Erica Robertson
AP English Language and Composition
Mr. Lane
Composition: Independent Research Argument (Third Draft)
May 17, 2010
The Cultural Clash
Section I
The United States of America is known as the “melting pot,” referring to the
variety of cultures that are mixed into society. A wave of Hmong refugee immigrants
from Laos entered the country and settled in Merced, California in the 1980’s, instantly
creating a mix of two very diverse cultures. One particular family, the Lees, had an
unfortunate run-in with the hospital staff early on in their new life. Lia Lee, a daughter of
Foua and Nao Kao Lee, suffered from epilepsy, known by the Hmong as the disease
where the spirit catches you and you fall down. Her doctors prescribed various
medication and regimes for Lia’s parents, but the language barrier prevented them from
understanding the doctors’ intentions. The many run-ins described throughout the
anthology leave me astounded. Why would you not hire a translator to help the family
understand the importance of giving their child the medicine at the right time and on a
consistent schedule? Which side, Lia’s parents or her doctors, is to blame for the
degeneration of her condition? Could Lia’s final state of vegetation have been
prevented? How could two cultures that are so entwined in everyday activities remain so
distinct and separate?
Section II
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The Spirit Catches You and You Fall Down was the first book that Anne Fadiman
had ever written. Working as a columnist for the Civilization Magazine and as an editor
for The American Scholar, she was not new to the writing career (Simon).
Her prior experiences at the two magazines definitely helped her research and write her
first journalistic book. Anne Fadiman says, “I like to move in a deep, narrow track in
which I can get really obsessed with something and do nothing else” (Smokler). Her
depth of focus on one task at a time ensures that she thoroughly researches and
understands the topic she is going to write about; she does not divide her attention
between five stories at once. In order to write The Spirit Catches You and You Fall Down,
Anne Fadiman spent eight years engrossed in the Hmong culture, researching the history
of the Hmong and the story of the Lee family (Smokler). The breadth and depth of the
information included in the whole book emphasize the intensity of research and
understanding of the culture. This book is noted for successfully weaving sociology,
psychology, medicine, and history into one, “raising the bar for literary journalism”
(Simon). Considering the amount of effort she put into retelling the vivid and complex
story, it is logical to say that the book heightened the level at which other literary
journalists must write.
The other two books she has written are a collection of essays, requiring a
different form of information gathering and writing. When Fadiman does conduct
research, she likens the process to making maple syrup. She must gather a large quantity
of information and sources, but in the end she sifts through everything until she only has
the most pertinent information left (Smokler). The idea of gathering so many books,
magazine articles, newspaper clippings, etc. and sort through all of them seems like such
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a hassle. The fact that she did that for eight years in order to write The Spirit Catches
You and You Fall Down shows that she will work hard in order to produce the end result
she had imagined. She states that “any good [the book] has done has been more or less
by accident” (Smokler). Creating a book that people in medical school would read to
learn about cross-culture medicine was not Fadiman’s intention. Rather, she hoped to let
the world know of the struggles the Hmong have faced throughout their existence.
Section III
Anne Fadiman argues that the Hmong have been treated inappropriately because
the American population has not taken the time to understand them as people. This lack
of understanding is exemplified in the story of the Lee family. As Lia is diagnosed with
epilepsy, her parents try to use shamanistic techniques while her doctors wish to use
modern western medicine. In order to understand why the Lee’s story is noteworthy,
Fadiman had to use the narrative technique to provide the reader with background
information. Starting with Chapter Two, every other chapter describes the Hmong
history, discussing the hardships and violence the group has overcome as a whole from
the very start of their existence. The narration also exposes the reader to the true Hmong
culture that has endured the many efforts to subdue their identity. Towards the end of the
book, the even chapters that had been depicting the Hmong history have caught up to the
1980’s and the story of Lia Lee (Fadiman 262). In the odd chapters, Anne Fadiman
expresses her argument about Lia Lee’s situation. She gradually develops her argument
by slowly retelling the tragic story of the Lee family.
