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

Anne Fadiman
4.5 out of 5 stars  See all reviews (660 customer reviews)

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Book Description

Winner of the National Book Critics Circle Award for Nonfiction

When three-month-old Lia Lee Arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit and fiercely people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, cleaved just as strongly to another tradition: that of Western medicine. When Lia Lee Entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication.

Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness aand healing as spiritual matters linked to virtually everything in the universe, while medical community marks a division between body and soul, and concerns itself almost exclusively with the former. Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness, qaug dab peg--the spirit catches you and you fall down--and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.



Editorial Reviews

Amazon.com Review

Lia Lee was born in 1981 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, overmedication, 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 of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty--and their nobility."

From School Library Journal

YA?A compelling anthropological study. The Hmong people in America are mainly refugee families who supported the CIA militaristic efforts in Laos. They are a clannish group with a firmly established culture that combines issues of health care with a deep spirituality that may be deemed primitive by Western standards. In Merced, CA, which has a large Hmong community, Lia Lee was born, the 13th child in a family coping with their plunge into a modern and mechanized way of life. The child suffered an initial seizure at the age of three months. Her family attributed it to the slamming of the front door by an older sister. They felt the fright had caused the baby's soul to flee her body and become lost to a malignant spirit. The report of the family's attempts to cure Lia through shamanistic intervention and the home sacrifices of pigs and chickens is balanced by the intervention of the medical community that insisted upon the removal of the child from deeply loving parents with disastrous results. This compassionate and understanding account fairly represents the positions of all the parties involved. The suspense of the child's precarious health, the understanding characterization of the parents and doctors, and especially the insights into Hmong culture make this a very worthwhile read.?Frances Reiher, Fairfax County Public Library, VA
Copyright 1998 Reed Business Information, Inc.

Product Details


Customer Reviews

Most Helpful Customer Reviews
773 of 785 people found the following review helpful
Format:Hardcover
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.
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349 of 361 people found the following review helpful
5.0 out of 5 stars This is an exceptional piece of work!! November 4, 1997
By A Customer
Format:Hardcover
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 !
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382 of 413 people found the following review helpful
5.0 out of 5 stars AS A HMONG AMERICAN April 7, 2000
By A Customer
Format:Hardcover
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.
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114 of 129 people found the following review helpful
3.0 out of 5 stars Hmong American reader here March 20, 2004
By A Customer
Format:Paperback
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.
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Most Recent Customer Reviews
2.0 out of 5 stars The main character you will never know in this book ...
The main character you will never know in this book. The ending left me bummed out. I wouldn't read it unless I wanted to know how the Hmong faired in the California medical system... Read more
Published 12 hours ago by Rodney C. Sullivan
5.0 out of 5 stars Five Stars
Great book - loved it.
Published 3 days ago by S. Maroof
4.0 out of 5 stars Four Stars
interesting
Published 5 days ago by Erin Milloy
4.0 out of 5 stars Good introduction to Hmong culture and beliefs.
My doctor read this book when in residency in a hospital serving many Hmong clients and said it clarified many of the difficulties in getting his patients to follow his... Read more
Published 9 days ago by LZSOB
5.0 out of 5 stars Five Stars
This should be required reading for every clinician or health practitioner working with patients. Every. One.
Published 11 days ago by Lua Wilkinson
3.0 out of 5 stars Three Stars
Complicated book but very helpful when working with different cultures
Published 11 days ago by Ron
5.0 out of 5 stars A wonderful book that really makes you stop and think of ...
A wonderful book that really makes you stop and think of ways we comunicate with people of that are different than us.
Published 15 days ago by Amazon Customer
4.0 out of 5 stars ... have read it on my own if someone had recommended it to me
I read this for my sociology class but I think I would have read it on my own if someone had recommended it to me! Read more
Published 21 days ago by Angela
5.0 out of 5 stars Enjoyed it.
A real eye opener. Enjoyed it.
Published 22 days ago by Janet Parsons
4.0 out of 5 stars Good read.
I found the book to be more interesting than I expected. It was very informational about the Hmong people. Read more
Published 24 days ago by Rosemary Voglewede
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More About the Author

Anne Fadiman is the Francis Writer-in-Residence at Yale. Her first book, The Spirit Catches You and You Fall Down, is an account of the unbridgeable gulf between a family of Hmong refugees and their American doctors. It won the National Book Critics Circle Award for Nonfiction, among other awards. Fadiman is also the author of two essay collections. The London Observer called Ex Libris "witty, enchanting, and supremely well-written." NPR said of At Large and At Small, "Fadiman is utterly delightful, witty and curious, and she's such a stellar writer that if she wrote about pencil shavings, you'd read it aloud to all your friends."

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