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Writer's pictureJesse Yuan

"The Spirit Catches You and You Fall Down" By Anne Fadiman

Updated: Feb 23, 2020

The novel talks about the history of the people of Hmong and uses Lia Lee’s life experience as an epitome of cultural difference and collision. The Hmong people are an ethnic group that is mostly located in East and Southern Asia, and Lia Lee is a member of the Hmong ethnicity. Her parents moved to Merced, California as refugees, and later give birth to Lia. Unfortunately, Lia is born with Epilepsy, and the story develops upon the cultural conflict between western medicine and Hmong medicine.


Comparing Hmong with the US, Hmong is more of a religious-based society while the US is more scientific. For example, Lia’s epilepsy is viewed as something to be proud of in the Hmong culture, but as a fatal disease in western culture. In the Hmong culture, treating illness is to treat the soul, but in the western world, treating illness is to treat the body. In the novel, the doctors in Hmong are Shaman, like wizards, who do pray and sacrifice to conjure back the missing soul back into the body. Because the Hmong has a different way of viewing medicine than western doctors, the difference makes them fear western doctors. Hmong believes western doctors often do experiments on their patients, and some doctors even eat the organs of their patients. They also think the western is extremely irresponsible since they only spend a relatively short amount of time with the patient while Shaman can spend more than 12 hours with the patient, and this causes many Hmongs to think western doctors are cold-blooded. The cultural difference not only shows on the difference of medical use, Hmong is an ethnicity that objects against oppressive power and long for freedom, but very often they remain silent instead of protest.


Because most of the doctors never learn about Hmong culture and their language, and the Hmong people never learn about cultures other than their own, Lia Lee’s family is never able to communicate with the doctors and know what exactly happened. The lack of communication leads to Lia’s family’s distrust. Lia’s parents are not able to understand what disease their daughter has and they cannot understand the information on the prescribed medicine. They often give Lia too much medicine or not gives her at all, so her condition never improves. But every time they meet with the doctors, Lia’s parents would lie and say that they follow all the instructions. During one time when Lia has a severe seizure, the MCMC brings Lia away to a medical center without previous acknowledge from her parents, and this completely overthrows the trust Lia’s family has on western medication. The whole collision starts with the lack of communication and cultural understanding, and later aggregated through many little incidences. If the doctors can learn more about the Hmong culture and find a way to communicate with them, and vice versa for the Hmong, there will be much fewer conflicts and Lia might even recover from her epilepsy.



As an international student, I find this book very interesting to read because I have faced similar misunderstandings and cultural conflicts after I came here. It is fascinating that the author brings up all the social issues, and I think it is incredibly inspiring.

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