A review of The Spirit Catches You and You Fall Down by Anne FadimanIn the minds of many of its most fairminded and supportive critics, the greatest challenge faced by Western medicine as it evaluates itself in the fading days of the twentieth century is not one that can be overcome in laboratories of immunology, genetics, or microbiology, or in the thinktanks of health care planners. It must be met at the bedsides of the sick. The challenge is an old one, but the profession has never universally acknowledged its gravity in the modern era, nor has confronting it been treated as a worthy endeavor by those responsible for training young physicians, except perhaps in lip service. Simply stated, the challenge is to respond to a reality whose enormous consequences are too often underestimated or ignored: patients bring to doctors not only their diseases, but also their entire lives, including the cultures and the worldviews of their families' history. American clinical teachers are fond of enjoining their students never to forget that diseases occur in sick people and not only in sick organs--and then they ignore their own injunctions by going ahead and treating those same patients as though they were no more than containers for the pathology.
The Spirit Catches You and You Fall Down - Why this will always be my favorite book
The Spirit Catches You and You Fall Down
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In the standard scenario of cultural collision, a Western rationalist -- a missionary doctor, say, or an explorer -- travels far away to a society of strange customs and tries to convert it to a different system of belief, with results that are sometimes comic, sometimes tragic. There is, for example, the story of the American missionary in China who showed movies of grotesquely enlarged flies, trying to convince the local people of the need to exterminate them. The local response: the flies in America, as big as tigers, are terrifying and dangerous, but here in China the flies are very small and harmless. In ''The Spirit Catches You and You Fall Down,'' Anne Fadiman writes of a reverse situation, showing what can happen when the bearers of an animist, nonrationalist, nonscientific culture come to the United States and collide with local customs and assumptions. Fadiman, a freelance writer who was recently named editor of the journal The American Scholar, describes the rich and absorbing case of a family of Hmong refugees in Merced, Calif. The family, whose surname is Lee, have a severely epileptic baby daughter, Lia. When the desperately sick baby is taken in hand by the system of Western medicine, two worlds of almost supreme incompatibility collide, with heart-wrenching consequences.
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Thank you! Fadiman, a columnist for Civilization and the new editor of the American Scholar, met the Lees, a Hmong refugee family in Merced, Calif. In the Lees' view, Lia's soul had fled her body and become lost. Believing that the family's failure to comply with his instructions constituted child abuse, Lia's doctor had her placed in foster care. A few months after returning home, Lia was hospitalized with a massive seizure that effectively destroyed her brain. With death believed to be imminent, the Lees were permitted to take her home. Two years later, Fadiman found Lia being lovingly cared for by her parents.