Maia B.'s Reviews > 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 by Anne Fadiman
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Apr 08, 2012

it was amazing
bookshelves: nonfiction
Read from April 05 to 07, 2012

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 your religion and culture and the whole idea of Western medicine are so unutterably different that just trying to pair them is like...well, it's basically impossible.

In a situation like this, what can you do? What can anyone do?

The family of Lia Lee, a severely epileptic Hmong girl, moved from Laos in the 1980s. Lia was born in America, and her epilepsy brought them into the local hospital in Merced, California countless times; her charts alone weighed almost a pound. Her parents and immediate family spoke no English, only the Hmong language they grew up with and which is radically unlike English. Treating Lia, getting Foua and Nao Kao (her parents) to understand the dosage of her many medicines, breaching the gulf between two cultures, keeping Lia alive during her many seizures - it should have been impossible, and, really, it was.

Lia's medicines changed so frequently that it would have been difficult for a standard, English-speaking family to understand, let alone a family who spoke a completely different language than the doctors did and had no concept of Western medicine; the Hmong used their own methods for two thousand years, and they survived. It was infuriating to watch Lia age, the Lee family growing older and more adapted to America, and still the abyss between Laos and Merced, California was widening. Translators (people who spoke both Hmong and English) were scarce, and cultural translators (people who could speak both languages and understood both cultures and could explain each one to the opposite party) were even scarcer.

In Western-medicine-language, Lia had status epilepticus. In Hmong, she had quag dab peg: the spirit catches you and you fall down. All illnesses for the Hmong originate in the soul, and can be healed by appeasing the dab spirits by sacrificing a pig, cow, or chicken. Foua and Nao Kao were convinced that Lia's medicines were actually making her sicker, and in a way, they were.

Eventually, inevitably, Lia's case became hopeless.

The CIA-run Quiet War in Laos is one of the best-kept secrets in the world, apparently. I knew nothing about it before this book; my father, who is incredibly well-informed on just about everything, had never even heard of the Hmong, who served in the Quiet War and died at a rate ten times that of American soldiers in Vietnam. The Lee family fled Laos after the war, walking miles and miles into Thailand, passing the dead and dying, leaving half their belongings behind. When they reached America, supposedly the country where everyone is equal and anyone can receive medical attention, not the best hospital in the world could heal their daughter.

This is a brilliant, wrenching book. It looks at two cultures, one more technologically advanced, the other far older and no less sophisticated, and in reading it, it becomes necessary to look at yourself and your own values. You're a better person after reading it - it poses questions which can't be answered and questions which America thought it had answered long ago, and asks you to rethink everything. It's impossible to come away from it without feeling that you've learned something vital about America, about medicine, about the Hmong, about acceptance, about the value of real biodiversity, and the value of the soul.

It's the kind of book that makes you cry, laugh, and scream. It should be read by every aspiring doctor and every citizen and every immigrant. It's a lesson in life. It's impossible to explain how important this book is; it should have changed the medical world forever. Lia Lee deserved something better.

Someone else will have something better, because of the Hmong.
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Comments (showing 1-2)

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Moira Russell Such a great book.

Maia B. Yes, it really is.

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