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The Spirit Catches You and You Fall Down by Anne Fadiman

April 10, 2012

I’m taking Bioethics this semester just for fun and this was one of the books on the syllabus. It is the first book I purchased using the awesome IndieBound app on my Kindle.

This book is so crazily interesting. I had seen it at the bookstore many times – I think there is something about the cover that people remember because whenever I talk about this book people inevitably talk about its design, whether they have read it or not. The title – The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures – pretty much sums it up.

During the Vietnam War, the US recruited the Hmong to fight a “secret war” in Laos, promising them that they would be taken care of after the war. When the war did end, the Hmong found themselves without a homeland and they were moved to a series of camps and settlements. The US eventually tried to make good on their promise and many Hmong came to Merced, California as refugees. The Lee family was among them.

Fadiman does an amazing job of detailing the culture clash the Hmong would have felt after leaving a farming life in Laos and arriving in tenement housing in an American city. When their daughter Lia is just a few months old and begins seizing, the Lees bring her to Merced Hospital. She is finally diagnosed as epileptic, but language barriers, cultural differences, misunderstandings, and distrust rapidly deteriorate the situation. Fadiman gives the reader both sides of the story, interviewing doctors who cared for Lia as well as Lia’s family, and tries to offer an understanding of what went wrong and what could have been done to make Lia’s medical journey better.

I had never thought much before about informed consent and how it relates to patient health in the US, but this book (and the bioethics class as a whole) have made me consider it. It’s a fascinating topic that I think most people don’t really think about, but reading this book will change the way you look at medical care, treatment, consent, and culture.

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