The Spirit Catches You and You Fall Down

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

By: Anne Fadiman

Narrated by: Pamela Xiong

Winner of the National Book Critics Circle Award for Nonfiction

When three-month-old Lia Lee arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, cleaved just as strongly to another tradition: that of Western medicine.

When Lia Lee entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication. Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness and healing as spiritual matters linked to virtually everything in the universe while medical community marks a division between body and soul and concerns itself almost exclusively with the former.

Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness qaug dab peg - the spirit catches you and you fall down - and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.

©1997 Anne Fadiman, Afterword copyright 2012 by Anne Fadiman (P)2015 Audible Inc.

Reader needs an audio dictionary

Fascinating story with broad applications for individuals employed in healthcare, social work, and various other fields in which one may encounter refugees and/or first-generation immigrants.
The reader, however, makes listening almost intolerable. She got two stars because she enunciates well and I assume say the Hmong words correctly. Unfortunately that's all the good I can say. She pauses awkwardly between words, seeming to misunderstand the grammar and thereby confusing content. I understand that many people struggle with medical terminology, but if you're going to narrate a book with one of the major elements being a young girl and her family's struggles in the healthcare system then perhaps you should figure it out. Additionally it's not just medical terms but words that I think most people, at least college-level educated, can pronounce.

Great book marred by amateur narrator

The book is a classic, no question. But as others have said, the narrator isn't at the professional level yet. She turns in a fine effort but her frequent mispronunciations add up to a big distraction from such a great book. It's a shame the producers didn't hire a more experienced narrator, or devote the effort to punching in corrections of English mispronunciations, as they obviously did take the effort to punch in what I assume are correctly and carefully pronounced Hmong and Lao words.

Some notable clunkers by the narrator:
"Indignant" for "Indigent"
"Amino" for "Amnio"
"ReFUSE" for "REFuse" (garbage)
"E-GREG-rious" for "Egregious"
"Injured" for "Inured"

And almost without fail throughout, double "S"s for plural possessives, as in:
Doctorses (for Doctors')
Cowses (for Cows')
Patientses (for Patients')
Similarly: Parentses, Ownerses, Soldierses, Communistses, and on and on like that. It's really bad, folks.

Despite all this, it's still quite listenable, and worth the effort to stay focused on the amazing text, but this book deserves far better narration than it got.

Read!

It's a great book, if youre going into the medical field I suggest reading this!

Incredible

This was a required reading for my medical anthropology class and I had no concept of its contents initially.
After reading it, I have a passion to further educate myself not only on the Hmong but also other cultures.
This was an amazing read and I am better for it.

A good read for health care workers

This book was an interesting perspective on how western health care interacts with minorities and how by changing perspectives, we can improve relations in our communities.

Amazing Book

I read a lot of ppl’s comments complaining about the readers mispronunciations and I’d just like to say she was chosen to read the book not b/c of her perfect English but b/c of her Hmong. You know the people who the book was written about. Personally as a Hmong growing up in America and speaking English well I tend to have an “accent” on various words such as school and bowl. Not to mention the Hmong and other Asian languages do not require pronunciation of words b/c afflictions are used on the same word to mean different things depending on the context. So when switching between languages it takes a conscious effort to try to change an unconscious action such as speaking.
Ironic that a book about cultural miscommunication and its consequences still have close minded comments being made about the Hmong reader... That being said.
The book did an amazing job of telling who the Hmong people are and it included many aspects of the culture which I appreciated as an “Americanize” Hmong since I grew up torn between the two cultures. This book made me appreciate the collective culture I grew up in. I am now able to understand my parents a little better too. My father was a Hmong officer who was captured and sent to seminary camp after the war, but was released when he fell ill after five years. He made it to Thailand where he met and married my mom and they were able to be sponsor by my uncle (dad’s big brother) to get them to America. It’s sad to hear how racist America still is when people like the Hmong also fought and died for it even before we’ve ever lived here. I’ve recently lost my father which makes me have to agree with Anne Fadiman that the American culture is abundant in wealth and opportunities but dry in love.

What a ride!

I came to this book after hearing a recommendation on a podcast.

I started it and could not put it down. I went back and forth emotionally, feeling for both the Lees and the doctors who cared for her at Merced Hospital.

I learned a ton about the Hmong and my major take-away was the cultural void that exists in the practice of American medicine when encountered other than our Western practice.

I enjoyed the journey and highly recommend.

I felt all the feelings

Loved it! An amazing book about the strength of communication. Thank you for the fifteenth anniversary edition. Simply beautiful

wordy but good

very wordy but a good book. Great for beginning Medical or ppl going it a job with other people.

Surprisingly amazing

I had to read (or listen to) this book for a sociology class. I wasn't prepared for how much striking information I would take in. Fadiman takes such care in detail, explaining a plethora of intricacies about Hmong culture. The is compelling and pulls at your heartstrings. I truly enjoyed it and it did evoke emotion. I also loved the narrator, which I know helped my experience.