The Spirit Catches You and You Fall Down


The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures is a 1997 book by Anne Fadiman that chronicles the struggles of a Hmong refugee family from Houaysouy, Sainyabuli Province, Laos,[1] the Lees, and their interactions with the health care system in Merced, California. In 2005 Robert Entenmann, Ph.D. of St. Olaf College wrote that the book is "certainly the most widely read book on the Hmong experience in America."[2]

On the most basic level, the book tells the story of the family's second youngest and favored daughter, Lia Lee, who was diagnosed with severe epilepsy, and the culture conflict that obstructs her treatment.

Through miscommunications about medical dosages and parental refusal to give certain medicines due to mistrust, misunderstandings, and behavioral side effects, and the inability of the doctors to develop more empathy with the traditional Hmong lifestyle or try to learn more about the Hmong culture, Lia's condition worsens. The dichotomy between the Hmong's perceived spiritual factors and the Americans' perceived scientific factors comprises the overall theme of the book.

The book is written in a unique style, with every other chapter returning to Lia's story and the chapters in-between discussing broader themes of Hmong culture, customs, and history; American involvement in and responsibility for the war in Laos; and the many problems of immigration, especially assimilation and discrimination. While particularly sympathetic to the Hmong, Fadiman presents the situation from the perspectives of both the doctors and the family. An example of medical anthropology, the book has been cited by medical journals and lecturers as an argument for greater cultural competence, and often assigned to medical, pharmaceutic, and anthropological students in the US. In 1997, it won the National Book Critics Circle Award for General Nonfiction.[3]

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