This may have been my favorite book of the profiles class. I have a hard time chosing between this and The Last American Man.
Anne’s Alternating Views
While writing her book The Spirit Catches You and You Fall Down, Anne Fadiman faced the daunting task of introducing a culture that is unfamiliar to many westerners and show how the difference between that culture and the American medical community ultimately caused a young girl to become irreversibly brain damaged. To pull this off successfully, Ms. Faden had to make sure that the readers couldn’t blame one person, one group, or one thing for what happened. At the end of the book, the readers had to completely understand every party’s perspective and ultimately lay the blame on something as intangible as cross-cultural misunderstanding. To accomplish this, Anne Faden chose to alternate the focus between chapters from broad to narrow and to alternate the point of view of scenes between Hmong and American.
In the first chapter, we (the readers) meet Lia Lee and her parents. The focus of this chapter stays with the Lee family, but through describing what Lia’s birth would have looked like in Laos instead of the States, we are introduced to some very specific Hmong traditions, including the practice of burying the placenta near the family house. Knowing the significance of this tradition becomes important in later chapters so that we can understand the frustration the Hmong experience when American doctors won’t allow them to take home a baby’s placenta. The second chapter pans out its focus to be more broadly about the history of the Hmong, but the author also explains how in Hmong culture any event is so interconnected by anything that came before it and to fully understand something, you must know its history. This then, is how Faden justifies why it is that she must explain so much about the Laotian Hmong to us for us to fully understand what happened with Lia, which is the ultimate question of the book.
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The book’s chapters continue to alternate between a broad focus of events related to Hmong in general, to specific incidents with the Lee family. The only exception to this is three chapters in the middle of the book (7, 8, and 9) where the focus stays with the Lee family. These chapters are shorter, the narrative speeds up and the events described are very tragic. Chapter 9 ends with a cliff hanger of Lia’s doctor Neil Ernst describing how her seizures increased in severity and how he dreaded eventually not being able to stop them. The next chapter pans out again, slowing down the narrative as we learn about the importance of the Hmong’s role in the Vietnam War. Towards the end of the book, the chapters are still alternating their focus, but are interconnecting issues, showing that what faces the Hmong as a whole is also why the Lee family experiences misunderstanding after misunderstanding with the Merced medical community.
Faden is also very good at showing us the frustrations both sides of the conflict experience by alternating points of view when describing scenes. A good example of this is chapter 4, “Do Doctors Eat Brains,” where she shows the readers scenes that would be familiar to them, from the point of view of the Hmong. Since we already know a little bit about the Hmong culture at this point, we see how intrusive something as simple as general questions during a routine visit to the doctor would be. In the beginning of chapter 7, the author shows Lia’s doctors point of view on the care she received, both how they experienced things in the midst of a crisis and how they feel while reflecting back on it at the time the book was written. When neither side of the story can deliver the impact necessary, Faden inserts herself and guides us through both points of views at the same time. On page 223, while describing an interaction between the Lees and the visiting nurse Martin Kilgore, the author’s point of view allows us to see the cross-communications taking place and the insight she gains while watching Kilgore talking to the Lees, thus giving us the same insight.
The end effect of this mastery of views and focuses is that when Faden on page 262 states that she has come to believe that Lia’s life was “…not ruined by septic shock or noncompliant parents but by cross-cultural misunderstanding.” we completely believe her and trust her authority to make that conclusion. By revealing the complexity of the issues involved in Lia’s medical case, she’s managed to make us sympathetic to the American doctors, the Lee family, and the Hmong culture as a whole–making it impossible for us to pick sides.