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

4.13  ·  Rating Details  ·  43,144 Ratings  ·  3,537 Reviews
Lia Lee was born in 1981 to a family of recent Hmong immigrants, and soon developed symptoms of epilepsy. By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy ...more
Paperback, 341 pages
Published September 28th 1998 by Farrar, Straus and Giroux (first published 1997)
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(showing 1-30 of 3,000)
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Matt
Jun 01, 2016 Matt rated it it was amazing  ·  review of another edition
If nothing else can be said about this book, it should be said that it will cause a reaction. Most books are a monologue. The author is telling you something and you listen. Anne Fadiman’s book is so engaging, and touches on so many sensitive subjects, that it’s more like a dialogue between author and reader. And I use the word dialogue literally. During the course of this book, I found myself audibly voicing my opinions at the page like a crazy person. My wife would ask me what I was saying, an ...more
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 it was amazing
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 really liked it  ·  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 it was amazing
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 liked it
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
Mmars
Dec 31, 2014 Mmars rated it it was amazing
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 Merced, CA when she experienced her first seizures. The Hmong and their language and their culture were yet virtually unknown and entirely misunderst
...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
Robbin
Feb 25, 2008 Robbin rated it it was amazing
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
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
Samantha Newman
Oct 09, 2007 Samantha Newman rated it really liked it
Shelves: nonfiction
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
Chelsea
Feb 18, 2008 Chelsea rated it it was amazing
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
K
Nov 19, 2008 K rated it it was amazing
Recommends it for: everyone, but especially book clubs, religious people, and medical personnel
"The Spirit Catches You and You Fall Down" explores the tragedy of Lia Lee, a Hmong child with epilepsy who eventually suffered severe brain damage, from a variety of perspectives. One perspective is that of her family, who believed that epilepsy had a spiritual rather than a medical explanation, and who had both practical difficulty (as illiterate, non-English speaking immigrants to the U.S.) and general reluctance to comply with Lia's complicated medical regimen. Another perspective is that of ...more
Merritt
Sep 02, 2007 Merritt rated it liked it
Shelves: memoirs
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
Sarah
Apr 12, 2009 Sarah rated it it was amazing
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
Naeem
Dec 27, 2007 Naeem rated it liked it  ·  review of another edition
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
Nicole
Dec 15, 2015 Nicole rated it really liked it  ·  review of another edition
Shelves: non-fiction, academic
Christ, what a ride. I thought this book would be dry and unreadable. I had to read this for my Cultures & Madness class and write a book report (that I still haven't done).

While there are times that it can be dense, it is very well written. Ms. Fadiman writes about the Hmong with incredible gravitas and emotionality. I don't know how she did it but, by the time I finished the book I was all teary. Sure, it could be that I haven't slept in days (finals) but I think it's because of how the s
...more
Irene Mcintyre
"The parents of one small boy emptied his intravenous bottle refilling it with a green slime of undetermined ingredients- herbal home brew made by the Hmong parents for ages. Hmong patients made a lot of noise in the hospital which annoyed their American counterparts. They sometimes wanted to slaughter animals in the parking lot or hospital room of a sick relative. One resident recalls" they would bang the crap out of some musical instrument while visiting sick relations and the American patient ...more
Miklos
Oct 17, 2011 Miklos rated it did not like it
Is it terrible that I found myself sympathizing with the doctors and that the family was getting in the way of treating their childs illness?
El
Jan 28, 2012 El rated it really liked it
Recommended to El by: Liz M
A little Hmong girl slammed the front door once and her three month old sister had what the medical community call an epileptic seizure. The Hmong family referred to it as quag dab peg which translates to "the spirit catches you and you fall down". It was the beginning of a long series of similar seizures, and the beginning of a long series of difficulties between the Hmong and American cultures.

Lia Lee and her family were refugees living in Merced, CA when the spirit first caught Lia in this wa
...more
Chrissie
Apr 12, 2012 Chrissie rated it really liked it
Recommended to Chrissie by: Lynne
Having now finished the book, I know Lia's fate. You must read the book to find out. No spoilers here!

It is important to note that this book should be read by those not only interested in anthropology and how medical practices could/should be improved, but also those wanting to learn more about the Silent War in Laos. So many have been written about the war in Vietnam and so few about that in Laos.

