The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

Hardcover (Print)
Used and New from Other Sellers
Used and New from Other Sellers
from $14.88
Usually ships in 1-2 business days
(Save 40%)
Other sellers (Hardcover)
  • All (18) from $14.88   
  • New (6) from $34.89   
  • Used (12) from $14.88   
Close
Sort by
Page 1 of 1
Showing All
Note: Marketplace items are not eligible for any BN.com coupons and promotions
$34.89
Seller since 2014

Feedback rating:

(9)

Condition:

New — never opened or used in original packaging.

Like New — packaging may have been opened. A "Like New" item is suitable to give as a gift.

Very Good — may have minor signs of wear on packaging but item works perfectly and has no damage.

Good — item is in good condition but packaging may have signs of shelf wear/aging or torn packaging. All specific defects should be noted in the Comments section associated with each item.

Acceptable — item is in working order but may show signs of wear such as scratches or torn packaging. All specific defects should be noted in the Comments section associated with each item.

Used — An item that has been opened and may show signs of wear. All specific defects should be noted in the Comments section associated with each item.

Refurbished — A used item that has been renewed or updated and verified to be in proper working condition. Not necessarily completed by the original manufacturer.

New
0374267812 This is a BRAND NEW hardback book! FULL SIZE RETAIL EDITION! PERFECT, UNREAD COPY! Crisp, clean pages and a super tight spine! Very minor signs of shelf ... wear on dust jacket...from storage-nothing major! Publisher overstock or retail store closing purchase that may show signs of shelf wear from storage-NOTHING MAJOR AT ALL! No remainder mark! PRICED TO SELL! SMOKE FREE STORAGE! Do not settle for worn, torn, throwaways. Pay a few pennies more for a beautiful, BRAND NEW copy!!! Read more Show Less

Ships from: Montgomery, AL

Usually ships in 1-2 business days

  • Standard, 48 States
$34.89
Seller since 2007

Feedback rating:

(1189)

Condition: New
Hardcover New 0374267812 This is a BRAND NEW hardback book! FULL SIZE RETAIL EDITION! PERFECT, UNREAD COPY! Crisp, clean pages and a super tight spine! Very minor signs of ... shelf wear on dust jacket...from storage-nothing major! Publisher overstock or retail store closing purchase that may show signs of shelf wear from storage-NOTHING MAJOR AT ALL! No remainder mark! PRICED TO SELL! SMOKE FREE STORAGE! Do not settle for worn, torn, throwaways. Pay a few pennies more for a beautiful, BRAND NEW copy! ! ! Read more Show Less

Ships from: Montgomery, AL

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
$43.99
Seller since 2005

Feedback rating:

(138)

Condition: New
New New Book, Noonday Press Books 1st edition, 1998, paperback, no marks inside, 341 pages of knowledge, a great book.

Ships from: Buford, GA

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
$47.88
Seller since 2014

Feedback rating:

(90)

Condition: New
Ships same day. Very slight shelf wear.tracking included.one word in ink back inside cover.dust cover a little rough.

Ships from: Hastings, MI

Usually ships in 1-2 business days

  • Standard, 48 States
  • Standard (AK, HI)
$105.00
Seller since 2014

Feedback rating:

(164)

Condition: New
Brand new.

Ships from: acton, MA

Usually ships in 1-2 business days

  • Standard, 48 States
  • Standard (AK, HI)
$145.00
Seller since 2014

Feedback rating:

(164)

Condition: New
Brand new.

Ships from: acton, MA

Usually ships in 1-2 business days

  • Standard, 48 States
  • Standard (AK, HI)
Page 1 of 1
Showing All
Close
Sort by

Overview

Winner of the National Book Critics Circle Award for Nonfiction

When three-month-old Lia Lee Arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit and fiercely people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, cleaved just as strongly to another tradition: that of Western medicine. When Lia Lee Entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication.

Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness aand healing as spiritual matters linked to virtually everything in the universe, while medical community marks a division between body and soul, and concerns itself almost exclusively with the former. Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness, qaug dab peg—the spirit catches you and you fall down—and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.

