Health Or Illness

Feb 19, 2021

This is Nicole English coming to you from the Sociology Department at Fort Hays State University for HPPR's Book-Bytes....

Language as well as cultural frustrations occurred with the families and medical providers in The Spirit Catches You and You Fall Down
Credit 864px-Hmong-Mien-en.svgn Wikimedia commons

This is a discussion 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 required reading for my graduate coursework in the Sociology of Health & Medicine.  In that class, we looked at different concepts of what constituted “health” or “illness”, and perceptions of what was healing (or not).  We tend to perceive illness and health through the lens of our respective cultures.  This book is a very engaging account that will appeal to anyone interested in healthcare, spirituality, traditional healing, culture, and diversity and inclusion. 

The book revolves around an in-depth view of the Hmong immigrants and refugees who settled in the Merced, California area in 1970s and 1980s, in the wake of the Viet Nam Conflict.  The Hmong were allies of the USA, and historically persecuted by the Chinese for centuries.  Thus, they were offered refugee status and relocated to various locations in the USA.  Clint Eastwood fans will also recognize this immigrant group as the Asian neighbors of Eastwood’s character in the 2008 film, Gran Torino.

The book focuses on the interactions of the Hmong with the hospital staff in Merced, California, and the frustrations on both sides with language and cultural barriers to communication.  The Hmong culture has very particular perspectives and customs that address health and medical concerns, such as childbirth or epilepsy.  (The title of the book, in fact, is the Hmong description for epilepsy, a condition that is considered less an “illness” and more of a spiritual attribute.)  Often, there were misunderstandings on both sides about the diagnosis and treatment of various illnesses. 

For example, it was customary in Hmong culture (as it is in many indigenous cultures) to bury the placenta after a birth, under or near the household, to “protect” the child’s soul and family, and to be available to the child’s soul for its final journey at death.  Also, the Hmong feel that any part of the body that is “removed” or surgically altered, renders the body as “damaged” for rebirth (after death).  The Hmong strongly believe that you cannot treat or heal the body without also addressing the soul, and vice-versa. 

For the hospital staff, they were often reluctant to give the placenta to the Hmong after childbirth, because they had the mistaken impression that the Hmong would eat the placenta, which was a practice they found repugnant.  Ironically, the Hmong had the mistaken impression that doctors would eat the body parts they removed from the Hmong during surgery.  Both were mistaken beliefs based upon miscommunications. 

What I feel is important about this book is the idea that the world is filled with different perspectives of illnesses and healing.  Our belief systems shape our healing processes, and it behooves us to be open minded about different approaches to healing and spirituality. 

In our own culture, we have had to struggle with different conceptions of illness over time.  We need look no further than the pandemic of 1918, when the “Germ Theory” was still considered too new and too controversial, to be accepted as fact.  After educating the public and promoting it as a public health strategy, it became more accepted. 

Again, this is a fascinating read that is as timely today as it was when it was first written. 

Enjoy Reading! Again, this is Nicole English from the Sociology Department at Fort Hays State University wishing you happy Book-Bytes.