The Center for Ethical Cannibalism

The Sacred Disease

The Spirit Catches You and You Fall Down by Anne F. Fadiman captures the health care system of Merced, California with all of its flaws, the most importantly being its failure to properly integrate the care of a (substantial yet) marginalized Hmong population; focusing on growing pains related to intersecting cultures and traditions of medicine. While a topical understanding would implicate Western medicine in its early failures (specifically with the Lee family), Fadiman takes on the role of an anthropologist by digging into ancient roots to bridge the gap. Ultimately Anne F. Fadiman silently pleads not only on behalf of the Lees and the Hmong but for us all to dismantle any structures that might impede the holistic care and understanding of all.

An honorary Critical Medical Anthropologists, Fadiman observes how in Merced, California is a complex slurry of “economic and political systems on health care” with a spectrum of success with how those “health-care systems define who is sick and how they get treated.” She first explains how the Hmong ethnomedicine actually values those similar to the subject of the story, 3 month year old Lia Lee, who suffers from seizures. Within Hmong culture, she would be expected to grow to be a leader if not shaman, who play the role of traditional healer. This runs counter to the Western medicine practiced by the doctors who over the course of months repeatedly miscommunicate and misdiagnose Lia. Yet even when this is rectified, the gap is not entirely filled:

“Dan had no way of knowing that Foua and Nao Kao had already diagnosed their daughter's problem as the illness where the spirit catches you and you fall down. Foua and Nao Kao had no way of knowing that Dan had diagnosed it as epilepsy, the most common of all neurological disorders. Each had accurately noted the same symptoms, but Dan would have been surprised to hear that they were caused by soul loss, and Lia's parents would have been surprised to hear that they were caused by an electrochemical storm inside their daughter's head that had been stirred up by the misfiring of aberrant brain cells.”

While triumph is clearly to be found when Dan Murphy breaks past the seemingly insurmountable communication barrier, there’s clearly a bittersweet element with these differing cultural values seeming to be doomed to never mesh.

Fortunately Fadiman appears to propose compatibility based on shared ancient roots. Citing the Greeks and their understand of epilepsy as “the sacred disease" she also invokes the likes of Soren Kierkegaard, Vincent van Gogh, Gustave Haubert, Lewis Carroll, and Fyodor Dostoyevsky, whose genius were not impeded but in fact enhanced by their seizures. This message is compounded when she quotes Dostoyevsky's Prince Myshkin:

"What if it is a disease? What does it matter that it is an abnormal tension, if the result, if the moment of sensation, remembered and analysed in a state of health, turns out to be harmony and beauty brought to their highest point of perfection, and gives a feeling, undivined and undreamt of till then, of completeness, proportion, reconciliation, and an ecstatic and prayerful fusion in the highest synthesis of life?"

The unspoken promise of Ann F. Fadiman’s work then seems to be that the mixed salad of America's cultural bowl might someday render a beautiful fusionist, near-utopian future that allows for not only the treatment of illnesses like epilepsy (should it be chosen) but also their integration; or better yet the recognition of those individuals not a sufferers but neo-shamans of philosophy and art. And that is infinitely more inspiring than the chaotic, Tower of Babel-esque mess we currently have in places like Merced, California. At least that’s my takeaway and hope.