The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

4.11 of 5 stars 4.11  ·  rating details  ·  22,957 ratings  ·  2,641 reviews
Winner of the National Book Critics Circle Award for Nonfiction

When three-month-old Lia Lee Arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-...more
Paperback, 341 pages
Published September 30th 1998 by Farrar, Straus and Giroux (first published 1997)
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Inder
This is the heartbreaking story of Lia, a Hmong girl with epilepsy in Merced. It is intended to be an ethnography, describing two different cultural approaches to Lia's sickness: her Hmong parents' and her American doctors'.

Don't read any further unless you don't mind knowing the basic story told in this book (there are no spoilers, since this is not a book with a surprise ending, but if you want to keep a completely open mind, stop now) ...

I have wavered between four and five stars for this on...more
Lisa Vegan
Oct 13, 2007 Lisa Vegan rated it 5 of 5 stars Recommends it for: anyone who has interest in understanding people different from them
I knew a little about this case, and before I read the book, I was certain I’d feel infuriated with the Hmong family and feel nothing but disrespect for them, and would side with the American side, even though I have my issues with the western medical establishment as well. Not that I didn’t feel angry (and amused) at times with both sides, but I also ended up empathizing with the people in both sides of this culture clash, which is a testament to Anne Fadiman’s account of the events. My culture...more
Teresa
Jul 27, 2012 Teresa rated it 4 of 5 stars  ·  review of another edition
Recommended to Teresa by: rhea
A book like this one should be required reading for anyone who lives in a community of multicultural members, and nowadays that's probably just about everyone. Sadly, and not surprisingly, those who would probably most benefit from a book like this would probably be the ones least likely to read it.

It's an eye-opener on cross-cultural issues, especially those in the medical field, but also in the religious, as the Hmong don't distinguish between the two. In understandable and compelling language...more
Eric
Jul 12, 2007 Eric rated it 5 of 5 stars Recommends it for: human nature considerers, foreign culture sponges
This is one of the best books I've read. I guess it would be considered part of the medical anthropology genre, but it's so compelling that it sheds that very dry, nerdly-sounding label. This was recommended to me in a cultural literacy course and it certainly delivered.

The story is of the treatment of the epileptic child of a Hmong immigrant family in the American health system. The issue is the clash of cultures and the confusing and heartbreaking results. And the takeaway lesson is in how to...more
Hamad
May 12, 2008 Hamad rated it 3 of 5 stars Recommends it for: Medical students, anthropologists
Recommended to Hamad by: Academic
The Spirit Catches You And You Fall Down may read like a documentary (thanks to Fadiman’s journalistic background), but it is really an introspection on the western system of medicine and science. We cannot ourselves metaphorically stand back and try to look at the system from the outside. However, comparing it to another (supposedly antithetical) system through the experiences of the Hmong refugees can be used as a tool to do just that. The Hmong’s presumed non-separation of any of the dimensio...more
Robbin
i read this book for a class i am taking called "human behavior and the social environment." it tells the story of a Hmong family in california with a little girl who has epilepsy. their experience as refugees who are illiterate and unable to speak english, traversing the american medical system ends up tragic. however, the author is really good at giving voice to both sides, the western doctors (impatient, overworked, stubborn, judgmental, dedicated) and the Hmong family (impatient, overworked,...more
Chelsea
Fadiman wrote a fascinating and sympathetic story about a culture that couldn't be much farther removed from ours in the West. It was especially interesting reading it right after Hitchen's God Is Not Great, because, theoretically, had there been no religion involved there wouldn't have been a real culture clash, and Lia could have grown up as an epileptic but functioning girl. Maybe.

But that's not really the point of Fadiman's book: she doesn't condemn anyone, and, in fact, she points out that...more
Samantha Newman
I never would have chosen this book to read on my own. So I must thank Eliza for lending it to me. (I now feel like lending/recommending a book proves friendship...)

I didn't know anything about Hmong culture and now I do. This book also taught me about the American medical system - it looks strange when you step back.

