The Spirit Catches You And You Fall

Part A

In the spirit catches you and you fall story, there is the Hmong family called the Lees. They have a young daughter called Lia who was diagnosed with a disease which the Hmong people called qaug dab peg which describes seizure. To them this sickness is a spirit which catches you and you fall, but the doctors realized that this sickness was actually epilepsy. Both the parents of Lia and the doctors want what is best for her; however there arises a conflict of culture between the doctors and the Lees. This coupled with the severity of Lia’s medical condition gave health care professional profound difficulties in dealing with her case. According to the culture of the Hmong it is founded on a set of superstitions and beliefs that are based on how the soul and body works and they use such beliefs to fight appearance and illnesses. For instance, Fadiman notes that although the Hmong people are of the idea that sickness can be caused by numerous sources, soul loss to them is by far the common cause of illness. The Hmong people therefore use holistic and spiritual approach in Lia’s health problems because it is all they know. On the other hand, the American doctors having realized that Lia was having seizures as a result of her cerebral neurons misfiring try to use American treatments and medicines, however the Lees do not comprehend what these treatments are and how such treatment will help their daughter.

Another instance that illustrates the conflict in cultures is when Lia’s father stated the at times the soul normally goes away nevertheless, the doctors do not understand and this, he tells the doctors to believe in their healing spirit (neeb). He says that doctors can only heal some diseases that have to do with the blood and body, but for the Hmong, we believe that people usually get sick because of their soul and this can only be healed by spiritual things. He believed that for Lia’s case a combination of a little neeb and some medicine would work well, but excess medicine he believed would reduce the effect of the healing spirit. He states that if Lia was to be given a little of each, then she wouldn’t get as sick as she was, but the doctors wouldn’t allow them to give a little medicine because they didn’t understand issues of the soul.

In the above examples a lot could have been to help Lia’s case, the misunderstandings and

The spirit catches you and you fall

errors by the two colliding sides is at the expense of Lia’s well being as she is mis-medicated, overmedicated and under-medicated. There should have been provision of translation services to enable both sides to work together. Such services could have enabled doctors to make Lia’s parents understand exactly what caused the seizures and the importance of the treatment the doctors were giving to her.

Part B

Neil’s effort to experiment with different medications was done in an attempt to find the most effective regimen for Lia; he was a doctor who believed in his profession and he desired to help people a lot. He sought to provide a high quality of care to all patients equally. Due to language barriers it became hard for him to dispense Lia’s medication, and this was the biggest challenge. Neil prescribed multiple drugs that were to be given to Lia in doses as this is what he considered necessary at the time. Nevertheless, this regimen did not work because Lia’s parents found Neil’s approach too confusing. The parents believed that if Neil had prescribed a single drug, then the approach could be more streamlined and it would have been easier for the parents to follow. it is at this point that Lia was taken from her home and put into foster care as her parents did not adhere to the orders of the doctor. After some time she was returned home with her family but it didn’t take long before she was placed under the care of a foster family as the parents did not adhere to the proper dosage of drugs. This approach was not the best because the parents were devastated by not having Lia at home; they were not to blame considering the language barrier that existed and their beliefs.

Utilitarianism vs. Deontology

In utilitarianism, it is a system of ethics that suggests that to maximize happiness in a given society is the most ethical thing that an individual can do. According to this approach each action has an outcome that can be calculated and that for each ethical choice that an individual makes there is always an outcome. It is such outcomes that lead to maximum happiness that should be capitalized on. Therefore for a utilitarian the end justifies the means.

The spirit catches you and you fall

For deontologists, unlike utilitarianism requires that the actions used to attain the outcomes should be themselves ethical. According to deontologists there are ethical truths and norms that are applicable to all people universally and that some actions are unethical despite their positive outcomes, such actions are therefore wrong. Thus for deontologists the means must justify the ends.

With regards to the case of Lai, a utilitarian would have allowed the parents to take care of Lai as opposed to taking her to a foster home, they could have allowed them to practice their beliefs and also give medication which would have made the parents happy. In comparison a deontologist will advocate for what doctors did, they would stick to the medication because this is believed to be the right thing to do.

According to Fadiman the Lees gave Lia outstanding care and wanted what was best for her, the complexity of her condition however could have bewildered even literate American born parents. Justice was not done to the Lees because language and culture barrier was not of their own making, Dee who was Lia’s foster mum had suggested that she be taken back home but the authorities refused until the 6 months lapsed.


Fadiman, A. (1997): The spirit catches you and u fall: A Hmong child, her American doctors, and the collision of two cultures. Farrar, Straus and Giroux, New York.

The spirit catches you and you fall