Sunday, November 4, 2007

Anne Fadiman/THE SPIRIT CATCHES YOU AND YOU FALL DOWN: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

In Merced, a city in Southern California, 1/5 of the population is Hmong refugees (now, their descendents) who were brought to the US in the 1970s and 1980s following the decimation of their people by various factors (let's just say the US was at least indirectly involved). Among these refugee families were the Lees, whose first American-born daughter, Lia, turns out to have a very serious kind of epilepsy, a condition which, in Hmong culture, is not infrequently occuring. An attack is considered to be the spirit leaving the body. In the Hmong language, epilepsy is called "when the spirit catches you and you fall down."

Anne Fadiman uses Lia's story as a tool for introducing the many facets of Hmong-American culture clash in this utterly absorbing book. I have to admit that when a friend lent this to me, my plan was to skim it quickly, say I liked it, and return it--the subject sounded small and not like something I would find particularly interesting. I decided to read the intro in good faith and then found I couldn't put it down. There is so much to know about so many things and Anne Fadiman offers you a really readable, well-informed edge here.

In a nutshell, the root of the problem at the heart of the book is that the Lees see their daughter's ailment as at least in part spiritual; the American doctors see it as purely medical, to be dealt with procedurally. Furthermore, doctor-patient relations are fraught with hardship, misunderstanding, and bitterness because the hospital cannot afford to retain Hmong interpreters and the Lees, who have never had any formal education, do not speak or write English, never mind medical jargonese. But Fadiman goes to impressive lengths to show the many contributing elements of the story--the history of Hmong oppression, the genocides and government sacrifice suffered in Laos, the death marches in Thailand, the limited immigration to America. Then, the challenges of going back to work under a Welfare system that makes it impossible to support your family by working yourself; the prejudices and rumors that arise among resident locals looking for a scapegoat; the perpetuation of stigmas associated with bad luck. The subjective sides of medicine; the protection of patients' rights; the horrors of being an immigrant in America; the challenges of maintaining your people's culture without being marginalized by your new society.

This is a really rich book--it makes you ask questions about moral relativism, the nature of medicine in America, multiculturalism, and the many forms of racism. I really recommend this--I think it really helps you think actively about your identity as a citizen of your own country as well as to ask some smart and leading questions about all the above issues. Plus it's a good read.


cyn said...

wow, not something i'd normally read either. but good for you for reading for good faith and being surprised. that's always wonderful. i've personally been pushing my reading boundaries a little myself of late.

Leigh Russell said...

Sounds like a challenging book. Have you read Chinua Achebe's "Things Fall Apart"?

angelle said...

oh i remember seeing this. it sounded interesting.

ReadDanceBliss said...

This is a great book! I wouldn't normally have read it either but Anne Fadiman was coming to my university to speak about it so I read it for that and loved it. And she was a *fabulous* speaker as well, very worth hearing. But, my god, if you love to read you have to read her _Ex Libris_. I cannot recommend it more strongly - my only advice is to try really REALLY hard not to read it all in one sitting so you have a longer time to enjoy it.

moonrat said...

another friend read Ex Libris about 5 years ago and loved it, but i'd forgotten about it (except i think at one point she says books should be well-worn, including used for coasters if necessary... is that the right book?). in any case, thanks for the reminder.

i've read that she's a really great speaker, too. i really liked this book because it was just so informative and carefully executed. i imagine she'd be very good live.