Peer Review

Peer Review



Thebook, TheSpirit Catches You and You Fall Downby AnneFadiman,examines the conflict between a refugee family and a small hospitalin California. The refugee family had a child, Lia Lee, who wastreated for epilepsy. While both the doctors and parents wished forthe kid’s recovery, there existed a misunderstanding between thetwo due to the cultural differences. The cultural conflict hinderedthe diagnosis of the kid hence worsening the situation. Fadimantries to explore the effects of cultural conflicts in hindering theattainment of the expected outcomes in any given situation. In thisparticular case, she identifies that miscommunications andmisunderstanding between the doctors and Lee’s family wascontributed by the varying cultural norms. The Hmong community, whereLee came from, believed in the spiritual factors when examining theappropriate interventions for diseases. The parents refused to giveLee certain medications to cure epilepsy because of mistrust.However, the doctors believed in the scientific process to treatailments. Still, the doctors did not make a step to understand theHmong’s cultural practices. Their actions made Lia’s conditiondeteriorate by the day. It is notable that the facets within thesocial environment, including cultural practices and language, informthe social interactions. Cultural competence plays a critical part inaddressing challenges and opportunities that may arise due todifferences in cultures in social groupings.

Fadimancaptures the mood of the readers by examining the Hmong’s culturalpractices and the challenges they faced due to discrimination(Fadiman, 2012).The community’s beliefs on medicine contradicted the westernpractices in medicine. Hmong’s could not allow the doctors to takeblood from their body. The community believed that a human being hassmall amount of blood hence taking one’s blood could be fatal. Sheeffectively narrates the significance of cultural competence inenhancing the realization of positive outcomes. The differencesbetween cultures resulted in miscommunication. It is known that it ishardly impossible to engage in any meaningful activity without propercommunication and understanding. In fact, communication getsdifficult when the individuals involved come from different cultures. Communication challenges are experienced in various aspects of lifein the society. It is known to affect the nature of humanrelationships that are essential in the realization of societalobjectives. Miscommunication was evident as the interpreters tried togive the doctor’s information to Lia’s family. The parents couldnot easily follow the doctor’s instruction regarding therecommended medication hence worsening the situation. At times, theycould not get the connection between seizure and its impacts on thebrains. Another important component that contributed tomisunderstanding was the belief on spirits. The parents believed thatLia’s seizure emanated from sound of a slammed door. They believedthat epilepsy required spiritual healing as opposed to medicines.Hmong’s community found it difficult to integrate with othercommunities due to their perceived rigidness and their beliefs onrituals.

Thedoctor’s perspective is also examined thoroughly to give anotheroutlook regarding a civilized society. While the doctors identifiedLia’s disorder, they did not give the appropriate medicine due tolack of interpreters. The doctors faced a situation where they couldcommunicate with the patient. At the same time, the doctor’sinstructions were difficult to follow owing to the lack ofcontemporary knowledge among the Hmong’s community. The civilizedsociety has nurtured and defined the communication styles. It isthrough these styles and knowledge that the doctors could easilyexplore the appropriate steps to take to realize positive effects. Ibelieve that the story is developed out of the conflict betweentraditional and civilized society(Fadiman, 2012).

Fadimanbelieves that human interactions should be guided by the need toacknowledge belief systems of other people. Through cross-culturalprograms, Fadiman asserts that the community will be in a position tounderstand and respect the values adopted by other communities. Ifthe doctors had sought to know the Hmong’s cultural practices, Liawould have improved her health condition. The doctors would have alsofound it easy to explain to the parents about the significance oftaking the recommended medicine. Understandingthe cultural differences enables individuals to look beyond theimmediate circumstances and realize the impact of their actions.Overall,cultural competence is an important component not just in healthcarebut also in enabling human interactions and understanding(Fadiman, 2012).

Inconclusion, human life is defined within the context of socialrelationships that makes people adopt cultural values, practices andinstitutional framework to suit their needs. It is appropriate thatthere be a common identity among individuals and groups within thesociety that will help promote co-existence, patterns of socialrelationship, and institutions. As Fadiman highlights in the book,the society need to embrace cultural competence to realize societalobjectives. It is not possible to have a global community thatsubscribes to similar cultural practices and values. As such,cross-cultural differences should not be a hindrance towards therealization of positive outcomes but should allow people to learnfrom one another.


Fadiman,A. (2012). Thespirit catches you and you fall down : a Hmong child, her Americandoctors, and the collision of two cultures.New York, NY: Straus &amp Giroux.