It would have been a good book for me to read when I was in Japan, too, because it kind of opened me up to the idea that people of other cultures can really be sooo different. It's...more
Merritt
An interesting story that highlights the many cultural differences between Americans and our immigrants (in this case the Hmong culture). Lia Lee is a Hmong child with severe epilepsy and the American doctors trying to treat her clash over her entire life with her parents, who are also trying to treat her condition. Fadiman walks a fine line in describing the story fairly from both perspectives; however, it's difficult, as an American, to not feel some anger toward this girl's family. I learned...more
Ngoc
This book is sooo good! I especially like the story of Lina and her family and their struggles. I think the book could have been shorter if they didn't go into so much depth about the interworkings of the social service and medical systems. Yes it's messed up and cultural competency is lacking. I liked that it gave enough information to show how the family was treated injustly and Lina couldn't get the medical treatment she needed because the doctors and parents weren't communicating. They all w...more
Mmars
There are so many valuable aspects to this book it's hard to decide what to mention. Having just learned that Lia, the subject of the book, passed away within the last week I'd like to express sheer admiration to her family, and especially her parents, for loving and caring for her for so many years.

Along with a large influx of Hmong, Lia lived in Oakland when she experienced her first seizures. The Hmong and their language and their culture were yet virtually unknown and entirely misunderstood...more
Crawford
Aug 14, 2010 Crawford marked it as to-read
Shelves: recommended
Educational warning: This book will teach you something important about non-compliant patients.


The title of The Spirit Catches You and You Fall Down is the literal translation of the Hmong words for epilepsy. All doctors know about epilepsy; virtually none know about the Hmong people. They are an ethnic group who lived in China for hundreds of years.

The Hmong have often been thought of as "outsiders." Over the centuries they have resisted taming by various domineering governments and oppressors....more
Heather
Anne Fadiman addresses a number of difficult topics in her depiction of a Hmong couple's quest to restore the soul to their child. While I consider myself a culturally sensitive individual, having been raised in a family of doctors and nurses, I have long held the conviction that the world's best doctors (whether imported or native) tread on American soil. Reading Fadiman's account (which sometimes includes actual excerpts from the patient's charts), I was forced to take a hard look at my assump...more
Sarah  Pi
Amazing book. In my work with people with developmental disabilities and epilepsy, I've seen a lot of examples of the disconnect between doctor and patient -- and that's even when both speak a common language and have a common cultural understanding of their roles. This book tells the story of an extreme example, in which the patient's parents neither understood the doctors nor trusted them, and the medical system held a reciprocal inability to understand where the family was coming from. In tel...more
Liz
This is a fabulous book. I read it several years ago when we were beginning to learn about the Hmong people coming to California and to our schools. I reread it last week after reading Fieldwork (and finding out the the tribe of people he writes about is made up) in order to get a better sense of what people from the hill tribes in Southeast Asia believe, think, and experience. In the case of this book, those thoughts and experiences are in direct conflict with the new country of residence for t...more
Kara
This book is a nonfiction look at the Hmong people, a Laotian ethnic group many of whom have come to the U.S. as refugees in the decades after they supported the U.S. against the communists in Laos, and the roots and impacts of the cultural misunderstandings that have inevitably arisen between the Hmong and America. A book club favorite, I believe (which is, of course, why I read it).

It alternates between chapters covering cultural history of the Hmong and chapters that focus on the case study...more
Reid Mortimer
Nov 26, 2007 Reid Mortimer rated it 5 of 5 stars Recommends it for: Everyone!
Born in 1981, Lia Lee was the daughter of Hmong immigrants new to the United States, who knew little English and little understanding of American culture. Soon after she was born, Lia starts having seizures that are soon diagnosed as epilepsy.
The book is the story of Lia’s life, and the battle to keep her alive. Her parents, with their own strong Hmong cultural beliefs, credited Lia’s seizures to an incident that happened right before her first seizure, when her older sister slammed the door,...more
Jenna
Extraordinarily well-researched nonfiction book whose author earnestly sought to understand how a medical tragedy involving a young Hmong girl came to take place. The chapter about the involvement of the Hmong people in the Vietnam War should be required reading for all Americans, if only because we shouldn't forget how much we owe these people or what far-reaching ramifications a short-sighted foreign policy can have. Like "Mountains Beyond Mountains," this book makes the argument that science...more
Anne
Every once in awhile I start reading a book and I just want to rush out and tell everyone about it. This is one of those books. This is the story of Lia Lee, a newborn Hmong girl living in Merced, California with her parents and seven siblings. Her parents speak no English, and when Lia begins suffering from epilleptic seizures, they reluctantly take her to the nearby hospital. From there, this book chronicles the vast cultural differences between mainstream Americans and the Hmong, and how lang...more
Ann
The Spirit Catches You and You Fall Down is the clash between western medicine and Hmong ritual healing as played out in the care of Lia Lee, a child with epilepsy. Author Anne Fadiman does an incredible job explaining the conflict, because I felt great frustration and great compassion for both the Lee family and the doctors, in succession as the story unfolded. The cultural barrier was often more insurmountable than the language barrier in trying to find common ground between the two worlds.

