The Spirit Catches You and You Fall Down

By Anne Fadiman

It’s tempting to think that everyone in the world thinks pretty much like we do – people are people, after all – particularly if they live here in the United States and especially if they dress like us. A little careful reading, however, can show us just how wrong that assumption is. In The Caliph’s House, author and protagonist Tahir Shah bumbles his way through Moroccan society with hysterical results. Anne Fadiman’s The Spirit Catches You and You Fall Down also examines what happens when cultures collide, but it is more likely to make you cry than laugh.

The Spirit Catches You and You Fall Down tells the story of a young Hmong (pronounced mong) girl named Lia Lee. You’ve never heard of the Hmong? Neither had I. In a nutshell, the Hmong are an Asian ethnic group that live in southern China and the mountainous regions of southeast Asia. (Fadiman explores Hmong culture and history in great depth because it is impossible to understand Lia’s story without understanding the Hmong.) The Lee family is from Laos, but fled to the United States after that country fell to Communist forces in 1975. The family eventually settled in Merced, California.

In 1983, 8-month-old Lia was diagnosed with epilepsy. Fortunately, Merced was home to an excellent hospital with excellent doctors – devoted, hard-working doctors that didn’t care that the Lee family was on welfare and had no insurance. Any Westerner would say that Lia’s prognosis was good. That’s because we Westerners don’t understand the Hmong at all.

“The language barrier was the most obvious problem, but not the most important,” said said Dr. Dan Murphy, one of the many doctors that treated Lia. “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.”

Some of those barriers? For one thing, among the Hmong, epilepsy or quag dab peg (which translated is “the spirit catches you and you fall down”) is not a physical problem. It is a spiritual problem caused when an evil spirit, a dab, steals one’s soul. For another, quag dab peg is an illness of some distinction. Hmong epileptics often become shamans, people of consequence. Then, too, the Hmong have little trust in medicines, particularly those with side effects. A medicine should not make a person sick, after all. These and other cultural differences conspired to make Lia Lee’s treatment particularly complicated.

It becomes evident early on that, in spite of everyone’s good intentions, Lia Lee’s tale is destined to end badly. This is a truly heartbreaking story, made all the more so because there are no good guys or bad guys, only misunderstandings and well-intentioned mistakes. At the same time, I found the Hmong culture fascinating, yet often exasperating (to my shame; I guess I’m as much a slave to my Western mindset as anyone). With a deft hand and a balanced view, Fadiman shows us the dangers inherent in assuming that we all think alike, a valuable lesson for all.