Anne Fadiman’s The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

The Spirit Catches You and You Fall Down

Although not a new book, Anne Fadiman’s The Spirit Catches You and You Fall Down (1997) classically highlights a life-and-death crisis that devolves from Western medical professionals’ living out an ethnocentric self-assurance and a hermetic professional worldview. Fadiman became intrigued by what she’d heard about the clash between the Western medical establishment of Merced, California and the concentrated group of Hmong refugees from Laos who had begun settling there in the 1970s, escaping persecution by the Vietnamese after their little-known contribution as guerrillas to the American cause.

The Hmong were involuntary migrants, not given to adopting American ways any more than necessary to survive. Some feared going to doctors whom they thought might rather study them than help them. To the Hmong, Western doctors engaged in hazardous practices. They extracted large volumes of blood from their patients. They opened the body in surgery and in autopsies, and inevitably and irreparably damaged the integrity of the person, not only for this lifetime but for future incarnations. They announced the probability of death. The Hmong mistrusted Western medications and took fractions of what had been prescribed, putting the physicians in the untenable position of trying to “game” how much they might have to prescribe to end up with a Hmong patient’s actually ending up taking the desired dose.

Fadiman began fieldwork with a particular Hmong family, whose six-year-old daughter Lia had been in and out of the Western medical machine since she was a baby because of her epileptic seizures. She inquired equally into the perspectives of the entourage of doctors who treated her and who attempted, to varying degrees, to communicate effectively with her parents.

Lia’s parents fundamentally disagreed with the doctors about the origin of Lia’s problem and about the impact of the medications that had been prescribed for her. To Lia’s parents, the troubles began when her soul was frightened out of her body when her sister slammed a door, and her seizures would be instigated by a spirit “catching” her. The cure would be perhaps a very short course of medicines, but ultimately would be carried by Hmong shamanism, animal sacrifices, and herbs.

Fadiman’s book sides neither with the native medical cosmology of the Hmong nor with the self-justifying medical culture of the West, situating Lia’s tragic decline in the very gaps between the two. If there was any fault, it lay in the failure of the Western physicians to give credence to the Hmong worldview or to incorporate it into a realistic treatment plan. Fadiman writes of the caricature–just an extreme of the actual–of the M.D., who is an “all-head-no-heart formalist who, when presented with a problem, would rather medicate it, scan it, suture it, splint it, excise it, anesthetize it, or autopsy it than communicate with it.”

While Fadiman concludes that “American medicine had both preserved [Lia’s] life and compromised it,” she wonders whether saving the body, as much of Western medicine is geared to do, or preserving the soul, as was part of the Hmong concern, could not both be considered.

Reading The Spirit Catches You and You Fall Down, I am reminded of the lyrics of “Walking in Space” from the rock musical Hair. Set against the backdrop of the Vietnam War–which the Hmong referred to as the American War–the song extols the visions possible under hallucinogenics:

In this dive
We rediscover sensation
In this dive
We rediscover sensation

Walking in space
We find the purpose of peace
The beauty of life
You can no longer hide

Our eyes are open
Our eyes are open
Our eyes are open
Our eyes are open
Wide wide wide!

It’s not that the singers saw nothing taking the hallucinogenics. The irony of the song is that they thought they saw everything–while only seeing some thing.

To subscribe to Skin in the Game’s monthly newsletter, send an email with “subscribe” in the subject line to sks@thinkingdr.com. To view past issues, click here.

701 thoughts on “Anne Fadiman’s The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures”

  1. In it something is also to me it seems it is excellent idea. Completely with you I will agree.


    I am final, I am sorry, but this answer does not approach me. Who else, what can prompt? 1 best movies, best 1980 movies, best movies best christmas movies

  2. Thanks for some other informative website. Where else may I get that type of information written in such a perfect approach? I’ve a venture that I am simply now running on, and I have been at the look out for such information.

