times until one time the Lees brought Lia in when she was still seizing and Dr. Dan tater was on shift. Dr. Murphy had some knowledge of the Hmong and could certainly diagnose her with epilepsy. In Hmong-English dictionaries Quad Dab Peg translates to epilepsy. Lees parents and the American doctors both knew what disease she had provided to different cultures it meant different things. As stated above, in Hmong culture it was a privilege and was caused by Lia losing her soul.In American culture, we believe epilepsy is caused by a infrequent malfunction of the brain due to a head injury, tumor, infection, etc. We view it as a disease and that it needs to be taken precaution of by giving the person anticonvulsant drugs since there is no cure. This is just what Dr. Murphy did. Lia was discharged with specific instructions on wh at medications to take, how much of each, and what time of day they were to be taken. Considering Hmong dont have the same time keeping system as Americans, cant read, dont know how to measure medicine, and dont believe in all this medication, Lia did not receive any medication.The Lees believed a txiv neeb could help Lia, so they had one come over and sacrificed a cow for her. It did not help and the American doctors act to see Lia not getting better when her parents kept saving her to MCMC. The American doctors thought that because Lia had no levels of medication in her blood her parents were hangdog of child abuse. If they would have seen how much the Lees loved and cared for Lia at foot they would have known this was not the case. Instead, they got the government involved and took Lia from the Lees and sent her to a harbor home.The Lees welcomed Lia home after a year a dissolve and lots of work with a social worker, Jeanine, whom was very interested in the Hmong and helped with administering the seizure medications. Hmong have many customs and folkways that are contradicted by those of the American mainstream and medical communities for example, upon Lias arrival home her parents sacrificed a cow to propitiate ancestors and cure her illness. They performed traditional Hmong medial practices like coin rubbing, pinching Lia, gave her an herb necklace, and tried changing Lias name so that the spirit would leave her body and not be able to find her.On Nov. 25, 1986 not long after being home, Lia had another(prenominal) seizure episode. After ten minutes had passed, Foua and Nao Kao got in touch with their nephew who could announce enough English to get an ambulance. By calling for an ambulance Lia was given more attention upon arrival in the emergency room, only if it delayed her treatment. Lia continued to seize for ii hours and was barely breathing. A twenty-minute bout of status elipticus is considered life threatening. Lia was transferred to Fresno Intensive Care Unit for Pediatrics.Foua and Nao Kao thought that Lia was being transferred because the doctor at MCMC was going on vacation, but in fact it was because Fresno had a paediatric unit. At Fresno Lia was diagnosed with septic shock, the result of a bacterial invasion of the circulatory system that triggers the failure of one organ after another scratch with the lungs and then moving to the brain. She also developed a condition in which her blood cannot clot. Lias EEG was flat. She had no brain activity left. The doctors resolute to discontinue the anticonvulsants because she was dead to them.The doctors explained that her seizure medicines lowered her immune system responses, which allowed a bacterium to take over and stop brain activity. Foua and Nao Kao were somewhat right the doctors were giving too much medicine and not enough neeb. It is to the highest degree likely though that if the Lees were still in Laos, Lia would have died before she was out of her infancy , from a prolonged bout of untreated status epilepticus. Foua and Nao Kao finally got leave to bring their daughter home as they had been insisting the whole time. Lia went home on Dec. , 1986 as a quadriplegic, spastic, incontinent, incapable of purposeful movement, and in a persistent vegetal state. To Lias parents she went home as their little princess that they loved with all their heart. At home, Lias parents adored her and never left her side. They federal official her teas from powdered roots and herbs, made several pig sacrifices, and bathed and dressed her four-fold times a day. Because of the quality care Lia was receiving, she was stable and her medical check-ups decreased. Lia did not die but did not recover.Examination of this unfortunate story of a clash of two cultures has led to the discovery of what can be done to serve cooperation between cultures. Dr. Arthur Kleinman from Harvard Medical School designed a series of 8 questions to elicit a perseverings explana tory model and alter the understanding of other cultures. The questions include What do you call the problem? why do you think it started when it did? What kind of treatment do you think the patient should receive? What do you fear most about the sickness?If the doctors at MCMC had taken the time to find a translator and sit down with the Lees to ask these questions, Lia might not be in a vegetative state. Other suggestions that could have aided in cooperation between the doctors and patients are pistillate doctors for female patients, involvement of the patients families in all decisions, the use of interpreters who are both bilingual and bicultural, and the practice of conjoint treatment. The doctor employ Western allopathic medicine can cure the disease but the indigenous healer heals the illness. This strategy promotes trust between the cultures.One persons worldviews should not dominate anothers because they feel it is right. We need to crystalize our view of reality is onl y a view, not reality itself. In the U. S. , the medical community rarely has ways to communicate with people of cultures so radically different from mainstream American culture even a genuine translator will find it difficult interpreting concepts between the two different cultures world-concepts. Doctors need to be able to transcend culture and practice cultural responsiveness where they listen to patients and respond to them both as members of their cultures and as un-stereotyped individuals.A whole doctor-whole-patient approach is imperative Ask not what disease the person has but rather what person the disease has. I am rejoicing to hear that we have been moving in this direction as an American culture since 1995. Medicine in the U. S has been teaching students to separate emotions from the patient dissociation is part of the job. In the last decade, efforts have been made to fabricate this way of thinking, and realize you are treating another human being not a universifiabl e body. Classes incorporating culture studies are being required as part of medical school and undergraduate school curriculum as well.