This is truly one of the finest books that I have had the pleasure of reading.

It is of such remarkable quality that it leaves me completely at a loss for words.

The impact it has had on me is profound, and all I can do is express my heartfelt wish that perhaps one day, I too could pen a book of such caliber.

The story within its pages is captivating, the characters are vividly brought to life, and the writing style is simply enchanting.

It has transported me to another world, filled with emotions and experiences that I will not soon forget.

I highly recommend this book to anyone who has a love for great literature.

It is a true gem that deserves to be cherished and shared.

This is truly an outstanding book that holds great value for anyone with an interest in a medical career. However, it is equally significant for those who wish to gain a deeper understanding of a new culture. The author has done an excellent job of writing this book in a way that is not only engaging but also easy to read. What I particularly liked was how the story was seamlessly interspersed with Hmong history. This added an extra layer of depth and authenticity to the narrative. Through reading this book, I have learned an enormous amount of information. I have no doubt that I will often reflect on the content of this book in the future. It has truly made a lasting impression on me.

Fadiman penned a truly captivating and empathetic tale about a culture that stands in stark contrast to our Western one.

It was particularly intriguing to read this right after delving into Hitchen's "God Is Not Great". Theoretically, without the involvement of religion, there might not have been a genuine culture clash, and Lia could have potentially grown up as an epileptic yet functioning girl. Maybe.

However, this isn't really the crux of Fadiman's book. She doesn't condemn anyone. In fact, she points out that there isn't a single person or group to blame for what happened to Lia. The essence of the book is to examine the cultural differences that exist in our country today and perhaps realize that there are more effective ways to handle the issues that emerge.

The exploration of the Hmong culture and history provided by the book is both fascinating and enlightening. The various levels of engagement the Lee family had with different Westerners were especially revealing and accounted for the widely diverse opinions that people had formed.

The story of Lia Lee is tragic, and the possibility that it could have had a different outcome makes it all the more so. It has been over ten years since the book was published, and I would dearly love to have some sort of update on how the Lee family is faring - especially Lia - and if any real progress has been made in resolving culture collisions in Mercer.

At its core, this book delves deep into the arduous struggles of a Hmong family as they strive to care for their child, Lia, who suffers from severe epilepsy. Their journey is one filled with countless hardships, taking them from the shadows of a covert CIA proxy war, where Hmong villagers were callously treated as mere pawns, to the squalor of a refugee camp, and finally to a country that offers them shelter but unfortunately condemns them to a life of poverty. This moving narrative is undeniably the book's greatest strength. It serves as a springboard, enabling readers to explore the rich and often overlooked history of a marginalized people.

It also vividly showcases how the family's unique background collided disastrously with the American systems, leading to a medical outcome that, although foreseeable, one still hopes would not come to fruition. Moreover, Fadiman does an excellent job of humanizing the medical staff who dedicated so much time to interacting with Lia's family and the broader Hmong community. She presents them in all their complexity, warts and all, from their sometimes open disdain for the Hmong to their heroic, albeit ultimately unsuccessful, efforts to ensure baby Lia received the care she so desperately needed.

However, therein lies the rub. Fadiman fails to fully humanize "the Hmong" as a whole. Somehow, while the medical staff are portrayed as living, breathing individuals with great depth, the entire Hmong community is flattened into a group of incongruous, tenacious mountain farmers with an otherworldly magical religion. To be fair, Fadiman describes the religious practices of "the Hmong" with great respect. Nevertheless, no amount of respect can prevent this cartoonish treatment of "the Hmong" from undermining the humanity of its central subjects: Lia and her family.

The phrase "the Hmong" appears no fewer than 430 times in this 360-page book. While Fadiman clearly intended to provide a more comprehensive context for Lia's family and culture, she instead ends up creating what can only be described as a misguided stereotype. Yes, Lia's family had certain customs and beliefs that differed significantly from American norms, but uncritically describing "the essential Hmong temperament" (while persistently attributing it to historical snippets) veers between the ludicrous and the pernicious. When English speakers use phrases like "the French" in stereotypes, it is generally understood that the people being stereotyped are individuals who may or may not actually conform to that stereotype to varying degrees. However, Fadiman's description of this marginalized community instead tends to construct "the Hmong" as a uniform monolith of alien people. (A trend that is still all too prevalent when describing Asians.) Where is the breadth and depth of character that is afforded to the non-Hmong characters?

