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

4.16  ·  Rating details ·  73,178 ratings  ·  4,829 reviews
Lia Lee was born in 1982 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 30th 1998 by Noonday Press (first published 1997)
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Rustina Sharpe Hmong spirits, such as the dab, are mentioned in this book. The author does a good job in explaining the cultural view of the Hmong people, and how sp…moreHmong spirits, such as the dab, are mentioned in this book. The author does a good job in explaining the cultural view of the Hmong people, and how spirits play an important role in their lives.(less)

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Oct 15, 2015 rated it it was amazing  ·  review of another edition
“When Lia was about three months old, her older sister Yer slammed the front door of the Lees’ apartment. A few moments later, Lia’s eyes rolled up, her arms jerked over her head, and she fainted. The Lees had little doubt what had happened. Despite the careful installation of Lia’s soul during the hu plig ceremony, the noise of the door had been so profoundly frightening that her soul had fled her body and become lost. They recognized the resulting symptoms as qaug dab peg, which means “the spi ...more
Mar 28, 2021 added it
Recommended to Nataliya by: Left Coast Justin
This book for me was truly emotionally exhausting. A story of a real tragedy - the collision between two conflicting systems, a spectacular culture clash, with a little girl caught in the middle while everyone genuinely wanted to do what was best for her, with these efforts clashing and hurting everyone involved.

And everyone - everyone - involved just wanted what was best for little Lia.

Unfortunately, nobody seemed to agree what that actually was.

“Lia’s case had confirmed the Hmong community
Lisa  (not getting friends updates) Vegan
Jun 24, 2007 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
Jun 25, 2020 rated it it was amazing
"If you can’t see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else’s culture?”

I often say that one of the things I most love about Goodreads is that I "discover" through friends' reviews books that I might otherwise have gone my entire life not knowing about. 

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

My GR friend Elizabeth wrot
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
Paul Bryant
Jan 24, 2021 rated it really liked it
Shelves: modern-life
I guess this all starts with President Eisenhower, who was big on the Domino Theory so he got the CIA to figure out some people who lived near China who might want to fight the communists on behalf of the USA. Because of course the USA could not be seen to be fighting directly, that would be a violation of something or another. One of these groups was the Hmong people in central Laos. I had never heard of them either.

It wasn’t that these Hmong hated the communists, but they got the idea that the
Jenny (Reading Envy)
What an incredible read! A clash of Western medicine with Hmong culture, exasperated by a lack of translators, cultural understanding, and education on both sides. Anne Fadiman shows how the situation involving one very sick child went wrong and makes suggestions as to more effective ways to communicate and provide care. I really enjoyed learning about the Hmong family in particular, and their own methods of parenting and treating the sick. The author suggests that millenia of Hmong people refus ...more
Jul 20, 2012 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
Aug 22, 2019 rated it really liked it
This is an impressive work! "The Spirit Catches You and You Fall Down" is a nonfiction book I've been meaning to read for years, and I'm glad I finally made time for it. Anne Fadiman writes about the clash of two cultures: Hmong and Western medicine. By following one Hmong family in California as they struggle to care for their epileptic daughter, we see how difficult it can be to assimilate, especially when there are strong differences in the culture of healing. Fascinating and engaging, I high ...more
Jul 12, 2007 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
Sep 17, 2012 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
Oct 04, 2017 rated it really liked it
In Hmong culture they revere their children so much, it is wonderful. This little girl was her parent's favorite and they believed her epilepsy was a special gift that made her more in tune with the spirit world. Many of the spirit healers in Hmong society have epilepsy.
More largely, this is the story of a clash between western and eastern cultures, a communication lapse that ultimately ended up hurting the parents of this little girl very profoundly.
Feb 18, 2008 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
Left Coast Justin
Feb 11, 2014 rated it it was amazing
Shelves: my-top-ten, medical
Rarely do I read anything that appeals to the heart and the brain in equal measure, rarer still one that both appeals and challenges. It is hard to believe that one book managed to teach me more than any other and made me feel more as well. The words tour de force were invented for works like this.

