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

A methodological position that one should not view or judge another culture by one’s own standards but rather view it on its own terms. Fadiman uses this approach to better understand the cultural beliefs and practices of her Hmong research participants and the medical staff at MCMC.

A malevolent spirit. The Hmong have many cultural taboos and folktales about dabs, who often are responsible for illnesses and soul loss. Shamans engage in spiritual battles with dabs and try to appease them with animal sacrifices.

The view that one’s own culture is superior to another culture. Limits cross-cultural understanding and tolerance for other ways of living. Many of the medical staff at MCMC exhibit ethnocentric attitudes, as they believe their medical knowledge and training is superior to that of their patients.

A full-blown epileptic attack. Lia experiences many episodes of grand mal seizures, which are extremely difficult for her doctors to treat.

A group of people identified by a shared heritage, language, and culture. Historically, the Hmong lived in southwestern China and migrated to Laos, Thailand, and other neighboring countries before coming to the United States, largely as political refugees, in the 1980s. Fadiman’s book focuses on a group of Hmong refugees living in Merced, California.

A Hmong, soul-calling ceremony traditionally conducted for babies on the third day after their birth. The ceremony marks the baby as fully human. In the United States, the ceremony usually occurs later. The Lees perform this ceremony for Lia when she is one month old.

A disease of an uncertain origin, or one arising spontaneously. Lia’s doctors do not know why she has epilepsy and label it as an idiopathic condition.

A severe form of epilepsy characterized by frequent seizures that manifests during infancy or early childhood. Lia has Lennox-Gastaut Syndrome.

A French term that means mountain dweller. The Hmong are known for their historical preference of living in highland, mountainous areas that are difficult for outsiders to reach.

A Hmong phrase that means, “The spirit catches you and you fall down.” It is the Lees’s explanation for Lia’s illness, which they attribute to a dab stealing her soul.

A term for when psychological distress is expressed through physical symptoms. Fadiman describes the high incidence of somatization that Hmong refugees experience in the United States, resulting from their traumatic experiences during the Vietnam War and post-war persecutions.

Prolonged seizures when a person does not regain consciousness for an extended period of time. Lia experiences status epilepticus on multiple occasions, having seizures for 20 minutes at a time, and only regains consciousness with anticonvulsant medications administered intravenously.