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The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures
The Spirit Catches You and You Fall Down A Hmong Child Her American Doctors and the Collision of Two Cultures
Author: Anne Fadiman
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 La...  more »
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ISBN-13: 9780374525644
ISBN-10: 0374525641
Publication Date: 9/28/1998
Pages: 352
Rating:
  • Currently 4/5 Stars.
 236

4 stars, based on 236 ratings
Publisher: Farrar, Straus and Giroux
Book Type: Paperback
Other Versions: Hardcover, Audio CD
Reviews: Member | Amazon | Write a Review

Top Member Book Reviews

reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 51 more book reviews
Helpful Score: 8
This book changed the way I looked at immigration, culture, the right to choose medically. Very thought provoking book. Extremely well written.
reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 26 more book reviews
Helpful Score: 7
I absolutely loved this book! It is written with such insight into the culture of the Hmong. It was an eye opener of the best kind - taking the reader into the midst of a medical case involving a very ill Hmong child in a small county hospital in California - language and cultural barriers that the author works to eliminate. Racial tensions, discrimination, miscommunication - the author worked through it and detailed the journey into a very readable, intelligent, thought-provoking piece of work.
reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 28 more book reviews
Helpful Score: 6
Awesome read! I loved it!! This was actually a text book for a medical anthro class, but I read it in two days (way ahead of the rest of the class). Great book.
reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 2 more book reviews
Helpful Score: 5
A Hmong child, her American doctors, and the collision of two cultures. Probably one of the best books I have ever read, a non-fiction that reads like a novel. This child is born with epilepsy, and the parents believe her condition is caused by spirits called "dabs", and don't administer her medications properly, if at all. Anne Fadiman is a wonderful writer, and you will be caught up in the drama as well as further understanding the Hmong people and their history. I can't recommend this highly enough.
reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 57 more book reviews
Helpful Score: 4
This book details the clash of two culturs: an immigrant Hmong family and the American medical system as each strives to keep the young daughter who has epilepsy healthy. Very though provoking--it provided the perspective of our medical care through the eyes of another culture. (good information for all health care professionals.) I also learned alot about the Hmong culture, how they were affected by the Vietnam war and how many immigrated to the US. This is not a light reading book; I also had a light-reading book to read so I could alternate between them as my mood dictated. Story plot detailed in other reviews.
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reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on
I loved this book. I learned so much about the Hmong culture by reading this book. I also learned about how difficult it can be to have a sick child when you have a cultural barrier. I have a daughter who has epilepsy and there was so much I took for granted about her health care. I grew to love the family, the Hmong culture and history, and the writing style. Worth the read. I recommended it out to a friend to read as soon as I finished reading it.
reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 6 more book reviews
Best book I've read. Makes you rethink how you deal with people. A wonderfull, but sad story.
charliedollie avatar reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 2 more book reviews
This book was required reading for my Cultural Anthropology class, and I'm glad I read it.

The book revolves around Lia, a Hmong child with severe epilepsy, and how her parents and doctors struggle to help her. Her parents are very traditional in Hmong terms and percieve Lia's seizures as a sign that Lia is able to see into the spirit world. This brings them a great sense of pride. However, being in America, doctors know how serious the situation is and try to convince the parents.

The parents only want what is best for their daughter, but, in there minds, where American doctors raise red flags, they struggle on what that is.

The Spirit Cathes You is a great book that really makes you think about culture as the "outline" of how we perceive the world.
Minehava avatar reviewed The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures on + 832 more book reviews
Fascinating insight into the Hmong culture and the clash with modern paternalistic medicine. Not the easiest book to read though. The writing style is quite verbose and I think some brutal editing would have made for better flow. Definitely not the sort of book you can read in one go.

HOWEVER it is also brilliant and thought provoking. Everyone should read this book. The history lesson alone is worth reading. America cant be trusted. It does this again and again. We have such short memories. Vietnam we all remember. Iraq, we all remember. Afghanistan, yes. Siria... ummm not so much, Yugoslavia almost forgotten. The Homong? never heard of them. And then there is the Medical aspect of the story. All medical and nursing students should read it.t is especially of relevance to anyone working with people from a different cultural back ground whether in medicine, education or the workplace in general.

