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Personal Reflection on 'The Spirit Catches You and You Fall Down'

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“The Spirit Catches You and You Fall Down” is a book that talks about issues between two different cultures inside the healthcare field. In “The Spirit Catches You and You Fall Down” essay we will review some issues and conflicts that are depicted in this book. In the story miscommunication leads to several complications of Lia’s health, simply like we read inside our textbook. 

The book begins with the Lee’s forced emigration to America and talks about Lia. She is the youngest of the family and was diagnosed with epilepsy. The flee for a better opportunity and a better life. As the story continues, there were several challenges that both cultures faced to provide the best care for Lia. Lia and her family are Hmong people. Hmong is an ethnic group in East and Southeast Asia. They lived in Southern China, Vietnam, and Laos. The family is religious people, and they have strong cultural beliefs. Western medicine only seen the biomedicine side of the care for Lia needs. There are lots of opportunities for changes and improved care. Looking at the Guidelines for implementing culturally competent care and the Core competencies for an interprofessional collaborative practice will identify some issues and how they can be addressed when caring for different cultures. In the end there is no one side to blame as the lack of understanding of the different cultures and communication played a significant role in Lia’s outcome.

They were super self-sufficient. They did things such as producing their own food. They would make their weapons. They were known for hunting their food. They would catch things like birds, monkeys, pigs, tigers, and more. They would also eat more lean things such as fish. They also gathered fruit, wild vegetables, and honey. Hmong people would rely on one another. Everyone farmed and was close with nature. Foua Yang grew up in the mountains so growing up she probably helped gather food. No one felt better than the next, because most Hmong’s was brought up the same. They all followed traditions, and most were farmers. Related to power is knowledge, and, the some whose knowledge is privileged. The Hmong culture views the western culture as superior.

Doctors attend expensive medical schools to acquire knowledge that their patients did not have. However, Lia’s neurologist did admit that there may have been a medical order which caused Lia to lose her brain function, and that the large doses of medications in her system may have made her more susceptible to the septic shock that caused the brain damage. Furthermore, that the Lees kept Lia alive for 26 more years suggests that their love and care was more powerful than the doctors medicine. The story so asks whether it is in the patient’s best interest to privilege Western knowledge. Lia’s story revealed strength of the family in Hmong culture. Most American families would have committed a daughter with brain damage to some medical institution rather than trying to handle it themselves. Lia’s family cared for her for twenty-six years. They bathed her, kept her dressed well. They even celebrated her birthday each year. I simply wasn’t expecting Lia to be in the vegetative state that she was in. I tried to imagine myself being forced to flee my country out of fear for liberty and life. I left behind all possessions, and experience severe emotional suffering and possible separation from my family. If you settle down in a new location, you will struggle to adjust into a new country as well. The Lee family faced language barriers and an inadequate understanding of the new country’s culture and customs.

While most of us and our families are lucky enough to go to sleep each night not worrying about violence and poverty. In Lia’s case, the language barrier of communication made it difficult for doctors to ask questions like what are some of the symptoms and what is the pain level. The hospital did not have English-Hmong translators or bilingual Hmong employees during that night shift. With this language barrier, Lia’s parents had no way of communicating important information, including any of the details of her seizures or even that she had seizures. Therefore, the doctors originally misdiagnosed her, they saw symptoms related to a bronchial infection instead of her actual diagnosis of epilepsy. During her treatments, varied combinations of drugs were tried to give help to Lia’s seizures. Misunderstandings and cultural barriers prevented Lia from receiving the correct dosages of prescribed medication. This event led to doctor becoming unsure if she was getting the right combinations and amount of her medicine. Part of what makes this, such a tragedy is that everyone that was a part of Lia ‘s life, both her family and the doctors who treated her, had the best intentions. But their perspectives on the causes of and treatments for her illness were so different that strife was inevitable. Most time I would get frustrated at Lia’s parents because they would listen to the doctor’s instructions regarding Lia’s medical condition. They did not see Lia’s illness as a burden but took good care of her. One of the things that I found challenging, is that Anne Fadiman shows the Hmongs as very different from the stereotypical immigrants glad to be in America, the land of freedom and opportunity. Anne made a fair point in this book. The book had a clear picture of the different issues regarding miscommunication and misunderstanding of two different cultures. I enjoyed how her family loved her no matter what. They are used to caring for one another and they value family. Most Americans would go to the doctor for a common cold. But Hmong will try to fight one of the trickiest health conditions.

Overall Lia’s struggle was an example on how disabled children and immigrants intimidated and confused by American Healthcare. Although she never again spoke a word after she turn four years old, Lia taught much of doctors and nurses to care for people with different background and different customs. The challenges that the Lee’s faced, taught us how important family. Understanding each other cultures is very important. I feel like healthcare providers should pay more attention to their immigrant patience. They should make sure they are well taken care of. They should also have a good understanding of the directions provided to them.

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Personal Reflection on ‘The Spirit Catches You and You Fall Down’. (2023, February 11). GradesFixer. Retrieved March 21, 2023, from
“Personal Reflection on ‘The Spirit Catches You and You Fall Down’.” GradesFixer, 11 Feb. 2023,
Personal Reflection on ‘The Spirit Catches You and You Fall Down’. [online]. Available at: <> [Accessed 21 Mar. 2023].
Personal Reflection on ‘The Spirit Catches You and You Fall Down’ [Internet]. GradesFixer. 2023 Feb 11 [cited 2023 Mar 21]. Available from:
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