The Hmong cultural practices and customs differed greatly from the western culture. The immigrants from Laos, such as the Lee family, therefore, went through a stressful time living among people with totally different cultures who were not willing to understand them. This creates the foundation on which Ms. Fadiman bases her book, The Spirit Catches You and You Fall Down. Right from the birth of Lia, a Hmong would view all the procedures performed during the birth to be discordant to what their culture dictates, hence the predicament of Lia could have originated this far.
The birth of Lia takes place in a western setup, whereby the midwives are required to take care of the expectant mother in all aspects. On the contrary, the Hmong culture expects the woman to be brave and strong enough to give birth on her own, while lying on a dirty floor and making sure that the baby is not woken up. The father is supposed to bury the placenta under their bed. A shaman, or one of their spirits, is also believed to negotiate for the health of the newborn baby and the mother from the realm of the unseen. The details of the Hmong culture are provided in the book, with the main focus being on health. This is to emphasize the fact that none of these rituals were performed in the case of Lia, hence making her a unique personality (Alper, Tjosvold & Law, 2000).
As Fadiman records, the Hmong culture dwelt so much on the health of the babies that the women were restricted in what they eat to ensure that the health of the baby is excellent. Lia’s mother Foua Yang also refuses to drink ice water, as her culture dictates that she drinks warm water for the blood to flow freely. Up to this point, there are so many clashes in the two cultures, and the only thing that was done right according to the Hmong was the naming ceremony, which was also very important as it bound the soul to the body of the baby. The history of the Hmong people tells us how precious they consider their culture is. When the French colonized Indochina, the native Hmong refused to adapt to their culture. They staged rebellions that led to the French getting tired of them and leaving them alone. They also refused to pay tribute to the Chinese Emperor who was forced to construct a wall to contain them. Still, they preferred resistance or even migrating to another location to submitting to another culture. This chapter introduces us to the spirit of the Lee family, who belong to a culture that cannot accept superiority of another culture, hence a compromise is not an option for them.
When Lia was three months old, she started experiencing seizures. The Lees believed that this occurred because Yer had slammed the front door, and the noise had frightened Lia’s soul out of her body, making it get lost. The symptoms of the seizures were viewed differently by this family; they recognized it as quag dab peg, which translates into English as ‘the spirit catches you and you fall down.’ Inasmuch as this condition was dangerous to the baby, it also was a blessing to them. According to the Hmong culture, this was as a result of a healing spirit entering the body (Alper, Tjosvold & Law, 2000).
After this diagnosis, the Lees started to treat Lia with a lot of passion and love, because she was a divine child; she would have a high status in the community, and would be considered to be endowed with high morals. There is, however, a sharp distinction from the way the western culture views epilepsy. When Lia was taken to MCMC, they were not of much help due to the language barrier and competition between hospitals for high-paying customers. When she was later attacked by a grand mal seizure, she was admitted at the ER. Dan diagnosed her with epilepsy and immediately set to work doing all manner of tests trying to understand what caused the seizure. Little did he know that the Lees had already established the cause – the slammed door. As the events unfold, we get to know about the different perceptions that the Hmong hold regarding the western medicine. For instance, the Hmong view drawing of blood a taboo, and for this reason doctors were also viewed as being very rude and never giving their full attention to the patients. The Shamans, on the other hand, were very friendly and polite; they spent a lot of time with the patient and rendered immediate diagnosis. The Hmong were even more surprised to see doctors performing an autopsy, and they actually thought that the doctors ate brains. This was caused by Dan’s recommendation to treat Lia’s condition by means of brain surgery (Amason, 1996).
The Lees’ belief in the Hmong culture continued to be a stumbling block for the medication of Lia. Her father believed that being obese showed that she was very healthy and well-cared for. The condition of Lia had deteriorated to the feared status epilepticus, which required massive amounts of anticonvulsant medications to be administered intravenously. Inserting a needle was very difficult due to her chubby nature, and when her hands were tied to hold up the veins, the parents viewed this as some kind of sadistic action. They often untied her hands and moved her about, which made the nurses’ work very difficult. Inasmuch as the doctors tried their best to help Lia, the parents proved a stumbling block to their efforts. Since the parents were illiterate in both the Hmong language and English, they often forgot the doctor’s instructions on how the prescribed medicines should be administered. In some instances they even stopped giving Lia the drugs intentionally, since they believed that her condition was due to the drugs she was given at the hospital. The Hmong actually had a belief that the drugs which were given by the doctors made the patient more ill instead of treating them; this belief was a major stumbling block for the medication process (Simmons, 2009).