At the end of the day, Lia's story and the stories of the Hmong refugees are indeed worth knowing. However, Fadiman's treatment of the material implicitly reinforces the very modes of thinking that give rise to stereotypes and biases. The Spirit Catches You is a product of the well-intentioned but perhaps somewhat naïve '90s notions of multiculturalism and demands a critical eye when reading it. *There is also more that could be said about the role that medical paternalism played in Lia's medical outcome, but medicine was not quite as advanced in the '90s, so I will let it pass for now.

Having now completed the book, I am privy to Lia's fate. However, you must peruse the book yourself to discover it. No spoilers here!

It is crucial to note that this book should be read not only by those intrigued by anthropology and the improvement of medical practices but also by those eager to learn more about the Silent War in Laos. So much has been written about the war in Vietnam, yet so little about that in Laos.

How does one teach doctors to feel empathy and love for their patients? Physical contact is a quick trick. And how many doctors look you in the eye? We all know when a doctor is truly communicating with us honestly. One doctor said she simply could not adhere to all the "cultural rules" necessary when communicating with the Hmongs....but they did sense her sincerity. She explained that the Hmong patients knew she was American and thus would be lenient. Body language speaks volumes. If we care, truly care, that message transcends most cultural divides. Empathy has a therapeutic effect. But it surely helps if we ensure doctors don't have 33-hour shifts and have access to interpreters.

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Through page 148: This is VERY difficult for me to read...... To clarify: I am petrified when I enter a hospital. Everything always goes awry. My own fears/experiences clearly enhance my empathy for Lia.

Nevertheless, this is a book that everyone should read.

I HAD to take a break from the book to pen this. I felt physically queasy. Writing gives me some detachment.

On an intellectual level, reading this after The Sacred Willow: Four Generations in the Life of a Vietnamese Family is simply perfect. The themes intersect.

Although Fadiman's skills are exemplary, I must note that I am not entirely certain the problem is solely cultural. All people misunderstand each other in tense situations, even those of the same culture. I would also like to state that sometimes medicine fails. We, as patients, struggle to accept this. I do not know, at this juncture, what will become of Lia...... but we must also accept that there is not a medical solution to every problem. Will Lia die? I don't know. I think if she does, there is not a single culprit. Cultural misunderstanding has indeed played a part, but also medical science today is not infallible and doctors are only human. Even the best make mistakes. These are my thoughts as I read this remarkable book.

This book vividly portrays the extensive misunderstandings that exist between Western medicine practitioners and a Hmong couple who have a child with epilepsy. Primarily, it is Lia Lee's story. Lia's parents, a Hmong couple, immigrated to California from Laos after residing in a refugee camp in Thailand. The Hmong spiritual beliefs directly conflict with the medical treatment regimens prescribed by the doctors. The tragedy is further compounded by the communication gap, as there are very few words in the Hmong language to describe medical terminology. It serves as a prime example of a significant cultural disconnect.

Interwoven into Lia's story are segments that detail the history of the Hmong people, their recruitment by the US government to fight the communists during the Vietnam War, and the family's flight from persecution by the Laotian government after the Americans withdrew from Vietnam. These segments provide much-needed respites from Lia's sad tale.

Both "sides" in this book have the best interests of their patient/daughter at heart, yet they do not concur on what that might entail. The doctors are clearly guided by their medical training, which focuses on treating the body, while the Hmong parents firmly believe that the soul is equally important. They practice shamanistic animism. The doctors diagnosed a rare form of epilepsy, while the family perceived it as a flight of the soul from the body when "the spirit catches you and you fall down."

The author describes her meetings with the family, doctors, foster parents, and others involved in Lia's care. Fadiman developed a deep understanding of the family after spending so much time with them, and she clearly empathizes with their situation. The book is well-written, although it can be a bit repetitive and has a few digressions towards the end. Nevertheless, it is a compelling read that offers much food for thought and would make an excellent selection for a book club.

The best book on the cultural and ethics side of medicine I've read till now!

However, when I re-read this in 2020, I had a completely different perspective. I felt that this book is steeped in orientalist and colonialist ideas. It seems to view other cultures through a distorted lens, perhaps influenced by the biases and power dynamics of a bygone era.