Read More Show Less

Editorial Reviews

Carole Horn
Superb, informal cultural anthropology — eye-opening, readable, utterly engaging. —The Washington Post Book World
Sherwin B. Nuland
I cannot think of a book by a non-physician that is more understanding of the difficulties of caring for peoplke. . .or of the conditions under which today's medicine is practiced. —The New Republic
Publishers Weekly - Publisher's Weekly
When two divergent cultures collide, unbridgable gaps of language, religion, social customs may remain between them. This poignant account by Fadiman, editor of The American Scholar, of the clash between a Hmong family and the American medical community reveals that among the gaps yawns the attitude toward medicine and healing. The story focuses on Lia Lee, whose family immigrated to Merced, Calif., from Laos in 1980. At three months of age, Lia was diagnosed with what American doctors called epilepsy, and what her family called quag dab peg or, 'the spirit catches you and you fall down.' Fadiman traces the treatments for Lia's illness, observing the sharp differences between Eastern and Western healing methods. Whereas the doctors prescribed Depakene and Valium to control her seizures, Lia's family believed that her soul was lost but could be found by sacrificing animals and hiring shamans to intervene. While some of Lia's doctors attempted to understand the Hmong beliefs, many interpreted the cultural difference as ignorance on the part of Lia's parents. Fadiman shows how the American ideal of assimilation was challenged by a headstrong Hmong ethnicity. She discloses the unilateralness of Western medicine, and divulges its potential failings. In Lia's case, the two cultures never melded and, after a massive seizure, she was declared brain dead. This book is a moving cautionary tale about the importance of practicing 'cross-cultural medicine,' and of acknowledging, without condemning, differences in medical attitudes of various cultures.'
Library Journal
Award-winning reporter Fadiman has turned what began as a magazine assignment into a riveting, cross-cultural medicine classic in this anthropological exploration of the Hmong population in Merced County, California. Following the case of Lia (a Hmong child with a progressive and unpredictable form of epilepsy), Fadiman maps out the controversies raised by the collision between Western medicine and holistic healing traditions of Hmong immigrants. Unable to enter the Laotian forest to find herbs for Lia that will 'fix her spirit,' her family becomes resigned to the Merced County emergency system, which has little understanding of Hmong animist traditions. Fadiman reveals the rigidity and weaknesses of these two ethnographically separated cultures. In a shrinking world, this painstakingly researched account of cultural dislocation has a haunting lesson for every healthcare provider. -- Rebecca Cress-Ingebo, Fordham Health Sciences Library, Wright State University, Dayton, Ohio
School Library Journal
A compelling anthropological study. The Hmong people in America are mainly refugee families who supported the CIA militaristic efforts in Laos. They are a clannish group with a firmly established culture that combines issues of health care with a deep spirituality that may be deemed primitive by Western standards. In Merced, CA, which has a large Hmong community, Lia Lee was born, the 13th child in a family coping with their plunge into a modern and mechanized way of life. The child suffered an initial seizure at the age of three months. Her family attributed it to the slamming of the front door by an older sister. They felt the fright had caused the baby's soul to flee her body and become lost to a malignant spirit. The report of the family's attempts to cure Lia through shamanistic intervention and the home sacrifices of pigs and chickens is balanced by the intervention of the medical community that insisted upon the removal of the child from deeply loving parents with disastrous results. This compassionate and understanding account fairly represents the positions of all the parties involved. The suspense of the child's precarious health, the understanding characterization of the parents and doctors, and especially the insights into Hmong culture make this a very worthwhile read. -- Frances Reiher, Fairfax County Public Library, Virginia
Richard Bernstein
Ms. Fadiman tells her story with a novelist's grace, playing the role of cultural broker, comprehending those who do not comprehend each other and perceiving what might have been done or said to make the outcome different.--The New York Times
Melvin Konner
This fine book recounts a poignant tragedy. . . It has no heroes or villains, but it has an abunance of innocent suffering, and it most certainly does have a moral. . .[A] sad, excellent book. -- The New York Times Book Review
Sherwin B. Nuland
I cannot think of a book by a non-physician that is more understanding of the difficulties of caring for peoplke. . .or of the conditions under which today's medicine is practiced. -- The New Republic
Carole Horn
An intriguing, spirit-lifting, extraordinary exploration of two cultures in uneasy coexistence . . . A wonderful aspect of Fadiman's book is her evenhanded, detailed presentation of these disparate cultures and divergent views--not with cool, dispassionate fairness but rather with a warm, involved interest . . . Fadiman's book is superb, informal cultural anthropology--eye-opening, readable, utterly engaging.--The Washington Post Book World
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 anti-convulsant 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 U.S., their culture, spiritual beliefs, ethics, and etiquette. While Fadiman is keenly aware of the frustrations ofdoctors 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.
The New Yorker
Fadiman describes with extraordinary skill the colliding worlds of Western medicine and Hmong culture.
Linnea Lannon
So good I want to somehow make it required reading . . . The Spirit Catches You and You Fall Down explores issues of culture, immigration, medicine, and the war in [Laos] with such skill that it's nearly impossible to put down.
The Detroit Free Press
From the Publisher
“Superb, informal cultural anthropology—eye-opening, readable, utterly engaging.” —Carole Horn, The Washington Post Book World

“This is a book that should be deeply disturbing to anyone who has given so much as a moment’s thought to the state of American medicine. But it is much more . . . People are presented as [Fadiman] saw them, in their humility and their frailty—and their nobility.” —Sherwin B. Nuland, The New Republic

The Spirit Catches You and You Fall Down changed how doctors see themselves and how they see their patients. Anne Fadiman celebrates the complexity and the individuality of the human interactions that make up the practice of medicine while simultaneously pointing out directions for change and breaking readers’ hearts with the tragedies of cultural displacement, medical limitations, and futile good intentions.” —Perri Klass, M.D., author of A Not Entirely Benign Procedure

Read More Show Less

Product Details

  • ISBN-13: 9780374267810
  • Publisher: Farrar, Straus and Giroux
  • Publication date: 9/30/1997
  • Edition description: reprint
  • Pages: 352
  • Product dimensions: 6.40 (w) x 9.58 (h) x 1.18 (d)

Meet the Author

Anne Fadiman's compassionate account of this cultural impasse is literary journalism at its finest. The Spirit Catches You and You Fall Down moves from hospital corridors to healing cereomies, and from the hill country of Laos to the living rooms of Merced, uncovering in its path the complex sources and implications of two dramatically clashing worldviews.

Read More Show Less

Read an Excerpt

THE SPIRIT CATCHES YOU AND YOU FALL DOWN (Chapter 1)Birth

If Lia Lee had been born in the highlands of northwest Laos, where her parents and twelve of her brothers and sisters were born, her mother would have squatted on the floor of the house that her father had built from ax-hewn planks thatched with bamboo and grass. The floor was dirt, but it was clean. Her mother, Foua, sprinkled it regularly with water to keep the dust down and swept it every morning and evening with a broom she had made of grass and bark. She used a bamboo dustpan, which she had also made herself, to collect the feces of the children who were too young to defecate outside, and emptied its contents in the forest. Even if Foua had been a less fastidious housekeeper, her newborn babies wouldn’t have gotten dirty, since she never let them actually touch the floor. She remains proud to this day that she delivered each of them into her own hands, reaching between her legs to ease out the head and then letting the rest of the body slip out onto her bent forearms. No birth attendant was present, though if her throat became dry during labor, her husband, Nao Kao, was permitted to bring her a cup of hot water, as long as he averted his eyes from her body. Because Foua believed that moaning or screaming would thwart the birth, she labored in silence, with the exception of an occasional prayer to her ancestors. She was so quiet that although most of her babies were born at night, her older children slept undisturbed on a communal bamboo pallet a few feet away, and woke only when they heard the cry of their new brother or sister. After each birth, Nao Kao cut the umbilical cord with heated scissors and tied it with string. Then Foua washed the baby with water she had carried from the stream, usually in the early phases of labor, in a wooden and bamboo pack-barrel strapped to her back.

Foua conceived, carried, and bore all her children with ease, but had there been any problems, she would have had recourse to a variety of remedies that were commonly used by the Hmong, the hilltribe to which her family belonged. If a Hmong couple failed to produce children, they could call in a txiv neeb, a shaman who was believed to have the ability to enter a trance, summon a posse of helpful familiars, ride a winged horse over the twelve mountains between the earth and the sky, cross an ocean inhabited by dragons, and (starting with bribes of food and money and, if necessary, working up to a necromantic sword) negotiate for his patients’ health with the spirits who lived in the realm of the unseen. A txiv neeb might be able to cure infertility by asking the couple to sacrifice a dog, a cat, a chicken, or a sheep. After the animal’s throat was cut, the txiv neeb would string a rope bridge from the doorpost to the marriage bed, over which the soul of the couple’s future baby, which had been detained by a malevolent spirit called a dab, could now freely travel to earth. One could also take certain precautions to avoid becoming infertile in the first place. For example, no Hmong woman of childbearing age would ever think of setting foot inside a cave, because a particularly unpleasant kind of dab sometimes lived there who liked to eat flesh and drink blood and could make his victim sterile by having sexual intercourse with her.

