“The Spirit Catches You and You Fall Down – A Hmong Child, her American doctors, and the collision of two cultures” by Anne Fadiman

This is another book that I read because of the Freshman Year Common Reading program at the college where I work. It was either a candidate book or the selected book a few years ago. Later, I will evaluate it according to the system I created and introduced in my post of December 6. (I originally read this book in January of 2013, because someone was giving away leftover copies.)

This book has “curb appeal” because the cover shows a photo of an adorable little girl in formal southeast Asian dress. She looks loved, even pampered. Her name is Lia. Her family came to the US after Laos fell in 1975. Lia was born in the US in 1981. I won’t try to summarize the complicated history of Southeast Asia as America struggled to extricate itself from Vietnam. Lia’s family and thousands of other ethnic Hmong were brought to the US to avoid retribution for having assisted the US military with its activities in Laos.

Lia suffered from epilepsy, and the book is a detailed account of how her family and her doctors tried to heal her. The differences between Hmong traditional medicine (inescapably intertwined with animistic religion) and modern Western medicine were so extreme that communication was almost impossible. Despite everyone’s good intentions, her condition deteriorated over months and years of crisis and intervention.

This book is an example of very high quality documentary writing, and worth careful examination in college courses. Academically, it would be classified, I think, as medical anthropology. It is clear and well organized.

Over time, Lia’s condition spiraled downwards. Eventually, she suffered a prolonged seizure and bout of sepsis (blood poisoning?) which left her severely brain damaged and terribly weak. The doctors discharged her to her parents care, expecting her to die shortly. Against the odds, she survived and in some senses improved, but this was not a “happy ending”. She never fully regained consciousness.

So there are two stories here. The book documents several years of intense struggle to control Lia’s seizures and give her a normal life. After that, Lia survived for TWENTY SIX YEARS under the loving care of her family. Few people in that so-called “vegetative state” live for more than a few years.

So using my rating system:

  • Globalization – 5 points. This book discusses languages, culture and history in great detail.
  • Engagement – 4 points. This book is about the American medical system, and the problems that people of good will and the best possible intentions have when faced with a totally unfamiliar world view.
  • Sustainability – 1 point, maybe? There is little here about “environmental” sustainability, which (I think) is what the college has in mind when they list sustainability as an organizing principle. From a broad socio-political point of view, the American intervention in Southeast Asia created an unsustainable situation from which only relocation offered hope of survival.
  • Learning – 3. This book highlights the need to KEEP learning, and the incredible difficulty of figuring out what you don’t know. How would an American doctor realize his/her need to understand a Laotian shaman?

So, that’s 12 or 13 out of a possible 20 points… But I think this book was a good choice for the common reading. It is challenging, well written and serious.


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