If you are truly interested in cultural competency in healthcare, it is essential to read books by actual BIPOC (Black, Indigenous, and People of Color). These authors can offer unique and authentic insights into the experiences and perspectives of diverse communities. By reading their works, we can gain a more accurate and nuanced understanding of the complex issues surrounding cultural competency in healthcare.

We should strive to move beyond the limitations of older, perhaps less enlightened works and embrace the rich and diverse voices that are available to us today. Only then can we hope to provide truly equitable and culturally sensitive healthcare.

What an incredibly engaging read this is!

It presents a vivid clash between Western medicine and Hmong culture, which is exacerbated by a dearth of translators, a lack of cultural understanding, and insufficient education on both sides. Anne Fadiman masterfully shows how the situation regarding one extremely ill child took a wrong turn and offers suggestions for more effective communication and care provision.

I was truly fascinated by learning about the Hmong family in particular, and their unique methods of parenting and treating the sick. The author posits that the millennia-long refusal of the Hmong people to be assimilated impacts the challenges faced by Hmong refugees in their new environments. As such, she delves into quite a bit of Hmong history, especially in Laos, and how it intersects with American history due to "The Secret War."

This is certain to spark a great book club discussion!

The edition I read had a new afterword by the author, providing some updates and a discussion of the book's impact. She also remarks on how it would have been impossible to write the book now, at least not in the same way.

It is truly very good to have this reminder to oneself. Reading outside of one's genre more often can bring about a plethora of benefits. It broadens our perspectives and exposes us to different writing styles, themes, and ideas. By delving into various genres, we can gain a more comprehensive understanding of the literary world. It enriches our vocabulary and enhances our writing skills. We may discover new authors and works that we never would have otherwise. This exploration of different genres also keeps our reading experience fresh and exciting. It allows us to break free from the monotony of always reading within our comfort zone. So, let's take this reminder seriously and make a conscious effort to read outside of our genre more frequently.

A book of this nature should be mandatory reading for every individual residing in a community composed of multicultural members, and in today's world, that likely encompasses just about everyone. Sadly, and yet not unexpectedly, those who would potentially gain the most from a book like this are probably the very ones least likely to pick it up and read it.

It serves as an eye-opening exploration of cross-cultural issues, particularly those within the medical field, but also in the religious realm, as the Hmong do not differentiate between the two. In clear and engaging language, it further elucidates the background of the Hmong (historically, a nomadic people without a homeland) and their role, having been recruited by the CIA, in the American War in landlocked Laos. This was a place they had no desire to leave but were compelled to do so, and it details how so many of them ultimately found themselves in Merced, CA.

There is an abundance of knowledge to be gleaned from this book. However, the most crucial aspect for me was the, perhaps avoidable, conflict and heartache that can arise when bureaucracies attempt to force everyone into their one-size-fits-all compartments.

Read around the world project - Laos

"The Spirit Catches You and You Fall Down" is the Hmong word for epilepsy, a medical affliction that Lia Lee was diagnosed with at the age of four. Lia is the daughter of Hmong refugees from Laos. This is the captivating story of Lia, her parents, her doctors, and her community. It展现了her family's cultural beliefs clashing with the medical community, the legal system, and the complex process of American assimilation. There is no doubt that everyone involved had the best intentions for Lia. However, after reading, the question of what is actually best still remains ambiguous to me.

This book is a fantastic choice for anyone interested in delving deeper into medical ethics and the experiences of refugees. Initially, I was unsure how well it would fit as a read-the-world pick, but upon finishing, I found it to be a solid and thought-provoking choice. It offers a unique perspective on the challenges faced by refugees and the importance of understanding different cultures in the medical field.

It is a well-known fact that involuntary migrants, regardless of the circumstances into which they are thrust, often resist assimilation.

In 1981, Lia Lee was born into a Hmong refugee family from Laos after they relocated to Merced, California. Tragically, she soon developed severe epilepsy. By 1988, she was at home, in a brain-dead state. The events preceding this tragedy, including misunderstandings, culture clashes, and flawed decisions, form the core of this story.

Certainly, the book delves much deeper as Fadiman becomes closely involved with this family, exploring every aspect in search of answers. This is a challenging and emotionally charged read, yet the narrative progresses with power and confidence. It is truly an eye-opening experience and a must-read, particularly for all medical students.

It offers valuable insights into the complex intersection of culture, medicine, and human lives, highlighting the importance of understanding and empathy in the medical field.