Once a Hmong woman became pregnant, she could ensure the health of her child by paying close attention to her food cravings. If she craved ginger and failed to eat it, her child would be born with an extra finger or toe. If she craved chicken flesh and did not eat it, her child would have a blemish near its ear. If she craved eggs and did not eat them, her child would have a lumpy head. When a Hmong woman felt the first pangs of labor, she would hurry home from the rice or opium fields, where she had continued to work throughout her pregnancy. It was important to reach her own house, or at least the house of one of her husband’s cousins, because if she gave birth anywhere else a dab might injure her. A long or arduous labor could be eased by drinking the water in which a key had been boiled, in order to unlock the birth canal; by having her family array bowls of sacred water around the room and chant prayers over them; or, if the difficulty stemmed from having treated an elder member of the family with insufficient respect, by washing the offended relative’s fingertips and apologizing like crazy until the relative finally said, “I forgive you.”

Soon after the birth, while the mother and baby were still lying together next to the fire pit, the father dug a hole at least two feet deep in the dirt floor and buried the placenta. If it was a girl, her placenta was buried under her parents’ bed; if it was a boy, his placenta was buried in a place of greater honor, near the base of the house’s central wooden pillar, in which a male spirit, a domestic guardian who held up the roof of the house and watched over its residents, made his home. The placenta was always buried with the smooth side, the side that had faced the fetus inside the womb, turned upward, since if it was upside down, the baby might vomit after nursing. If the baby’s face erupted in spots, that meant the placenta was being attacked by ants underground, and boiling water was poured into the burial hole as an insecticide. In the Hmong language, the word for placenta means “jacket.” It is considered one’s first and finest garment. When a Hmong dies, his or her soul must travel back from place to place, retracing the path of its life geography, until it reaches the burial place of its placental jacket, and puts it on. Only after the soul is properly dressed in the clothing in which it was born can it continue its dangerous journey, past murderous dabs and giant poisonous caterpillars, around man-eating rocks and impassable oceans, to the place beyond the sky where it is reunited with its ancestors and from which it will someday be sent to be reborn as the soul of a new baby. If the soul cannot find its jacket, it is condemned to an eternity of wandering, naked and alone.

Because the Lees are among the 150,000 Hmong who have fled Laos since their country fell to communist forces in 1975, they do not know if their house is still standing, or if the five male and seven female placentas that Nao Kao buried under the dirt floor are still there. They believe that half of the placentas have already been put to their final use, since four of their sons and two of their daughters died of various causes before the Lees came to the United States. The Lees believe that someday the souls of most of the rest of their family will have a long way to travel, since they will have to retrace their steps from Merced, California, where the family has spent fifteen of its seventeen years in this country; to Portland, Oregon, where they lived before Merced; to Honolulu, Hawaii, where their airplane from Thailand first landed; to two Thai refugee camps; and finally back to their home village in Laos.

The Lees’ thirteenth child, Mai, was born in a refugee camp in Thailand. Her placenta was buried under their hut. Their fourteenth child, Lia, was born in the Merced Community Medical Center, a modern public hospital that serves an agricultural county in California’s Central Valley, where many Hmong refugees have resettled. Lia’s placenta was incinerated. Some Hmong women have asked the doctors at MCMC, as the hospital is commonly called, if they could take their babies’ placentas home. Several of the doctors have acquiesced, packing the placentas in plastic bags or take-out containers from the hospital cafeteria; most have refused, in some cases because they have assumed that the women planned to eat the placentas, and have found that idea disgusting, and in some cases because they have feared the possible spread of hepatitis B, which is carried by at least fifteen percent of the Hmong refugees in the United States. Foua never thought to ask, since she speaks no English, and when she delivered Lia, no one present spoke Hmong. In any case, the Lees’ apartment had a wooden floor covered with wall-to-wall carpeting, so burying the placenta would have been a difficult proposition.

When Lia was born, at 7:09 p.m. on July 19, 1982, Foua was lying on her back on a steel table, her body covered with sterile drapes, her genital area painted with a brown Betadine solution, with a high-wattage lamp trained on her perineum. There were no family members in the room. Gary Thueson, a family practice resident who did the delivery, noted in the chart that in order to speed the labor, he had artificially ruptured Foua’s amniotic sac by poking it with a foot-long plastic “amni-hook” that no anesthesia was used; that no episiotomy, an incision to enlarge the vaginal opening, was necessary; and that after the birth, Foua received a standard intravenous dose of Pitocin to constrict her uterus. Dr. Thueson also noted that Lia was a “healthy infant” whose weight, 8 pounds 7 ounces, and condition were “appropriate for gestational age” (an estimate he based on observation alone, since Foua had received no prenatal care, was not certain how long she had been pregnant, and could not have told Dr. Thueson even if she had known). Foua thinks that Lia was her largest baby, although she isn’t sure, since none of her thirteen elder children were weighed at birth. Lia’s Apgar scores, an assessment of a newborn infant’s heart rate, respiration, muscle tone, color, and reflexes, were good: one minute after her birth she scored 7 on a scale of 10, and four minutes later she scored 9. When she was six minutes old, her color was described as “pink” and her activity as “crying.” Lia was shown briefly to her mother. Then she was placed in a steel and Plexiglas warmer, where a nurse fastened a plastic identification band around her wrist and recorded her footprints by inking the soles of her feet with a stamp pad and pressing them against a Newborn Identification form. After that, Lia was removed to the central nursery, where she received an injection of Vitamin K in one of her thighs to prevent hemorrhagic disease; was treated with two drops of silver nitrate solution in each eye, to prevent an infection from gonococcal bacteria; and was bathed with Safeguard soap.

