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The Sprit Catches You and You Fall Down Research Paper

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Updated: Feb 4th, 2019


There is a common concern of the constant struggle between modern medicine and cultural beliefs that oppose the modern treatment. The story of Lia is painful and tragic but it presents a distinct illustration of how traditions and culture can clash with the contenporary medicine. The purpose of this paper is to synthesize major concepts of the course and relate them to experiences described in the story.

Ethical Situation in the Story

The book describes the story of Lia struggling with epilepsy that worries both the family and doctors. As the story begins, it is possible for the reader to relate with the experiences doctors have at the hospital as they try to solve Lia’s problem.

One can easily understand the doctors’ attitude and perceive Lia’s family as being selfish and ignorant since they are more interested in following their culture other than working with the medical workers to save the girl’s life. However, the author later presents the point of view of Lia’s family and the reason they take such a stand. After this, readers can understand how the Hmong people interpret and comprehend certain things that impact on their beliefs on treating such illnesses (Fadiman, 1998).

Ethical Principles in the strory

Cultural understanding

The most important and conspicuous ethical principle in the story is the understanding of the existence of diverse cultures in the world. Equally significant is learning what views these cultures present in the quest for a common goal of healing (Black, 2013).

In the story, the predicaments of Lia are caused by persistent misunderstanding based on diverse religious perspectives. The conflict is also based on the existing language barrier that made Lia’s family be noncompliant to Lia’s medical instructions. Similarly, the doctors are unwilling to consider cultural beliefs of the Hmong in their treatment of the girl.

The author presents a struggle of different beliefs and cultures in the characters of the medical workers and Lia’s parents with each emphasizing on their way in the treatment. The people of Hmong are described to have fought different cultures over centuries. For instance, they were forced to leave China where they belonged to Laos then to Thailand, and later to the United States.

These movements exposed them to different cultures that threatened their cultural beliefs and practices (Fadiman, 1998). Throughout the history, the nation of Hmong has had no motivation to assimilate to other cultures because they spent their lives in the traditional South East Asia mountain villages in almost complete isolation.

Differently Ethical Discussion

In the story, Fadiman (1998) seems to be acutely aware of the frustrations faced by the medical professionals in providing health care to individuals from different cultures. Despite these people having radically practiced worldviews, the author is able to present a case to physicians to acknowledge and understand such family realities (Black, 2013).

Much like the present Hmong people in America who chose not to assimilate themselves to the American culture, it was easy for the pre-war Hmong to resist assimilation to more wealthy cultural groups. They believed that they were more wealthy, more numerous, and more politically superior by resisting contact with “this land of leeches” and would be less likely to succumb to tropical diseases (Fadiman, 1998).

Selected Solution. People should not fight over the dilemma but find a way of understanding and accepting the arguments of each side. According to Andrews and Boyle (2008), the conflict is mostly fueled when the medical professionals and hospitals are extremely insensitive to different cultural beliefs of their patients.

Compromise in medical treatment

It is evident from the story that the doctors are willing to treat Lia but her parents believe that she should be treated according to their guidelines because the Hmong people consider that illnesses are due to emotions which leads to the concept that the soul is the key factor of their argument. On the other hand, the American culture takes illnesses as physical conditions meaning that the mind and the body are separate. To the Hmong, the soul is more important than the patient’s life. With the American doctors, it is quite the opposite. The family members understood that the cause of Lia’s seizures was that her soul had left her body. So, in their eyes the cure for Lia depended on getting her soul back with no medication giving. On the contrary, Foua and Nao Kao believed these medications would make Lia sicker.

Selected Solution. Fox (2005) recommends that the principle of compromise should also be applied to doctors who should accept different thinking patterns of their patients. For the modern medicine to be truly effective in most cases, there must be a cooperation or balance between the technology-based Western medicine and the spiritual and cultural beliefs of the patient and family.

Medical professionals need to accommodate the thinking patterns of different people and practice professional tolerance even if they will not follow their demands in the treatments. Throughout the story Lia Lee struggles with epilepsy, her first seizure occurring at just three months of age. The violent progression of Lia’s disease and the destruction of her brain, as well as the appropriate treatment are the foundation of a constant tug-of-war between her doctors and parents.

Ethics of Love

Another ethical principle is love and care since the story implies that only love exists when everything else disappears. In the story, the doctors went on with their medical treatment and did not care or even show respect for cultural perspectives of the Hmong people. However, showing love to Lia and taking care of her health and mental needs remain the only point of agreement.

Selected Solution. Doctors should handle medical treatments with love and care to make patients and their families happy despite being sorrowful. It is hurting to see how Lia is robbed of the joys in life and the reader gets tormented by the failure of the Western medicine to halt the progression of her epilepsy.

The doctors failed to diagnose her for five months and failed to initiate the appropriate seizure protocol. A child was held by its mother all day and night and they loved their sons more. The Lees adored Lia. They did not hide the fact that Lia was their favorite child, the one they considered most beautiful, the one most hugged and kissed, and dressed in the most exquisite clothing (Fadiman, 1998).


The paper presents a conflict of the modern medicine and traditional viewpoint that is fueled by the lack of compromise between the two sides. Each side of the two perspectives is filled with the best intentions of patients and seems to be keeping the goal of healing in mind. However, cultural differences between the two sides are stronger than their good intentions (Black, 2013). These two extremes are the dilemma that the readers find themselves when taking sides of the most appropriate solution for Lia.


Andrews, M., & Boyle, J. (2008). Transcultural Concepts In Nursing Care:Transcultural Concepts In Nursing Care. New York, NY: Lippincott Williams & Wilkins.

Black, B. (2013). Professional Nursing: Concepts and Challenges. Philadelphia, PA: Elsevier Health Sciences

Fadiman, A. (1998). The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York, NY: Farrar, Straus and Giroux

Fox, R.(2005). Cultural Competence and the Culture of Medicine. New England Journal of Medicine, 353:1316-1319.

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