  3. Thanks for another excellent post. Where else could anybody get that kind of information in such an ideal way of writing? I have a presentation next week, and I’m on the look for such info.

  4. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  5. Thanks for your useful article. Other thing is that mesothelioma cancer is generally brought on by the breathing of dust from asbestos fiber, which is a carcinogenic material. Its commonly noticed among workers in the engineering industry who definitely have long exposure to asbestos. It is also caused by moving into asbestos protected buildings for an extended time of time, Genes plays an important role, and some folks are more vulnerable on the risk as compared to others.

  6. Thanks for expressing your ideas. I’d also like to mention that video games have been actually evolving. Modern tools and innovative developments have made it easier to create practical and interactive games. These kinds of entertainment games were not really sensible when the actual concept was first of all being attempted. Just like other styles of technological know-how, video games also have had to advance via many years. This is testimony on the fast growth of video games.

  7. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  8. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  9. Thanks for some other informative website. Where else may I get that type of information written in such a perfect approach? I’ve a venture that I am simply now running on, and I have been at the look out for such information.

  10. Thanks for the suggestions about credit repair on this particular web-site. The things i would offer as advice to people is usually to give up this mentality that they buy at this point and fork out later. Being a society most of us tend to make this happen for many factors. This includes trips, furniture, in addition to items we’d like. However, it is advisable to separate one’s wants from the needs. As long as you’re working to raise your credit ranking score actually you need some trade-offs. For example you may shop online to economize or you can check out second hand outlets instead of high priced department stores intended for clothing.

  11. Thanks for the sensible critique. Me and my neighbor were just preparing to do a little research about this. We got a grab a book from our local library but I think I learned more from this post. I’m very glad to see such magnificent info being shared freely out there.

  12. Thanks for your useful article. Other thing is that mesothelioma cancer is generally brought on by the breathing of dust from asbestos fiber, which is a carcinogenic material. Its commonly noticed among workers in the engineering industry who definitely have long exposure to asbestos. It is also caused by moving into asbestos protected buildings for an extended time of time, Genes plays an important role, and some folks are more vulnerable on the risk as compared to others.

  13. Thanks so much for giving everyone such a special opportunity to discover important secrets from this web site. It is usually very amazing and as well , stuffed with a great time for me personally and my office acquaintances to search your blog at the very least three times in one week to read the fresh things you have. And lastly, I’m also certainly fascinated with the exceptional strategies you serve. Selected 1 tips on this page are without a doubt the most suitable we have all ever had.

  14. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  15. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  16. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  17. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  18. Thanks for your exciting article. Other thing is that mesothelioma is generally due to the breathing of material from asbestos fiber, which is a carcinogenic material. It can be commonly witnessed among employees in the building industry who definitely have long contact with asbestos. It’s also caused by moving into asbestos covered buildings for some time of time, Family genes plays an important role, and some persons are more vulnerable on the risk than others.

  19. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  20. Thanks so much for giving everyone such a special opportunity to discover important secrets from this web site. It is usually very amazing and as well , stuffed with a great time for me personally and my office acquaintances to search your blog at the very least three times in one week to read the fresh things you have. And lastly, I’m also certainly fascinated with the exceptional strategies you serve. Selected 1 tips on this page are without a doubt the most suitable we have all ever had.

  21. Thanks for the sensible critique. Me and my neighbor were just preparing to do some research about this. We got a grab a book from our local library but I think I learned more from this post. I am very glad to see such excellent information being shared freely out there.

  22. Thanks for your exciting article. Other thing is that mesothelioma is generally due to the breathing of material from asbestos fiber, which is a carcinogenic material. It can be commonly witnessed among employees in the building industry who definitely have long contact with asbestos. It’s also caused by moving into asbestos covered buildings for some time of time, Family genes plays an important role, and some persons are more vulnerable on the risk than others.

