The Spirit Catches You and You Fall Down

“’The doctors can fix some sicknesses that involve the body and blood, but for us Hmong, some people get sick because of their soul, so they need spiritual things’” -p.100

I was debating whether or not I would include The Spirit Catches You and You Fall Down in my parent's blog.  While I considered this to be a very interesting read, this text by Anne Fadiman is very different than the other books I have read and included here.  This story is based on a true story, a true tragedy, of a cultural collision between a Hmong refugee family and American doctors both concerned with caring for a severe epileptic child.  This is such a medically and culturally dense book that outlines the radically different approaches that Hmong and Americans have to medical treatment, and the perception of medical conditions themselves.  What I gained from this book is that treating a medical condition or disability takes teamwork above all, and even though a parent has different approach to caring for their child, they are trying to do what is best for their child.  Seeing the failure between parents and doctors to build a trusting relationship in this book made me realize just how important it is to value the parent's role in educating students with special needs.

In the book, Anne Fadiman describes the real-life failed struggle between the Lees, a Hmong family that immigrated to California in the 1980s, and American doctors to care for their epileptic daughter Lia resulted in irreparable brain damage.  Epilepsy in American society is perceived as neurological misfirings in the brain, to be treated with anticonvulsant medication.  In Hmong society, epilepsy is known as qaug dab peg, or “the spirit catches you and you fall down,” where a human’s body is taken over by malevolent spirits after their own soul wanders away from the body (Fadiman 48).  Although this condition is considered harmful by both societies, the Hmong view it as somewhat of a status symbol, because patients often “experience powerful senses of grandeur and spiritual passion during their seizures and powerful creative urges in their wake” typical of Hmong religious shamans (Fadiman 29).  While American doctors perceived the best treatment to be a strict regimen of medication, Lia’s parents preferred to consult with a religious shaman and sacrifice animals to help Lia’s physical and spiritual well-being.  They even changed Lia’s name in hopes that the alleged malevolent spirits attacking her would mistake her for someone else and leave her body alone.

  Even though both Lia’s family and her doctors sought to help Lia, Lia’s parents failed to see the connection between a seizure and the detrimental effects it had on the brain.  At times, Lia’s mother would stop giving Lia medication because she believed too much medication would be detrimental over a long period.  While interpreters could explain a doctor’s instructions to the Lees, they would be confused when the medication created Lia to be lethargic, ultimately believing the medication to be bad for Lia.  For a point in time, Lia is put into foster care services because the confusion the Lees have over administering medication, which only heightens the tension between the family and the American doctors.  Ultimately, Lia suffers one final, crushing seizure that leaves her braindead.

As I began reading this book, I believed the customs and practices of the Hmong to be bizarre, and was frustrated over the fact that they stopped giving Lia medication.  However, after finishing the book, I concluded that this was a failure of both parents and doctors.  The Lees loved Lia dearly, and wanted to do everything in their power to ensure her health and safety.  While they believed treating medical conditions should treat the whole soul, the American doctors saw her disorder in purely medical terms.  It is commonplace in industrialized societies to believe that when something is wrong with your body, it is not an illness of the whole soul, but rather a misfunction of the body part (weak chest, nervous stomach).  If the doctors were more willing to meet the Lees halfway on medicinal treatment, instead of casting off their beliefs as wrong, maybe Lia's fate would have played out differently.