Foua’s own date of birth was recorded on Lia’s Delivery Room Record as October 6, 1944. In fact, she has no idea when she was born, and on various other occasions during the next several years she would inform MCMC personnel, through English-speaking relatives such as the nephew’s wife who had helped her check into the hospital for Lia’s delivery, that her date of birth was October 6, 1942, or, more frequently, October 6, 1926. Not a single admitting clerk ever appears to have questioned the latter date, though it would imply that Foua gave birth to Lia at the age of 55. Foua is quite sure, however, that October is correct, since she was told by her parents that she was born during the season in which the opium fields are weeded for the second time and the harvested rice stalks are stacked. She invented the precise day of the month, like the year, in order to satisfy the many Americans who have evinced an abhorrence of unfilled blanks on the innumerable forms the Lees have encountered since their admission to the United States in 1980. Most Hmong refugees are familiar with this American trait and have accommodated it in the same way. Nao Kao Lee has a first cousin who told the immigration officials that all nine of his children were born on July 15, in nine consecutive years, and this information was duly recorded on their resident alien documents.

When Lia Lee was released from MCMC, at the age of three days, her mother was asked to sign a piece of paper that read:

I CERTIFY that during the discharge procedure I received my baby, examined it and determined that it was mine. I checked the Ident-A-Band® parts sealed on the baby and on me and found that they were identically numbered 5043 and contained correct identifying information.

Since Foua cannot read and has never learned to recognize Arabic numerals, it is unlikely that she followed these instructions. However, she had been asked for her signature so often in the United States that she had mastered the capital forms of the seven different letters contained in her name, Foua Yang. (The Yangs and the Lees are among the largest of the Hmong clans; the other major ones are the Chas, the Chengs, the Hangs, the Hers, the Kues, the Los, the Mouas, the Thaos, the Vues, the Xiongs, and the Vangs. In Laos, the clan name came first, but most Hmong refugees in the United States use it as a surname. Children belong to their father’s clan; women traditionally retain their clan name after marriage. Marrying a member of one’s own clan is strictly taboo.) Foua’s signature is no less legible than the signatures of most of MCMC’s resident physicians-in-training, which, particularly if they are written toward the end of a twenty-four-hour shift, tend to resemble EEGs. However, it has the unique distinction of looking different each time it appears on a hospital document. On this occasion, FOUAYANG was written as a single word. One A is canted to the left and one to the right, the Y looks like an X, and the legs of the N undulate gracefully, like a child’s drawing of a wave.

It is a credit to Foua’s general equanimity, as well as her characteristic desire not to think ill of anyone, that although she found Lia’s birth a peculiar experience, she has few criticisms of the way the hospital handled it. Her doubts about MCMC in particular, and American medicine in general, would not begin to gather force until Lia had visited the hospital many times. On this occasion, she thought the doctor was gentle and kind, she was impressed that so many people were there to help her, and although she felt that the nurses who bathed Lia with Safeguard did not get her quite as clean as she had gotten her newborns with Laotian stream water, her only major complaint concerned the hospital food. She was surprised to be offered ice water after the birth, since many Hmong believe that cold foods during the postpartum period make the blood congeal in the womb instead of cleansing it by flowing freely, and that a woman who does not observe the taboo against them will develop itchy skin or diarrhea in her old age. Foua did accept several cups of what she remembers as hot black water. This was probably either tea or beef broth; Foua is sure it wasn’t coffee, which she had seen before and would have recognized. The black water was the only MCMC-provided food that passed her lips during her stay in the maternity ward. Each day, Nao Kao cooked and brought her the diet that is strictly prescribed for Hmong women during the thirty days following childbirth: steamed rice, and chicken boiled in water with five special postpartum herbs (which the Lees had grown for this purpose on the edge of the parking lot behind their apartment building). This diet was familiar to the doctors on the Labor and Delivery floor at MCMC, whose assessments of it were fairly accurate gauges of their general opinion of the Hmong. One obstetrician, Raquel Arias, recalled, “The Hmong men carried these nice little silver cans to the hospital that always had some kind of chicken soup in them and always smelled great.” Another obstetrician, Robert Small, said, “They always brought some horrible stinking concoction that smelled like the chicken had been dead for a week.” Foua never shared her meals with anyone, because there is a postpartum taboo against spilling grains of rice accidentally into the chicken pot. If that occurs, the newborn is likely to break out across the nose and cheeks with little white pimples whose name in the Hmong language is the same as the word for “rice.”

Some Hmong parents in Merced have given their children American names. In addition to many standard ones, these have included Kennedy, Nixon, Pajama, Guitar, Main (after Merced’s Main Street), and, until a nurse counseled otherwise, Baby Boy, which one mother, seeing it written on her son’s hospital papers, assumed was the name the doctor had already chosen for him. The Lees chose to give their daughter a Hmong name, Lia. Her name was officially conferred in a ceremony called a hu plig, or soul-calling, which in Laos always took place on the third day after birth. Until this ceremony was performed, a baby was not considered to be fully a member of the human race, and if it died during its first three days it was not accorded the customary funerary rites. (This may have been a cultural adaptation to the fifty-percent infant mortality rate, a way of steeling Hmong mothers against the frequent loss of their babies during or shortly after childbirth by encouraging them to postpone their attachment.) In the United States, the naming is usually celebrated at a later time, since on its third day a baby may still be hospitalized, especially if the birth was complicated. It took the Lee family about a month to save enough money from their welfare checks, and from gifts from their relatives’ welfare checks, to finance a soul-calling party for Lia.

Although the Hmong believe that illness can be caused by a variety of sources—including eating the wrong food, drinking contaminated water, being affected by a change in the weather, failing to ejaculate completely during sexual intercourse, neglecting to make offerings to one’s ancestors, being punished for one’s ancestors’ transgressions, being cursed, being hit by a whirlwind, having a stone implanted in one’s body by an evil spirit master, having one’s blood sucked by a dab, bumping into a dab who lives in a tree or a stream, digging a well in a dab’s living place, catching sight of a dwarf female dab who eats earthworms, having a dab sit on one’s chest while one is sleeping, doing one’s laundry in a lake inhabited by a dragon, pointing one’s finger at the full moon, touching a newborn mouse, killing a large snake, urinating on a rock that looks like a tiger, urinating on or kicking a benevolent house spirit, or having bird droppings fall on one’s head—by far the most common cause of illness is soul loss. Although the Hmong do not agree on just how many souls people have (estimates range from one to thirty-two; the Lees believe there is only one), there is a general consensus that whatever the number, it is the life-soul, whose presence is necessary for health and happiness, that tends to get lost. A life-soul can become separated from its body through anger, grief, fear, curiosity, or wanderlust. The life-souls of newborn babies are especially prone to disappearance, since they are so small, so vulnerable, and so precariously poised between the realm of the unseen, from which they have just traveled, and the realm of the living. Babies’ souls may wander away, drawn by bright colors, sweet sounds, or fragrant smells; they may leave if a baby is sad, lonely, or insufficiently loved by its parents; they may be frightened away by a sudden loud noise; or they may be stolen by a dab. Some Hmong are careful never to say aloud that a baby is pretty, lest a dab be listening. Hmong babies are often dressed in intricately embroidered hats (Foua made several for Lia) which, when seen from a heavenly perspective, might fool a predatory dab into thinking the child was a flower. They spend much of their time swaddled against their mothers’ backs in cloth carriers called nyias (Foua made Lia several of these too) that have been embroidered with soul-retaining motifs, such as the pigpen, which symbolizes enclosure. They may wear silver necklaces fastened with soul-shackling locks. When babies or small children go on an outing, their parents may call loudly to their souls before the family returns home, to make sure that none remain behind. Hmong families in Merced can sometimes be heard doing this when they leave local parks after a picnic. None of these ploys can work, however, unless the soul-calling ritual has already been properly observed.

