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The Spirit Catches You and You Fall down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures Paperback – September 28, 1998

4.5 out of 5 stars 883 customer reviews

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Editorial Reviews

From Kirkus Reviews

A vivid, deeply felt, and meticulously researched account of the disastrous encounter between two disparate cultures: Western medicine and Eastern spirituality, in this case, of Hmong immigrants from Laos. Fadiman, a columnist for Civilization and the new editor of the American Scholar, met the Lees, a Hmong refugee family in Merced, Calif., in 1988, when their daughter Lia was already seven years old and, in the eyes of her American doctors, brain dead. In the Lees' view, Lia's soul had fled her body and become lost. At age three months Lia had had her first epileptic seizure--as the Lees put it, ``the spirit catches you and you fall down.'' Lia's treatment was complex--her anticonvulsant prescriptions changed 23 times in four years--and the Lees were sure the medicines were bad for their daughter. Believing that the family's failure to comply with his instructions constituted child abuse, Lia's doctor had her placed in foster care. A few months after returning home, Lia was hospitalized with a massive seizure that effectively destroyed her brain. With death believed to be imminent, the Lees were permitted to take her home. Two years later, Fadiman found Lia being lovingly cared for by her parents. Still hoping to reunite her soul with her body, they arranged for a Hmong shaman to perform a healing ceremony featuring the sacrifice of a live pig in their apartment. Into this heart-wrenching story, Fadiman weaves an account of Hmong history from ancient times to the present, including their work for the CIA in Laos and their resettlement in the US, their culture, spiritual beliefs, ethics, and etiquette. While Fadiman is keenly aware of the frustrations of doctors striving to provide medical care to those with such a radically different worldview, she urges that physicians at least acknowledge their patients' realities. A brilliant study in cross-cultural medicine. -- Copyright ©1997, Kirkus Associates, LP. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

About the Author

Anne Fadiman is the author of two essay collections, At Large and At Small and Ex Libris, and the editor of Rereadings: Seventeen Writers Revisit Books They Love. The Spirit Catches You and You Fall Down received a National Book Critics Circle Award, an L.A. Times Book Prize, and a Salon Book Award. Her essays and articles have appeared in Harper’s, The New Yorker, and The New York Times, among other publications. She is the Francis Writer-in-Residence at Yale.

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Product Details

  • Paperback: 341 pages
  • Publisher: Farrar, Straus and Giroux (September 28, 1998)
  • Language: English
  • ISBN-10: 0374525641
  • ISBN-13: 978-0374525644
  • Product Dimensions: 5.5 x 1 x 8.3 inches
  • Shipping Weight: 12.6 ounces
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (883 customer reviews)
  • Amazon Best Sellers Rank: #21,571 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

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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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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By A Customer on April 7, 2000
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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By A Customer on March 20, 2004
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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