This book is an excellent illustration of the importance of cross-cultural competence in the practice of psychology, education, and healthcare. After reading this book, I cannot imagine a case where any professional could walk into a situation with a client from another culture and fail to take stock of cultural factors.
The story beautifully illuminates how culture 'colors' all of our experiences, impressions, and perceptions. ALL practioners should read this book and take heed in professional practice. Further, because this book only highlights the challenges for professionals with ONE culture, there is a message between the lines that all cultures require this deep and specialized look at the values and norms therein.

A very interesting and detailed look into the life of this young Hmong child and the important role that cultural barriers played in her medical care. A wonderful account from both points of views. I would say this is a must read for any doctor.

marvelous book, well worth a thoughtful read; a little Hmong girl caught between well-meaning medical establishment and traditional culture. In microscopic detail shows how caring is not enough--cultural knowledge and understanding is needed as well. The author did a remarkable job, not only is the research impressive but the book is a great read. One of the best books I've read this year.

Because this book came along with two others, one which was quite huge and heavy, the book cover was damaged when it arrived. Other than that it arrived within estimated arrival time.

The Spirit Catches You and You Fall Down chronicles the story of a little epileptic Hmong girl whose family does not accept the ways of the Western world and Western medicine. After reading this book, I find that I am more understanding to other cultures and ways of life. I too held almost an elitist opinion of the "American Way". This book gives a glimpse into the other side of the story. Good parenting is subjective and cultural. I definitely recommend this book to anyone who would like to become more open-minded and accepting.

This was an wonderfully written nonfiction book that offers insight for helping professionals working with the Hmong population. The author gives a detailed account of how cultural and communication barriers affected medical treatment for a Hmong child. The outcome for this child and family could likely have been different had the professionals understood more about the Hmong culture and had been able to communicate with the family, incorporating their beliefs and understanding of the child's diagnosis. This book reminds helping professionals that utilizing an interpreter with cultural brokering skills is beneficial for everyone involved.

I bought this book as part of my coursework in Public Health Nursing. It is a wonderful book. It speaks to our general lack of cultural awareness from the medical community standpoint. It also opened my eyes to a strong and brilliant culture (Hmong). I am glad that my instructor recommended this book.

The Spirit Catches You and You Fall Down
Never received the book. Was very upset. Would never utilize a 3rd party buyer again. A complete waste of my time.

Well-written, gripping, thoughtful, thorough investigation into the tragic and seemingly unavoidable events in the life of a sick young girl and her loving family. Everyone wanted the best, but it all went terribly wrong. A compelling example of why we all need to keep learning from each other.

Well-written, gripping, thoughtful, thorough investigation into the tragic and seemingly unavoidable events in the life of a sick young girl and her loving family. Everyone wanted the best, but it all went terribly wrong. A compelling example of why we all need to keep learning from each other.

As the title implies, this book offers an alternative perspective of epilepsy, or seizures, as seen through the lens of the Hmong people. It also provides a fresh view of Western so-called civilization itself, and most particularly Western medicine.

I doubt there's any American today who doesn't harbor at least some ambivalence about how medicine's practiced in the United States, and I'm not just talking bills and insurance. Foua and Nao Kao Lee didn't trust the doctors who tended to their baby daughter Lia when she began to have seizures; they worried about doing damage to their baby's soul. In the Hmong culture, sickness is a signal of disturbance to the soul, and healing is a matter of tending to that soul. When did you last see an American doctor do that?

Even had the doctors who cared for Lia known of this tenet of the Lees' belief system, they probably wouldn't have given it consideration. As things were, they knew little about their patient's family: not only did the Lees not understand English, but the Hmong culture is so far from that of anything remotely American, the doctors hadn't the ears to hear, eyes to see, or consciousness to absorb any of it. To them, as to many Americans, the Hmong are a "Stone Age" people, ignorant and superstitious.

Certainly Hmong rituals and healing ceremonies are strange and arcane--but no stranger than those of the Catholic or Jewish faith: all utilize symbols, whether it's wine standing in for the blood of Jesus, drops of wine spilled onto a plate for Egyptian plagues, or a wooden bench transformed into a winged horse carrying a healer in search of a sick person's soul. Why is it that the good citizens of the United States laugh only at the latter?

