Customer Reviews

The Spirit Catches You and You Fall Down

5 star:		(210)
4 star:		(68)
3 star:		(17)
2 star:		(8)
1 star:		(6)

 

 

I was one of the physicians involved in the care of Lia Lee. I'm referred to in the book as the physician that first diagnosed Lia's spells as seizures. Neil Ernst and Peggy Philp, the principal pediatricians in the book, were and are good friends of mine. Having experienced Lia Lee's saga personally, and then having read the book, I can only refer to Anne Fadiman's talent as astounding. Anne walks an incredibly fine, and very well documented, line as she describes what happens when American medical technology meets up with a deep and ancient Eastern culture. My team (Western medicine) failed Lia. Never have I felt so fairly treated in defeat, and never have I felt so much respect for an author's skillful distillation of a tragically murky confrontation of cultures.

ADDENDUM (8/8/09) I wrote the above review almost a decade ago. The experiences that I had during the events described in this book have continued to guide the way that I practice medicine. The Spirit Catches You has become a true classic in the medical and anthropological fields, being read in college, medical school, and nursing classes throughout the United States every year. This speaks to the enduring quality of the work that Anne Fadiman did in a book that remains unique in the skill with which it was written. The story it contains remains fresh and astoundingly relevant to the practice of medicine in particular, and cross-cultural relationships in general.

I don't think I should be writing in here since I am a part of the book. This book was amazing! It took me two days to read it and of course I shed a few tears on the way. My sister, Lia Lee, is doing well although she will never be able to see the bright sunlight or the incredible stars that we see everyday and everynite. She is an incredible child with so much love and affection from her family and the many friends she have encountered during her hardships. I was only 7 when all this happened, but I do recall everything from the door slamming incident to the day the doctors told my family that it was okay for her to come but she will not live pass 7 days. I will never forget that week or those many years of pain my family or the doctors had to go through. This book has given me a better view of what can really happen when two different cultures have their own ways of interpreting medicine or life in general. We must understand that different cultures have different ways of curing a person and doctors have their policy they must follow. To avoid another incident like this, we must work together as a whole and not blame each other for not cooperating with one another. Lets hope this book tells us what can happen in the future if we don't work with this now. Anne did a great job on this book! My family couldn't have ask for more. She has become a great friend of my family and we are greatful for it. Anne-thank you !

The Spirit Catches You and You Fall is a novel based on the clash of two cultures---the Hmong culture and the American culture. A little Hmong girl is diagnosed with epilepsy which her parents believe is caused by spirits. Because of this belief, they try to cure her illness not with western medication but their own Hmong ways. There is a huge misunderstanding between the parents and the doctors that Anne Fadiman explores. Anne Fadiman provides readers with a vivid, detailed history of the Hmong in Laos to their involvement in the Vietnam War to their struggles in America that explains this clash. On the other hand, she also explains why Americans see and felt the way they did about the Hmong culture particularly the doctors. One shortcoming is that the author implies that Hmong Americans and their experiences are completely homogenous, but the beauty of this book is that she is able to view both sides without judgment. As a Hmong American, it's hard to imagine an American who can achieve this, but the author achieves this so beautifully. It's hard to look at something from a totally different perspective especially because westerners are very rigid about their beliefs and have a sense of superiority in regards to other cultures thus I was shocked that Fadiman was able to communicate and understand the Hmong in such a way. She did a great job of digging beyond the surface and really understanding the Hmong people, their beliefs, and where they are coming from. As a Hmong American, I think she did a great job! She talked of things that I couldn't imagine an American even knowing about until I read this book. It's great to know that an American can look at the Hmong culture without judgment and even come to admire it and see some good in it even though it's very different from her own beliefs. I recommend this book to anyone especially those that are interested in learning more about the Hmong.

People who are not familiar with Hmong Americans may read this book and assume that all/most Hmong Americans are like the Lee family and other Hmong families presented in the book. The events that took place with the Lee family occured when Hmong first arrived here in the late 70s/early 80s. These days, the majority of Hmong Americans are a lot more Americanized compared to the early 1980s. Although the assimilation has been slow compared to other first generation Americans, things have changed a lot since then. For example, many Hmong no longer practice the traditional Hmong religion and have converted to Christianity. The Lee family was a lot more traditional than most Hmong American families in the early 80s. I just wanted to clear this up.

Having said that, I enjoyed this book because it does the impossible. Fadiman is able to make the reader better understand the traditional Hmong culture, a culture that seems irrational and is opposite of western culture. It doesn't mean that you will agree with the Hmong culture but you will better understand it, including why the family did/did not do certain things to help their daughter who had epilepsy. I also believe that this book is important for those who work with the public because it promotes sensitivity towards other cultures. The doctors and the family had the very best intentions for the daughter who had epilepsy but the cultural barriers were just too much.

Anne Fadiman's book is a fascinating account of what happens when a left-brain culture (the American medical establishment) and a right-brain culture (a Hmong refugee family) go on collision course over a very ill little girl.

