In Chapter 3 of The Spirit Catches You and You Fall Down, Fadiman explains the reason for Lia’s frequent visits to the doctor.. Lia suffered from epilepsy but her parents believed her symptoms arose from an incident that occurred when Lia was three months old. The Lee’s older daughter Yer slammed the front door of the apartment and Lia had a seizure. They believed the noise of the door slamming “had been so profoundly frightening that her soul had fled her body and become lost” and that Lia’s epilepsy was a phenomenon called “quag dab peg” which translates to “the spirit catches you and you fall down” (Fadiman 20). The rest of Chapter 3 details the Lee’s first experiences in taking Lia to the emergency room and the doctors incorrectly diagnosing her with bronchitis since they had no way of knowing her congestion was caused by a seizure due to the language barrier.
This speaks to the greater problem in the United States public health system of not funding programs which help immigrant and refugee families find accessible hospital treatment and healthcare. In the novel, Fadiman writes that rural country hospitals have more financial problems because most of their patients are not privately insured (Fadiman 24). Wealthy patients will either go to private hospitals or larger city hospitals (Fadiman 24). This reminded me of the Race: The Power of an Illusion videos, specifically when it is mentioned that it was white flight which caused integrated neighborhoods to go down in real estate value but it was African Americans who were blamed for the declining market. Programs like Medicare are constantly demonized as being a burden on the general American public in terms of tax dollars and only serving “lazy” people of color and immigrants.
My personal belief is we should have free countrywide healthcare for everyone and that there should be funding for translator programs in order to help families like the Lee’s. In my personal experience as the child of two Mexican immigrants, not providing programs as simple as addressing the language barrier leaves immigrant and refugee families with an alarming lack of knowledge about the American healthcare system and other information that is needed to live in the United States. As a child, I was often asked to translate for my parents which is why I found this line in the novel striking, “ten-year old girls have had to translate discussions of whether or not a dying family member should be resuscitated” (Fadiman 25). The problem with this is it places a huge emotional burden on children. Furthermore, these are just kids and they could miss things in translation that are out of their understanding as children.
In Chapter 4 of Fadiman’s novel, some really important concepts are discussed that would be helpful in dealing with the culture and language barrier faced by refugees and immigrants. Fadiman writes about the distrust Hmong refugees had of refugee camp hospitals because there was no effort on the part of the American staff to work with the Hmongs; instead they tried preaching to them. However, there was a case of an ethnographer named Dwight Conquergood who found ways to communicate with the Hmongs and have them trust him in medical matters (Fadiman 35). He put on a performance, which prompted the Hmongs to bring in their dogs for rabies shots, which was highly effective (Fadiman 36). Conquergood said his relationships with the Hmongs was “a productive and mutually invigorating dialog, with neither side dominating or winning out” (Fadiman 37). This statement by Conquergood is beneficial in explaining that Westerners should work with refugees and immigrant peoples in order to reach a mutual understanding rather than preach at them because they think they know better. I found this point salient because it reminded me our discussion in class about not trying to eradicate racial and ethnic differences, rather appreciate one another’s cultures.