Writer Anne Fadiman decided to look at American medicine through the prism of Lia Lee's sad story. She discovered, and conveyed to readers, the richness of Hmong culture, devoid of sentimentality. Fadiman is careful not to imbue the Hmong with the kind of romanticism that European Americans tend to hold about Native Americans: she does not evade the fact that they can be extremely difficult. By allowing them full humanity, she brings them vividly to life the same way a novelist does her characters--though non-fiction, thi book is as compelling as a great novel.

The Hmong came to America in the 1980s courtesy of war in Southeast Asia. They'd been living in the mountains of Laos, to which they'd migrated from China. The Hmong never assimilate into the culture of the country they inhabit, and have suffered persecution for centuries. Much like the Roma or the Jews, they're a migratory tribe without a homeland--but I doubt they ever felt quite as displaced as they did when they got to the United States. Because they helped the CIA in Laos, the Hmong were promised they'd be welcome in the U.S.--but when the troops left, they jetted only generals and hotshots out of the country, leaving the rest of the populace to fend for themselves. With the Laotian army hunting them down as enemies of the state, Hmong families set off on foot, carrying whatever they could manage. Many, particularly the old and the young, died along the way. Most possessions were shed, too heavy to carry, on the days-long journey. When they arrived in Thailand they were placed in refugee camps, where they waited to be rescued by the Americans. Those who were finally brought to America were `resettled' all over the map, without regard for family cohesion or transferability of survival skills: in Detroit, Minneapolis, Utah, Vermont--the Hmong were distributed all over the country so as to not unduly `burden' any one locality.

The Hmong tend to have large broods of 12 or 13 children, who they deeply adore, and they view disability as a consequence of some parental transgression, for which they atone by treating children with disabilities extra lovingly. They're used to living near relatives, who they see frequently, if not daily. The diaspora of the Hmong represented unspeakable hardship--which they resolved with what they call their `second resettlement.'One family would pack up a hastily purchased jalopy and drive off, looking for a spit of land hospitable to growing vegetables and the herbs necessary for healing rituals. They'd end up where all pioneers do, in California, and send news to relatives in Detroit or Chicago or Billings, Montana. Eventually, pockets of Hmong were clustered in a few locations around the country. Of these, Merced, California, where the Lee family settled, is one of the largest.

About one in every six residents of Merced, formerly an all-white rural area, is now Hmong. Here their culture and community thrived, parallel to the dominant culture, assimilating as little as possible. One way they did have to assimilate is medically: since 80% receive some form of government assistance, social services closely monitor them. American social workers do not have a high level of tolerance for cultural difference, and many Hmong practices, like gardening on the living room floor, or animal sacrifice, put parents in danger of losing their children to foster care--an unthinkable consequence that did occur, for a period of time, to Lia Lee.

The Hmong had heard about Western medicine even before arriving on these shores. They approved of antibiotics--swallow a pill and get well in a week--but not of much else. Surgery was anathema, since cutting the flesh or removing organs risks the flight of the soul. When their daughter Lia fell into the hands of the medical establishment, the Lees suffered deep agony over every procedure, from IV insertion to spinal taps.

Fadiman explores the interactions between the Lees and their daughter's medical caretakers in exhaustive detail. Whenever Lia suffers a setback, the Lees blame the doctors and their methods. The doctors accuse the Lees of "noncompliance" when they fail to properly dose Lia with three different kinds of anti-convulsants at the various times of day prescribed, not realizing that the Hmong don't even use clocks. Fadiman presents a balanced picture, blaming neither the family nor the hospital, but cultural barriers, for what goes wrong--and eventually things do go terribly wrong. By the age of four Lia is brain dead. The hospital hooks her up to feeding tubes, expecting her to die within days, but the Lees insist on taking her home, where they disconnect every tube and treat Lia as a favored family member. They take turns carrying her around on their backs; like a mama bird, Foua pre-chews her daughter's food and feeds it to her orally; they sacrifice pigs in healing ceremonies; and Lia sleeps with her parents every night. To the astonishment of the medical community, Lia does not die, and by the end of the book, years after being declared brain dead, she's still alive. As I write this, Lia Lee is still alive and lovingly cared for by her mother and siblings. Her medical condition has not changed. Her father, Nao Kao Lee, died in January of 2003.

This book enriched, and possibly changed, my life. I can't recommend it too highly.

A fascinating case study of a Hmong family's profoundly frustrating encounter with a county medical center in rural California. The book is very well written, and gave me fresh insight into what it really means for us to be a "nation of immigrants." My only frustration was with the organization of the book. As it jumped backed and forth between the micro and the macro, and between the recent and more distant past, the narrative lost some of its momentum. But that said, it is one of those rare books that has made me look at the world in a new way, and for that reason, I highly recommend it.