  23. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  24. Thanks so much for providing individuals with an exceptionally nice opportunity to discover important secrets from this web site. It is always very terrific and as well , jam-packed with a good time for me personally and my office fellow workers to visit your site on the least thrice in one week to study the new guides you have. And indeed, I am actually impressed with all the remarkable things served by you. Some 4 ideas on this page are without a doubt the best I have ever had.

  25. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  26. Thanks for another informative web site. Where else may I am getting that kind of information written in such an ideal way? I have a project that I am simply now running on, and I have been at the glance out for such information.

  27. Thanks so much for giving everyone such a special opportunity to discover important secrets from this web site. It is usually very amazing and as well , stuffed with a great time for me personally and my office acquaintances to search your blog at the very least three times in one week to read the fresh things you have. And lastly, I’m also certainly fascinated with the exceptional strategies you serve. Selected 1 tips on this page are without a doubt the most suitable we have all ever had.

  28. Thanks for this article. I’d also like to say that it can possibly be hard if you are in school and starting out to initiate a long credit rating. There are many students who are just simply trying to live and have long or good credit history can sometimes be a difficult matter to have.

  29. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  30. Thanks so much for giving everyone such a special opportunity to discover important secrets from this web site. It is usually very amazing and as well , stuffed with a great time for me personally and my office acquaintances to search your blog at the very least three times in one week to read the fresh things you have. And lastly, I’m also certainly fascinated with the exceptional strategies you serve. Selected 1 tips on this page are without a doubt the most suitable we have all ever had.

  31. Thanks for the suggestions about credit repair on this particular web-site. The things i would offer as advice to people is usually to give up this mentality that they buy at this point and fork out later. Being a society most of us tend to make this happen for many factors. This includes trips, furniture, in addition to items we’d like. However, it is advisable to separate one’s wants from the needs. As long as you’re working to raise your credit ranking score actually you need some trade-offs. For example you may shop online to economize or you can check out second hand outlets instead of high priced department stores intended for clothing.

  32. Thanks for this article. I’d also like to say that it can possibly be hard if you are in school and starting out to initiate a long credit rating. There are many students who are just simply trying to live and have long or good credit history can sometimes be a difficult matter to have.

  33. The best dental specialists in Raleigh are focused on ensuring your dental experience is agreeable. We are a group of dentists in Raleigh dedicated to staying on top of the latest diagnostic tools and treatments. Dentist in Raleigh NC

  34. Thanks for your entire work on this blog. Kim loves setting aside time for internet research and it’s easy to understand why. A number of us learn all about the powerful tactic you present priceless ideas through the blog and improve participation from some others on that content and our favorite princess is always becoming educated a whole lot. Take pleasure in the rest of the new year. You are doing a fantastic job.

  35. The next time I read a blog, I hope that it won’t disappoint me as much as this particular one. After all, I know it was my choice to read through, but I truly believed you would have something interesting to talk about. All I hear is a bunch of whining about something you could fix if you weren’t too busy looking for attention.

  36. Thanks so much for giving everyone such a splendid possiblity to read from this blog. It can be very brilliant and as well , jam-packed with a great time for me and my office fellow workers to visit your blog at least 3 times in 7 days to find out the fresh items you will have. Of course, I’m just at all times amazed for the fantastic tricks you serve. Selected 1 ideas in this post are honestly the most efficient I’ve had.

  37. The best dental specialists in Raleigh are focused on ensuring your dental experience is agreeable. We are a group of dentists in Raleigh dedicated to staying on top of the latest diagnostic tools and treatments. Dentist in Raleigh NC

  38. Thanks so much for giving everyone such a splendid possiblity to read from this blog. It can be very brilliant and as well , jam-packed with a great time for me and my office fellow workers to visit your blog at least 3 times in 7 days to find out the fresh items you will have. Of course, I’m just at all times amazed for the fantastic tricks you serve. Selected 1 ideas in this post are honestly the most efficient I’ve had.