To better develop her argument, Fadiman also uses description. In the very first
chapter, Fadiman begins by describing the difference in birthing a child in Laos and in
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the United States (Fadiman 3). In the first twelve pages, Fadiman has established a clear
distinction between American culture and Hmong culture. Foua’s anecdote of birthing
Lia in an American hospital shows disjointed overlap of the American and Hmong
culture. Some doctors acquiesced to let the parents take their child’s placenta home in
order to bury it while others have vehemently disagreed, neither group choosing to learn
their reason for wanting to take the placenta home (Fadiman 6). This petty disagreement
goes to show that the doctors would do nothing to understand or empathize with the
Hmong in the many other situations that are bound to arise concerning medical treatment.
One of the many examples that Fadiman presents as support that the Hmong
culture is misconstrued is when she has the Lee parents complete the explanatory model.
At first glance the questions have obvious answers, but when put in context of the
situation and thought through, the questions provide more insight than originally
anticipated. When Fadiman told Neil and Peggy, Lia’s doctors, what the Lee’s answers
were, the two were amazed with their responses. Yet when Fadiman discussed the results
with Arthur Kleinman, the model’s creator, he agreed with each of the answers, not
surprised by any of them. Kleinman explains that if one cannot understand their own
culture, they will never be able to understand another’s culture (Fadiman 261). Because
Kleinman was a psychiatrist and medical anthropologist, he sees how cultural
discrepancies hinder simple activities. On the other side are Neil and Peggy: their lack of
cultural knowledge leaves them unaware of how the Lee’s view the doctors’ actions.
As Fadiman is telling the Lee’s story, she uses diction that pulls at the reader’s
heart strings and persuasive techniques to sway the reader to her side of the argument.
After Lia’s longest and most debilitating seizure of her life, Fadiman portrays Lia as
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being “on the verge of death” (Fadiman 141). Lia could have been described as being in
a coma, a seemingly more medical term, yet Fadiman describes Lia in a way that brings
to mind someone teetering on the edge of a cliff. The doctors do not even bother to
update Lia’s parents when she seized for two hours, saying that due to the severity of the
case, “consent is implied” (Fadiman 145). By including this situation, Fadiman is able to
show the doctors’ carelessness and disregard of a family’s rights to know what is going
on with their child. When Lia was taken by Child Protective Services because Neil felt
her parents were endangering her, Foua and Nao Kao proved their trustworthiness by
winning over the foster family, the Kordas (Fadiman 88). By spending time with the
Lees, the Kordas understood the Hmong culture and were able to see that her parents
were not trying to harm her, they were doing what they thought was best for her. The
many examples that Fadiman provides support her argument that the Hmong are
misunderstood and therefore treated unsuitably.
One of the only weaknesses of the book is how Fadiman expresses both sides of
the story. Some have speculated that “what makes her book most fascinating is the way
she presents both sides of the dilemma in which there are no good guys or bad guys”
(Conniff). She is displaying her ability to keep an open mind, yet the reader is unable to
draw a definite conclusion as to which side she is favoring until the very end.
The shifting of preferences of sides leaves the reader, unable to catch up to the different
attitude of the subject, perplexed and their emotions lost. Without Fadiman markedly
expressing her support for one side, the reader expresses a whiplash of sentiments and
thoughts.
Section IV
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As Anne Fadiman elaborated on the discussion of cross-cultural clashes, she
developed both sides of the argument. Although her support for the Hmong culture came
through in the end, she provided many facts for the counterargument. Throughout the
whole book, Fadiman works to uncover whose fault it truly is that Lia ended up in a
vegetative state. The doctors viewed their modernized and westernized form of medicine
as being superior to the shamanistic form of treatment where the focus was on the soul
(Hmong). Fadiman found that the doctors felt it inconsiderate of the Hmong not to
convert fully to the American culture and ways. They often said that the Hmong were in
America and should therefore be doing their everyday activities in an American manner.
