1. Kaleng1
KalengWong
Name of professor
Engl 100
Date
Cultural misunderstanding
In “The Spirit Catches You and You Fall Down”, Anne Fadiman makes the
following claim: “I have come to believe that her life was ruined not by septic shock
or noncompliant parents but by cross-cultural misunderstanding.”
CLAIM
I agree with her claim as the story highlights: language barrier, poor translation,
cultural misunderstanding, lack of corporation between hospital workforce and
patients, mistrust and different cultural practices.
Miscommunication is a major issue in most hospitals. “The most common case is
when patients and the hospital personnel do not speak a common language(Ger-Ann
27). Interpreterscansometimes be insufficient as seen in the story when Lia‟s mother
spoke on and on for almost four minutes but the interpreter simply gave a contrasting
answer. In the story, both the medical personnel and Lia‟s parents were inclined
towards saving the little girl‟s life. However, language breakdown and lack of interest
by the hospital personnel in understanding the value of cultural practices of the
Hmong beliefs caused a tragedy in Anne‟s story. “Such misunderstanding at the
hospital is a source of difficulty that causes confusion and resentment in all parties”,
Ger-Ann27).

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Ann Fadiman‟s work shows how the Hmong girl and her parents suffer as a result
of cultural misunderstanding. Lia‟s family puts theblame on the departure of one of
her spirits that is responsible for her poorhealth and wellbeing which occurred,“the
moment her elder sister Yer accidentally slammed the door with such ferocity that she
frightened a „dab‟, away”, (Fadiman 20).The parents intend to find the lost spirit
through introduction of the Hmong medical and spiritual practices. Hmong view
spirits as beings and objects that can be frightened away. The absence of these spirits
results to death and diseases.
Their sickness and bad fortunes is blamed on the soul stealing creature. However,
they do have a system of healing. When compared to thewesternized doctors who
know the causes and effects of diseases, the Hmong have onthe contrary, a different
understanding in terms of diseases. It is their strong belief that has kept their strong
culture alive and given them strong mental and physical strength. Their different
understanding sparks difficulties.
Cross-cultural misunderstanding is vividly brought out via the difficulties
between the Hmong and the American Agencies. The doctors diagnose Lia with
epilepsy while her parents strongly believe that she has lost one of her spirits. This
places the parents and doctors on differing angles. It is due to this cross-cultural
misunderstanding that the girl‟s parents fail to administer the doctor‟s drug
prescription correctly to their child. “For them the crisis was the treatment, not
epilepsy” (Fadiman53) to the parents, western medicine was making their
daughtersicker than before although the irony was that they had failed to give her

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medication correctly.
“The mortality rate of Hmong between infant and nineteen years is seventeen
times more than the non-Hispanic Caucasian”, (Yang, Mills, and Nasser 8). This is
according to a research done in California. Most of them do not have prenatal care
because they dislike the checkup given by doctors. In the Hmong custom, which is a
concrete point, Lia‟s severe seizures bringa clash between Western medication and
Hmong traditional spiritual healing. The contrast impacts to the reception of
inadequate treatment.
Hmong‟s spiritual belief gives a rise to mixed health care to Lia. Hmong has the
strong beliefs on the spirit that is close related to everything in their life. There are all
kinds of possibility which can cause soul lost in the tradition Hmong beliefs, for
instances, “eating the wrong food,the negligence of making offerings to one‟s
ancestors,having a stone implanted in one‟s body by an evil spirit master, and digging
a well in a dab‟s living place” (Fadiman10). These common reasons of soul losing do
not depend on scientific explanation although they lack concrete evidences to show
soul lose, are caused by above reasons. Hmong believes that to prevent children‟s
spirit from being stolen by a dab, parents should dress their children with hats and
wear silver necklaces to lock their soul inside their body. Lia‟s parents emphatically
assert the absenceof hersoul which then causes her to have seizure. Unfortunately,
soul losing is not the actual reason for Lia‟s epilepsy. No matter what they have done
to prevent Lia‟s soul lose, their strong belief is not the true cause of her actual disease
as perceived by westernized medical grounds.

