Literature, Arts, and Medicine Database

Fadiman, Anne
The Spirit Catches You and You Fall Down

When Lia Lee's sister slammed the front door to their Merced, California, apartment, Lia experienced her first in several years of increasingly severe seizures. The Lee family knew that the noise had awakened a dab, an evil spirit who stole Lia's soul. They also knew, in the midst of their grief for their infant daughter, that people suffering from "the spirit catches you and you fall down" often grew up to be healers in their Hmong culture.

Not surprisingly, the physicians and other health professionals who worked with Lia and her parents over the next seven-plus years did not share this diagnosis--most of them did not even know about it. Fadiman melds her story of Lia, the Lees, the family's physicians and social workers, and countless other people who enter the Lees' life (usually uninvited and unwelcome) with the long history of the Hmong people, their religion and culture, and their more recent lives as refugees from war in Laos and Cambodia (and the troubled history of their relationship to the U.S. military system).

This is a rich, powerful account of cultures out of step with each other and the difficulties in communicating across barriers that are buried in centuries of war, distrust, religion, and healing beliefs and practices. In addition to spending thousands of hours with Lia's family and other Hmong citizens, Fadiman spends equally long hours with Lia's physicians, social workers, and foster parents. Fadiman distinguishes between a translator and a "culture broker" in the kinds of help needed in such situations, and she draws heavily on Arthur Kleinman's writings about cultural difference and illness narratives.