The Spirit Catches You And You Fall Down Analysis

The Spirit Catches You and You Fall Down, written by Anne Fadiman, emulates on the ways in which cultural ignorance can have drastic effects on the lives of people caught in between two cultures. Published in 1997, the book chronicles the struggles of a Laos refugee family, and their experience with the health care system in Merced, California. This story centers on Lia Lee, a young Hmong child diagnosed with epilepsy. At three months old; Yer, Lia’s older sister, slams a door that triggers Lia’s first sensors. Her parents, Foua and Neo Kao, believe that this noise causes her soul to flee and diagnose her with qaug dab peg, “the spirt catches you and you fall down.” While the family is concerned with the health of her daughter they also see her sickness as something special. This is a beautifully written book- you feel for everyone in the story.

Fadiman recounts the story of two different cultural realities: Western rationalism and Hmong animism, as they continuously collide into one another.

For Lia, this collision ends fatal as she relied on them both for her survival and wellbeing. These realities failed to help this girl because of their mutual ignorance and prejudice for one another. In many ways this is a failure of cultural pathology and not biological pathology. As Fadiman explains: “I have come to believe that her life was not ruined by septic shock or noncompliant parents but by cross-cultural misunderstanding” (262). This kind of cultural ignorance takes on faces of conflicting languages, religions, and cultural

prejudice.

Lia’s parents did not speak English, nor did the hospital they attended have Hmong translators or even bilingual employees. The inability for the doctors and the patient’s parents to communicate well put both groups of people in a difficult position. In the book, Fasiman describes the situation: “Doctors on the late shift in the emergency room has no way of taking a patient’s medical history, or of asking such questions as, where do you hurt?” (25). Because of this lack of communication there was no way for Lia’s parents to tell the doctors about her seizures. This led to the misdiagnoses of a bronchial infection and for her seizures to be untreated for several months. Once Lia was diagnosed correctly, due to the language barrier, her parents were unable to fully understand what this diagnoses meant. The language issues also made it impossible for them to provide her with the correct medications. This irregular drug routine caused harm to her already fragile brain.

The conflicting religious frameworks of the rationalist doctors and the spiritual, animist Lees also had a profound impact on how Lia was treated. The Lees believed that sickness was caused by malevolent spirit that torments and steals a person’s soul. The lost can only then be returned to the body by rituals performed by their shaman. People with epilepsy are often made shaman. Shamans are also very expensive and these treatments burnt through the Lees small income. The Lees believed that a little of both methods was what was best for their daughter. However, the doctors did not, they believed that the problem was strictly biological. Lia’s doctors were unable to translate their methods into a framework that her parents could understand. In the end, if the doctors had tried to work alongside and understand the religious views of the Lees, Lia may have been better off. Lia’s mother was right when see said: “With Lia is was food to do a little medicine and a little neeb” (100).

Both the doctors and the Lees had cultural prejudices. Neither the doctors nor the Lees realized that their view was not the only one. The doctors thought their rationalistic, medical worldview was the only legitimate way to approach the situation. They assumed their authority would be respected and followed. They were dumbfounded by things the Lees found to be taboos. The Lees thought that animist, traditional Hmong was the only legitimate way to approach life. They continued to practice traditional Hmong values and religion. Just as the doctors were baffled by the Lees, the Lees were baffled by the doctors. This class in cultures led to different views and understanding of pathology. These different understandings ultimately hurt Lia.

The Spirit Catches You and You Fall Down, offers wonderful insight into how people can misunderstand one another due to differences in culture. I feel deeply for both parties involved in this tragic story. The frustration the doctors’ must have been feeling with the Lees. And I fully appreciate everything the Lees did. They did not want to sacrifice their culture and beliefs. They were doing the best that they knew how to do for their sweet little girl. This book is definitely a wakeup call for not only the medical community but for all societies. To truly understand a person you have to understand their culture. It’s just a shame that this wakeup call came at the cost of Lia.