For other doctors, like Neil Ernst, it was wrong to have two levels of care for their
patients. They did not distinguish their patients based on their background: Hmong,
American, German, Japanese, Italian, etc (Fadiman 78). In this respect, doctors were
attempting to disregard the cultural barriers in order to provide the best possible care for
all their patients. The doctors display their good intentions that Fadiman acknowledges
and emphasizes. Although doctors attempt to never become attached to their patients,
Neil showed a slight attachment to Lia. After her massive and brain damaging seizure, it
took Neil three days of walking past her room before he had the courage to see Lia in a
coma (Fadiman 173). Despite all the troubles Lia and her family had caused, Neil
recognized how hard it would be for him to see Lia like that. The compassion he shows
provides a good example that the doctors meant no harm and wanted the best for their
patients. Overall in the end, Fadiman provides numerous examples of when the doctors’
culture does nothing to sway his course of action or attachment to his little patient.
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As Lia frequented the doctor, Fadiman introduced the many doctors who actually
do take the time to understand and care for the Hmong and their beliefs, an example
being Dr. Roger Fife. Instead of completely ignoring how the Hmong go about their
daily lives, Dr. Fife obeys their wishes (Fadiman 76). This example shows how not all of
the doctors were conceited enough to consider only their ways of treatment. Also,
Francesca Farr and Jeanine Hilt were two social workers who expressed their love for and
valued the Hmong culture (Fadiman 265). Instead of hastily stereotyping the Hmong,
they both learned the customs and ways of the Hmong, showing their respect. These
scant but existent examples of cordial relationships between the Hmong and Americans
go to show that not everyone ignores the cultural differences.
Section V
By the end of the novel, I had experienced an emotional roller coaster with the
doctors involved in the story of Lia Lee. With both groups attempting to treat her
epilepsy, the cross-cultural misunderstanding is highlighted by the numerous encounters.
The condescending attitudes of the doctors convey a negative message to the Hmong, and
now the Hmong no longer trust the doctors. If only all the doctors had made an effort to
really appreciate the cultural differences, then many of the failed cases would have had a
different outcome. To think that such discrepancies can exist between two groups of
people is unbelievable. The Hmong did come to the United States, but that does not
mean they must drop all of their traditions and customs and adopt those of the Americans.
The traditions viewed as American today were actually from places all over the world.
As long as the Hmong preserve their culture, it will soon be incorporated into the
American culture. Eventually, people will start noticing that the Hmong are different
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people than the Americans and make an effort to learn the way of the Hmong. The
American people need to follow the example set by the few doctors and social workers
who treat the Hmong with respect. Without immigrants like the Hmong, our nation
would not exist.
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Section VI
Works Cited
Conniff, Ruth. "The Spirit Catches You and You Fall Down: A Hmong Child, Her
American Doctors, and the Collision of Two Cultures." The Progressive Dec.
1998: 39. Student Resource Center - Bronze. Web. 4 May 2010.
Fadiman, Anne. The Spirit Catches You and You Fall Down. New York: Farrar, Straus,
and Giroux, 1997. Print.
“Hmong Culture.” Lao Family Community. Lao Family Community of Minnesota Inc.,
1997. Web. 5 May 2010.
Simon, Justin. “The Spirit Catches You and You Fall Down: A Hmong Child, Her
American Doctors, and the Collision of Two Cultures.” The American Journal of
Psychiatry. American Psychiatric Association, 2003. Web. 5 May 2010.
Smokler, Kevin. “Reading ‘til 3:00 am: An Interview with Anne Fadiman.” Rain Taxi:
Review of Books. Rain Taxi, 2008/2009. Web. 5 May 2010.
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Date
Name
Topic/Title
Area
Ideas and Content
Organization
Word Choice
Sentence Fluency
Voice
Lower Order Concerns
Presentation (Research Guide)
Insight
Support
Introduction and Conclusion
TOTAL
GRADE out of 50
Score
Comments
10
10
9
9
9
9
10
10
9
10
95
47 Nice job dealing with a book that does not give you a ton with wh
work; see comments, LOCs, and revise