The Spirit Catches You and You Fall Down

Summarily, “The Spirit Catches You and You Fall Down” by Anne Fadiman describes a distressing tragedy centered on a child, Lia Lee, whose family emigrated from a traditional tribe known as Hmong in Laos to the Merced in San Joaquin, California. One day Lia’s older sister slammed their door, and at the same time, Lia rolled hers going into an epileptic episode (Fadiman, 2012). Coming from a traditional Indochinese community that believed in superstition, her parents felt that when the door was slammed, it provoked an evil spirit known as dab to enter their child thus causing the fit (Fadiman, 2012).

In three months, Lia had experienced 20 epileptic episodes and had been admitted to the hospital three times. Lia’s American pediatricians carried out the appropriate tests and prescribed standard Western medication. However, Lia’s condition continued to be worse, and it was clear that although her parents deeply loved her, they were not able to provide the necessary care to their child (Fadiman, 2012).  Lia’s condition continued to worsen especially after she fell off a swing and went into a vegetative state due to septic shock. Her seizures were, however, “cured” after she became brain dead.

One of the most striking aspects of the book is the authors’ competency in writing this narrative. If a catastrophe is defined as antagonism of two goods, if it moves humans like a melodrama, if it necessitates the unfolding of intense human propensities in a cultural context that makes the consequences appear to be inevitable, then “The Spirit Catches You and You Fall Down” is a perfect catastrophe. Throughout this article, the author narrated every event with exceptional skills that pictured the collision between Hmong culture and Western medicine (Fadiman, 2012). Lee’s family immigration marked a historic transition for Lia Lee as it led to a life of culture clashes, untold terror and sorrow in the face of a changing environment, parental affection, the child’s doctors’ sense of responsibility, as well as the misconception circulated daily until they became colossal misunderstandings. This poignant narrative has no villain or hero, but it is marked by tremendous innocent sufferings, though it surely has a moral lesson.

The proponent of the bioecological theory, Bronfenbrenner, asserts that a child’s development is primarily influenced by his/her interactions with different facets and spheres of their surroundings. These spheres include the microsystem, mesosystem, ecosystem, and macrosystem. The microsystem consists of a child’s immediate environment including school, neighborhood, family, and childcare surroundings. Lia’s parents and relatives held traditional beliefs that influenced their actions probably making Lia’s sickness worse. From an anthropological view, Lia’s condition was a blessing in disguise (Fadiman, 2012). Her parents believed that their daughter was spiritually gifted and therefore thought that the excessive care and medication were doing her more harm.

The mesosystem provides connections between a child’s microsystem structures. This can be described as traditional and western medicine as they both affected Lia’s life concurrently.  The Lees believed that Lia should be protected from any injury during the epileptic fits, and should they seek the attention of a Hmong healer known as txivneeb. However, since the Hmong healer was not readily available in America, they sought help from western doctors. From the doctor’s point of view, the distressing chains of events were begun because the parents could not understand how the prescription worked.

The ecosystem consists of other places and people that a child does not interact with often but still affects his/her life. Lia had long migrated from the Indochinese illiterate community, but the practices and beliefs held in this place affected her life tremendously. In fact, only a Hmong healer could get rid of her disease.

The macrosystem relates to a child’s cultural values, laws, and customs as they related to the child. Although Lia’s doctors understood the significance of western medicines, they also understood the power of culture. The doctors dedicated long hours studying Hmong cultural believe when Lia’s condition grew worse. One day, a Hmong healer visited Liain the hospital where she lay comatose. Surrounded by her adoring family, the healer sacrificed a pig and chicken and used their blood as well as sacred chants to call Lia’s soul back (Fadiman, 2012). Surprisingly, when he repeated the chants for seven times saying ‘‘Come home” Lia woke up and her parents took her home to care for her in their traditional way.

This narrative changed my perception about the interception of the cultural crash and real human life. When the child to Lia’s pediatricians becomes sick with leukemia Lia’s Mrs. Lee’s heart goes out to the other mother. She expressed genuine concern which can be seen from the questions she asked as well as her facial expressions (Fadiman, 2012). Although Mrs. Lee honestly thought that western doctors were imperfect healers, Mrs. Lee hugged Peggy passionately, and they were both shedding tears. I understood that sorrows of parenthood cut through humanity regardless of the cultural barriers as it affects the real human living. Through this observation, I realized human nature makes human life possible even when the world is marked by constant culture clash.

One aspect of the book that is lacking was an anthropological explanation of how the Hmong healer was able to get Lia to wake up from the coma. The author should have explained why traditional sacrifice was more powerful than Western Medicine. This explanation is necessary because it shows how traditions shape daily life. The fact that traditional sacrifices can get Lia from the coma shows the highest form of culture collision given that western medicine could not.



Fadiman, A. (2012). The spirit catches you, and you fall down: A Hmong child, her American doctors, and the collision of two cultures. Macmillan.