Author speaks about cultural differences

By Melanie Muller

Monday, Sept. 13, Anne Fadiman spoke at the University of Massachusetts about “The Spirit Catches You and You Fall Down,” her award-winning book about the experiences of an epileptic Hmong girl, Lia Lee and the cross-cultural difficulties that arose between her family and her doctors in treating the condition. The talk was open to the public and held in Bartlett Hall.

“The Spirit Catches You and You Fall Down” tells Lee’s story from birth until after she suffered the severe brain damage that caused her to enter a vegetative state at the age of four. Questions about medical ethics and cultural sensitivity are explored extensively, as misunderstandings between the Lee family and western doctors complicate her treatment. Along the way, Fadiman gives information about the history and beliefs of the Hmong, their role in fighting a proxy war in Laos for the American government and the immigration of many Hmong people to the United States after the war in Laos.

Fadiman’s appearance at UMass was a part of the Commonwealth Honors College’s Fine Print Program. In the Fine Print Program, all incoming freshmen in ComCol were asked to read “The Spirit Catches You and You Fall Down” over the summer. They then discussed the book in small groups during the honor college’s Welcome Weekend Orientation.

After being introduced, Fadiman began by thanking those who, like herself, are procrastinators and didn’t read the book until the last minute, thus forgoing a “final trip to mall” or viewing a movie to finish it.

“I applaud your sacrifice,” said Fadiman.

She went on to give a brief overview of facts about the Hmong she thought many students that were eager to read more of Lia’s personal story, may not have known.

Speaking for about an hour from a manuscript, Fadiman then discussed how she first became interested in the story, her interaction with Lia’s family and how, eventually, she came to turn her research into a book. Originally, Fadiman wrote the story as a freelance article for the New Yorker, but after a change in editors it was not published by the magazine. Fadiman said that she was driven to write the book out of “embarrassment” and after months of interviews, she didn’t have the heart to call Lia’s parents and tell them nothing would come of their daughter’s story.

Fadiman said that she did not attempt to be objective because she was too close to both, members of the western medical team that treated Lia, and the Lee family. Anecdotes about her time researching the story in Merced are interspersed throughout the book and Fadiman expresses her own opinions frequently. She does not, however, explicitly take the side of either the doctors or the Lee’s.

Fadiman went on to describe how she felt she was personally affected by the experience. Observing how Lia’s mother, Foua, raised her large family, influenced how Fadiman decided to raise her own children.

After Fadiman finished speaking, she took questions from the 70-person audience for another hour. A number of questions focused on what has happened to the Lee’s in the 13 years since the book was published. Fadiman said that she has stayed in contact with the family since the publication of the book, with a number of Lia’s sisters visiting her home at one point. Lia is now in her ‘20s and Foua is still alive, but her father has passed away.

A group from UMass’ nursing program asked questions about what kinds of practices Fadiman would recommend to help avoid cross-cultural insensitivity and confusion while treating patients. Fadiman pointed to a list of questions for care providers to ask patients created by Arthur Kleinman that appear towards the end of the book. Fadiman believes them to be “brilliant” in helping to clarify a patient’s point of view. She noted, however, that this approach would not have helped Lia’s doctors understand the Lee family, as they mainly saw the Lees in crisis situations while Lia was having a seizure.

At the end of the evening, Fadiman was presented with a statuette commemorating the event. She stayed afterward to sign copies of her books and to answer any additional questions.         

Melanie Mueller can be reached at [email protected]