A review of The Spirit Catches You and You Fall Down by Anne FadimanIn the minds of many of its most fairminded and supportive critics, the greatest challenge faced by Western medicine as it evaluates itself in the fading days of the twentieth century is not one that can be overcome in laboratories of immunology, genetics, or microbiology, or in the thinktanks of health care planners. It must be met at the bedsides of the sick. The challenge is an old one, but the profession has never universally acknowledged its gravity in the modern era, nor has confronting it been treated as a worthy endeavor by those responsible for training young physicians, except perhaps in lip service. Simply stated, the challenge is to respond to a reality whose enormous consequences are too often underestimated or ignored: patients bring to doctors not only their diseases, but also their entire lives, including the cultures and the worldviews of their families' history. American clinical teachers are fond of enjoining their students never to forget that diseases occur in sick people and not only in sick organs--and then they ignore their own injunctions by going ahead and treating those same patients as though they were no more than containers for the pathology.
The Spirit Catches You and You Fall Down
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One of their daughters, Lia Lee, suffers from severe epilepsy, and Fadiman covers the terrible struggles the family endures in dealing with her illness in the American medical system of the s. Much of the provision of care was free, but the cultural barriers were enormous. The Lees fled their village of Houaysouy in Sainyabuli province, Laos after the communists came to power in Between and , the tonnage of bombs dropped on the Plain of Jars alone exceeded the tonnage dropped by American planes in both Europe and the Pacific during World War II… Hmong soldiers died at a rate about ten times as high as that of American soldiers in Vietnam. Just leaving the country was drama enough, and given the struggles refugees face today, it is illuminating to read the fight they faced getting to the United States in the first place.
By Anne Fadiman. It is the tale of an immigrant child whose family went in one generation from traditional tribal life in the war-torn mountains of Laos to a bustling existence in the town of Merced in the fertile San Joaquin Valley of California. This was a historic transition, and this child's story is in many ways her people's tale in microcosm -- and taken to an extreme. It is a tale of culture clashes, fear and grief in the face of change, parental love, her doctors' sense of duty, and misperceptions compounded daily until they became colossal misunderstandings. It has no heroes or villains, but it has an abundance of innocent suffering, and it most certainly does have a moral. At the age of three months, Lia Lee had an epileptic seizure.
Thank you! Fadiman, a columnist for Civilization and the new editor of the American Scholar, met the Lees, a Hmong refugee family in Merced, Calif. - In the standard scenario of cultural collision, a Western rationalist -- a missionary doctor, say, or an explorer -- travels far away to a society of strange customs and tries to convert it to a different system of belief, with results that are sometimes comic, sometimes tragic.