The Book Caught Me

I just finished reading The Spirit Catches You and You Fall Down by Anne Fadiman, a journalistic investigation of the multicultural conflicts between Western doctors and the family of their Hmong patient, a girl name Lia Lee, who had severe epilepsy (which the Hmong know as "the spirit catches you and you fall down.")  I had first heard of the book when Aunt Banana had read it for nursing school and raved about the insights it provided her.  And then just a few weeks ago, I came across Lia Lee's obituary in the NYTimes.  Thinking it would be both interesting and helpful for my hospice work (specifically the discussion of how a very different culture reacts and interacts with Western medicine), I got a copy and devoured the book in just a few days.

It was everything I hoped and more.  I learned about the history of the Hmong people, from origins in China to cycles of conflict and immigration, most recently with the US war in Laos and escapes to the US.  I learned about Hmong culture--the dedication to family and clan and culture that provides their identity while rejecting assimilation, the animist religion that dominates their worldview and conflicts so with Western understanding of the body and medicine and science.  I gained more insight to Western medical culture, from training to daily experiences (33 hour shifts?!) to ethics and both the efficacy and blindness of rationalist, Cartesian thinking, and how different doctors work with or outside of all of those parameters, including the 8 questions for . . . ..  And I empathized with the parents, faced with the illness of their second-youngest child in a land where they couldn't tell the doctors what was wrong with her and what they could do.

But lastly, I think I gained some insight into my in-laws.  Of course, they are not Hmong or war refugees or animists.  But they are from a different culture, first Chinese, then Thai, first the children of immigrants in Bangkok and now immigrants themselves in the US.  And while they have been here almost 40 years, they are not really of here, nor really want to be. In one section of the book, ethics comes under discussion.  What is ethical?  Were Lia's parents unethical for not complying with doctors' instructions for Lia's treament or were they ethical for staying true to their personal spiritual and communal beliefs?  For them, ethics demanded loyalty to family, clan, and Hmong, not to Western doctors who patronized and even persecuted them (so to speak:  Lia was made a ward of the state for a period of time, at her doctor's insistence).  Weren't they then ethical by their own definition?  And perhaps my in-laws' dedication to their own culture's ethics and beliefs is what keeps them so apart here and causes such confusion/isolation, even with their own American children?  Can we really ever truly bridge such gaps?  Must the immigrating generation, as someone in Fadiman's book notes, always sacrifice their own happiness in the cultural conflict that immigration often creates?  At least, in my family's case, a girl's health and life were not devastated in the breech, which is in itself a Western bias--Lia's family long felt that her illness was in many ways a spiritual gift.

The book about her certainly was.