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

The theme of cross-cultural miscommunication features predominately in Fadiman’s book. Early on, she describes the experience of listening to the interview recordings of Lia’s family and her doctors. Fadiman wishes she could splice the recordings together so she can hear their voices “on a single tape, speaking a common language” (ix). The desire to hear a common language is central to her study of cross-cultural conflict at MCMC—a conflict that ends tragically for Lia and her family. For, as Fadiman summarizes at the end of the book, “I have come to believe that [Lia’s] life was ruined not by septic shock or noncompliant parents but by cross-cultural misunderstanding” (262).

Fadiman relies on extended, ethnographic narratives to set up two very different worldviews about the etiology of Lia’s illness. The first details the cultural beliefs and traditional healing practices of Lia’s family and wider Hmong society. The second explains the cultural paradigm of Western biomedicine, which relies on Cartesian, rationalist reasoning. The divergent perspectives of the Lee family and Lia’s doctors repeatedly collide, as neither side understands the other—an issue that is more than a problem of insufficient translation. For instance, Lia’s family attribute her seizures to soul loss, which they call quag

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