This book succeeds on so many levels...As a primer on organizing huge amounts of information into a highly readable format, for one thing. Equally as an introduction to Hmong culture, and no less U.S.
Feb 17, 2019 rated it really liked it
The first, spontaneous reaction with regard to the stranger is to imagine him as inferior, as he is different from us.

Lia Lee's parents immigrated to this country in the early 1980s from Laos. They were of the Hmong culture, a people who inhabited mountaintops and all they wanted was to be left alone. During the war they sided with the Americans. Their men joined the military some even becoming pilots. When the war was lost, they had to leave their country or die. They were promised a place in
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
Nov 26, 2007 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
Rosie Nguyễn
May 26, 2021 rated it it was amazing
This is one of the best books I've ever read. It's so good it makes me speechless. I can only say, I wish I could write a book like that one day. ...more
May 12, 2020 rated it it was amazing  ·  review of another edition
Published in 1997, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures is a remarkable masterpiece that feels just as significant today, more than 20 years after being published, for its commentary on cultural differences, social construction of illness, and most important of all, empathy.

Lia Lee was born in California's Merced Community Medical Center, or MCMC, in July of 1982 to mother Foua and father Nao Kao. At 3 months old, Lia e
Sleepless Dreamer
Apr 19, 2020 rated it it was amazing
I've never quite read a book like this.

Essentially, The Spirit Catches You and You Fall Down is about the medical struggles of a child with epilepsy. However, through this narrative, Anne Fadiman discusses cultural challenges in medicine (and in general), immigration, Hmong history and culture, and trust in an incredibly thorough and fascinating way.

I find that it's easy (for me, at least) to fall into two camps when talking about different cultures and medicine. Either I find myself thinking
Nov 12, 2008 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
I especially appreciate books that help me see the world differently, whether they are mysteries, literary fiction, vampires, or nonfiction. When they are as thoughtful and engaging as this one, I have found a treasure.

Anne Fadiman's book, The Spirit Catches You and You Fall Down: A Hmong child, Her American Doctors, and the Collision of Two Cultures, does just that. She probably hears the Hmong family better than she hears Lia Lee's doctors, but Fadiman tries to understand both.

Lia Lee had a s
Samantha Newman
Sep 30, 2007 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
Mar 22, 2020 rated it really liked it
I rarely read nonfiction, but I found The Spirit Catches You and You Fall Down in a Little Free Library after a one-way run, and picked it up to read at a coffee shop with a post-run latte (pre-COVID-19, sigh). I started reading in line and only stopped since to squeeze in book club reads.

The Spirit Catches You and You Fall Down tells the tragic story of Lia Lee, a young Hmong child living in Merced, California. Her family came to the U.S. as refugees after escaping Laos via Thailand. As a child
Feb 25, 2008 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
Sep 02, 2007 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
Sep 23, 2018 rated it really liked it
Book Concierge
Subtitle: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

The 150,000 Hmong refugees who came to the United States in the late 1970s arrived in a country and culture that could not have been more foreign to them. The Lee family had escaped their native village in the hills of Laos and settled in Merced California. In July 1982 Foua Yang gave birth to her fourteenth child; Foua and her husband Nao Kao Lee would name the little girl Lia. She was a loved child, tenderly cared
Emma Deplores Goodreads Censorship
This is a fantastic work of journalistic nonfiction. It begins with a toddler, Lia Lee, living in California in the 1980s. The daughter of Hmong refugees, Lia begins suffering epileptic seizures as an infant, but her treatment goes wrong as her parents and the American doctors are unable to understand and respect one another. The book expands outward from there, exploring the history and culture of the Hmong, their enlistment in the U.S.’s secret war in Laos, and their subsequent refugee experie ...more
"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
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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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