Review – The Spirit Catches You and You Fall Down

The Spirit Catches You and You Fall Down by Anne Fadiman

From Kirkus Reviews -

A vivid, deeply felt, and meticulously researched account of the disastrous encounter between two disparate cultures: Western medicine and Eastern spirituality, in this case, of Hmong immigrants from Laos. Fadiman, a columnist for Civilization and the new editor of the American Scholar, met the Lees, a Hmong refugee family in Merced, Calif., in 1988, when their daughter Lia was already seven years old and, in the eyes of her American doctors, brain dead. In the Lees’ view, Lia’s soul had fled her body and become lost. At age three months Lia had had her first epileptic seizure–as the Lees put it, “the spirit catches you and you fall down.” Lia’s treatment was complex–her anticonvulsant prescriptions changed 23 times in four years–and the Lees were sure the medicines were bad for their daughter. Believing that the family’s failure to comply with his instructions constituted child abuse, Lia’s doctor had her placed in foster care. A few months after returning home, Lia was hospitalized with a massive seizure that effectively destroyed her brain. With death believed to be imminent, the Lees were permitted to take her home. Two years later, Fadiman found Lia being lovingly cared for by her parents. Still hoping to reunite her soul with her body, they arranged for a Hmong shaman to perform a healing ceremony featuring the sacrifice of a live pig in their apartment. Into this heart-wrenching story, Fadiman weaves an account of Hmong history from ancient times to the present, including their work for the CIA in Laos and their resettlement in the US, their culture, spiritual beliefs, ethics, and etiquette. While Fadiman is keenly aware of the frustrations of doctors striving to provide medical care to those with such a radically different worldview, she urges that physicians at least acknowledge their patients’ realities. A brilliant study in cross-cultural medicine.

My thoughts -

This book utterly and completely fascinated me.  Fadiman did SUCH an excellent job with her incredibly diligent research about the Hmong culture, the Lee family, every single doctor or hospital that ever treated Lia, and medicine in general.  I was actually a little nervous that I wouldn’t enjoy this, because my best friend who is a nurse lent it to me and I assumed she enjoyed it so much because she works in the medical field… and of course, I was all wrong.  I was engrossed in the story up until the very last page.  Fadiman spent a few chapters on the history of the Hmong culture (Hmong people are from Laos, but because of an American sponsored war which they fought for us, they were kicked out of their home country), and those chapters were very enlightening because previously I had no knowledge of the Hmong people and their distinctly interesting culture.  The main focus of the book was the collision of the two cultures – how different Western medicine is from the Hmong’s traditional beliefs about healing – and how these differences can, or should, get resolved in order to treat Hmong people.  In this case, the gap between the two cultures was more like an ocean and for Lia, cultural understanding by her doctors and social workers came too late.  After reading the book, I found myself really thinking about who was right in all this.  Obviously, living in the United States, we are huge fans of our doctors, hospitals, medicines, and general ability to cure diseases and ailments, we believe in all of these things deeply.  But I found myself imagining how I would feel if I went to a country like Laos and they wanted to cure my children using herbal remedies and shamen when I know that what my kid really needs is a cast on his arm or some pain medication.  Thinking about that, I can only feel perhaps a tenth of the frustration and anger the Lees must have felt when their daughter’s doctors did not try to understand their cultural ways of healing and treatment, and continued to give Lia medical treatments and drugs even among her parents’ protests.  But on the other hand, doctors take an oath to save lives no matter what, so in treating Lia they were simply doing their jobs to the best of their abilities.  This book really, really made me think about these questions as well as many others, and I’d highly recommend reading it.

Rating: 10/10

Read Andi’s review here and Jeane’s review here.

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