The Spirit Catches You and You Fall Down by Anne Fadiman Essay

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Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.)

As part of my Culture, Health and Illness class, I undertook a critical analysis of the book “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures” by Anne Fadiman. This book was published in 1997, and documents the struggle of a Hmong family from Laos in communicating with and understanding the American health system.
The Vietnam War caused great destruction in Laos, and so the Lee family migrated to America, after spending a short time in refugee camps in Thailand. After
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Illness causation seems very black and white to a healthcare professional. The illness is explored and explained, and a suitable treatment is offered to a patient. It is this explanatory model that Lia’s American doctors employ. “The notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process”. (Kleinman. 1980.) The healthcare professionals in the United States recognised Lia’s epileptic condition, and ran many different tests on the little girl, but ultimately, no cause was ever found for her seizures. Although there is no ‘treatment’ available to fully heal Lia, her American doctors seek to manage her condition with several different medications, and different combinations of these medications. This is the healthcare system that we are familiar with. The illness is identified and a suitable treatment is recommended.
However, in our multi-cultural world, there are many lay theories regarding illness causation. These lay theories are based on the concept of misfortune. Someone is ‘unlucky’ enough to be suffering from this illness. The causation of many illness can be attributed to four different areas.

• Individual: These can be controlled, or uncontrolled. Such as lifestyle (controlled) or personality (uncontrolled).
• The natural world: This is when the causation of an illness is attributed to the world around the patient, such as the climate or pollutants.

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