About book The Spirit Catches You And You Fall Down: A Hmong Child, Her American Doctors, And The Collision Of Two Cultures (1998)
This is a very serious book filled with history, medical information, Hmong culture and the politics of war and immigration in the United States. It is a rather damning text, both to the U.S. in our international politics, and to the rigidity of our medical system. Lia Lee is the 13th child of a Hmong couple from Laos. When the communists are victorious in Laos the Hmong people were killed, tortured, starved for their part in the war which was fighting on the U.S. side. So Lia's parents (Lia was not born yet) took their children and walked, in great danger, to Thailand where they lived in a refugee camp until they were given permission to emigrate to the U.S. Culture shock doesn't even begin to describe it. Like many Hmong they ended up going to Merced, CA. hoping for a bit of land to farm as this is what they knew. They didn't get any land, most Hmong didn't. Lia's mother grew her plants and herbs in her apartment building's parking lot.Lia is born in a hospital in CA. (The other children had been born at home in Laos, caught by their mother's forearms so they wouldn't touch the dirt floor, in silence so complete that the other children were not wakened.) Lia seemed normal but at about 8 months her sister slammed a door and Lia fell down in an epileptic seizure. The U.S. doctors understand this condition as a storm of electrical activity in the brain that causes seizure. The Hmong understand this condition as 'the spirit catches you and you fall down', her soul fled when she was frightened by the slamming door. They took her to the ER and here started the collision between the American doctors and Lia's parents and the Hmong community. Because Lia's parents did not comply with the regimen of anti-convulsant meds she was taken away from them when she was two and put into foster care, by her doctor's request to the courts of CA. Even though she had great foster parents I think this whole experience was to Lia's great detriment. She was given back to her parents before a year was up and they gave her the prescribed meds but Lia kept getting sicker and eventually contracted sepsis and seized until she was essentially brain dead. Western medicine sent her home to die expecting it to happen within hours or at the most days. Lia did not die, her parents took the most excellent and loving care of her. She was clean, fragrant, beautiful and emotionally responsive to her parents. Her parents used herbal medicine that they knew from Laos and Hmong shamanistic healing ceremonies. That didn't mean Lia came back, but she lived. The last scene where the chanter is calling her back is just heartbreaking. This book was of particular interest to me as I was epileptic as a child, and also because I have a disabled child. I felt somewhat ashamed reading how Lia's parents took care of her. We take good care of our son, but not as spectacular as her parents did. I thought I should make more of an effort. I also believe that there is a spiritual aspect to all of life. That as long as we are alive on this earth our body and soul cannot be separated or treated medically without consideration for the physical and spiritual aspects of a person. I think that there is every possibility that both the western understanding of epilepsy and the Hmong understanding of epilepsy (if you are Hmong) are both true and not mutually exclusive. I was impressed with and interested in Hmong culture and looked up to see if they have a community here in Seattle. They do. It was also interesting to read about animal sacrifice, now in modern day life. Not warehouse killing but individual animals sacrificed in propitiation or thanks. Altogether, an amazing book.
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 way. Lia quickly became well known at the medical center where she was taken each time she was sick; but the medical community is hugely different from the Hmong culture with a different set of beliefs and rules and expectations. The medical center physicians wanted to treat Lia with medication from the get-go - but the language barrier made that difficult, not to mention the medications went against the Lee's entire belief system. On the Lee side they met the doctors with distrust and suspicion; on the physician side they met the Lees with often disgust and accusations of non-compliance.This was an incredibly hard book for me to read. I work in a medical environment and certainly see the positive effects of medication and surgery. But I can understand the other side of this story too - a family that doesn't speak English, watching things being put in their daughter with very little interpretation, being told if they don't do x then y would happen, being told everything they have practiced for years (that appear to most Americans as just being naively superstitious); I can't imagine the fear the family must have felt. Every culture feels they know best, that their practices are the most appropriate, that everything else is sub-par.I had to read this book slowly, in small chunks, because I would find myself frustrated with the Lee family the same way the physicians were frustrated with them - I found myself saying, "If you just gave Lia the medication the way the doctors told you, she wouldn't be so sick...", and then immediately I would feel disgust at myself. At other times I found myself saying, "American doctors have no clue - listen to your patients...", and I found myself questioning the things I say and do every single day at work. I found myself on both ends of the spectrum, and each time I had that overwhelming feeling of frustration I knew it was time to put the book down. This, I imagine, is what Anne Fadiman was going for when she wrote this book. She wants her readers to be able to see both sides of the story, that neither one is especially right while neither side is especially wrong either. It's a fine and delicate line that must be straddled, but who is to say which is the right way to straddle it?
