The Spirit Catches You and You Fall Down

Home

Why We Are Here

Current News

Job Announcements

How to Become a
CASA Volunteer

Volunteer Training

Giving

Staff and Board

Resources and Links

—Articles
—Book Reviews
—Client Profiles

Thanks to SFCASA Volunteers Alan Burkett and Mary McAllister for recommending one of the finest books I have read in recent years: The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman. Mary wrote: “This is the true story of a Hmong child who was caught in the middle of the American medical system and her culture. Its morale is that one culture cannot judge what’s best for another culture. It is extremely well-written and quite non-judgmental of everyone involved.”

In The Spirit Catches You and You Fall Down, Fadiman investigates the role of all the caregiver — doctors, nurses, social workers, and foster parents — in the treatment of an epileptic child. In particular, Fadiman examines the way in which the medical care system responded to their perceptions that the family was refusing to comply with their orders without sufficient understanding of the meaning of those orders in the context of Hmong language and beliefs. She quotes Dr. Arthur Kleinman of Harvard Medical School:

If you can’t see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else’s culture? (pg. 261)

Fadiman is not recommending that doctors should change their point of view or overlook the observable truth that Western medicine save lives. She only asks that they acknowledge their patients’ realities so that they can work cooperatively in the best interests of the children.

The Spirit Catches You and You Fall Down is far more than a textbook on medical anthropology. It is a personal narrative, a medical investigation, a description of Hmong history and culture, and a great read. This is a book I can’t stop thinking about. It goes on the top of my list for books about Cultural Awareness.

—Libby Colman, Ph.D.