Book Review the Spirit Catches You and You Fall Down
by Anya Selleck
The Spirit Catches You and You Fall Down
Book Review
A few years back in academy, a friend of mine in medical school gave me a book to read. I didn't read it. Like so many of my generation, while studying, we place ourselves on a definitive trajectory to our desired goal. With blinders on, we convince ourselves this goal has the utmost virtue, and we get swept away by its potential. Stories similar this one about always get disregarded on our quest for earth affliction eradication. How could a story of one female person child from a remote culture I had never heard of, (the Hmong people from Laos,) situated in a small community in the United States mean anything? Recently, the volume institute it's mode dorsum to me. I finished it and discovered my initial assumptions those years past were incorrect.
'The Spirit Catches You and You lot Autumn Down' is the literal translation of the Hmong terminology for an epileptic seizure. The journalist Anne Fadiman takes you through the maddeningly frustrating journey of a loving Hmong family and their dedicated western doctors. We lookout man Lia, the petty Hmong girl diagnosed with epilepsy, slowly fade from this earth with every seizure. Fadiman brilliantly roasts united states of america over a tiresome flame by revealing the family unit's agony in tandem with the doctor'due south feelings of futility. In an age where nosotros love to write nearly medical incompetence, Fadiman chooses a much more than corrosive subject: incompatibility.
Language is inextricably linked to civilisation, and as a md, inevitably you will come beyond a few patients who will bring with them a friend or family member who will be acting as an interpreter. This person volition, therefore, be a subjective participant. You as a western doctor are the one with the foreign practise, and even with someone's belief in their complete complacency, such terms are relative beyond cultural borders.
The Hmong civilisation, as Fadiman illustrates, therapeutically centres around Animism. Lia's own family believed her seizures were caused by her soul leaving her trunk, which could be returned to her via brute sacrifice. Throughout the book, nosotros encounter Lia's Hmong family unit constantly questioning the doctor's intention as the doctors uselessly boxing against the family'south inability to carry out instructions. How could Lia'southward mother take her child's pulse at habitation when she doesn't ain a watch or know what a minute is? How could Lia's family trust the dedication of doctors who angrily throw them out of their child'southward hospital room with apparently no reason? (The reason often being that they were aimlessly trying to administer an IV into a chubby little girl's arm, with veins impossible to find, as she'southward having a seizure.) Then there was the issue with medication. The list of medications Lia was administered or prescribed could span this entire article. Medication is only effective if you accept it, and even and so, health is not bodacious. Lia suffers the sick furnishings of being given medication at the wrong time or sometimes not at all. Fadiman shows united states of america that the effectiveness of western medicine lives and dies depending on execution, whereas, shamanism is dependent on intention. Being a journalist, she maintains a general neutrality throughout her book and tactfully avoids the blame game. No i could ever question the love or dedication Lia's family unit and the community had for her. Their intention stretched across the normative Hmong way of life, and their co-operation with western medicine was equally much as could exist expected. No one could question the intention of the many doctors that treated Lia. However, the intention is non their primary job. Theirs was execution and, for whatsoever reason, that didn't happen. Western medicine's inability to solve the staggeringly dangerous problem of proper or consistent outpatient medication intake is one of the greatest medical problems of the 21st century. I could easily argue that once out of the infirmary, that this is the patient's responsibleness. Yet, if execution and timing are truly the modus operandi of western medicine, then those are the principal responsibilities of the physician. It'southward a difficult trouble, and one devoid of an like shooting fish in a barrel solution. All the same, I am merely highlighting my stance of the ethics.
Lia doesn't dice, and I don't think I'chiliad ruining the book for anyone by saying so. If you lot are a dr. or a medical educatee, this is a valuable volume to read for all its other reasons. For the attempts of the doctors to go Lia her medication, even going so far as to accept her legally taken from her family unit into foster care with a western family who do THEIR best, and scout everything fall apart anyway. Or for the exquisitely detailed portrait of the Hmong culture Fadiman gives us. She spends a great deal of time with many of them, collecting stories which she comprehensively articulates in the volume, not shying away from all the incongruities that the western doctors must face as they laissez passer Lia's medical file from ane set of specialists to some other. The crux of this story, however, culminates from the disorientation the western physician's experience while juggling a chronic case of epilepsy and an ill-equipped civilization's non-co-operation. Ultimately, they drib the ball. They drop it until null works. Her usual drugs go ineffective and she must be given stronger ones. Ones and so stiff she has to be put under general amazement and a Swan-Ganz catheter invasively threaded into her pulmonary artery. A crash. Septic shock. Bleeding everywhere, as Lia finally develops disseminated intravascular coagulation. A dozen new medications to fight infection. A bronchoscopy, a tracheostomy and a crying, chanting mother who is told her daughter will not wake up, always. Somewhere along the line, Lia's brain was deprived of oxygen for too long and she sustained irreversible brain damage.
The inference in the stop was, that had Lia been given her anticonvulsants sooner, her outcome would have well-nigh certainly been different. Every bit information technology is, here are the essentials: Had Lia never received western treatment, and her family unit left to but the devices of her Hmong culture, she would have most likely died in infancy. Notwithstanding, she would accept been sent off from this world with ritual, ceremony and almost certain closure for her family. Every bit it is, she did receive that western intendance and she remained alive, permanently in a vegetative state. Lia would now demand 24-hour care for decades, equally her family sits with her; on the border of perception, deaf and mute, between this earth and the side by side.
Source: https://ubcmj.med.ubc.ca/the-spirit-catches-you-and-you-fall-down/
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