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"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 patients close-by would complain. Finally we had to have a talk with them and tell them "No Gongs and No Dead Chickens!" Excerpt from The Spirit Catches You and You Fall Down II. The customs they were expected to follow were so numerous and seemed so peculiar, rules and regulations were hard to learn, many Hmong were simply overwhelmed. Some newcomers wore nightgowns as street clothes, poured water on electric stoves to extinguish them, lit charcoal fires in their livingrooms;stored blankets in their refrigerators; washed rice in the toilet; washed clothes in swimming pools; washed their hair with Lestoil; cooked dinner with motor oil & furniture polish, drank clorox bleach; ate cat food;planted crops in public parks; shot and ate skunks, woodpeckers, porcupines,robins,sparrows, egrets, a bald eagle, and hunted pigeons w a crossbow in the city streets of Philadelphia." pages 187-188
—Irene
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 cultures collide, but it is more likely to make you cry than laugh. The Spirit Catches You and You Fall Down tells the story of a young Hmong (pronounced mong) girl named Lia Lee. You’ve never heard of the Hmong? Neither had I. In a nutshell, the Hmong are an Asian ethnic group that live in southern China and the mountainous regions of southeast Asia. (Fadiman explores Hmong culture and history in great depth because it is impossible to understand Lia’s story without understanding the Hmong.) The Lee family is from Laos, but fled to the United States after that country fell to Communist forces in 1975. The family eventually settled in Merced, California. In 1983, 8-month-old Lia was diagnosed with epilepsy. Fortunately, Merced was home to an excellent hospital with excellent doctors – devoted, hard-working doctors that didn’t care that the Lee family was on welfare and had no insurance. Any Westerner would say that Lia’s prognosis was good. That’s because we Westerners don’t understand the Hmong at all.“The language barrier was the most obvious problem, but not the most important,” said said Dr. Dan Murphy, one of the many doctors that treated Lia. “The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference.”Some of those barriers? For one thing, among the Hmong, epilepsy or quag dab peg (which translated is “the spirit catches you and you fall down”) is not a physical problem. It is a spiritual problem caused when an evil spirit, a dab, steals one’s soul. For another, quag dab peg is an illness of some distinction. Hmong epileptics often become shamans, people of consequence. Then, too, the Hmong have little trust in medicines, particularly those with side effects. A medicine should not make a person sick, after all. These and other cultural differences conspired to make Lia Lee’s treatment particularly complicated.It becomes evident early on that, in spite of everyone’s good intentions, Lia Lee’s tale is destined to end badly. This is a truly heartbreaking story, made all the more so because there are no good guys or bad guys, only misunderstandings and well-intentioned mistakes. At the same time, I found the Hmong culture fascinating, yet often exasperating (to my shame; I guess I’m as much a slave to my Western mindset as anyone). With a deft hand and a balanced view, Fadiman shows us the dangers inherent in assuming that we all think alike, a valuable lesson for all.
—Stephanie
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 there isn't anyone person or group who can be blamed for what happened to Lia. The point of the book is to take a look at the differences in cultures that exist in our country today, and maybe realize that there are better ways of dealing with the issues that arise.The look at the Hmong culture and history the book provides is fascinating and enlightening. The different levels of engagement the Lee family had with various westerners was particularly telling, and explained a lot about the wildly varying opinions people had formed.The story of Lia Lee is tragic, and the possibility that it could have turned out differently makes it especially so. It's been over ten years since the book came out, and I would love to have some kind of update as to how the Lee family is doing - especially how Lia is doing - and if there has been any real progress made in solving culture collisions in Mercer.
—Chelsea
