The Spirit Catches You And You Fall Down

A Hmong Child, Her American Doctors, and the Collision of Two Cultures

Published by Farrar, Straus & Giroux, Incorporated
Publication date: September, 1997
ISBN: 0374267812 (hardcover)

Synopsis

The Lee family immigrated from Laos to Merced, California, in 1980. Lia Lee was born in 1981. Lia had her first seizure at age three months. Unable to enter the Laotian forest to find herbs for Lia to "fix her spirit," her family instead winds up in the Merced County emergency medical system, which has little understanding of Hmong animist traditions.

Her American doctors call Lia's disorder epilepsy, but the Lees call it quag dab peg, or "the spirit catches you and you fall down." A complex regimen of 23 different anticonvulsant medications were tried over four years. What the doctors viewed as clinical efficiencythe Hmong viewed as frosty arrogance. The Lees were sure that the medicines were bad for Lia and did not comply with their Western doctor's instructions. The doctor viewed this as child abuse and had Lia placed in foster care.

A few months after returning home, Lia suffered a massive seizure which caused extensive brain damage. The Lees' American doctors believed that Lia was brain dead. The Lees believed that Lia's soul had fled from her body and become lost. Expecting that Lia would die quickly, her doctors allowed the Lees to take Lia home for final care. But two years later Lia was still alive, being lovingly cared for by her family. Still hoping to help her wandering soul find its way back to her body, they arranged for a Hmong shaman to conduct a healing ceremony in their apartment, featuring the sacrifice of a live pig.

It's clear that the Western doctors were doing their best to provide medical care but were frustrated by the radically different world view, language, culture, and spiritual beliefs of the Lees. Without devaluing any of the participants Fadiman encourages health care providers to at least acknowledge the existence of their patients' beliefs. She makes it clear that both the Lees and their doctors are loving, caring people who simply aren't prepared to deal with the foreigness of the other's culture.

Never losing sight of the emotionally-wrenching story, Fadiman manages to weave in an ethnographical picture of Hmong history and culture, including their work for the CIA in Laos and their subsequent resettlement in the United States.

Nominated for the 1997 Book Critics Circle Award for non-fiction, this book comes highly recommended by many major reviewers.