The Spirit Catches You and You Fall Down by Anne Fadiman

The Spirit Catches You and You Fall Down by Anne Fadiman

Three Questions from Questions 1-6

Question One

Traditional Hmong birth practices are unique. Birth occurs in the family home on a clean dirt floor, where the mother delivers the baby herself. The husband may help but must avoid looking at the birthing process. The mother must be silent during labor to avoid hindering the birth, but she may pray to her ancestors. The placenta is buried under the floor, and a soul-calling ceremony (hu plig) is performed to ensure the child’s well-being and connection to ancestral spirits. Nonetheless, in Lia’s case, she was born in a modern hospital, Merced Community Medical Center (MCMC). The delivery involved medical professionals, and no family members were present. The placenta was incinerated, and medical procedures like eye treatment were administered soon after birth (Fadiman, 2007). Hire our assignment writing services if your assignment is devastating you.

Notably, Hmong and American birth practices differ in terms of the birth setting, attendants, and postpartum practices. Unlike American practices, which majorly involve a more formalized medical setting with medical professionals present, Hmong birth takes place at home, with the mother taking an active role in the delivery process. Hmong perform a soul-calling ceremony after the placenta is cut by the father and buried on the floor. Such rituals are absent in American birth practices; the placenta is incinerated, and postpartum practices involve medical procedures to ensure the health of the newborn.

Question Three

Dr. Dan Murphy’s statement means that even though the language barrier was one of the problems when caring for Hmong patients, the cultural barrier was the biggest problem. In Dr. Dan Murphy’s view, because of their differing cultural beliefs, dealing with the Hmong was tremendously different and challenging than dealing with patients from other cultural backgrounds. For instance, Dr. Murphy noted that the Hmong lacked specific anatomical vocabulary due to practices like burying the dead intact, so conveying complex medical ideas when they shared no foundation of anatomical knowledge was extremely challenging.

Question Six

I think Dr. Fife is among the doctors who highly respected patient autonomy. Like Hmong patients wanted, he did not perform episiotomies, avoided cesarean sections, and handed them their babies’ placentas. As such, his strengths include cultural sensitivity and respect for patient preferences. Dr. Fife demonstrated cultural sensitivity through his ability to communicate effectively with the Hmong, possibly by talking more slowly, contributing to his popularity among these patients. He also respected Hmong patients’ preferences by avoiding particular procedures such as cesarean sections, which aligns with their cultural beliefs, an approach that enhances trust and cooperation between doctors and their patients. However, Dr. Fife seems not to be curious about the cultural practices of the Hmong, which might limit his understanding of their cultural beliefs and practices.

Besides Dr. Fife, Dr. Dan Murphy was able to communicate with the Hmong through his interest in and friendship with the Hmong. Dr. Dan understood that the Hmong had differing beliefs, so he invited Hmong leaders to the hospital so that they could share their experiences (Fadiman, 2007). A key takeaway from this is the imperative need for healthcare professionals to familiarize themselves with patients’ cultures that may differ from their own beliefs to ensure they deliver culturally competent and patient-centered care, foster effective communication and understanding, and respect diverse perspectives that can influence care outcomes.

Two Questions from Questions 7-10

Question Seven

Lia’s parents, Foua and Nao Kao faced challenges administering Lia’s medications, partly due to language barriers and not understanding prescriptions. Their decision not to administer medication consistently was highly motivated by the significant drugs’ side effects along with Lia’s adverse reactions to routine immunizations. Cultural beliefs also motivated their skepticism about the effectiveness and safety of the drugs. Foua, the mother, noted that the drugs changed Lia’s spirit and made her face look different (Fadiman, 2007). I sympathize with them because besides struggling to comprehend the complexity of the drugs, Lia’s parents only wanted their daughter to get better and felt that the medications made her worse.

Question Eight

The major reason for removing Lia under the custody of her parents was because of poor parental compliance regarding prescribed medications. However, a better solution would have been to consider the language barrier problem, cultural differences, and the Lees’ concerns about the effectiveness and safety of the prescribed medications. Foua could not even identify some of the drugs. Therefore, the first thing would have been effectively addressing the language and cultural barriers to enhance communication. Second, the medication regimen could have been simplified, for instance, by using visual aids or written instructions in a language the Lees could understand. Third, educating the Lees about the medications and their potential side effects could have improved their understanding and compliance.

Five Questions from Questions 11-21

Question Eleven

The folktale of Shee Yee fighting nine evil dab brothers reflects the Hmong’s cultural beliefs that incorporate elements of the supernatural, magic, and transformation. Mountains, tigers, and dragons, among other natural aspects in the story, showcase the close relationship between the Hmong and nature. Additionally, the mountain crossroads with paths leading to different parts of the earth reflect the Hmong’s life, like their historical migratory patterns and connection to the land.

