“The Spirit Catches You and You Fall Down:

A Hmong Child, Her American Doctors, and the Collision of

Two Cultures”A book by Anne Fadiman

Winner of the National Book Critics Circle Award

Summary

• The book chronicles the story of a very sick girl, Lia Lee, her refugee parents, and the doctors who struggled desperately to treat her.

Two main issues discussed in the book:

1) The limits of Western medicine

2) The experience of migrants in a global world.

Lia Lee

• Born in the San Joaquin valley in California to Hmong refugees.

• At the age of three months, she first showed signs of qaug dab peg.

Qaug Dab Peg

• Literally: “The spirit catches you and you fall down.”

• In the West, this condition is known as epilepsy.

Doctors

• Saw the best treatment in a large collection of pills, that kept constantly changing.

Parents

• Preferred a combination of Western medicine and folk remedies designed to coax her wandering soul back to her body.

• Over a period of four years, deep cultural differences and linguistic miscommunication exacerbated the rift between well-intentioned parents and doctors.

Result

• Lia lost all of her higher brain functions.

Chapters 1-4

• The Hmong are an ethnic group who traditionally lived in Laos, among other places in Southeast Asia.

Hmong History:

• Is full of struggle.

• For most of their history, the Hmong lived in what is China today.

• The Chinese called them Miao, meaning “barbarians,” or “bumpkins.”

• Though both sides were violent, this was not a symmetrical relationship.

• The Hmong never had any interest in ruling over the Chinese or anyone else; they wanted to be left alone. However, history has shown that this is the most difficult request any minority can make of a majority culture.

• The Hmong were subject to a special criminal code. Instead of being imprisoned, offenders were either executed or had their noses, ears, and testicles sliced off.

• Around A.D. 400, the Hmong succeded in establishing an independent kingdom.

• It lasted for five hundred years before the Chinese managed to crush it.

Beginning of the 19th century:

• The Hmong had enough of China.

• Half a million migrated to Indochina (the peninsula of southeast Asia comprising Vietnam, Laos, Cambodia, Thailand and Burma).

• The French established colonial control over Indochina in the 1890s.

• The Hmong rebelled against their extortionate tax system in series of revolts.

Hmong

• Never possessed a country of their own, never had a king, all they have wanted is the right to live as free people in this world.

• Since 1975, at least 150,000 Hmong have had to flee Laos.

• The Lees do not know if their house is still standing.

• Twelve of the Lee’s children were born in Laos, and following local custom, the parents buried the placentas two feet deep in the dirt floor of their home.

Placenta

• An organ developed by female mammals during pregnancy, through which the mother’s body provides oxygen and nutrients to the fetus and allows it to eliminate waste and carbon dioxide.

In Laos

• The placenta was always buried with the smooth side up, since otherwise it might cause the baby to vomit after nursing.

When a Hmong dies

• His or her soul must travel back from place to place until it reaches the burial place of its placenta, and puts it on.

• The placenta is considered a “jacket”, the first and finest garment a person ever wears.

After birth – Naming Ceremony:

Names are conferred in a hu plig (soul calling) ritual.

Until this ceremony is performed, a baby is not considered to be fully a member of the human race.

The soul in Hmong culture:

• Is very important.

• The most common cause of illness is considered to be soul loss.

• A soul can be separated from its body through anger, grief, fear, curiosity or a desire to travel.

Souls of newborn babies:

• Especially vulnerable and prone to disappearance, because they are so small, vulnerable and precariously situated between the realm of the seen and the realm of the unseen.

• Babies’ souls may wander away; they may leave if a baby is feeling sad; they may be frightened away by a sudden loud noise; or they may be stolen by a dab.

Dab = Malevolent Spirit

In groups of 3:

• What do you think of traditional Hmong birth practices (pp. 3-5)?

• Compare them to the techniques used when Lia was born (p.7).

• How do Hmong and American birth practices differ?