Lia’s hu plig took place in the living room of her family’s apartment. There were so many guests, all of them Hmong and most of them members of the Lee and Yang clans, that it was nearly impossible to turn around. Foua and Nao Kao were proud that so many people had come to celebrate their good fortune in being favored with such a healthy and beautiful daughter. That morning Nao Kao had sacrificed a pig in order to invite the soul of one of Lia’s ancestors, which was probably hungry and would appreciate an offering of food, to be reborn in her body. After the guests arrived, an elder of the Yang clan stood at the apartment’s open front door, facing East 12th Street, with two live chickens in a bag on the floor next to him, and chanted a greeting to Lia’s soul. The two chickens were then killed, plucked, eviscerated, partially boiled, retrieved from the cooking pot, and examined to see if their skulls were translucent and their tongues curled upward, both signs that Lia’s new soul was pleased to take up residence in her body and that her name was a good one. (If the signs had been inauspicious, the soul-caller would have recommended that another name be chosen.) After the reading of the auguries, the chickens were put back in the cooking pot. The guests would later eat them and the pig for dinner. Before the meal, the soul-caller brushed Lia’s hands with a bundle of short white strings and said, “I am sweeping away the ways of sickness.” Then Lia’s parents and all of the elders present in the room each tied a string around one of Lia’s wrists in order to bind her soul securely to her body. Foua and Nao Kao promised to love her; the elders blessed her and prayed that she would have a long life and that she would never become sick.

THE SPIRIT CATCHES YOU AND YOU FALL DOWN Copyright © 1997 by Anne Fadiman

Read More Show Less

Table of Contents

Preface vii

1 Birth 3

2 Fish Soup 12

3 The Spirit Catches You and You Fall Down 20

4 Do Doctors Eat Brains? 32

5 Take as Directed 38

6 High-Velocity Transcortical head Therapy 60

7 Government Property 78

8 Foua and Nao Kao 93

9 A Little Medicine and a Little Neeb 106

10 War 119

11 The Big One 140

12 Flight 154

13 Code X 171

14 The Melting Pot 181

15 Gold and Dross 210

16 Why Did They Pick Merced? 225

17 The Eight Questions 250

18 The Life or the Soul 262

19 The Sacrifice 278

Afterword to the Fifteenth Anniversary Edition 289

Note on Hmong Orthography, Pronunciation, and Quotations 305

Notes on Sources 307

Bibliography 327

Acknowledgments 341

Index 345

Read More Show Less

Reading Group Guide

About This Guide
This guide is intended to enrich your experience of reading The Spirit Catches You and You Fall Down, winner of the National Book Critics Circle Award. This moving chronicle of a very sick girl, her refugee parents, and the doctors who struggled desperately to treat her becomes, in Anne Fadiman's deft narrative, at once a cautionary study of the limits of Western medicine and a parable for the modern immigrant experience.

Lia Lee was born in the San Joaquin valley in California to Hmong refugees. At the age of three months, she first showed signs of having what the Hmong know as qaug dab peg (the spirit catches you and you fall down), the condition known in the West as epilepsy. While her highly competent doctors saw the best treatment in a dizzying array of pills, her parents preferred a combination of Western medicine and folk remedies designed to coax her wandering soul back to her body. Over the next four years, profound cultural differences and linguistic miscommunication would exacerbate the rift between Lia's loving parents and her caring and well-intentioned doctors, eventually resulting in the loss of all her higher brain functions. Fadiman weaves this personal tragedy, a probing medical investigation, and a fascinating look at Hmong history and culture into a stunningly insightful, richly rewarding piece of modern reportage.

Questions and Subjects for Discussion
1. What do you think of traditional Hmong birth practices (pp. 3-5)? Compare them to the techniques used when Lia was born (p. 7). How do Hmong and American birth practices differ?

2. Over many centuries the Hmong fought against a number of different peoples who claimed sovereignty over their lands; they were also forced to emigrate from China. How do you think these up-heavals have affected their culture? What role has history played in the formation of Hmong culture?

3. Dr. Dan Murphy said, "The language barrier was the most obvious problem, but not the most important. The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference" (p. 91). What does he mean by this?

4. The author says, "I was struck . . . by the staggering toll of stress that the Hmong exacted from the people who took care of them, particularly the ones who were young, idealistic, and meticulous" (p. 75). Why do you think the doctors felt such great stress?

5. Dr. Neil Ernst said, "I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids' lives. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior" (p. 79). Do you think the Hmong understood this message? Why or why not? What do you think of Neil and Peggy?

6. Dr. Roger Fife is liked by the Hmong because, in their words, he "doesn't cut" (p. 76). He is not highly regarded by some of the other doctors, however. One resident went so far as to say, "He's a little thick." What do you think of Dr. Fife? What are his strengths and weaknesses? The author also speaks of other doctors who were able to communicate with the Hmong. How were they able to do so? What might be learned from this?

7. How did you feel about the Lees' refusal to give Lia her medicine? Can you understand their motivation? Do you sympathize with it?

8. How did you feel when Child Protective Services took Lia away from her parents? Do you believe it was the right decision? Was any other solution possible in the situation?

9. Were you surprised at the quality of care and the love and affection given to Lia by her foster parents? How did Lia's foster parents feel about Lia's biological parents? Was foster care ultimately to Lia's benefit or detriment?

10. How did the EMT's and the doctors respond to what Neil referred to as Lia's "big one"? Do you think they performed as well as they could have under the circumstances?

