The Spirit Catches You and You Fall Down


My physician assistant class read Anne Fadiman’s The Spirit Catches You and You Fall Down for our Professional Seminar course, its purpose to help us examine cultural competency in medicine.  Since then I have found out that this book is required reading for many university ethics classes, medical ethics courses, and various medical practioner schools such as ours.  With good reason.  The Spirit Catches You is the true story of young Lia Lee, born to US immigrants of the Hmong culture.  Lia had epilepsy, which her parents saw as a gift and a sign that she was divine.  Doctors in their California community didn’t see it that way, however, because epilepsy is serious and dangerous.  And so sets off a clash of cultures, traditional vs. western medicine.  Each side is trying to do what is best for Lia, resulting in disaster.  

Faidman describes Lia’s situation from both the family’s perspective and the doctors’.  This story is truly frustrating.  You want to shout at her parents for not understanding, or trying; you want to shout at the medical team for not listening, or trying!  Yet everyone is trying!  So you’re even more frustrated.  I tried to put myself in the case while reading the book, attempting to see where and when I would have done something different to avoid the outcome, but time and time again I felt like people made the decisions they had to make, on both sides.  I guess that’s why we read it for class though, so we see medicine as not always black and white, and understand the importance of patient values in their own care.

There were a few chapters inserted into the story to provide character development and background on the Hmong culture that I felt were a little extraneous.  I wanted them to stick to Lia’s medical story.  But, now that I write that, I guess that is again westernized medicine poking it’s head in.  It’s hard to ignore what you’ve learned and how you’ve been raised.


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1 Response to The Spirit Catches You and You Fall Down

  1. Marlys Woodard says:

    Hi Sadie, my name is Marlys, I am a school nurse in Dallas, Texas. I have been reading The Spirit Catches You and you Fall down, along with about 20 of my colleagues. This Thursday evening, August 13th we are gathering at my house together to have a dinner together and discuss the book, and I am leading the discussion. I really appreciate your comments, especially what you said about the chapters relating to Hmong culture – I found them hard to read and almost annoying because I wanted to keep reading about what was happening with Lia. But as you said, “it’s hard to ignore what you’ve learned and how you been raised”. Without these chapters, giving the reader a better understanding of where the Lee family has been and why they think and do what they do, the story would not be complete. Thank you again for your comments. Good luck as you complete your training.

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