  39. The best dental specialists in Raleigh are focused on ensuring your dental experience is agreeable. We are a group of dentists in Raleigh dedicated to staying on top of the latest diagnostic tools and treatments. Dentist in Raleigh NC

  40. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  41. The best dental specialists in Raleigh are focused on ensuring your dental experience is agreeable. We are a group of dentists in Raleigh dedicated to staying on top of the latest diagnostic tools and treatments. Dentist in Raleigh NC

  42. Thanks for your entire work on this blog. Kim loves setting aside time for internet research and it’s easy to understand why. A number of us learn all about the powerful tactic you present priceless ideas through the blog and improve participation from some others on that content and our favorite princess is always becoming educated a whole lot. Take pleasure in the rest of the new year. You are doing a fantastic job.

  43. Thanks for the suggestions about credit repair on this particular web-site. The things i would offer as advice to people is usually to give up this mentality that they buy at this point and fork out later. Being a society most of us tend to make this happen for many factors. This includes trips, furniture, in addition to items we’d like. However, it is advisable to separate one’s wants from the needs. As long as you’re working to raise your credit ranking score actually you need some trade-offs. For example you may shop online to economize or you can check out second hand outlets instead of high priced department stores intended for clothing.

  44. The best dental specialists in Raleigh are focused on ensuring your dental experience is agreeable. We are a group of dentists in Raleigh dedicated to staying on top of the latest diagnostic tools and treatments. Dentist in Raleigh NC

  45. Thanks for your entire work on this blog. Kim loves setting aside time for internet research and it’s easy to understand why. A number of us learn all about the powerful tactic you present priceless ideas through the blog and improve participation from some others on that content and our favorite princess is always becoming educated a whole lot. Take pleasure in the rest of the new year. You are doing a fantastic job.

  46. Thanks so much for providing individuals with an exceptionally nice opportunity to discover important secrets from this web site. It is always very terrific and as well , jam-packed with a good time for me personally and my office fellow workers to visit your site on the least thrice in one week to study the new guides you have. And indeed, I am actually impressed with all the remarkable things served by you. Some 4 ideas on this page are without a doubt the best I have ever had.

  47. Thanks so much for providing individuals with an exceptionally nice opportunity to discover important secrets from this web site. It is always very terrific and as well , jam-packed with a good time for me personally and my office fellow workers to visit your site on the least thrice in one week to study the new guides you have. And indeed, I am actually impressed with all the remarkable things served by you. Some 4 ideas on this page are without a doubt the best I have ever had.

  48. Thanks for sharing superb informations. Your site is very cool. I’m impressed by the details that you’ve on this blog. It reveals how nicely you understand this subject. Bookmarked this web page, will come back for more articles. You, my pal, ROCK! I found simply the info I already searched everywhere and just couldn’t come across. What a great site.

  49. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  50. Thanks a lot for providing individuals with an extremely remarkable opportunity to read in detail from this blog. It’s always very pleasant and also packed with a lot of fun for me and my office peers to visit your site at the very least three times in one week to read the latest guides you have got. Not to mention, I am just always happy considering the spectacular pointers you give. Certain 2 facts on this page are absolutely the simplest we have all had.

  51. Thanks for your entire work on this blog. Kim loves setting aside time for internet research and it’s easy to understand why. A number of us learn all about the powerful tactic you present priceless ideas through the blog and improve participation from some others on that content and our favorite princess is always becoming educated a whole lot. Take pleasure in the rest of the new year. You are doing a fantastic job.

  52. That is really attention-grabbing, You’re an overly skilled blogger. I have joined your feed and look forward to in the hunt for more of your great post. Also, I have shared your web site in my social networks!

  53. Thanks for the sensible critique. Me and my neighbor were just preparing to do some research about this. We got a grab a book from our local library but I think I learned more from this post. I am very glad to see such excellent information being shared freely out there.

