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

“I have always felt that the action most worth watching is not at the center of things but where the edges meet. I like shorelines, weather fronts, international borders. There are interesting frictions and incongruities in these places, and often, if you stand at the point of tangency, you can see both sides better than if you were in the middle of either one. This is especially true, I think, when the apposition is cultural. When I first came to Merced, I hoped that the culture of American medicine, about which I knew a little, and the culture of the Hmong, about which I knew nothing, would is some way illuminate each other if I could position myself between the two and manage not to get caught in the cross fire.”

This quotation presents an analytical framework to Fadiman’s study of cross-cultural conflict. She prefers to view conflicts from the edges or sides, as this is where tension points are the greatest. Her hope is that by studying both sides—the culture of the Hmong and the culture of American medicine—she will better understand the reasons for the conflicts when the two sides meet. Fadiman’s analytical approach to cultural conflict is an important precursor to borderland studies, i.e., studies that focus on two or more cultures meeting in a common place, like a hospital setting.

“Although the Hmong believe that illness can be caused by a variety of sources […] by far the most common cause of illness is soul loss. Although the Hmong do not agree on just how many souls people have (estimates range from one to thirty-two; the Lees believe there is only one), there is a general consensus that whatever the number, it is the life-soul, whose presence is necessary for health and happiness, that tends to get lost. A life soul can be separated from its body through anger, grief, fear, curiosity, or wanderlust. The life-souls of newborn babies are especially prone to disappearance, since they are so small, so vulnerable, and so precariously poised between the realm of the unseen, from which they have just traveled, and the realm of the living.”

This quotation emphasizes the importance of the life-soul in Hmong culture. It provides context to the Lees’s understanding of Lia’s illness, which they attribute to soul-loss. The passage illustrates Fadiman’s close attention to Hmong conceptions of health and illness and her descriptive, ethnographic prose.

“The professor of French who told me this story said, ‘Fish Soup. That’s the essence of the Hmong.’ The Hmong have a phrase, hais cuaj txub kaum txub, which means ‘to speak of all kinds of things.’ It is often used at the beginning of an oral narrative as a way of reminding the listeners that the world is full of things that may not seem to be connected but actually are; that no event occurs in isolation; that you can miss a lot by sticking to the point; and that the storyteller is likely to be rather long-winded”

This quotation conveys the tone of Fadiman’s research, particularly her interactions with Hmong respondents who talk at length about their history and cultural beliefs and practices. Like fish soup, her respondents like “to speak of all kinds of things,” which Fadiman skillfully captures and reconveys in her extended narratives of Hmong life in China, Laos, and the United States.