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Another belief which is not a scientific method in order to help cure Lia‟s
epilepsy is when herparents tried to change her name to Kou. They believe that “if a
patient is called by a new name, the dab that stole her soul would be tricked into
thinking that she was someone else, and the soul could return” (Fadiman111).
From the above belief, it is true to assert thattraditional Hmong beliefs prevented
and delayed the medication that was to have been given correspondingly to Lia. The
parents may have failed in understanding the connection between a seizure and what
it did to the brain. Such misunderstanding affected how the parents reacted to the
doctor‟s instructions. Their beliefs barred them from following instructions given by
the doctors since their minds were more settled on their own beliefs apart from
language barrier.
Language barrier and lack of education amplifies the misunderstanding on how
the treatment of the girl was understood by her parents. When Lia arrived in the
emergency room for the first time when her seizures had occurred, her parents could
not explain to the doctor what had happened to her. Lack of proper explanation to the
doctor could have been due to language barrier between the doctor and the girl‟s
parents. The consequence of such a misunderstanding resulted to the improper
diagnosis of bronchopneumonia. Once they were at the hospital, Lia‟s seizure stopped
and the doctors had no other way of diagnosing her correctly.The parents could not
communicate in English with the doctor.Additionally, they could not even read the
Arabic number on the dose of prescription. Apart from having beliefs that hindered
their daughter in getting correct medication, the parents were not educated and thus

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could not properly give medicine as stated by the doctor. Lack of education resulted
to misinterpretation of information.
Another instance was misinterpretation. Poor translation by the interpreter could
have been as a result of mistrust. The interpreter understood the two different
languages of the doctor and that of the Lai‟s parents but may have chosen to filter out
some information.
Although translator were sometimes present during their appointment with
doctors, it was not very helpful. As Fadiman‟s own experience, when she interviews
the Hmong, “the interpreter would translate and the Hmong would talk animatedly to
the interpreter for four or five minutes. Then the interpreter would turn and say, „He
says no‟” (Fadiman94). It is hard to communicate between Hmong and Americans
even with the presence of an interpreter. The purpose of language is to communicate
different ideas between peoplebut language barrier counter affects the desired
message in communication (Ger-Ann 8).
Cultural misunderstanding is also seen through different cultural practice. “Txiv
neebs is a person who can heal a spirit. Txiv needs will never undress their patients,
but doctors asked patients to take off all their clothes, and sometimes dared to put
their fingers inside women's vaginas" (Fadiman33).
The westernized cultural practices strongly differ with the traditional practices of
the Hmong. Ignorance is achieved in the sense that science westernized medicine does
not give room for their client‟s cultural beliefs. Later on as the story end In Anne‟s
book, science is questioned. While the doctors concluded that the little girl would

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remain a vegetable for the rest of her life, we learn that she lived on. The Lee family
later on after failed attempts from modern medicine went ahead and carried traditional
practices on the girl who lived on.
The above conflicting results as compared to the western medicine could not be
explained. It only further shows that it is important for doctors to incorporate both
traditional practices of a client and scientific medicine so as to solve cultural conflict
between the western world and the traditional beliefs of people.
According to Marcelle et al (88), “differences should be respected in order to
work together”. These two authors describe the fundamental patterns of cultural
differences in order to achieve harmony. They include: communication styles,
attitudes towards conflict, approaches to completing tasks, decision-making styles
attitudes toward disclosure, and approaches to knowing.
CONCLUSION
In conclusion, Anne„s claim is correct as it points out the weaknesses in
cross-cultural studies that make communication in a diversified community rather
challenging.language barrier, poor translation, cultural misunderstanding, lack of
corporation between hospital workforce and patients, mistrust and different cultural
practices can be resolved in order to reach all people in a cross-cultural platform..

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Works Cited
Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong. (1997).
Child,Her American Doctors and the Collision of Two Cultures. New
Communication Challenges. Web. 27 Feb, 2012.
Ger-Ann. G. Caring for Patients from Different Cultures.Web. 27 Feb, 2012.
Marcelle. E, DuPraw and M. Axner. Working on Common Cross-Cultural. (1997).
Communication Challenges .Philadelphia: University of Pennsylvania Press.
Yang. R, P. Mills, and K. Nasseri. Patterns of Mortality in California Hmong.
York: Farrar, Straus, and Giroux Print.(2010).