The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors and the Collision of Two Cultures by Anne Fadiman (1998, Paperback)

I bought this book as required reading for a class. As it was winter break, I had time and decided to read it before the class. It was so engaging that I hardly put it down, and I kept wanting to read more even after I had finished it.

It follows the story of a young Hmong girl with epilepsy, Lia Lee, from both the point of view of her doctors and of her family. Her parents were refugees from Laos who immigrated to Merced, California in the aftermath of the Vietnam War. They speak no English and understand very little of US culture, as the Hmong have always lived in the mountains as farmers. They face tremendous difficulty in trying to communicate with the doctors; each side is trying to do what their culture says is best for Lia, but the two are often not compatible, not to mention that neither side can seem to make itself understood.

Anne Fadiman really did her research, seeming to have talked to anyone who had contact with Lia during these troubled years. She explains Hmong culture in a straight-forward, matter-of-fact manner, as she learned it from the Hmong people she came to know as friends. She also describes the troubles and even personal health issues of the American doctors who were trying so hard to help Lia.

I think Fadiman does justice to both sides, not laying blame on either, but showing how the vast differences in ways of thinking can lead to such large problems. She also tells how problems such as these have lead to the American medical industry becoming more open to other cultures' forms of medicine, and learning how to have a happy medium between the two.

A highly-engaging read for even someone who knows nothing about the Hmong, the medical industry, or problems with communication between two cultures.

In our culture, when one is sick, one has to do everything in order to get better. This includes going to a doctor, taking the required medicines and even undergoing surgery to “fix” any physical abnormalities of the body. It is simply assumed that being sick is a bad thing and thus, undesirable (DeJong 1983). However, in certain cultures such as Hmong’s, a particular “sickness” is actually desirable. This particular sickness is epilepsy. In Hmong culture, epilepsy is more known as a state of qaug dab peg when it literally means “the spirit catches you and you fall down”. Although known as a serious condition, it is still desirable because a Hmong with epilepsy can often become shaman, a person with higher social status in Hmong’s community for his/her spiritual healing power (Fadiman 1997). This view clearly contradicts the view of modern Western medicines, and therefore often results in a clash between the two cultures: Hmong and American’s, as shown in “The Spirit Catches You and You Fall Down, A Hmong Child, Her American Doctors, and the Collision of Two cultures” by Anne Fadiman. Through this book, we are forced to question the credibility of medical model and the possibility of embracing alternative models, such as the one employed by Hmong people and in the process of doing so, we may be able to learn respecting cultures and backgrounds that are different from ours.

Not many books show and tell in such excellent detail a story about crosscultural interactions, especially within the realm of medicine. In reading the bok it helps bring out any ethnocentric opinions one might have when dealing with other cultures. It is quickly discovered how different two people can view the world as the author takes the reader into the world of the Hmong, a displaced, abused, proud people. She shows clearly the conflict of them as displaced people in a foreign land with a worldview, which is 180 degrees opposite theirs, as well as showing the frustration and difficulty experieced by the medical professionals in handling the Hmong.

There are always "must reads" out there. I acquired the book for a required reading for first year medical school, and I have to readily say that it is a must read for all, because in medicine in this day and age we must all work with cultures quite unlike our own. This book opens the eyes to the reality and validity of the views and beliefs of those around us, though worlds apart. Upon reading the book you will not be able to view any other culture, including your own, in the same light again. It has been truly humbling to me, someone that has worked on several different continents, among vastly different cultures.

This book gives an insight into a culture different from our own. This happened in the town I live in and I'm familiar with the doctors and hospitals mentioned which added interest. In my job I deal with the Hmong and this very poignant story gave me exactly what I needed at the time I was dealing with a medical issue of one of my Hmong students. The chapters are paralleled with the Hmong history and what the family and little girl were experiencing in the western world and the clash of those cultures. Read this book when it came out and bought this book for my daughter who is joining the ranks of teaching. I would recommend this book to help develop cultural sensitivity.

It was a required reading for school, and I was actually dreading reading it. Once I started the book, I couldn't put it down. It was a very interesting cultural diversity story and lesson. Lia Lee's story is very eye awakening. Willingness to understand and accept the values and customs of the Hmong culture by the American medical personnel could have drastically affected the outcome for Liaand her family.