The idea that struck me most while reading this book is the fact that so much of a people’s history and general experiences can be surmised by taking a look at their cultural practices and rituals. What medical practitioners and social workers who work with these minority cultures can learn from studying these practices is that the fears that these persons, like the Hmong, have can be detected through the cultural practices that are dear to them. The major lesson that can be learned through this text is that learning about cultures, their practices and their fears is essential to a holistic treatment of any individual within that culture.
Such understanding and compassion is the only true way to respect the members of a culture. While Americans are generally right when they consider that their advanced scientific knowledge and technology will be of some help to immigrants, when considering spirit and mind in conjunction with the body, these American personnel would do better to work along with these immigrants rather than austerely and unbendingly inflict their wills upon them.
The ways that an understanding of the Hmong culture can be achieved are many in this book by Anne Fadiman. In The Spirit Catches You and You Fall Down, the earliest chapters give insight into the many afflictions that persons within these cultures might have faced during pre- and post-natal care. The extents to which they go to ensure the safety of the births demonstrate the intense love they have for their children. During the delivery of Foua’s children, the reader learns for example that when her throat became dry her husband was permitted only to bring her hot water. This stems from the belief that cold foods during or after a birth would lead to the congealing of the blood in the uterus.
This belief and practice points historically toward the existence of such complications during the birth of children in those areas, and knowledge by American practitioners about why such a practice (or others of that kind) is carried out might give insight into the medical proclivities of that race. Respecting such information could help in the treatment of these persons as they may even provide a look into their medical history.
Respect is alos relevant to the central medical case of the text. The doctors pronounce Lia brain dead after a severe epileptic seizure, when their several epileptic medicines had proven unhelpful. The fact that Lia was still alive two years later under the care of her immigrant parents should have elicited the respect of the American medical practice. This respect should point toward the viability of at least some of the cultural practices performed by this ethnic group. Respect should also be accorded them as intelligent human beings, understanding that throughout the generations that these persons and their ancestors have lived, a certain amount of useful knowledge must have been accrued and passed down.
Therefore, not all their seemingly eccentric and superstitious practices are to be scoffed at. Foua herself gave birth to not one but twelve children on her own. These were all live births, and this testifies to the effectiveness of even the unfamiliar medical practices that the Hmong people have in their culture. Knowledge of this breeds respect, and some such respect should be extended to them even though it is known that the Hmong prize their epileptics (as they believe they would become shamans). Though American doctors do not feel the same, the fact that Lia was brought to them at all demonstrates that to some degree her family was concerned about the epilepsy—and with a bit more diplomacy on the part of Americans, the family may have had a better experience overall.
In addition to the fact that these immigrants from Laos are to be respected and treated with consideration, certain questionable practices that they have (such as capturing brides) can never be condoned within the American culture. The lesson of respect still applies here, however, because when Americans show true respect for these persons such courtesies will not be lost on them. When they know they are respected, it becomes easier for them to hear and understand why certain practices are not acceptable within the society in which they now choose to live. An understanding of the culture is indispensable in the pursuance of this goal. It is this understanding that will create an environment in which such inter-cultural dialogue can be attempted.
Fadiman, A. (1997). The Spirit Catches You and You Fall Down. New York, NY: Farrar, Straus, and Giroux.