The medical profession has acquired a great sense of dignity and prestige due to the accelerated and often effective advancements of surgical procedures, diagnostic technology, pharmaceutical remedies, and prosthetics. Biomedical science has been upheld as the highest standard of American healthcare as it examines human health through the domain of inquiry pertaining strictly to the objective, physical realm. Surprisingly enough, when looking at the history of western medicine, biomedicine has not always remained as the mainstream understanding of health as the west once believed as the incredible Hmong did; the spirit and mind simultaneously affect a person’s well-being.
It wasn’t until the French mathematician, Rene Descartes (1569-1650), challenged the common thought of the Orthodox Christian church and revolutionized Europe with his mind-body dualism philosophy that severed the mind, and the body as two distinct entities that could not work in unison. (FOOTNOTE) Mind being a metaphysical, conscious, intangible substance as the body, a mechanical, unthinking entity. This separation of mind and body was a crucial theoretical advancement within human history as many diseases were attributed by the church to the particular non-scientific or spiritual intensities felt by the general population through personal/communal wrongdoings.
Now free from religious stigma, the human body was to be studied in fascinating, scientific ways. Although mind-body dualism permitted the fields of anatomy and physiology to exist, it denied the integral significance or philosophy that support both mind and body having an effect over an individual’s health. Although the definition of health was had altered and was soon widely understood as the absence of a disease in the west, this was not the case for the rest of the world.
Anne Fadiman’s ethnography The Spirit Catches You and You Fall Down archives and explores how the different idiosyncratic definitions of health between Lia Lee’s family of Hmong descent and the western medical physicians led to the Hmong religion to be created and rendered invisible in the world of Merced, California during the 1980s. The Lee family belong to the Hmong ethnic group, which consist of montagrads that live in a tightly knitted community that utilize specific methods of agriculture in the lands of Laos, China, and Vietnam. The Lees migrated to the United States after the American War in Vietnam had seized in the 1980s. Before their migration to America, the Hmong had previously faced migrational displacement within nations like China and Vietnam. China, Laos, and Vietnam were countries that historically once rendered the Hmong as an uncivilized, barbaric population as the Hmong community responded to the nations’ persecution and pressures to assimilate through migration or violence. The historical migrational deracination of geographic locations is a result of geographical and historical differences that perpetuate the erasure of the Hmong religion during Lia Lee’s treatment for epilepsy.
The way in which the Hmong live their lives by interpreting the physical world through the metaphysical and inter-relational connections of the natural with the spiritual, by many nations, were considered as potential political threats the respective (Chinese, Vietnamese, and Laotian) establishments and forms of resistance. The Hmong actually wanted nothing to do with the nations that opposed and oppressed them. Rather, they just wanted to live their lives in sovereign peace. From Fadiman’s perspective “The Hmong were so preoccupied with medical issues because they are so concerned with their wellbeing in life.” The Hmong are essentially concerned with the preservation and maintenance of the soul, symptoms felt by the vessel, how the vessel functions properly to seal or ground the spirit, and the journey that the soul undergoes to retrace the life that was known before. This ancient Eastern philosophy and religion created a cultural discord among the Lee family and the western practitioners as the American Merced doctors had never encountered a community quite like the Hmong until they were confronted with Lia Lee’s medical condition at Merced Community Medical Center (MCMC).
The previous societal and geographic conflicts that played a massive role in the ethnic background of the Lee family are much more critical than the events that occur in Merced as it relates greatly to the disintegration of Hmong identity but this geographic diaspora also attributes to the way in which Lia’s medical condition is treated at MCMC. Traditionally, the Hmong do not practice western medicine nor did they come close to encountering it until they arrived at the refugee camps in Thailand and later, in America. The Hmong use “non-traditional” methods of healing to assess and preserve their health. These methods of healing include practicing shamanistic rituals called neebs, coining, cupping, animal sacrifice, herbal remedies, and using musical instruments that aid shamans to guide souls back to their bodies. These shamanistic rituals are intricately executed through actions like animal sacrifice and many others to please the dabs (bad spirits). As western medicine in American healthcare operates under a biomedical perspective, these healing practices were not embraced but rather criticized by American doctors during Lia’s treatment.
The Hmong who live in Merced utterly reject western medicine because it reenforces the Hmong to assimilate to a culture that does not entirely understand the Hmong and can inevitably cause them to lose their souls. Such biomedical practices utilized and administered by western medicine as anesthesia, surgery, autopsies, and repeated blood samples can cause the soul to wander, as well as various illnesses, death, and the possibility that the person will be physically incomplete, once they enter into their next life because the body has essentially been tampered with. As this perception of health starkly juxtaposes the definition of health understood by Lia’s American physicians, there was a resistance from the Lees to fully comply with the healing methods of Lia’s treatment. This clash of cultural definitions caused the Hmong identity to be invisible as they were encouraged and coerced to forget everything that they knew and assimilate to the American way of maintaining their souls.
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