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

Fadiman provides a summary resolution to many of the characters in the book. Lia does not die but also does not recover. Her siblings grow up navigating between their American and Hmong worlds, variously attending high school and college and enrolling in the Marine Reserves. Nao Kao gains weight and has high blood pressure while Foua feels tired a lot. Jeanine convinces them to let Lia return to her special school so they can have a break from their caregiving duties. Dee and her foster children see Lia at the school and come to terms with her brain death. In 1993, Jeanine suffers from a severe asthma attack that causes respiratory failure and oxygen deprivation, resulting in the loss of all brain function. She develops the same condition as Lia and dies three days later. Neil and Peggy develop a close relationship with Foua when she learns that their son has leukemia. She expresses genuine concern, and they are grateful for her compassion.

Fadiman follows up with Terry Hutchinson, the pediatric neurologist who oversaw Lia’s care in Fresno. He explains to Fadiman that “Lia’s brain was destroyed by septic shock, which was caused by the Pseudomonas aeruginosa bacillus in her blood” (254).