The Spirit Catches You And You Fall Down Ch.19 & Overview

The ending of the novel was sad but also hopeful. We all knew Lia could not wake from her vegetative state, but the overview was nice to read as it described some of the cultural competency advancements made since Fadiman wrote her novel. Lia may not have been able to come home to her family as they hoped during the sacrificial ceremony the txiv neeb performed, but Foua’s other children thrived and helped her take care of Lia once she became too old. I found it nice that May became a clinical health educator after her childhood experiences translating between her parents and the doctors. May also made the interesting point she realized no one was to blame after starting her job, although she used to blame the doctors as a child.

Dan’s “Patient and Family Centered Care Clinic” was a nice detail that Fadiman let the reader know about. I was especially happy to hear Neil and Peggy joined his practice later on. Fadiman also noted MCMC became a center of cross-cultural innovation, beginning the first formal shaman policy. Fadiman also discussed cultural competency and noted that although it is an advancement in cultural sensitivity, it also has dangers. People trained in cultural competency might actually begin to stereotype minorities because they believe themselves experts. We saw this in the video we watched in class where a medical practitioner said Latinos exaggerate their pain, and that she had learned this in a cultural competency session. Overall, this was bittersweet ending because I knew Lia would not recuperate but it gave me hope for advancements in the treatment of minorities. The final passage where Nao Kao thanks Neil after finally understanding he did care about Lia’s well being, was especially touching.

I liked Fadiman’s point that American culture does not know how to mourn. This resonated with me because I believe the message that work is the most important thing is leading to the deterioration of Americans’ health, as people shut away their emotions.

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