  54. Thanks for sharing excellent informations. Your web-site is so cool. I am impressed by the details that you have on this web site. It reveals how nicely you understand this subject. Bookmarked this website page, will come back for extra articles. You, my pal, ROCK! I found simply the information I already searched everywhere and just could not come across. What a great website.

  55. Thank you, I have just been looking for information approximately this subject for a while and yours is the greatest I’ve came upon till now. However, what in regards to the bottom line? Are you sure concerning the supply?

  56. Thanks so much for providing individuals with an exceptionally nice opportunity to discover important secrets from this web site. It is always very terrific and as well , jam-packed with a good time for me personally and my office fellow workers to visit your site on the least thrice in one week to study the new guides you have. And indeed, I am actually impressed with all the remarkable things served by you. Some 4 ideas on this page are without a doubt the best I have ever had.

  57. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  58. Thanks so much for providing individuals with such a spectacular possiblity to read articles and blog posts from here. It can be so pleasurable and as well , stuffed with a great time for me and my office colleagues to visit your blog at least 3 times every week to learn the latest secrets you will have. And of course, I’m also actually contented with the exceptional secrets you serve. Some 4 areas in this post are without a doubt the most effective we have had.

  59. Thanks for sharing superb informations. Your site is very cool. I’m impressed by the details that you’ve on this blog. It reveals how nicely you understand this subject. Bookmarked this web page, will come back for more articles. You, my pal, ROCK! I found simply the info I already searched everywhere and just couldn’t come across. What a great site.

  60. Thanks for your useful article. Other thing is that mesothelioma cancer is generally brought on by the breathing of dust from asbestos fiber, which is a carcinogenic material. Its commonly noticed among workers in the engineering industry who definitely have long exposure to asbestos. It is also caused by moving into asbestos protected buildings for an extended time of time, Genes plays an important role, and some folks are more vulnerable on the risk as compared to others.

  61. Thank you for sharing excellent informations. Your website is very cool. I’m impressed by the details that you’ve on this blog. It reveals how nicely you understand this subject. Bookmarked this website page, will come back for extra articles. You, my pal, ROCK! I found just the information I already searched all over the place and just couldn’t come across. What an ideal website.

  62. Thank you, I’ve just been looking for info about this subject for a long time and yours is the best I’ve came upon so far. However, what in regards to the conclusion? Are you positive in regards to the source?

  63. Thanks for some other informative website. Where else may I get that type of information written in such a perfect approach? I’ve a venture that I am simply now running on, and I have been at the look out for such information.

  64. Thank you, I’ve just been looking for info about this subject for a long time and yours is the best I’ve came upon so far. However, what in regards to the conclusion? Are you positive in regards to the source?

  65. Thanks for your exciting article. Other thing is that mesothelioma is generally due to the breathing of material from asbestos fiber, which is a carcinogenic material. It can be commonly witnessed among employees in the building industry who definitely have long contact with asbestos. It’s also caused by moving into asbestos covered buildings for some time of time, Family genes plays an important role, and some persons are more vulnerable on the risk than others.

  66. Thanks for sharing superb informations. Your site is very cool. I’m impressed by the details that you’ve on this blog. It reveals how nicely you understand this subject. Bookmarked this web page, will come back for more articles. You, my pal, ROCK! I found simply the info I already searched everywhere and just couldn’t come across. What a great site.

  67. Thanks for expressing your ideas. I’d also like to mention that video games have been actually evolving. Modern tools and innovative developments have made it easier to create practical and interactive games. These kinds of entertainment games were not really sensible when the actual concept was first of all being attempted. Just like other styles of technological know-how, video games also have had to advance via many years. This is testimony on the fast growth of video games.

  68. Thanks for sharing superb informations. Your site is very cool. I’m impressed by the details that you’ve on this blog. It reveals how nicely you understand this subject. Bookmarked this web page, will come back for more articles. You, my pal, ROCK! I found simply the info I already searched everywhere and just couldn’t come across. What a great site.