11. How does the greatest of all Hmong folktales, the story of how Shee Yee fought with nine evil dab brothers (p. 170), reflect the life and culture of the Hmong?

12. Discuss the Lees' life in Laos. How was it different from their life in the United States? Foua says, "When we were running from Laos at least we hoped that our lives would be better. It was not as sad as after Lia went to Fresno and got sick" (p. 171). What were the Lees running from? What were they hoping to find in the United States?

13. When polled, Hmong refugees in America stated that "difficulty with American agencies" was a more serious problem than either "war memories" or "separation from family." Why do you think they felt this way? Could this have been prevented? If so, how? What does the author believe?

14. The Hmong are often referred to as a "Stone Age" people or "low-caste hill tribe." Why is this? Do you agree with this assessment of Hmong culture? Does the author?

15. What was the "role loss" many adult Hmong faced when they came to the United States? What is the underlying root cause? How does this loss affect their adjustment to America?

16. What are the most important aspects of Hmong culture? What do the Hmong consider their most important duties and obligations? How did they affect the Hmong's transition to the United States?

17. What does Dan Murphy mean by, "When you fail one Hmong patient, you fail the whole community" (p. 253)?

18. The author gives you some insight into the way she organized her notes (p. 60). What does it say about the process of writing this book? She chooses to alternate between chapters of Lia's story and its larger background-the history of the Lee family and of the Hmong. What effect does this create in the book?

19. The concept of "fish soup" is central to the author's understanding of the Hmong. What does it mean, and how is it reflected in the structure of the book?

20. It is clear that many of Lia's doctors, most notably Neil Ernst and Peggy Philp, were heroic in their efforts to help Lia, and that her parents cared for her deeply, yet this arguably preventable tragedy still occurred. Can you think of anything that might have prevented it?

21. What did you learn from this book? Would you assign blame for Lia's tragedy? If so, to whom? What do you think Anne Fadiman feels about this question?

Other Books of Related Interest
Virginia Barnes Lee, Aman: Story of a Somali Girl; Michael Bérubé, Life as We Know It; Robert Olen Butler, The Deep Green Sea; Lan Cao, Monkey Bridge; Temple Grandin, Thinking in Pictures: And Other Reports from My Life with Autism; Jamaica Kincaid, My Brother; Maxine Hong Kingston, Woman Warrior; Oliver Sacks, The Man Who Mistook His Wife for a Hat: And Other Clinical Tales; Esmeralda Santiago, When I Was Puerto Rican; Susan Sheehan, Is There No Place on Earth for Me?; Abraham Verghese, My Own Country: A Doctor's Story.

About the Author
Anne Fadiman is the editor of The American Scholar. Recipient of a National Magazine Award for Reporting, she has written for Civilization, Harper's, Life, and The New York Times, among other publications. She lives in New York City.

Read More Show Less

Customer Reviews

Average Rating 4
( 126 )
Rating Distribution

5 Star

(65)

4 Star

(37)

3 Star

(12)

2 Star

(5)

1 Star

(7)

Your Rating:

Your Name: Create a Pen Name or

Barnes & Noble.com Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & Noble.com that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & Noble.com does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at BN.com or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

  • - HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
  • - Time-sensitive information such as tour dates, signings, lectures, etc.
  • - Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
  • - Comments focusing on the author or that may ruin the ending for others
  • - Phone numbers, addresses, URLs
  • - Pricing and availability information or alternative ordering information
  • - Advertisements or commercial solicitation

Reminder:

  • - By submitting a review, you grant to Barnes & Noble.com and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Noble.com Terms of Use.
  • - Barnes & Noble.com reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & Noble.com also reserves the right to remove any review at any time without notice.
  • - See Terms of Use for other conditions and disclaimers.
Search for Products You'd Like to Recommend

Recommend other products that relate to your review. Just search for them below and share!

Create a Pen Name

Your Pen Name is your unique identity on BN.com. It will appear on the reviews you write and other website activities. Your Pen Name cannot be edited, changed or deleted once submitted.

 
Your Pen Name can be any combination of alphanumeric characters (plus - and _), and must be at least two characters long.

Continue Anonymously
See All Sort by: Showing 1 – 20 of 128 Customer Reviews
  • Anonymous

    Posted April 29, 2007

    A Must-Read for anybody in healthcare

    As a physician myself, this book really hit close to home. It really was an eye-opener for everybody in the health care system as well as for anybody in the Western world to strive not to view the world in an ethnocentric manner. Most of the time, physicians have a 'tunnel vision' when interacting patients. Though oftentimes done without malice, it nevertheless disregards the patient as an individual with his/her own values and beliefs.This redefines medicine and focuses on it being an art rather than a science of treating patients as whole individual:body, mind and soul. Anne Fadiman succeeded in presenting the material not in an antagonistic way, by focusing on Lia and her family, and by providing a better understanding of the Hmong culture. I keep a copy in my office with the cover showing Lia's picture within easy view to serve as a reminder to me in my everyday interaction with patients.

    11 out of 11 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted May 11, 2007

    Adequate writing, biased observations

    While Fadiman¿s writing style is adequate and the book is easy to read, it only merits two circles. Fadiman¿s anti-American bias is evident throughout and her half-hearted attempts at objectivity are flaccid at best. Fadiman covers in detail what she feels is wrong with the American doctors and their treatment of immigrants but the shortcomings of the Lees are mitigated. Lia¿s plight is sad, but blame can¿t be placed entirely on the American doctors and must be shared by the parents¿ inaction as well. Several of the doctors made valiant efforts to learn the idiosyncrasies of the Hmong culture in addition to their regular duties without compensation. Lia¿s parents¿ response lacks an equal spirit of cooperation by their steadfast refusal to learn more of the American culture and specifically American medicine. Regardless of how superior an immigrant feels his/her culture, or country of origin to be, it is incumbent upon the immigrant to learn the customs and language of the host culture. This is especially important where the health of a child is concerned and is illustrated by this book. Many counties in California offer free English classes for immigrants. Why didn¿t Lia¿s parents utilize this service? I would recommend this book as a cautionary tale to immigrants who fail to see the need of learning the language of their adopted country.

