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

4.12 of 5 stars 4.12  ·  rating details  ·  33,502 ratings  ·  3,163 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-
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Hardcover, 339 pages
Published September 30th 1997 by Farrar, Straus and Giroux (first published 1997)
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(showing 1-30 of 3,000)
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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
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Lisa Vegan
Oct 13, 2007 Lisa Vegan rated it 5 of 5 stars  ·  review of another edition
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
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Eric
Jul 12, 2007 Eric rated it 5 of 5 stars  ·  review of another edition
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
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Hamad
May 12, 2008 Hamad rated it 3 of 5 stars  ·  review of another edition
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
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
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
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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
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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
Crawford
Aug 14, 2010 Crawford marked it as to-read  ·  review of another edition
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.
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K
"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
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
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Sarah
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
Irene
"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
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
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El
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
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Chrissie
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
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smetchie
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
Emily
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
Jerzy
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
Stephanie
Jun 18, 2009 Stephanie rated it 4 of 5 stars  ·  review of another edition
Recommended to Stephanie by: Nikki's Book Club
It’s tempting to think that everyone in the world thinks pretty much like we do – people are people, after all – particularly if they live here in the United States and especially if they dress like us. A little careful reading, however, can show us just how wrong that assumption is. In The Caliph’s House , author and protagonist Tahir Shah bumbles his way through Moroccan society with hysterical results. Anne Fadiman’s The Spirit Catches You and You Fall Down also examines what happens when cul ...more
Maia B.
It's terribly difficult for the family - any family - of a severely epileptic child to deal with the situation. Imagine it: not knowing when the seizures would start, not sure whether the medicine was helping or hurting, seeing the doctors without another route to take when it's clear what they've been doing isn't working. It's awful.

Now imagine that you can't speak any English at all, you spent 90% of your life living in a tiny east-Asian country and only moved to the U.S. a few months ago, and
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Kurt
This book is amazing. Heartbreaking, informative, honest, intense... Fadiman presents a case study of Lia Lee, a young Hmong girl who suffers from seizures. The case study is emotionally gripping from the start - Fadiman is an expert at weaving together narratives from a variety of eyewitness accounts, and it is clear from their tone that Fadiman is presenting what may be the most poetic autopsy in history. Clearly, Lia's condition is going to get worse, and clearly, there will be a literary inv ...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
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
Lilisa
This book sheds light on the clash of cultures and the misinterpretation of what is best medically for little Lia Lee. It demonstrates two opposing views on how we view life – a person’s physical and spiritual being in Hmong culture is very different than viewed in the Western world. The book takes us through the challenges Lia's family faces as they battle her epilepsy and its treatment as they see fit from their cultural viewpoint against the medical community doing everything it can to find s ...more
Dolly
Mar 10, 2013 Dolly rated it 4 of 5 stars  ·  review of another edition
Recommends it for: nonfiction fans and medical professionals
I doubt that I would have ever discovered this book had it not been for my local book club. One of the members suggested it and said that it was an interesting book about clashing cultures.

As I read this book, I chose to read the story Jouanah: A Hmong Cinderella by Jewell Reinhart Coburn with our girls. I loved that this folktale helped all of see a small glimpse into the life of the Hmong people, especially before they were forced to flee their life and lands in Laos.

I have to admit that at
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Kristen
Feb 24, 2009 Kristen rated it 5 of 5 stars  ·  review of another edition
Recommends it for: Everyone, But Particularly Doctors, Nurses, SWs, etc.
Recommended to Kristen by: Charlene Dy
The Spirit Catches You and You Fall Down by Anne Fadiman is simply an excellent read. Fadiman skillfully describes the collision of two worlds, western medicine and traditional Hmong culture, by using the case of one little girl as a springboard to explain the historical, cultural and spiritual background of this collision. As these two cultures had to coexist for optimal treatment, the reader is shown honestly and sympathetically how difficult that coexistence can be to develop and maintain.

For
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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
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Schumpp, EII Hono...: The Spirit Catches You and You Fall Down 1 1 Apr 29, 2014 08:45AM  
NYT Article 5 70 Sep 27, 2013 02:41AM  
"a little medicine and a little neeb." 3 56 Mar 23, 2013 04:44PM  
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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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“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.” 21 likes
“The action most worth watching is not at the center of things, but where edges meet.” 15 likes
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