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Hmong vs. Western Mbedical Explanatory Models


In the novel The Spirit Catches You and You Fall Down, the focus of the novel is on a young Hmong child named Lia who suffers from severe epilepsy. Within the novel, two different explanatory models explained the belief that Lia suffers from epilepsy. One explanatory model was that of the Hmong perspective, while the second came from Lia’s American physicians.


The Hmong culture believes that all physical disease comes from a spiritual nature, which is shown in the reasoning for how Lia became ill. Lia’s parent’s believed that when Lia’s sister slammed the door to their house, that Lia’s soul was lost. This loss of her sole was also believed by Lia’s parents to be the cause of Lia’s illness. The Hmong also believe that the spirits are alive and are involved in the daily lives of their people. This is another Hmong explanatory model for the cause of Lia’s epilepsy. This is represented in the theory that the spirit caught Lia and is continuously making her ill.


The second explanatory model in The Spirit Catches You and You Fall Down is a western explanatory model described to Lia’s parents by her American doctors. These doctors believed that the reason that Lia had recurring seizures was based strictly on their education in western medicine. During their education these doctors were taught the signs and symptoms of epilepsy. These signs included attacks of motor, sensory, or psychic malfunctions, which were all present in Lia, leading to her diagnosis of epilepsy. While western medical teachings was believed by the doctors to be the main cause of Lia’s seizures, western ways of thinking were also involved. The thoughts and viewpoints that Lia’s parents did not give Lia her medications on purpose was another explanatory model used by the doctors. This explanatory model was both correct and incorrectly used at the time. This was because while Lia’s parents did not administer Lia her medications at times because of their own beliefs, there were also times in which Lia’s parents did not understand the directions they were given.


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While explanatory models may help with the diagnosis and treatment of diseases and illnesses, they can also create problems at the same time. In incidents such as Lia’s illness, language barriers may cause explanatory models to be misunderstood, this leading to mistreatment of the patient as well as the illness. In Lia’s case it was very difficult for the Hmong explanatory model to mesh with the western medical explanatory model, eventually leading to the death of Lia.





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