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Summary and Analysis of 'The Spirit Catches You and You Fall Down'

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In the world of modern health care system, hospitals, clinics are filled with professional doctors, professors, nurses who has many medical experiences. Therefore, is a good thing but there are always two sides of the story. Perhaps, because we depend too much on pharmaceutical medicine that we forget about traditional medicine. When I mentioned traditional medicine, this is just one point to support my idea which is we focuses too much on how to cure, how to do treatment but we forget to heal patient’s spirit too. Let’s take “The spirit catches you and you fall down” story as example for the essay. 

This story has a strong condemnation on this modern medical and reveal the hard, sad truth about this matter. It involves a Hmong family which named is Lee Family. It has Foua Lee is the wife and Nao Kao is the husband. Lia – the daughter is the poor main character who appeared to had epilepsy in this story and it burden me when I read this book. Because of the ignorance of the doctor and nurse and the lack of communication between the family lead to unhappy result. The first thing I noticed here is that because Lia’s parents is follows Hmong culture and it basically their life depends on their ancestor’s instructions. They have a strong spirit mind and cherishes their tradition. They have a tradition that they consider that Lia’s epilepsy is an illness honor and Lia’s soul is a special soul, and it so special that anyone who has epilepsy ae respected as txiv neebs. I admire and appreciate their tradition but however, their knowledge is sort of behind our contemporary tradition and they should learn more. They also avoid blood take – out to check the blood sample and perform surgery which considers to them as absurd. They believe mind and body are viewed as one so they would not take any chance to let anybody cut their body. The moment Lia and her parents spend her time in MCMC when she was a little girl, the hospital and the family already feel the language barriers among them and this is the part that I think the hospital done absolutely wrong. When an individual pays their money and their health insurance to any clinic or hospital, they expect the positive and genuine attitude from the opposite side. I can understand for American physician at that time because the student failed to received education about cross- cultural empathy and communication so they didn’t realize Hmong’s culture and doesn’t know any information to accommodate it. Neil and Peggy are the doctors who take responsible for Lia’s cases and in fact, they are both professional doctors and always give high quality treatment and give back a positive result. Nevertheless, these two doctors are too stubborn insensitive about Lee’s family belief.

The first thing I believe doctor should comprehend is being cultural sensitivity plus cultural knowledge and cultural resources to finally understand Culturally Congruent Care. Lee’s family culture doesn’t come from nowhere, it passed from generation to generation so it included their beliefs, values, perceptions, expectations, attitudes and assumptions. Accordingly, Lee’s family tradition builds on age, life style, class, ethnicity, gender, religion. It consists of many religious things and as doctors, has the responsibility to conceive that knowledge. Culturally Congruent Care are so important to providers due to their skills are being showed and it can enhance their healthcare practice. Additionally, the healthcare consumers will also aware of significance of how culturally congruent care can strengthen your health and boots up your healing.

From I learned from the courses, there are three modes to bridging the gap between providers and clients: cultural care validation/preservation which support providers to find values, practices and beliefs of the client to perceived the knowledge of client’s culture. Figure out what important to them will help providers to set out their mutual goal between consumers and providers. In this case, Neil and Peggy should hired a translator, take a research about Hmong culture, take note and discuss what they can provide and what the family should take into consideration. They should plan out a treatment that ensure Lee’s family anxiety, but also help to cure Lia’s illness. Cultural care accommodation/negotiation is about one’s culture to adapt and negotiate to come with beneficial outcomes for both sides. Accommodation here is that allowing Lee’s family to participate in the treatment and carefully explained to them what procedure Lia has to endure. Lee’s family used to lay on the floor with their mat so the staffs can remove the bed, and provide them a spacious room for them to stay in, increase family’s time. Especially, when Lia had to MCMC in Hmong New Year, the hospital should plan out a festive for Lee’s family to celebrate during their New Year’s Eve. They should be more considerate and stop giving her medication during that day based on their family request. Cultural Care Negotiation support the power of balance in healthcare provider – client relationship by letting the client know that their view and opinion are taking seriously. The doctor should build trust because due to what I felt, their relationship was on the edge of collapsed. Trust and respect are essentials fundamental step to build up the relationship. Introduce hem therapies that can help Lee’s family to apprehend, suggest them various of plans and choices for them to choose. Prioritize their opinion, show consideration and make them to feel that their idea is priorities. Cultural care Reframing/Repatterning is mostly on the patient side. Reframing is the opportunities for client to see things differently and change their behaviors and attitude towards it. Repatterning is trying to change their action to do things differently in order of better viewing of diverse outcomes. When providers try their best to change their ways of operation, consumers should take all possible strategies into thinking and try the new things. In this case, Lia’s parents should learn about Western medicine and see what it can do to help their daughter. It’s nothing harmful is they do more research about the Western ways. They need to understand that Lia’s illness is not an illness honor and it will not do any good for their daughter, stop using suitable medication will make their daughter weaker or maybe lead to paralyzed. Afterwards, due to conflicts, Lia become quadriplegic make only trembling, movement. However, after time to time, the gap between Lee’s family and the doctors getting smaller and they finally understand each other, they share knowledge and love. Lia’s epilepsy even got deceased, all the infections and she was able to move but she still have brain damaged which last for life.

Looking back, I feel regret all of the choices, acts and words didn’t get along from the start to minimized the brain damaged of Lia. She would have been live longer with little illness in her body, she would have lived a happier life if the communication barriers got fixed from the start. This story sends a message to anyone who work with somebody from another ethnic background, it’s that there are a lot of alternative ways to operate if everyone takes a step back, think and act more carefully. The situation will get better if the providers and consumer took their research and being more sensitive to other traditions. The four communication skills which are Thinking, Listening, non – verbal and Thinking should be prioritized. Another point is that, people around the globe should understand equality reminds humanity remember to be kind to each of any person in this planet, each individual has different personality and ethnic so not everyone the same and we should all have respect towards that. Diversity is more than welcome. Cultural differences should be embrace. Generalizations is a stupidity idea and understand that familiarity equals competence.


  • BOOKRAGS(n.a), The Spirit Catches You and You Fall Down – Preface Summary & Analysis – Anne Fadiman. Retrieved from:
  • Bradley. G, Cultural Care Framework. Week 3, Barriers of Competence. Retrieved from:
  • Strivastava. Rani.H( 1960), The healthcare professional’s guide to clinical competence. Retrieved from:

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Summary and Analysis of ‘The Spirit Catches You and You Fall Down’. (2023, February 11). GradesFixer. Retrieved March 26, 2023, from
“Summary and Analysis of ‘The Spirit Catches You and You Fall Down’.” GradesFixer, 11 Feb. 2023,
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