    5 out of 10 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted September 1, 2010

    I Also Recommend:

    THE SPIRIT CATCHES YOU AND YOU FALL DOWN, by Anne Fadiman,

    This is a compelling story of a family of Hmong immigrants and their struggles with the American medical community following the onset of their daughter's epilepsy. This book made me care about a whole host of things and people I had never heard of, the Hmong. This powerful tale, (true), is about the clash of two cultures and is written beautifully with great feeling. The reader sympathizes with both the terrible trouble that the Hmong people have had in recent years and with the plight of the American doctors of trying to treat people whose cultural life is so different from their own. Reads like fiction.Really good!!

    4 out of 4 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted April 2, 2010

    more from this reviewer

    Justifiably won the National Book Critics Circle Award

    A moving and informative story on two counts.

    First, it is the story of Lia Lee, a little Hmong girl born in Merced CA, who suffered from a severe form of epilepsy, and the tragedy that occurred because of the vast cultural differences between her family and the doctors at Merced Community Medical Center who wanted nothing more than to help her.

    Second, and just as important, it is also the story of the Hmong, many of whom emigrated to the US from Laos as a result of the Vietnam War, and of the culture shock a great number of them went through when they came here.

    Because of this culture shock, Lia's epilepsy eventually caused her to go into an irreversible coma, and at the time Fadiman wrote this book she was still alive although in a completely vegetative state. The tragedy is that nobody in particular is really to blame for Lia's situation - the differences between her community (the Hmong) and the community that wanted to help her (the MCMC doctors) were just so vast as to make it next to impossible for a resolution to her illness to be found.

    Fadiman patiently makes friends not only with Lia's family, but with the Merced Hmong in general as well as the doctors and staff at MCMC who tried to help her. And she does not show any signs of anger or impatience in this effort, which shows in her narration of Lia's story - indeed, she shows nothing but respect for them. She is just as respectful with her history of the Hmong. There are no boring statistics or dry history to be found in this book - Fadiman throws in several pieces of Hmong folklore and legends to make their story more interesting.

    Reading this book I really wished for a miracle towards the end - that Lia would somehow come out of her coma and once again become a happy and healthy little girl. But unfortunately life does not always give us everything we want.

    4 out of 5 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted November 11, 2009

    more from this reviewer

    The Spirit Catches You and You Fall Down

    The Spirit Catches You and You Fall Down by Anne Fadiman, describes the tumultuous life of the Lee family, a Hmong immigrant family with an epileptic special needs child. Many misunderstandings and cultural clashes occur because the Hmong people refuse assimilation into the American lifestyle. The Hmong will not accept American norms and they stubbornly cling to their traditions and culture against great odds and tumult. Life for the average new Hmong immigrant family is very complicated and unnerving, but the life of the Lee family is even more turbulent and disrupted because their epileptic thirteenth child, Lia, requires frequent medical attention or hospitalization.
    The Hmong society has their own methods of treatment for the sick and they fail to comply with the regulations and laws of the American Medical system. The father, Nao Kao Lee, and mother, Foua Yang, do not understand the reasoning behind the American medical procedures. Problems communicating with the medical practitioners and doctors who serve the Lee family are further compounded because neither of the parents can read nor speak English. The parents can write their names in English and will often sign consent forms that they do not understand in attempts to shorten the hospitalization. The family often does not comply with hospital regulations or with norms that relate to the medical profession because what they perceive as healing practices are not followed and instead foreign methods that are perceived to be harmful or not nurturing are introduced. Problems escalate when the Lees fail to properly administer prescribed medications to Lia. A cycle of unfortunate hospitalizations occurs, always ending with doctors at wits end to deal with the Lee family. Eventually, Lia is sent to live with the Kordas, a foster care family. In the end of the story Lia is again hospitalized for a seizure that places her into a comatose state. The Lee family must fight a long battle for the right to take Lia home again and finally they are granted the permission to take her home to provide love and nurturing until Lia's pending death. Their goal is always to reunite the family by taking Lia home and caring for her in the method they believe is best for their child.
    The Lee family is fortunate because a support group of doctors and health care workers have taken an interest in Lia and they want to find the best solution for Lia and the family. Jeannie Hilt is the primary social worker that works with the Lee family case. Jeannie Hilt is accepted and trusted by the Lee family to the extent that she is welcomed into their home. Jeannie Hilt's efforts help the family regain Lia after foster care.
    Other characters of the story are medical professionals who come to the aid of the Lee family. Neil Ernst is a doctor that dedicates much of his time and profession to helping the Lee family. He rushes to Merced Community Medical Center (MCMC) whenever he can to alleviate Lia's pain and to help Lia with her seizure. Doctor Ernst works very closely with his wife, Peggy Philp, to care for Lia almost as their exclusive patient. The teams of Neil Ernst and Peggy Philp have almost crossed professional boundaries because of their extent of devotion to Lia and the Lee family.

    4 out of 4 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted May 6, 2001

    A must for all interventionists

    The Spirit Catches You and You Fall Down by Anne Fadiman is the compelling story of Lia Lee, a young Hmong child with a progressive form of epilepsy, and the way in which her family's culture collided with the culture of her American doctors. Fadiman tells the Lee's story within the context of Lia's family history and the painful, complicated history of the Hmong people. The story she tells is a tragic one in which a lack of communication coupled with two radically different belief systems ultimately leads to a devastating cultural impasse. Fadiman tells Lia's story interspersed with descriptions of the struggles of the Hmong people during the Vietnam war, as well as how they were viewed once they came to America. For example, the Hmong viewed welfare checks as the promised repayment for their services in the war. Americans viewed the Hmong as draining limited services, jamming the schools, and taking money away from the states. Fadiman identifies the cultural barrier between the scientific based practices of the American doctors and the animistic, spiritual practices of the Hmong culture. This cultural barrier poses an even larger threat than the language barrier. She explains this effectively, while providing insight into methods that can be used to bridge the gap between them. Within the context of the book, there are many useful suggestions for anyone who is working with members of Hmong families or any family from a culture other than their own. One of the unique attributes of this book is the way in which Fadiman remains unbiased, or at least honest about her biases, towards both sides of the cultural dyad. Fadiman presents the Lee family in a positive light, showing their dedication to and love for their daughter Lia. She presents Lia's doctors in a positive light as well, presenting the reader with displays of their concern and commitment to Lia's welfare. While the information presented in the book would certainly have the most relevance for people working in a medical profession, it carries along many implications for other professionals as well. For speech-language pathologists (SLPs) working with members of a Hmong family, it is important to look beyond the language differences and recognize the cultural differences that will affect treatment at an even more fundamental level. For example, as with many cultures, when discussing something of importance, it is respectful to speak to the oldest male. When speaking through the use of an interpreter, speak to the family, not the interpreter. However, when possible, the interpreter should be bicultural, and be able to act as a cultural informant for the SLP. Perhaps one of the most summative and useful points of the book is when Fadiman discusses the following eight questions used by Arthur Kleinman, a psychiatrist and medical anthropologist from Harvard Medical School. 1. What do you call the problem? 2. What do you think has caused the problem? 3. Why do you think it started when it did? 4. What do you think the sickness does? How does it work? 5. How severe is the sickness? Will it have a short or long course? 6. What kind of treatment do you think the patient should receive? What are the most important results you hope she receives from this treatment? 7. What are the chief problems the sickness has caused? 8. What do you fear most about the sickness? If used correctly, these questions could provide great insight into doing any kind of medical work with patients from a different culture. Many of them can be altered quite easily to fit the clinician-client model that is used for speech language pathology. Had these questions been asked of the Lee family, and the answers to them taken seriously, the outcome of Lia's struggle may have been changed significantly. These eight questions could have also been appropriately applied to Lia's doctors. This may have helped her doctors realize that they approached Lia'

