Kara's Reviews > The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

The Spirit Catches You and You Fall Down by Anne Fadiman
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's review
Oct 25, 08

bookshelves: nonfiction, book-club
Read in October, 2008

This book is a nonfiction look at the Hmong people, a Laotian ethnic group many of whom have come to the U.S. as refugees in the decades after they supported the U.S. against the communists in Laos, and the roots and impacts of the cultural misunderstandings that have inevitably arisen between the Hmong and America. A book club favorite, I believe (which is, of course, why I read it).

It alternates between chapters covering cultural history of the Hmong and chapters that focus on the case study of an epileptic Hmong child. The case study looks at how the differences between her parents' and her American doctors' perceptions of her illness and their inability to communicate with each other (both linguistically and culturally) led to imperfect management of her illness, her traumatic removal from her family, and ultimately her brain death. Sad story.

Fadiman raises a lot of questions about the role your cultural beliefs should be able to play in your medical treatment. Are we free to choose, or are we compelled to choose the way of the medical establishment? After the recent study that showed the large percentage of doctors who routinely give placebos, I wonder whether a the treatment prescribed by a person's spiritual beliefs wouldn't be at least as effective.
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