Writer Anne Fadiman decided to look at American medicine through the prism of Lia Lee's sad story. She discovered, and conveyed to readers, the richness of Hmong culture, devoid of sentimentality. Fadiman is careful not to imbue the Hmong with the kind of romanticism that European Americans tend to hold about Native Americans: she does not evade the fact that they can be extremely difficult. By allowing them full humanity, she brings them vividly to life the same way a novelist does her characters--though non-fiction, thi book is as compelling as a great novel.

The Hmong came to America in the 1980s courtesy of war in Southeast Asia. They'd been living in the mountains of Laos, to which they'd migrated from China. The Hmong never assimilate into the culture of the country they inhabit, and have suffered persecution for centuries. They're a migratory tribe without a homeland. Because they helped the CIA in Laos, the Hmong were promised they'd be welcome in the U.S.--but when the troops left, they jetted only generals and hotshots out of the country, leaving the rest of the populace to fend for themselves. With the Laotian army hunting them down as enemies of the state, Hmong families set off on foot, carrying whatever they could manage. Many, particularly the old and the young, died along the way. Most possessions were shed, too heavy to carry, on the days-long journey. When they arrived in Thailand they were placed in refugee camps, where they waited to be rescued by the Americans. Those who were finally brought to America were `resettled' all over the map, without regard for family cohesion or transferability of survival skills: in Detroit, Minneapolis, Utah, Vermont--the Hmong were distributed all over the country so as to not unduly `burden' any one locality. It should be noted that most of these people had never seen snow, or electricity. Never used indoor plumbing, or seen a car. They have no organized religion, but believe in Shamanism, demons, spirits, and sacrificing animals to achieve balance.

The Hmong tend to have large broods of 12 or 13 children, who they deeply adore, and they view disability as a consequence of some parental transgression, for which they atone by treating children with disabilities extra lovingly. They're used to living near relatives, who they see frequently, if not daily. The diaspora of the Hmong represented unspeakable hardship--which they resolved with what they call their `second resettlement.'One family would pack up a hastily purchased jalopy and drive off, looking for a spit of land hospitable to growing vegetables and the herbs necessary for healing rituals. They'd end up where all pioneers do, in California, and send news to relatives in Detroit or Chicago or Billings, Montana. Eventually, pockets of Hmong were clustered in a few locations around the country. Of these, Merced, California, where the Lee family settled, is one of the largest.

About one in every six residents of Merced, formerly an all-white rural area, is now Hmong. Here their culture and community thrived, parallel to the dominant culture, assimilating as little as possible. One way they did have to assimilate is medically: since 80% receive some form of government assistance, social services closely monitor them. American social workers do not have a high level of tolerance for cultural difference, and many Hmong practices, like gardening on the living room floor, or animal sacrifice, put parents in danger of losing their children to foster care--an unthinkable consequence that did occur, for a period of time, to Lia Lee.

The Hmong had heard about Western medicine even before arriving on these shores. They approved of antibiotics--swallow a pill and get well in a week--but not of much else. Surgery was anathema, since cutting the flesh or removing organs risks the flight of the soul. When their daughter Lia fell into the hands of the medical establishment, the Lees suffered deep agony over every procedure, from IV insertion to spinal taps.

Fadiman explores the interactions between the Lees and their daughter's medical caretakers in exhaustive detail. Whenever Lia suffers a setback, the Lees blame the doctors and their methods. The doctors accuse the Lees of "noncompliance" when they fail to properly dose Lia with three different kinds of anti-convulsants at the various times of day prescribed, not realizing that the Hmong don't even use clocks. Fadiman presents a balanced picture, blaming neither the family nor the hospital, but cultural barriers, for what goes wrong--and eventually things do go terribly wrong. By the age of four Lia is brain dead. The hospital hooks her up to feeding tubes, expecting her to die within days, but the Lees insist on taking her home, where they disconnect every tube and treat Lia as a favored family member. They take turns carrying her around on their backs; like a mama bird, Foua pre-chews her daughter's food and feeds it to her orally; they sacrifice pigs in healing ceremonies; and Lia sleeps with her parents every night. To the astonishment of the medical community, Lia does not die, and by the end of the book, years after being declared brain dead, she's still alive. Lia Lee lived for 10 years longer than the awrage vegetative patient, lovingly cared for by her mother and siblings. Her medical condition had never changed. Her father, Nao Kao Lee, died in January of 2003.


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