Summary
The Spirit Catches You and You Fall Down is Anne Fadiman's National Book Critics Circle Award-winning account of the clash between a small county hospital in California and a refugee family from Laos over the care of their epileptic daughter. Lia Lee was born in Merced, California, to Hmong refugees Foua Yang and Nao Kao Lee. At three months old, she suffered her first epileptic seizure. The Hmong, who did not distinguish between mental and physical illnesses, understood her symptoms as qaug dab peg, "the spirit catches you and you fall down." They believed her seizures were caused by soul loss and could be treated with herbal remedies and animal sacrifices. Lia's American doctors, Neil Ernst and Peggy Philp, diagnosed her with epilepsy and prescribed anticonvulsant medications. However, due to cultural barriers and language difficulties, Lia's parents struggled to understand and comply with the prescribed treatment regimen.
The family practice residents at Merced Community Medical Center (MCMC) viewed the Lees as noncompliant, while the Lees viewed the doctors as disrespectful of their beliefs. After a particularly severe seizure, Lia was placed in foster care. While Lia’s health stabilized in foster care, her parents were devastated by her removal. This incident deepened the mistrust between the family and the medical staff. Lia was eventually returned to her family, but the cultural misunderstandings persisted. They believed her worsening condition was a result of the foster care placement and the excessive medication administered by the doctors.
After another severe seizure, Lia suffered irreparable brain damage and entered a persistent vegetative state. While her doctors expected her to die, Lia’s family, through meticulous care and traditional healing practices, kept her alive for many years. The Spirit Catches You and You Fall Down examines the collision between Western medicine and Hmong spiritual beliefs, highlighting the devastating consequences of cultural misunderstanding in health care. Fadiman emphasizes the need for cultural sensitivity and the importance of bridging the gap between traditional healing practices and Western medicine.