    3 out of 3 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted October 15, 2011

    Highly recommended especially for healthcare providers

    Love it! It was really educational. I feel like I learned a lot about the Hmong people and their culture and some of the challenges faced in healthcare every day with cultural barriers. As a nurse myself, I sometimes come in contact with patients who are from different cultures and ethinic groups and although my hospital does its best to provide interpreters either via live or phones or videos, there are the rare moments when we simply have no interpreter for a patient and communication becomes a really hassle at that point. I could see clearly relate to both Lia's parents and the doctors and thier struggles. As someone whose first language isn't English, I could realte to Lia's parents'struggles in dealing with a new country and new set of rules and regulations while trying to maintain their own cultural beliefs and practices. As a nurse in the Western World, I could also see the frustrations the healthcare providers were feeling when they thought they were doing their best and from their view points, it appeared that Lia's parents were not cooperating and seemed to be largely ignoring their recommendations in regards to their daughter's health. It was tragic that Lia's live ended up in such a state and I wish I knew what ever happened to Lia and her family after the book ended. Thumbs up to the author for doing a great job! Loved the book!

    2 out of 2 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted October 9, 2011

    Captivating

    Amazing!

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted July 10, 2011

    Highly Recommend

    One of my all time favorites. I agree, it should be required reading for anybody in the medical field. I can only think to descibe it as a consequence of cultural misunderstanding.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted April 10, 2011

    Unforgettable

    This is one of my favorite non-fiction books ever. This story will change the way you view the world and other cultures. If you are interested in medicine, anthropology, or a wholly absorbing human interest story, you will not be disappointed.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted September 19, 2010

    more from this reviewer

    Fantastic Book

    Anyone involved in healthcare should be required to read this book. What an eye opener. Well written and impossible to put down.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted February 14, 2010

    Wonderful Read!

    Great book, gives great insight into cultural differences and perceptions.
    Was a required reading for one of my classes but it was wonderful!
    Makes you see differences between the American culture and the Hmong people.
    you will enjoy it!

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted July 18, 2009

    Very Interesting and Well-written Book!

    I love this book for its comprehensive dealing with a difficult subject. I liked that there seemed to be no bad side--just different sides that didn't understand each other. With more and more immigrants bringing differing cultural beliefs and expectations, it is a very relevant subject matter. It is one of the best books I have ever read. While I wished for a better outcome, the well-researched info on the Hmong culture was fascinating and well worth the time taken to read.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted June 28, 2009

    A Must Read for Medical Social Workers

    I bought this book for a social work student for her graduation. I am a social worker in a pediatric hospital. This book is so relevant for us because we are confronted with similar dilemmas every day. This book reminds us to take culture into consideration when assessing for medical neglect.

    For general readers, this book is just a great read.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted April 29, 2009

    The Spirit Catches You and You Fall Down

    I had to read this book for a Nursing class. At first I was irritated that I would have to read the whole book as well as the other 2 that came for the class. I started reading this story and I have to tell you that it was hard to put it down once I started it. I read the book in 1 day and reread it again for the class to catch all the details that I missed the first time. I also had to write a case study on the book and that was so much fun. This story tells the real life issues that face immigrants that come to our country and do not speak the language. Most Hmong can not read or write in their own language, for get them using ours. Not all, there are some that have been raised in America and can read and write English very well. I was at the hospital with my family and there was a poster that said "point to your language and we will get you a interpreter". I laughed, most Hmong could not read the sign, even though their language was one of them listed. Anne Fadiman know how to tell a story and the history and research that she did for this book is truely amazing. I wish she would write an update and tell us how Lia Lee is today.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted March 9, 2009

    Excellent

    This book was assigned to me for a course that I took. One of the best assigned readings I have ever had!

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted December 16, 2008

    I Also Recommend:

    Educational

    This is an important book and well written. We had it in college as common reading and I delighted at how easy it was for me to follow. I came away with a greater understanding of the cultural beliefs of the Hmong people. Another exceptional book to read on the Hmong is by Kao Kalia Yang. The book is entitled "The Latehomecomer."

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted September 24, 2008

    An eye-opening account of the Hmong culture

    I felt the author was depicting a culture that was so radically different from America's, that to simply come to America and learn to speak English, wouldn't have sufficed. I don't think the author was biased towards the Hmong. She gave a fascinating account of their very different culture and showed how difficult it was for the parents to deal with American doctors, as well as how difficult it was for the doctors to deal with the parents. I'd highly recommend this book.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted December 3, 2004

    Excellent eye-opener

    This book really makes you think and puts your life into perspective. For a family who cares so greatly for their daughter to keep going during such a difficult time is amazing! I can't imagine being in their shoes.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted February 9, 2004

    This is a MUST READ in today's nation of diverse cultures.

    As a Hmong woman who was born and raised in the US, this book was an eye opener. Not only did it teach me about my own culture, but it helped me to relate to the difficulties that all minorities in this nation face. Because of my personal experiences, I recommend this to, at the very least, all educators and health care providers. This story is very touching and is indeed, very sad. It's very disappointing that we live in such a free nation, yet we are so ignorant of all the different people and cultures around us.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
See All Sort by: Showing 1 – 20 of 128 Customer Reviews

If you find inappropriate content, please report it to Barnes & Noble
Why is this product inappropriate?
Comments (optional)