The Spirit Catches You and You Fall Down Summary

Anne Fadiman


(Literary Masterpieces, Critical Compilation)

The Spirit Catches You and You Fall Down is the riveting narrative of a showdown between modern American medicine and ancient Hmong beliefs, a blow-by-blow account of the battle fought over the body and soul of a very sick young girl. Anne Fadiman’s thorough, compassionate, and scrupulously fair presentation of Lia Lee’s story provides a balanced and unbiased view of events. Clearly sympathizing with both the girl’s family and her doctors, Fadiman examines every facet of a complex situation, while challenging her readers’ perspectives on medicine and spirituality.

The Spirit Catches You and You Fall Down alternates chapters on Lia Lee’s medical record with accounts of Hmong history, culture, and religion. The author’s comprehensive research is evidenced by the inclusion of “Notes on Hmong Orthography, Pronunciation, and Quotations,” an extensive bibliography, detailed source notes, and an index. By combining the universality of a family tragedy with a scholarly history of Hmong culture, this book offers a unique and thoroughly satisfying reading experience.

The focal point of this family tragedy is Lia Lee, the fourteenth child of Hmong immigrants Nao Kao and Foua Lee, born in Merced, California, in 1982. The first of the Lees to be born in the United States (and in a hospital), Lia was a healthy baby until she suffered her first seizure at three months of age. Although emergency room doctors at the Merced Community Medical Center initially failed to diagnose Lia’s epilepsy (mistakenly treated as a bronchial infection), her family correctly identified her affliction immediately. They understood that Lia was suffering fromqaug dab peg (the spirit catches you and you fall down), or epilepsy. They believed that her soul, frightened by the sound of their apartment door slamming, fled her body and got lost. Although concerned for their daughter, they had mixed feelings regarding her condition, because the Hmong (and many other cultures) believe that epilepsy is indicative of special spiritual powers. The Lees “seemed to accept things that . . . were major catastrophes as a part of the normal flow of life. For them, the crisis was the treatment, not the epilepsy.” During the following few months, Lia suffered nearly twenty more seizures, was admitted to the hospital seventeen times between the ages of eight months and four-and-a-half years, and made more than one hundred outpatient visits to the emergency room or pediatric clinic. Her medical chart eventually reached five volumes and weighed nearly fourteen pounds, the largest in the history of the hospital. The case frustrated and confounded Lia’s doctors, husband and wife Neil Ernst and Peggy Philip, who possessed a “combination of idealism and workaholism that had simultaneously contributed to their successes and set them apart from most of their peers.” Although exceptionally conscientious and concerned, Ernst and Philip were hampered in the treatment of Lia not only by their inability to communicate with her parents (hospital translators were seldom available) but also by their ignorance of the Hmong culture. While “failing to work within the traditional Hmong hierarchy . . . [they] not only insulted the entire family but also yielded confused results, since the crucial questions had not been directed toward those who had the power to make decisions.”

In an attempt to control her ever-worsening seizures, the doctors placed Lia on a complicated drug regime that would have been difficult for English-speaking parents to follow, let alone the non-English-speaking Lees. The Lees failed to...

(The entire section is 1475 words.)