Question Fourteen

In this context, the Hmong are likened to a “Stone Age” people or a “low-caste hill tribe”, majorly due to their cultural practices and approach to healthcare, like avoiding particular medical interventions. I don’t agree with this assessment because these phrases are derogatory characterization that expresses a perception of the Hmong as backward or primitive. This assessment is also biased and oversimplifies the Hmong people’s practices and beliefs. The author also disagrees with this view, stating that it does not appreciate the richness of the traditional Hmong culture and ignores the significant social, cultural, and economic transformations the Hmong experienced during the Vietnam War (Fadiman, 2007).

Question Seventeen

In the healthcare context, Dr. Murphy’s statement implies that the well-being and treatment outcomes of an individual Hmong patient are closely tied to the perception and trust of the whole Hmong community. Suppose an individual Hmong patient experiences failure or dissatisfaction in medical care. In that case, the patient’s negative perception can extend from the individual and affect the entire community’s trust in the healthcare system. As such, Lia’s case reinforced the Hmong’s negative stereotypes and prejudices about medical professionals.

Question Nineteen

The “fish soup” concept serves as a metaphor that mirrors the intricate and interconnected nature of Hmong culture, history, and identity. It means that truly understanding the Hmong requires looking into various aspects of their lives. The “fish soup” concept is reflected in the book’s structure through the author’s narrative style. Anne Fadiman adopts a storytelling approach that weaves together the diverse aspects of the Hmong, their culture, history, and personal stories. This narrative style reflects the “fish soup” concept, where different ingredients are mixed intricately when preparing fish soup.

Question Twenty

Personally, cultural misunderstandings are to blame for Lia’s tragic case. These misunderstandings resulted from a language barrier and cultural differences between the doctors at MCMC and the Lees. Consequently, this led to misdiagnoses, administration of the wrong medications, and Lia’s parents failing to give Lia her drugs and blaming them for worsening her condition. Therefore, Lia’s tragic case could have been prevented if MCMC had professional interpreters and if the doctors had familiarized themselves with the Hmong culture so as to create a cultural rapport with Lia’s parents, thereby enhancing better communication and trust. Also, such a rapport would have created an opportunity to integrate the Hmong medical practices into Western medicine, potentially leading to better treatment outcomes.

References

Fadiman, A. (2007). The spirit catches you, and you fall down. Farrar Straus & Giroux Inc.

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The Spirit Catches You and You Fall Down by Anne Fadiman

Instructions:
For this assignment, please choose questions to answer from the back of the book.
Choose three questions to answer from questions 1-6, choose two from questions 7-10, and choose five questions to answer from questions 11-21. Your response should be between 3 and 4 typed pages (double-spaced). You’ll be graded on the following criteria:
Questions and Subjects for Discussion (Discussion Board Response Questions; Choose According to Schedule.)
1. What do you think of traditional Hmong birth practices (pp. 3-5)? Compare them to the techniques used when Lia was born (p. 7). How do Hmong and American birth practices differ?
3. Dr. Dan Murphy said, “The language barrier was the most obvious problem, but not the most important. The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference” (p. 91). What does he mean by this?
6. Dr. Roger Fife is liked by the Hmong because, in their words, he “doesn’t cut” (p. 76). However, he is not highly regarded by some of the other doctors. One resident went so far as to say, “He’s a little thick.” What do you think of Dr. Fife? What are his strengths and weaknesses? The author also speaks of other doctors who were able to communicate with the Hmong. How were they able to do so? What might be learned from this?                                                                                                                                                                7. How do you feel about the Lees’ refusal to give Lia her medicine? Can you understand their motivation? Do you sympathize with it?  8. How did you feel when Child Protective Services took Lia away from her parents? Do you believe it was the right decision? Was any other solution possible in the situation?
11. How does the greatest of all Hmong folktales, the story of how Shee Yee fought with nine evil dab brothers 9p. 170), reflect the life and culture of the Hmong?
14. The Hmong are often referred to as a “Stone Age” people or “low-caste hill tribe.” Why is this? Do you agree with this assessment of Hmong culture? Does the author?
17. What does Dan Murphy mean by “When you fail one Hmong patient, you fail the whole community” (p. 253)?
19. The concept of “fish soup” is central to the author’s understanding of the Hmong. What does it mean, and how is it reflected in the structure of the book?                                                                                                                                                                                20. It is clear that many of Lia’s doctors, most notably Neil Ernst and Peggy Philp, were heroic in their efforts to help Lia and that her parents cared for her deeply, yet this arguably preventable tragedy still occurred. Can you think of anything that might have prevented it?