This was an outstanding book. You may need to be a social anthropologist at heart to really love it, but the book was so enlightening on so many different levels. The background and customs of the Hmong are fascinating, and their clash with western culture is eye opening. I learned so much, not just about the Hmong, but about my own beliefs.

If anyone's been patient enough to read all hundred-plus reviews up to this point, they already know what this book is about, how well-written it was, how well researched, and how terribly humane.

All I can add is that, though I read (well, start, at any rate) about a hundred books a year, and have been doing so for about three decades now, this is the single best book I've ever read.

During my senior year of college, I took a "Holistic Living" course and this was one of the books we were required to read. As I've mentioned in other reviews, I don't normally gravitate towards non-fiction, however, there are instances when I read a piece of non-fiction and find myself as captivated by the story as if it were a novel. "The Spirit Catches You and You Fall Down" was one of these books.

In her book, Ms. Fadiman presents the story of a Hmong-American family who is forced to step outside their comfort zone to seek medical treatment for their infant daughter, Lia, an epileptic. Not only do Lia's parents have to overcome a language barrier, but they also hold views which differ greatly from those held by the Western-trained medical doctors treating Lia. What results, is an enormous culture clash between Lia's parents and her treating physicians. Sadly, the consequences of the mis-communication and cultural mis-understanding which take place between the Lees and Lia's doctors has a tragic and permanent effect on Lia's life.

Alongside the Lee's story, Ms. Fadiman presents an informative history of the Hmong people, while also addressing a number of important ethical considerations germane to the medical treatment of non-western patients.

I highly recommend this book to anyone in the medical profession or to anyone interested in learning about traditional Hmong culture.

This was a required reading for my college class. It was a good read, story base; yet, it was also a frustrating read. Trying to get past the authors too many details - took you on sides roads from the real story. It is a sad story.

This book is an extremely well-written and interesting story. I read this book for my bookclub and it made for great discussion about culture, ethics, and healthcare. I highly recommend this book to all healthcare professionals and bookclubs.

I enjoyed this book so much! I really appreciated the author's ability to view both sides objectively. Her story telling ability left me breathless for the three days that it took me to finish. I'll recommend this book to everyone that I know.

This author does an incredible job showing all sides of the story. I think it is amazing how she made me feel and hurt for everyone involved in this case. I wish everyone could/would read this book.

I don't think you can read it without looking at life, medical care, and cultural differences just a little differently afterwards.

a very interesting review of culture clashes, as well as an eye opener to the public of how difficult it is for medical professionals in the US to take care of a multitude of culturally diverse persons, while sticking to the standards of care established by biomedicine. I am glad that this was a required text for one of my classes, or I would have never even heard of this book; it has even helped me in my own practice to be more open minded and culturally sensitive (not completely, mind you, but just enough to appreciate why i get frustrated as well as why some of the families I care for get frustrated too.)

Fadiman writes that in 1982 the Lees rushed their then three month old convulsing daughter, Lia, to the Merced Community Medical Center. The Lees' diagnosis was quag dab peg, or " `the spirit catches you and you fall down' ". According to the Lees, their baby had fallen over (quag) and a soul stealing spirit (dab) had hit (peg) her. Because the Lees could not speak English, nor could the medical staff speak Hmong, the Lees' diagnoses was left unsaid, and Lia's symptoms, which had abated in the three block run to the hospital, were not shared. Five months later, one of Lia's convulsive episodes was finally witnessed by a physician at the Merced emergency room. The doctor on duty diagnosed Lia with. . .I don't want to ruin it for you. Fadiman chronicles a tragic circumstance where twentieth century science intersects hazardously with Hmong animistic religious beliefs and practices. The result, sadly, is a disastrous quagmire of cross-cultural misunderstandings and failure. You find yourself feeling sorry for all parties involved and frustrated with the parties involved. You will not be able to put the book down.

my AAUW book group met this morning and it was revealed that this book is being used as a text by very many colleges in their classes to try to help students understand the sometimes impossible task of really communicating with other cultures. it's an indeapth study of the Hmong people from China/Laos and how the medical care of a sick child went awry due to communication and missunderstanding difficulties on both the part of the American doctors and the parents of the child.

