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

Summary: Subtitled "A Hmong Child, Her American Doctors, and the Collision of Two Cultures," the nonfiction The Spirit Catches You details the intersection of western medicine and native culture through the life of Lia Lee.  Lia, the youngest daughter of Hmong immigrants, develops a seizure disorder.  Both her doctors and her parents wish to save her life, but each believes in markedly different means of doing so, causing conflict that has lasting repercussions.

Musings: The Spirit Catches You is an interesting book, both for its look into Hmong culture (of which I knew nothing) and for its nuanced look into cross-cultural misunderstandings and the danger they can pose.

The life of Lia is undeniably tragic, but Fadiman is careful to show that her sufferings are not due from fault, abuse, or neglect on either side.  Instead, both sides are unable to recognize the others' intents and motivation.  The doctors want to use modern medicine, and they look down on the parents for their reluctance to do so and their failure to follow Lia's prescription routines.  The parents want to heal their daughter through some medicine--though strictly determined by them--but also by traditional healing practices which utilize beliefs in spirits.  The refuse to administer medicine and procedures with which they disagree.

Fadiman explores the nature of these cultural misunderstandings, and she also attempts to understand if they could be surmounted.  Unfortunately, the obstacles are many, from the Hmong's lack of English and American acculturation to the doctors' failure to recognize the family's situation (how could they administer a complicated prescription routine when they are not literate?). 

The book spends a good amount of time on the Hmong people, their nomadic lifestyle, their work for the C.I.A., and their difficult immigration to the United States.  Although all this information is important in understanding the family's belief systems and actions, the history chapters sometimes read too much like textbook to me.  Despite the Hmong's tragic and complicated past, I had a hard time paying attention.

I was more engaged when the story focused on Lia and her family, though I was frequently frustrated.  Misunderstandings and problems seemed to arise at every corner, and though many people placed blame, there was little to be done to improve the situation.  Of course, much of Lia's story is a story of frustration, so my feelings as a reader are probably apt.

The Spirit Catches You and You Fall Down would be good reading for anyone interested in medicine or cross-cultural studies.  It was written in the '90s and based on events that occurred largely in the '80s, so it would be important for anyone looking for more information on the Hmong in America to note that undoubtedly changes have occurred since the book's publication.