How do you teach doctors to feel empathy and love for their patients? Physical contact is one quick
...more
Paul Gaya Ochieng Simeon Juma
Western Medicine vs Traditional Medicine
Hmong people vs American Authorities
Culture vs Civilisation

I need to start from the beginning, what is civilisation? The noun civilisation comes fro the word civil. Time and again we've heard people being asked to act in a civil manner. This means that there are certain codes and values which an individual should learn in order to live peacefully with people.

In this case the American authorities would define what being civil means. It means learning the c
...more
Charlton
Jun 08, 2016 Charlton rated it it was amazing
Shelves: favorites, fact, cultural
I thought this book was extraordinary (sp).
You learn about Lia Lee (the child with epilepsy)and also about the Hmong society.
This book is heart-wrenching,there are many sad moments.
smetchie
Dec 17, 2014 smetchie rated it liked it
If you like non-fiction just ignore my lack of stars. This is a really interesting story, well told. I learned all kinds of stuff. It made me mad when the author wanted me to be mad and it made me sad when she wanted me to be sad. She exposed the massive cultural divide between Hmong and Western medicine while telling a sweet and heartbreaking story. She made me think and explore my own cultural bias. The topic is extremely thought-provoking. It's all there. I expect most everyone would enjoy th ...more
LeeAnn
Jan 11, 2016 LeeAnn rated it it was amazing
There is so much to chew on here. I began this book (with the latest addition on Kindle) at the recommendation of my sister-in-law when she realized my son was serving a mission for our church in Merced, an area with many Hmong. She was right; this was an interesting lesson in the cross cultural clash of two very foreign ways of being: American (western) and Hmong. It is also a lesson in seeing things from other viewpoints or at least being aware that there IS, or at least may be, another view. ...more
Kaion
Apr 25, 2016 Kaion rated it really liked it
Anne Fadiman does a good job of laying out some of the complexities of the case of Lia Lee from the various viewpoints of her doctors, family, social workers, and other caretakers. However, reviews had me expecting something more of an exploration of cross-cultural medicine, or medical ethnography, and the turn in the later half of the book threw me in for a bit of a loop.

I appreciated that Fadiman really got into explaining Hmong culture and beliefs towards medicine and disease -- the title ref
...more
Elizabeth
Feb 09, 2015 Elizabeth rated it it was amazing
Oh I loved this book on so many levels! The book cover captures the basic thread “A Hmong Child, Her American Doctors, and the Collision of Two Cultures.” I picked the book recently after reading of the death of a major character. I just can’t believe I haven’t read it earlier.

At the most basic level, it is a story about clashing cultures, but it is so much more. I live in a metro area with one of the largest populations of Hmong outside of Asia, yet I didn’t realize how little I knew about the
...more
Emily
Dec 19, 2014 Emily rated it really liked it
The Spirit Catches You and You Fall Down is an engaging and thoughtful look at the role culture plays in medicine. This is a true account of doctors trying to care for their patient and a family trying to cope with a foreign culture, with Lia, a girl with a severe seizure disorder, caught in the middle. Everything that could go wrong does, and each side has their own views of the causes and consequences. Fadiman tends to side with the Hmong, which is understandable. They are clearly the underdog ...more
Chana
This is a very serious book filled with history, medical information, Hmong culture and the politics of war and immigration in the United States. It is a rather damning text, both to the U.S. in our international politics, and to the rigidity of our medical system.
Lia Lee is the 13th child of a Hmong couple from Laos. When the communists are victorious in Laos the Hmong people were killed, tortured, starved for their part in the war which was fighting on the U.S. side. So Lia's parents (Lia was
...more
Jerzy
Apr 03, 2014 Jerzy rated it it was amazing
A very thought-provoking, useful read for anyone working in a cross-cultural setting, not just health care. The assumptions that a Westerner takes for granted (e.g. your doctor knows what medications to prescribe, and you endanger yourself if you don't take the full dose) may be quite contrary to other peoples' beliefs (e.g. a Hmong parent is making an eminently reasonable compromise by giving their child a little of the Western medications and a little of their own spiritual healing, instead of ...more
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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
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“I have always felt that the action most worth watching is not at the center of things but where edges meet. I like shorelines, weather fronts, international borders. There are interesting frictions and incongruities in these places, and often, if you stand at the point of tangency, you can see both sides better than if you were in the middle of either one.” 28 likes
“The action most worth watching is not at the center of things, but where edges meet.” 18 likes
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