Review: The Spirit Catches You and You Fall Down, by Anne Fadiman

Reviewed by Christina

Published: 1997

It's about: The subtitle is "A Hmong Child, Her American Doctors, and the Collision of Two Cultures." It's Anne Fadiman's account of a little girl named Lia Lee, who was born to Hmong refugees in California in 1982. Lia has severe epilepsy, which her doctors and parents all try to treat as best they can. But major cultural differences and language barriers erode the already tenuous relationship between them, and Lia suffers the consequences.

I thought: When I picked up this book, I knew next to nothing about the Hmong people. I actually thought Hmong and Laotian were the same thing, so I had nowhere to go but up in the learning curve. I think I represent the intended audience, though, because Ms. Fadiman alternates chapters telling Lia's story with chapters about the Hmong's history, their role in American military history, their language, their religion, and their experience as refugees in Thailand and the U.S. The Spirit Catches You and You Fall Down is densely packed with meticulously-researched information, but the writing is so clear and full of anecdotes, that I never felt bored or bogged down.
I was especially impressed by Ms. Fadiman's ability to present both sides of the conflict with empathy and rationality. The Lee family differ from their American doctors in almost every conceivable way, and it is nearly impossible for the two groups to see each others' point of view. I worried, originally, that this book was going to be a tirade, like "This is what those awful doctors did to that poor little girl, and she would have been just fine if only they would have stuck with natural remedies." I'm not sure where I got that idea, because that's not the case at all. Anne Fadiman certainly never implies that Hmong shamanistic rituals could have cured Lia's epilepsy. She presents the facts, both as the medical establishment perceived them, and as Lia's parents perceived them. She only very rarely inserts her own opinion, and she does so carefully.
In the end, this isn't just a case study of little Lia Lee. It's an extended discussion of the problem of cross-cultural medicine, and also a meditation on the Hmong refugee experience in general. I loved it. I learned so much, and I was moved by the heartbreaking history of the Hmong people, especially the Lee family.

Verdict: DEFINITELY on the shelf.

Warnings: Some swears and racial epithets in quotations from real-life jerks.

Favorite excerpts: "The customs they were expected to follow seemed so peculiar, the rules and regulations so numerous, the language so hard to learn, and the emphasis on literacy and the decoding of other unfamiliar symbols so strong, that many Hmong were overwhelmed. Jonas Vangay [a Hmong immigrant] told me, 'In America, we are blind because even though we have eyes, we cannot see. We are deaf because even though we have ears, we cannot hear.' Some newcomers wore pajamas as street clothes; poured water on electric stoves to extinguish them; lit charcoal fires in their living rooms; stored blankets in their refrigerators; washed rice in their toilets; washed their clothes in swimming pools; washed their hair with Lestoil; cooked with motor oil and furniture polish; drank clorox; ate cat food; planted crops in public parks; shot and ate skunks, porcupines, wookpeckers, robins, egrets, sparrows, and a bald eagle; and hunted pigeons with crossbows in the streets of Philadelphia."

"Animal sacrifices are common, even among Christian converts, a fact I first learned when [my interpreter] May Ying Xiong told me that she would be unavailable to interpret one weekend because her family was sacrificing a cow to safeguard her niece during an upcoming open-heart operation. When I said, 'I didn't know your family was so religious,' she replied, 'Oh yes, we're Mormon.'"

What I'm reading next: The Winter Queen, by Boris Akunin