The Hmong are among the most fascinating people in the world. Their unique cultural experiences and practices make them one of the most intriguing people to study. Hmong interactions with the culture of people in the West can be full of situations where native Hmong values conflict greatly with prevailing Western attitudes. This sample academic essay provided as part of the essay writing services of Ultius focuses on exploring The Spirit Catches You and You Fall Down, a gripping tale of the struggle of Western medicine with the Hmong cultural and medical practices.

The Spirit Catches You and You Fall Down: Hmong Cultural Dissonance

In Anne Fadiman’s The Spirit Catches You and You Fall Down, the author offers a case study of a famous instance of what she terms “cultural dissonance”, or the clash between two widely different cultures with regards to how they act in certain situations and contexts and the complexities various religions can create. The author, Anna Fadiman, is attempting to prove the importance of having medical professionals understand and embrace the viewpoints of other cultures, and to understand that radically different cultural practices at odds with our own may need to be understood instead of attacked in these situations.

Lia’s family did not opt to use treatment for their daughter, and the medical community did not conduct itself well with regards to the acquisition or persuasion of treatment. Instead, this book illustrates the high level of cultural variation that can contribute to the complication of the treatment of medical issues between various cultures.

Synopsis of the book

The book itself tells the story of how a family of Hmong refugees living in California dealt with the experience of having an epileptic daughter named Lia, who suffered from a condition that is seen as a sign of spiritual enlightenment and blessedness. The family, through a mixture of both cultural differences, a linguistic inability to communicate with medical professionals, and the family’s own strongly held personal views regarding appropriate medical treatment, begins to reject mainstream medical opinion regarding epilepsy and instead utilizes traditional Hmong medical techniques.

Their actions created an astute cultural resistance to modern medical practices. Though doctors attempted to impress upon the patient’s family the importance of medical treatment and the administration of anticonvulsants, the aforementioned barriers prevented the proper application of care and, over time, led to more and more violent seizures that eventually resulted in a prolonged attack that caused the then four year old Lia to enter into a persistent vegetative state, a condition in which she would remain until her death at the age of thirty.

The culture of the Hmong people

The Hmong culture has undergone significant strain given the historical legacy of the people. Without a homeland, the Hmong people suffered greatly during the Vietnam War and, as a people, were split between siding with the communists or the American-backed Royal Lao Government. As a subset of the Vietnam War, the “Secret War” in Laos is fundamental to the contemporary way Hmong culture has been shaped (Her & Buley-Meissner, M., 2010). Hmong culture, as evidenced in Fadiman’s text, is a unique collection of religious and social practices that are both unique and alien to mainstream Western society.

The historical struggle for the establishment of a Hmong homeland has played a direct role in the establishment of this unique cultural identity- set against all odds, the Hmong have refused assimilation into their host nation and actively embrace their own unique cultural heritage as a defining characteristic of what makes them their own people. Buley-Meissner and Her (2010) argue that the historical legacy of the Hmong’s constant struggle to retain their own identity in the face of adversity is reflective of the people’s religious and cultural practices.

In essence, the Hmong approach their issue of the “soul searching” of their people as representative of “facing the ghosts and the suffering” that defines their sociocultural beliefs (p. 42). Moreover, being Hmong is seen as a journey, a gathering and accumulation of experiences and emotions over time that bind the collective together. 

Culture vs. science

The primary health issues that the Hmong Lee family experienced consisted of the existence of Lia, the patient, as having been diagnosed with dangerous epilepsy. For the Hmong culture, medical treatment is based primarily on the shoulders of medical shamans, individuals who act in accordance with the wishes and desires of the spirit world. To the Hmong, the spirit world is violent and dangerous and evil spirits constantly attempt to cross over from the spirit world to our own.

In response, certain humans have the ability to momentarily travel between the two realms and have a positive impact on the battle between the evil spirits and good humans. Epileptics, then, have the ability to move between realms, and they thus bear a strong moral and ethical responsibility to make sure that they, as mediators between the two worlds, help as many people as possible.

This condition is called “quag dab peg”, or “the spirit catches you and you fall down”.

Her family, by rejecting American medical assistance out of both ignorance and their own cultural views, oftentimes refused to comply with doctor’s orders regarding the proper application of medicine that would prevent the seizures. Indeed, the actions of medical professions were viewed by the family as “inexplicably sadistic”, given that the doctors were often forced to tie Lia to her bed to prevent her from injuring herself during her more violent fits (p. 43). The seemingly alien nature of Western medical practice in contrast to the shamanistic approach favored by the Hmong put medical professionals and Lia’s parents at odds with regards to how to approach the issue of treatment, a situation that would have greatly benefitted from a religious specialist. 

The cultural disconnect in modern medicine

From the patient’s point of view, it is repeatedly mentioned that Lia would often refuse treatment out of an unwillingness to take medication. In Hmong culture, Western-style medicine is usually only given in cases of clear sickness, in which a single shot or injection cures the affliction relatively quickly. However, in Lia’s case, medicine is only applicable when the actual fits are occurring, or there is a clear and present ailment. As such, Lia’s family often refused to administer the medications at home, or did so haphazardly and not in compliance with doctor’s orders. This, however, is a result of the existence of cultural barriers as well as a simple inability of the parents to understand the complexity of the situation.

This inability stemmed from the fact that Lia’s parents were illiterate, both in Hmong and English, and that even if they could read English, Lia’s medications changed some twenty-three times in less than four years (p. 46).

From Lia’s perspective she, like children her age often do, simply did not like taking medicine. Pills were not fun for her to swallow, and the nurses often were forced to disguise her medicine within other foods. Even then, it was not uncommon for her to try to refuse treatment. 

Conclusion-Perspective is key

The Lee’s reluctance to give Lia her medicine as prescribed is regretful, but understandable from the viewpoint of the family. The motivation of the parents stemmed, first and foremost, out of a desire to protect their daughter from the possible drawbacks of Western-style medical treatment and the need to ensure that Lia would be healthy and able to continue her spiritual journey to help people in need. From the Lee’s perspective, the treatments were oftentimes damaging and at odds with what the Hmong believed medical treatment should consist of with regards to the application of medicine, surgery, and other modern practices.

The unfortunate conflation of medical treatment with sickness in the eyes of the Hmong came as a result of the fact that the antiepileptic drugs given to Lia could, if prescribed improperly or administrated wrongly, result in mood swings, lethargy, and attention deficit/hyperactivitydisorder (Fadiman, 2005).

Indeed, the father of the family eventually became

more and more reluctant to give medications at all because he feels that the medicines are causing the seizures and also the fever (p. 50).

Moreover, Lia, in one instance, injured herself at the hospital with a minor head injury that the parents viewed with distrust and as the fault of the doctors. The Lee family, then, maintained its hesitancy and reluctance with regards to proper treatment through a mixture of cultural ignorance, distrust of the medical professionals and the medical treatments they were offering, and an inability to comprehend exactly what was being done to their daughter in the hospital. Their motivation, however, stemmed ultimately from a core desire to protect their daughter from potential harm at the hands of alien medical practices.