The spirit catches you and you fall down by Anne Fadiman


Apr 8, 2011

This book was suggested to me by a library patron – a nurse.  This non-fiction, cultural anthropology book describes an arrival of South East Asian community of Hmongs to a small town called Merced, California in the 1980s.  The Hmong people who lived for centuries in isolation, with their history dating back to the 3rd century, were given a refugee status in America for their support of CIA militaristic efforts in Laos. This book is a tragedy of Shakespearean dimensions of cultural classes and misunderstanding.  A little Hmong girl Lia is diagnosed with epilepsy and is brought to be treated by western doctors at the Merced Community Medical Center.  Her parents believe that her illness is caused by spirits which they try to cure while following cosmology principles and relying on ceremonies to scare off spirit thieves. Western medical technology meets up with a deeply rooted ancient Eastern traditions.  In a horrifying way this book show a collision of two cultures, the unpreparedness of medical staff to deal with newly arriving imigrants to provide desperately needed medical care. Within the next 4 years Lia was seen in the emergency room more than 100 times. The medical staff is often communicating with the parents via a janitor, if he happens to be on duty and is available to translate. The language barriers and basic misunderstandings prevented Lia from getting correct dosages of prescribed medication as her mother does not know how to read the clock and how to measure and administer the complicated combination of dosages. To protect their own dignity and conceal their ignorance about the doctors’ explanations and instructions, parents keep saying “yes”, which simply means that they are politely listening, not that they are agreeing with or have any idea what the doctor is saying.  This well researched book uses medical records and is written very objectively. This books should be mandatory reading for  medical staff  and for individuals working with immigrants opening the door on respect and the understanding of other cultures. 1997 this book won the National Book Critics Circle Award.

Reviewed by Library Staff