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Overall Summary
The Spirit Catches You And You Fall Down is a work of literary nonfiction that chronicles the life and medical troubles of Lia Lee, a young girl from Merced, California. In the 1980s, Lia was part of the Hmong population in America who were refugees from Laos. She had epilepsy and struggled with American medicine because she did not speak English. Fadiman tells her story while also providing an anthropological study on Hmong culture as well as interviews with many other people about their experiences living in America.
Unlike the other thirteen children Foua Lee had, Lia was born in a hospital. She is also the first to survive past infancy. Although this may seem like good news, it’s actually bad news because she has a seizure when her sister slams the door loudly at three months old. Her parents believe that this noise caused her soul to leave her body and that she will die unless they do something about it (this belief is common among Hmong people). The Hmong regard quag dab peg as an evil spirit or “soul loss” but also see potential for great things from those who have seizures since healers need them to communicate with evil spirits and fight for souls of their victims.
Foua Lee is highly protective of Lia, so although they are saddened by what happened they are pleased by the idea that one day Lia might become a healer; therefore, he tries everything he can think of to make sure his daughter won’t die.
The Hmong people are conflicted about the effectiveness of Western medicine. They have a lot of faith in it, but they also think that their traditional remedies work better than Western medicine. Lia’s family has had mixed experiences with MCMC (Merced County Medical Center). On one hand, they’ve taken her there twice hoping she would get some medication to stop her seizures and stabilize her condition. Unfortunately, she always stops seizing before arriving at the hospital both times because there aren’t any translators available to explain why they’re taking Lia there or what is wrong with her health. Eventually though, on Lia’s third visit to MCMC while still seizing, a doctor named Dan Murphy becomes curious about Hmong culture after talking with Nao Kao and Foua for a long time.
The parents are trying to figure out how to help Lia. A nephew translates for them and helps explain the procedure that will be used. The doctors want to give her medicine that they think will help control the seizures, but they have no way of knowing if it’s going to work or what other effects it might have on Lia. They keep her in the hospital for a few days before discharging her, giving Nao Kao and Foua directions on how to administer this medicine without explaining why they’re doing so.
In the past, Hmong people were not fans of Western medicine. In fact, they believed that hospitals and certain medicines could make them even sicker than they already were. This was because of their spiritual practices and commonly held beliefs such as those about anesthesia. They thought that when a person is unconscious his soul is “at large,” which means any form of anesthesia essentially invites evil spirits to harm him or her during surgery. Despite these misgivings, Nao Kao and Foua continue to take Lia to MCMC when she has major seizures many times; in fact, between the ages of eight months and four years old she goes there 17 times for treatment in the emergency room! During this time period Neil Ernst (an amazing doctor) meets the Lees through Lia’s frequent visits at the hospital.
Neil and Peggy work hard to help Lia, but they find it difficult to get Nao Kao and Foua (the parents) to follow their directions. They try explaining the importance of each medication, but they don’t seem to understand why each one is important. After some research, Neil and Peggy conclude that the parents are not following through with the medications because they don’t fully understand them or trust them.
