The Spirit Catches You and You Fall Down: A Hmong child, her American doctors, and the collision of two cultures by Anne Fadiman. 1997. New York, NY: Farrar, Straus and Giroux.
Anne Fadiman describes the connections between a Hmong family and the American medical community. Her study of the clash of cultural beliefs and practices touches some fundamental issues surrounding scientific progress and humanity.
Foua and Nao Kao Lee immigrated to the United States along with thousands of other Hmong people from Laos. Their daughter, Lia, was born in 1982 and had her first seizure when she was just three months old. The Lees believed that the seizure had spiritual causes, because Lia’s soul was lost and wandering the spirit world looking for Lia’s physical body. The Lees did not speak English and, therefore, could not communicate information about their infant daughter’s sickness to the doctors.
After several seizure episodes, Lia was still convulsing when she was brought to the hospital emergency room. The American doctors diagnosed her as suffering from epilepsy. From the medical perspective, Lia’s condition was biological in origin and could be alleviated with drug therapies. The family was confused and reluctant to medicate their daughter without considering their traditional spiritual/medical approaches. Over the next four years, doctors changed Lia’s anticonvulsant prescriptions 23 times. Gradually, the Lees came to doubt that these medications had any positive effect on their daughter. When they refused to administer the drugs to Lia, the doctors had Lia removed from their home and placed in foster care. With medication, the seizures subsided. A few months after returning home to her parents, Lia had a massive seizure which left her brain dead. Believing that death was imminent, the doctors allowed Lia to remain home.
Two years later, Fadiman arrived in Foua and Nao Kao Lee’s apartment. There, she found Lia alive and well and lovingly cared for. The Lees still had hopes of reuniting Lia’s soul with her body and arranged for an elaborate pig sacrifice.
In this book, Fadiman answered the most frequent questions about the Hmong, whose prehistoric ancestors are thought to have migrated from Eurasia through Siberia and into China. The Chinese called them the Miao or Meo, meaning “barbarians,” “people who sound like cats,” or “uncultivated grasses.” The Chinese word is an insult. Hmong people prefer “Hmong,” which means “free men” or “the people.” They never possessed a country of their own, but they have always fought to remain free and emigrated whenever and wherever necessary.
Among the scholarly studies and personal stories recorded and published within the last three decades, this book is a basic guide for Hmong themselves, as well as others who are interested in or who work with the Hmong. For others, the book helps to reflect upon the things which are often taken for granted.