How...more
Naeem
So close and yet so far.

Fadiman sets up an epistemological encounters between US doctors and Hmong culture. The life of a young woman is at stake.

The book is well written, well researched, and Fadiman's heart seems to be in the right place.

The book fails however. Ultimately, as hard as she tries, Fadiman cannot overcome her biases. That would be less of a problem if she did not want to come across as "objective."

A touch of theory and a bit of world history might have been enough to take Fadima...more
Christopher Mims
All I remember about this book is that I have been searching for it ever since I read half of a friend's copy in college and then forgot the title - that and a few scenes. Unbelievably vivid.
Ianthe
It;s incredible that this is non fiction. It reads like a novel, so rich in description and pathos. I learned a lot about a culture I had never heard of. The Hmong people. It's also an in depth look into our health care system.
Christina
Fascinating, moving work of nonfiction! Here's my review: http://thebluebookcase.blogspot.com/2...
I really, really wish Ms. Fadiman would publish an updated edition. Or maybe just a "where are they now" appendix. 1997 was a long time ago.
Carol
A very interesting read -- I knew next to nothing about the Hmong culture before reading this book. It's a true story about a Hmong girl with Epilepsy and communication struggles between the girl's family and their doctors in California. I read it a couple of years ago but still think about the things I learned. I do remember that at times it was more detailed than I would prefer, and sometimes the author would site several examples to illustrate a point, so it felt a bit repetitive. Nonetheless...more
Janis
This account of Lia (a Hmong child), her parents, and her western doctors as they all struggle with her epilepsy is heart-breaking and entirely fascinating. The title is a translation of the Hmong phrase for epilepsy and makes clear that the Hmong people feel this is a spiritual crisis. This belief and other Hmong beliefs and practices clash with the intentions and advice of Lia's doctors, with tragic consequences. I could almost feel myself changing as I read this book, in the same way that the...more
Shane Jaynes
One of the themes that recurred throughout Fadiman's telling of this tragic turn of events is how the Hmong people and various iterations of American culture(medicine to be sure, but also the public assistance, child protection, etc.) see one another ethnocentrically. She memorably describes this as each party turning the other's "gold into dross." I was pleased at this even-handed assessment. It made me reflect on the fallability we carry as individuals and the need for humilty and curiosity ab...more
Rachel
By intertwining the investigation of a community hospital's failure to work effectively with a young Hmong's girl's family to treat her severe epilepsy and a brief history of the Hmong people, Fadiman manages to raise salient points about the role of healthcare in any culture, the role of healthcare in American culture, and the relationship between the American government, local communities, and refugee immigrants. Although the story of Lia Lee and her family could have been told chronologically...more
Kent
This is a wonderful book about displaced people (Hmong) with a strong but decidedly non-western culture in America, and particularly with the American medical system. As a physician, I can appreciate the difficulties of cross-cultural medicine, but more than that of listening and being able to listen to patients and what the believe and accepting that our answers in western scientific medicine are not always the right answers for everyone, even those in our own culture. Sometimes we do not reali...more
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The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Hardcover)
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Paperback)
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (ebook)
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Kindle Edition)
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Kindle Edition)

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Anne Fadiman, the daughter of Annalee Whitmore Jacoby Fadiman, a screenwriter and foreign correspondent, and Clifton Fadiman, an essayist and critic, was born in New York City in 1953. She graduated in 1975 from Harvard College, where she began her writing career as the undergraduate columnist at Harvard Magazine. For many years, she was a writer and columnist for Life, and later an Editor-at-Larg...more
More about Anne Fadiman...
Ex Libris: Confessions of a Common Reader At Large and at Small: Familiar Essays Rereadings: Seventeen writers revisit books they love The Best American Essays 2003 A Life in Medicine: A Literary Anthology

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