The Spirit Catches You and You Fall Down

nett Paper The liven up Catches You and You F tout ensemble mass By Anne Fadiman Meghan Mal iy 26 April 2013 To understand the struggles that the Hmong pack face living in the States it is important to understand where they come from and what they harbor gone through. The majority of the Hmong people rise from the mountainous country of Laos. The mountains created isolation from the neighbor market-gardenings and cultivated a clan identity. They were interpreter of a society where everyone worked to exhausther and lived make the land. They in any case patternd oral custom duty since they could non read or preserve any language.Unfortunately, in the 1960s Laos became the orbit for the Vietnam War. The land was destroyed and the Hmong were forced to instill or fight. Many evacuated while umpteen were trained and armed by the U. S. as a secret guerrilla army. During this quantify of war, the Hmong lost entirely self-sufficiency, and became dependent on the U. S. for food as well as survival. An exodus of Hmong from Laos to Thailand was the death of many. The Hmong were hunted and forced to leave everything behind. The clan identity was unexpended behind as well for it was everyman for himself. Those that were well-heeled enough to make it to Thailand were faced with assimilation.The Hmong see assimilation as an insult and a threat to their culture. In order to resist oppression, the Hmong took the unit of measuremented States auspicate of land and regimen support, and moved to America. dormant resisting assimilation in the U. S. , the Hmong were faced with culture shock. One of the biggest differences betwixt Hmong culture and Ameri wad culture is the practice of medicine. Anne Fadiman in The Spirit Catches You and You Fall Down tells this clash as the story of Lia sightwind and her Ameri hobo doctors. Lia Lee is a Hmong child that was born in the U. S. n July 19, 1982, after her p arnts, Foua and Nao Kao Lee, moved to America. She was delivered at a hospital in Merced, calcium they way Americans think is normal-on a metallic element table, scissors to snip the placenta, washing the bollocks up with soap, and hurlting the baby in a heated box. Normal childbirth for the Hmong would be the mother pulling the baby away herself in silence on the dirty word floor of their hut and then bury the placenta under the house. The Hmong conceptualize that when you die your consciousness result come back to get your placenta. When Lia was three months old, her sister, Yer, slammed the front door in her face.Moments later Lias eyes turn over up, her arms flailed over her head, and she fainted. Lias p bents think that the noise of the door had been so frigh 10ing that her soul fled her bole and became lost. The resulting symptoms ar recognize as Quag dab Peg, The belief catches you and you fall down. Having Quag Dab Peg gives the person the power to cover things others can non see, and is a prerequisite for th e journey into the earth of the unseen. Quag Dab Peg is considered an keep and blessing in Hmong culture. It allows the person the hazard of becoming a txiv neeb, or warmheartedness healer.It also confers an enormous amount of amicable term in the community because the txiv neeb is seen as a person of high clean-living character since the spirit chose them. In Hmong culture, salve face is of high importance. Foua and Nao Kao Lee brought Lia to Merced corporation health check Center (MCMC) after she had 20 of what Americans call seizures. At measures, the Lees believed that Lias epilepsy wasnt as some(prenominal) of a health check problem as a gift. The Hmong believed in shamanistic animism, which asserts that malevolent spirits are constantly seeking human souls, specially those of vulnerable or unloved children.Their rely was that if the spirits decided to keep keep open of Lia, that long-term she would become a tvix neeb, and if she did not become a tvix neeb, then their intrust was that the disorder would be short-term. The American doctors in MCMC bewitch the Hmong as problematic patients and were not empathetic with the handed-down Hmong lifestyles. Because on that point are no interpreters, communication is al slipway an issue, they deal 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 stop think 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 get laiding that the bronchial over-crowding was caused by aspiration of saliva or vomit during her seizure without trying to take place with the Lees. The doctors put a pen and radical in front of the Lees and had them scribble on it. The doctors assumed the Lees would be able to pervert and administer the medications that the paper described in detail.In reality the Lees had no idea what they on the dot signed and walked out. This same situation happened a few more times until one time the Lees brought Lia in when she was still seizing and Dr. Dan Murphy was on shift. Dr. Murphy had or so 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 moreover to various 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 sporadic malfunction of the brain payable to a head injury, tumor, infection, etc. We view it as a disease and that it requests to be taken care of by giving the person anticonvulsant drugs since there is no cure. This is just what Dr. Murphy did. Lia was execute with specif ic instructions on what medications to take, how ofttimes of each, and what time of day they were to be taken. Considering Hmong wear upont pass water 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 start out 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 continued to see Lia not acquire better when her parents kept bringing her to MCMC. The American doctors thought that because Lia had no levels of medication in her blood her parents were guilty of child abuse. If they would crap seen how much the Lees loved and cared for Lia at position 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 promote dental plate.The Lees welcomed Lia home after a twelvemonth a case 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 examination 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 herbaceous plant necklace, and tried changing Lias differentiate so that the spirit would leave her body and not be able to vex her.On Nov. 25, 1986 not long after cosmos home, Lia had another(prenominal) seizure episode. After ten minutes had passed, Foua and Nao Kao got in touch with their nephew who could chatter enough English to get an ambulance. By calling for an ambulance Lia was given more forethought upon arrival in the emergency room, but it delayed her treatment. Lia continued to seize for ii hours and was barely breathing. A twenty-minute bout of office elipticus is considered life threatening. Lia was transferred to Fresno Intensive Care Unit for Pediatrics.Foua and Nao Kao thought that Lia was cosmos transferred because the doctor at MCMC was going on vacation, but in fact it was because Fresno had a pediatric unit. At Fresno Lia was diagnosed with septic shock, the result of a bacterial invasion of the circulatory system that triggers the mischance of one organ after another starting with the lungs and then pitiable 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 decided to forego the anticonvulsants because she was dead to them.The doctors explained that her seizure medicines lowered her insubordinate system responses, which allowed a bacterium to take over and stop brain activity. Foua and Nao Kao were jolly right the doctors were giving too much medicine and not enough neeb. It is intimately 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 permission to bring their female child home as they had been insisting the building block time. Lia went home on Dec. , 1986 as a quadriplegic, spastic, incontinent, incapable of purposeful movement, and in a persistent vegetative 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 fed her teas from powdered grow and herbs, made several pig sacrifices, and bathed and refined her multiple times a day. Because of the prize care Lia was receiving, she was stable and her medical check-ups decreased. Lia did not die but did not recover.Examination of this ill-omened story of a clash of ii cultures has led to the discovery of what can be done to facilitate cooperation betwixt cultures. Dr. A rthur Kleinman from Harvard Medical School designed a series of eight questions to elicit a patients explanatory model and change 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. another(prenominal) suggestions that could have aided in cooperation in the midst of the doctors and patients are female doctors for female patients, intimacy of the patients families in all decisions, the use of interpreters who are both multilingual and bicultural, and the practice of conjoint treatment. The doctor use Western allopathic medicine can cure the disease but the natal healer heals the illness. This strategy promotes trust between the cultures.One pers ons worldviews should not pretermit anothers because they feel it is right. We need to get ahead our view of reality is completely 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 hitherto a good 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 react to them both as members of their cultures and as un-stereotyped individuals.A unharmed doctor-whole-patient approach is imperative Ask not what disease the person has but alternatively what person the disease has. I am glad 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 disassociation is part of the job. In the last decade, efforts have been made to correct this way of thinking, and realize you are treating another human being not a universifiable body. Classes incorporating culture studies are being required as part of medical crop and undergraduate school curriculum as well.