While the Hmong culture's values of stubborn solidarity, family unity, & a new desire to become educated should help them thrive in America, this book should not be a chapter in their cultural history that they are proud of.

Chosen ignorance, even if due to a defeatist attitude from generations of abuse, is a pretty poor way to show love for your child. The mom never even learned numbers so she could dial a phone for help. & animistic superstitions make for some entertaining stories, but people from an American upbringing that really believe them aren't playing with a full deck of cards.

Overall a wayyyyy long drawn out, super boring, overy detailed, tedious story. Could easily have been told in 5 fairly interesting chapters & still kept in the sob stories about how the Hmong suffered, don't really want to be here, & it's not their fault.

Wonderful book, really shows the diversity in cultures and interputation of medical practices and errors of judgement.

This book is a gripping perspective on Hmong Culture, Medicine and different cultures, and life. My Anthropology Professor used this as a supplement in our course on Ethnicity, Gender, and Class. The author made great strides in presenting the perspectives of all participants in her studies. There are lot of people in the world that believe their culture is superior to another, we really need to break down this communication barrier. I think this book delves into how we understand reality and the processes we take to live within it. Read this, I truly think you will experience a paradigm shift in your outlook on the world and its diversity.

Very interesting and intriging. A testament to the US health system and the problems that can and will occur

This was an incredibly insightful look at a culture whose reaction to immigration has been radically different from what we might imagine based on experience with other imigrant cultures. She provides a very balanced understanding of the viewpoints of both patient and medical establishment. It will forever change the way I interact with my Hmong patients.

I read "The Spirit Catches You, and You Fall Down" as a required reading for a Sociology course on Health and Ilnness in Society. This is simply put, an amazing piece of work, that not only is thorough, but has a great deal of emotion and you really are able to sense the pain, frustration, and joy, of both the Lee family and the medical community that cared for her. This work is also a testiment to the Hmong people and culture, who are often grealty overlooked in US Asian American culture. Anne Fadiman goes into great detail describing their culture, from it's language, history, and religion both here and in Loas, and to their unfortunate and tragic involvement in the US war in Vietnam which landed them in refugee camps in Thailand. My opinions vacillated at times from anger to empathy for her parents and their inability and refusal to follow the doctors advise, that could've saved their daughters life. I encourage this book to be read by anyone going into the medical field where you will encounter a myriad of ethnicities, that often fly in the face of conventional US medicine. This is nonfiction that reads with the excitement and personality of a well crafted novel.

exceptional book for those involved in anything dealing with human relationships. gives unbiased information from all sides of the issue (language & cultural barriers resulting in medical "errors")
this book smacks you in the face with your own preconceptions about what families know about their child, and what professionals know about their field, and how sometimes those two don't mesh, resulting in the child being put in the middle.
oh yeah, and every once in a while you will want to yell out about "the guy hiding behind the rock." because hindsight is so clear!

I was assigned this book as a supplement to a Cross Cultural Communication class. It's a very interesting read about a young girl who gets caught between Eastern and Western medicine. It makes a good read to see how CCC can be so important in our daily lives. It has a good lot of medical jargon and even more characters. There are a lot of doctors that are important for various reasons. It is certainly not a light beach read. Once you read it though you'll want someone else to read it to have someone to talk about. You can get in long discussions over who is "right" and if there is a right.

Detailed, researched look at the Hmong people of Vietnam in America through the experiences of one family in the medical/hospital system as they try to help their epileptic child. Although the action takes place in California, the story would probably have been similar no matter where the family lived. Non judgemental author keeps reader engaged. Structure of the book with alternating chapters detailing the history of the Hmong and then the specific family works well. Cross cultural misunderstandings seem inevitable given language and cultural differences. Sad without being depressing.

An excellent book. A powerful and moving true story of a cultural east/west clash, especially concerning medical care. I couldn't put the book down. Enlightening also when it comes to the drugs used in treating status epilecticus, specifically in children under three. I also appreciated learning about some of the political history regarding the beautiful people of Laos. My heart goes out to the Hmong people.

This book is worthwhile to read to learn more about the Hmong people. It gives a good background on these people without glossing over some of the bad stuff.
It would be good for the medical anthropology student.

