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

4.17  ·  Rating details ·  60,482 ratings  ·  4,331 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…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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 ·  60,482 ratings  ·  4,331 reviews

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Oct 15, 2015 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
Lisa 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
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
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
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
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
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
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
Aug 13, 2010 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.
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
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
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
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
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
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
Sep 23, 2018 rated it really liked it
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
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
Claudia Putnam
In graduate school (comparative religion), I took a class called ritual, illness, and the body. This book came out just a few years later. Though we studied other fascinating examples of medical anthropology looking at Western, especially American, practices, it would have been wonderful to be able to use this text.

Though doctors today more often take courses in cross-cultural awareness in med school, it's still just a small portion of their training, if they get it all. This book is highly rel
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
Jan 21, 2009 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
Aug 20, 2010 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?
Nov 15, 2018 rated it it was amazing
“It is well known that involuntary migrants, no matter what pot they are thrown into, tend not to melt.”

In 1981, after relocating to Merced, California, Lia Lee was born to a Hmong refugee family, from Laos.. She quickly developed severe epilepsy. By 1988, she was living at home, brain-dead. The events that led up to this tragedy: the misunderstandings, the culture clashes and flawed decisions, are the backbone of this story. Of course, the book goes much deeper, as Fadiman becomes involved wit
Jan 19, 2012 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
Mar 25, 2008 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
Bonnie Brody
Mar 07, 2012 rated it it was amazing
I first read this book about three years ago and recently re-read it. I am a socal worker and educator but I have been giving copies of this book to everyone I know because it is relevant to anyone who has any interactions with people of different cultures. It reads like a novel and is a page-turner. It is also loaded with information and written in a literary and beautiful style.

The book focuses on the clash between Hmong culture and traditional western medicine. The story is of one little girl
Polly Vella
May 01, 2018 rated it it was amazing
This book was so interesting and very moving. I learned a lot about the Hmong community that has settled in many parts of the United States. The Hmong are mostly from Laos, but they are in other parts of Asia as well, including in Yunnan province where we just went on China Alive! In China this group is referred to as the Miao. This ethnic minority has traditionally lived in mountain and areas which are landlocked. Because of this, they have maintained their ancient belief system and have very h ...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
“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.” 45 likes
“The Hmong have a phrase, hais cuaj txub kaum txub, which means “to speak of all kinds of things.” It is often used at the beginning of an oral narrative as a way of reminding the listeners that the world is full of things that may not seem to be connected but actually are; that no event occurs in isolation; that you can miss a lot by sticking to the point; and that the storyteller is likely to be rather long-winded.” 19 likes
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