The novel The Spirit Catches You and You Fall Down by Anne Fadiman recounts the tale of the Lee family, a group of Hmong who struggle to treat their daughter Lia Lee for epilepsy. The central conflict throughout the novel is the clash of cultures between the superstitious, traditionalist Hmong family and the secular, science-based Western medical culture. What’s more, there is a communication barrier, as the American doctors are unable to effectively communicate with the family since they speak different languages and use different ways of relating to the world. To that end, the book essentially studies the importance of communication and its effect on inter-cultural interactions; a young, innocent girl’s life is at stake, and the push and pull between the Hmong family’s traditionalism and the medical knowledge of the Americans is the battlefield on which this conflict is fought.
As the book progresses, Fadiman discusses the different subjects by which the two groups conflict over the treatment of Lia Lee. Both sides are shown to be somewhat set in their ways in terms of relating to each other; the Hmong obviously relate to very antiquated and superstitious myths about how their daughter’s condition works, believing that her epilepsy is a divine gift bestowed upon her. However, the American doctors also show an unwillingness to learn more about Hmong culture and language in order to find the best way to communicate with the family. The Hmong fear the American doctors, as they have heard horror stories about American doctors eating Hmong livers and kidneys, while the American doctors see the family as a nuisance whose dedication to their own myths will sacrifice their daughter’s life.
While the Hmong find it difficult to understand the doctors, the doctors themselves find that they are in a bind with regards to the Hippocratic Oath. The doctors feel that the Lees are endangering their child by not giving her the treatment she needs, particularly the holistic methods the Hmong family want to give her. The inability for the Lees to perform their treatment regimen as instructed makes this even more difficult for them.
One of the most prominent cultural barriers present in the book is the different ways in which the Hmong and the American doctors view health and life. Hmong culture is shown to place a strict divide between being alive and being dead; meanwhile, American medicine creates a spectrum of quality of life, quantifying wellness to a level that ends up confusing the Lees quite a bit. Hmong view symptoms as an imbalance in the universe and one’s spirit, and so personal treatment or medicines should not be used to treat them. That being said, the Lees submit to the requests of the doctors, but for reasons that are somewhat bittersweet; the only thing that let the Lees give in was the fact that they could not truly understand the instructions their doctors gave them for Lia, and were unable to express their confusion. To that end, the Hmong idea of passive obedience, regardless of whether or not they understood, became the best way to preserve the dignity of the physicians. Because of that, the doctors were able to treat Lia, but not in a way that furthered understanding.
In the end, The Spirit Catches You and You Fall Down is a textbook case of cultural relativism. The book details the struggles of two cultures to fight over the health (and soul) of a young, innocent child, being unable to communicate with each other properly to do so. The divide between science and faith, secular versus sacred, and speaking versus understanding is made very clear in this instance, as the doctors and the Lees both look down on and fear each other, respectively, based on what they do not know about each other. Lia’s health suffers as a result of this cultural and language barrier, showing the importance of cultural education and tolerance of different worldviews on both parts.
References
Fadiman, A. (1997). The spirit catches you and you fall down. New York: Farrar, Straus and Giroux.
