1. Do you think the author was evenhanded in her presentation of Hmong culture and medical culture? I absolutely believe that the author was evenhanded in her presentation of the two cultures. Throughout the book it was clear that she tried to look at everything from as many perspectives as possible to accurately portray the Hmong culture and medical culture. 3. Over the centuries, the Hmong fought against many different peoples who claimed sovereignty over their lands. What role has this tumultuous history played in the formation of Hmong culture?
The history of the Hmong people is one of the more predominant factors in the formation of the Hmong culture. Through all the fighting and migrating that the Hmong had to go through as a group resulted in a culture, in which everyone is extremely close and unified. Even after the majority of their population left the Chinese land to move to Indochina, they were again in conflict with the French and underwent even more fighting and rebellion. Surely, the nature of the Hmong culture was significantly influenced by the fact that their history of non-stop aggression and need to be independent. As one could easily imagine, this kind of history lends itself to the formation of a culture that consists of a closely-knit community that has a lot of pride. This is made especially clear with how everyone does their best in trying to help the Lee’s with Lia. 4. How does the Hmong folktale about how Shee Yee fought with nine evil dab brothers, told at the end of chapter 12, reflect Hmong culture?
This folktale demonstrates the essence of the Hmong culture on several levels. In the fighting, the themes of determination, never giving up, and being smart in one’s judgment reflects some of the underlying premises the Hmong culture. 5. What do traditional Hmong consider their most important duties and obligations? What do American doctors consider their most important duties and obligations?
Fadiman clearly makes a distinction between the duties and obligations of the Hmong versus the American doctors. Certainly, during instances in which the two cultures clash do these distinctions shine. For example, it is perceived that American doctors prioritize things such as their personal welfare, monetary wealth, medicine and family over other things. The Hmong on the other hand prioritize their children and family first and foremost overall. Then comes their extended family, culture, and community. These distinctions are one of the primary reasons for the friction between the two cultures.
7. In matters of attitude, what might the average American doctor learn from a Hmong txiv neeb (shaman)? What might the txiv neeblearn from the doctor? The average American doctor, as documented not only by Fadiman, but also by numerous other sources – such as any material concerning narrative medicine – could learn to appreciate the pros of the Hmong cultural and shaman practices. For example, as is a theme in both narrative medicine and how the shamans approach healing, the idea of incorporating a sense of a stronger connection between the patient and healer: spending more time with patients, adding a spiritual dimension to their treatment, and being open to the culture in general.
On the other side of things, the txiv neeb shaman could also undoubtedly benefit some of the American doctor practices. The objectivity of evidence based diagnostic medicine and the physical medicines available to American doctors are part of what makes the western healthcare successful in certain regards. 8. In her preface, the author says that while she was working on this book, she often asked herself two questions: “What is a good doctor?” and “What is a good parent?” How do you think she might have answered her own questions? How would you answer them?
I think that after reading the story my definitions of what describes a good doctor and good parent have adjusted to become somewhat synonymous with what I would imagine Fadiman’s descriptions would be. At the very least I would imagine that both of us would agree that a good parent is one that puts the best interest of the child at the forefront of every decision concerning them – whether this includes health concerns or not. Similarly it follows that a good doctor is one that does everything possible to help his or her patient. This includes spending time with the patient in a capacity larger than just tests and prescriptions. The characters
10. The Spirit Catches You and You Fall Down revolves around a small child who for much of the book is too young to speak for herself, and at the end is unable to. Do you nonetheless feel you know Lia Lee? Do you believe that even though she cannot walk or talk, she is a person of value? Why?
I suppose that while Lia Lee never gets the chance to communicate with the reader of the book, the experiences that we read give us some kind of insight into what she must feel. While I feel that I can claim I know Lia Lee on a sympathetic level, I do not think I could say I know her more than that…we can never know what goes through her mind or what she is feeling emotionally or mentally.
Even though Lia Lee cannot walk or talk this certainly does not justify the claim that she is not a person of value. Every living person maintains value in some sense and to deny her that right simply because of her physical ailments seems extremely unreasonable from a moral and scientific sense. 12. How do you feel about the Lees’ reluctance to give Lia her medicine as prescribed? Can you understand their motivation? Do you sympathize with it?
As much as I can sympathize with the unwillingness for the Lees to give Lia her medicine, there is a line that needs to be drawn. I understand that they truly did believe that the medicine was detrimental to Lia and thus, as any good parent would do, they used their judgment to stop giving her the medicine. But, at the same time, the Lees are parents, not physicians or healers. I think that, at least when it comes to the health of their child, a physician’s judgment should have a significant weight in their decision-making if not the final say in matters such as these. Yet, by the text, it does not seem that the Lees even remotely gave much consideration to the medicine of the American doctors when deciding to stop medicating their child. As a result, I am forced to not sympathize with their decision.
