The Spirit Catches You and You Fall Down

by Anne Fadiman

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Was Neil Ernst justified in filing a report with child protective services claiming child endangerment due to the Lees' noncompliance with Lia's medical regimen in The Spirit Catches You and You Fall Down?

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I think the answer to your question is a matter of opinion—and it is this very matter of opinion that forms the quandary at the heart of this heartbreaking story. The ultimate debate, as raged between Lia’s parents and her doctors, is this: which medical regimen will help Lia, and what type of treatment does she need?

In Lia’s parents’ opinion, their daughter should be treated in line with the practices of their ancient Hmong culture. It seems there is something to be argued for this type of medicine, because while doctors at the Merced Community Medical Center initially misdiagnosed Lia’s epilepsy as a bronchial infection, her family identified the condition correctly—only to them, epilepsy stemmed from their daughter’s soul having left her body and gotten lost.

In Neil Ernst’s opinion, on the other hand, Lia needed to be given the very best that Western medicine had to offer her.

Although Lia’s condition did not actually improve once she had been removed from her family and placed with foster parents to ensure that her medications were taken correctly, it must be noted that in taking these actions, Neil Ernst took what he firmly believed to be be best course of action, based on his medical training and experience in the field. A doctor can unfortunately never foresee how a treatment plan is going to work out, but he was not acting with anything but the best intentions.

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