Lia Lee is epileptic; she has uncontrollable seizures which require medical intervention and treatment. Lia's doctors see her family as negligent and ignorant because their inability to follow a complicated medical regimen makes her condition deteriorate; her family see the doctors as arrogant and insensitive, and insist the medicine they are giving her actually made her sicker. The tragedy is that both the doctors and the family genuinely want to help Lia, but their total lack of communication and inability to understand each other, linguistically and culturally, makes cooperation impossible. Those of us in the 'helping' professions (medicine, nursing, social work) often lose sight of the fact that the relationship between 'helper' and 'helpee' is most effective when each sees the other as an equal partner who deserves equal consideration and respect; instead, the 'helpers' often dole out advice and directions which the 'helpees' are expected to follow without question, and are then labeled backwards, resistant, or even negligent, when they refuse.

The book zeroes in on the dangers of ethnocentric thinking in working with or treating people of different cultures; the Lees may have been illiterate and 'backwards' by American cultural standards, but they knew and loved their child. We end up admiring and respecting the Hmong for their warm family life and their support of each other in times of crisis, as well as respecting the medical personnel who grew as human beings as they came to recognize the Lees' humanity and their incredible strengths as parents. Many, if not most, American families would institutionalize a child such as Lia; but to her family, the sicker she became, the more precious she became. Anne Fadiman has given us an informative, excellently researched, uplifting and yet humbling book about a very special family and a very special child.

Judy Lind

I am an educated Hmong woman. I was motivated to read this book by my older brother who has a degree in Anthropology. Before reading this book, I thought that I knew enough about my culture and that I didn't need to read a book which tries to explain my own culture to me - yet, I have found the information in this book very interesting. I've learned new things about my own culture that I didn't know before, such as the perception of the Hmong through the American people. One thing that I especially appreciated about Anne Fadiman's work in this book is that she seems to give it as it is. For instance, she would even quote some one when they responded negatively towards the Lee family. Another is that she would talk about how Hmong people would do such weird things and then explain the reasons so that it just doesn't leave the reader wondering. I haven't read other books written about my own culture, but even so, I can rate this book as excellent.

As a professional educator who works with Hmong students and their families, I relished the opportunity to read this book, hoping to gain some understanding into the culture and values of the Hmong community. What I got was a fist-in- the-gut experience that left me practically breathless. I finished the book in less than a day - a day in which I accomplished little else. Fadiman knows her topic well and writes with refreshing clarity and brutal honesty. The Hmong are resistant to adaptation of western values - a fact that had long frustrated me and left me somewhat skeptical of their willingness to adapt to life in this country. I now realize that the clash of cultures goes well beyond geographic and language issues. Deeply spiritual and devoted to their families and clans, every facet of Hmong life revolves around the spiritual.

Fadiman's book is a cross between a case study and ethnic history. The case is that of a young girl stricken with epilepsy, and her family's struggle against western medicine and medical doctors. The history is a broad ranging but concise history of the Hmong people.

I highly recommend this book for anyone interested in culture clashes, and especially for anyone who knows a Hmong, or works with them. It will open your eyes.

What a wonderful feat! A book that made me care about a whole host of things and people I had never heard of -- the Hmong, Lia Lee, her family, her doctors and Merced. I think this is the best type of nonfiction writing; you're learning AND you become emotionally invested in the people and places you're learning about.

I think very highly of this book, and use it in one of my classes. But readers should be aware of two things:
1. The events described in this book took place in the 1980s, not long after Hmong refugees first came to the United States. This book describes a Hmong family at that point in time. Today many Hmong are college-educated professionals (some are doctors). Fadiman's book might - unintentionally - promote some stereotypes.
2. The historical background in chapter 2, especially the account of the Hmong in China, is nearly worthless. Fadiman perpetuates the errors in Keith Quincy's _Hmong: History of a People._ (The story of the "Hmong" king Sonom's defeat by China, for example, actually concerns the conquest of the Jinchuan people, who were not Hmong.)
Despite my reservations, Fadiman's book is on the whole a sensitive and compelling account of the clash of two cultures. But it should be read critically.

This was one of the best books I've read in years. In writing this book, Fadiman beautifully portrays the story of a Hmong family who, like so many of their people, were suddenly transported from their rustic lives in mountains of Laos into a a confusedly modern society that rejected or disclaimed all that they had ever known or believe in. She also reveals some major flaws in our healthcare system, which is governed by rigid treatment protocols that were not designed adapt to individual needs or cross cultural barriers. Not that she characterizes the healthcare system or the professionals who cared for Lia as villians... Fadiman makes it clear that Lia's physicians worked feverishly and devotedly, often against a tide of tremendous resistance and lack of cooperation from her family, to control her disorder. Yet, as much as the practices and behavior of the Hmong hampered the doctor's efforts to manage Lia's disease, the refusal of Lia's treaters to acknowledge and address the motives and reasons for these behaviors undermined her treatment as well. As you read the book, it becomes obviously that Fadamin came to love the Hmong family and the culture she wrote about, and so made me slowly fall in love with them too. Descriptions of their behavior and practices early in the book first struck me as primative and somewhat repugnant, yet as layer after layer of the history, belief systems, and values of the Hmong were revealed, I came to appreciate them as beautiful, intricately complex, and deeply spiritual. From beginning to end, the story of Lia, her family, and the medical staff her cared for her is emotionally riviting... the final pages left me in tears and haunted me for days afterword. I also found myself missing Lia and her family as though I had known them personally... I was reluctant to leave them and their cultural ways behind.