Anne Fadiman tells the story of little Lia Lee, a Hmong-American child with epilepsy, and weaves together the woof of parental love and biomedical treatment with the warp of Hmong and American cultures. This book brings into focus how extensively cross-cultural transitions impact both the approaching and approached peoples. In an interview in 2001, Fadiman explains what drew her so deeply into this book, "Yes, it is about an epileptic Hmong toddler, but it is also about many other things. . . I started pulling on a slender thread, the thread that was Lia Lee, the small sick child . . . I pulled on the thread and the thread became a string and the string became a rope, and then I tugged really hard on the rope and I discovered that it was attached to the entire universe."

Fadiman alternates chapters about Lia with chapters on the history and culture of the Hmong people. Interwoven in Lia's story is the story of her people. The parallel can be drawn that the spirit catches the Hmong people with wars and threats of assimilation, and in response the Hmong eschew resistance and migrate. Most of Merced's Hmong population came to the U.S.

Lia's parents wanted "a little medicine and a little txib" (p. 110.) While medical care at MCMC was provided at no charge, Lia's family spent large sums on buying amulets, having a tvix neeb perform ceremonies, and sacrificing chickens, pigs, and even a cow. Foua would grow herbs and make special concoctions both for feeding to Lia as well as bathing her. The author was privileged to be present when the family sacrificed a pig in their living room in order to seek her wandering soul and bring it back to Lia.

From the doctors' perspective Neil Ernst said, "I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids' lives" (p. 59.)

The Spirit Catches You and You Fall Down was both thought-provoking and emotionally rewarding. It is recommend for those who enjoy a well-told story, as well as those working in public health fields, interested in cross-cultural transitions, or who have special interest in the Hmong people.

Anne Fadiman discussed Lia Lee with medical anthropologist Arthur Kleinman. His observations brings out the crucial point (p. 260), "You need to understand that as powerful an influence as the culture of the Hmong patient and her family is on this case, the culture of biomedicine is equally powerful. If you can't see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else's culture?"

Where is Lia Lee now? In a Newsweek article in 2005, then 22 year old Lia was still in a persistent vegetative state, still cared for at home by her careful and loving mother.

This book was required summer reading for my college. I'd never heard of the Hmong people before reading it, and the story was definitely eye-opening. It's informative, but not too engrossing, so be prepared!Oh, also don't expect a happy ending to this one. However, the book is thought-provoking, which I think was its purpose. Mission accomplished.

I'm just your run of the mill American and I never thought about how our pretty Western medicine isn't what everybody on the planet absolutely strives to attain. This was an eye opening read that I reccomend to anyone who believes that what we have here is the end all be all when others think otherwise.

Ann Fadiman is an incredible writer and this book is superb, not only for people in the medical profession, but any lay person interested in the culture of, and barriers facing, immigrants in the U.S.

This is a great story, and my experience with this seller was good as well.
I was a expecting a boring read since it was recommended for my graduate class, but I was pleasantly surprised.

The story of the little Hmong girl caught between two clashing cultures to her great detriment made me weep with sadness and frustration at our American medical system. The book was in a strong, clear, matter-of-fact style which made the tale even more horrifying. I highly recommend this book to anyone with an interest in medicine or an interest in learning about new cultural belief systems. Merced, California is also a character in this book. A great read.

At three months of age while living in Merced, California (where 20% of the residents were Hmong, 80% of those received Medi-Cal benefits, and most felt they were entitled due to their military involvement in Laos on the side of the U.S.), favored daughter Lia Lee (born July 19, 1982), the fourteenth child of Hmong refugee couple Nao Kao and Foua suffers her first epileptic seizure. The cause of her neurological condition, explained by the Hmong by the phrase used as the book's title, is attributed to "soul loss," resulting from a sister slamming a door preceding the episode. Due to a lack of communication between the physician and Lee family, who do not speak English, and the fact that Lia was no longer seizing when they sought treatment, she is diagnosed and treated for a bronchial infection. Not until March of 1983 during a third visit to the same reputable county hospital (MCMC) with Lia experiencing a grand mal seizure, is the correct diagnosis, of which the Lees are already well aware, made. Later, married pediatrician MCMC employees Drs. Neil Ernst and Peggy Philp, who provide much of Lia's care during subsequent visits, alternately treat her; determined to fine-tune her meds and compel the parents to administer them correctly. Of the pair, author Fadiman, writes: "Neil never visited their [Nao and Foua's] home...and Peggy visited only once;" "[They] were...six two and five nine...and had...perfect posture;" "[They] had no idea what the Lees were doing to heal Lia because they never thought to ask;" "[They]...never volunteered their first names [to the Lee family]." The author's opinion of the unarguably competent pair is as biased to the negative as her unfailingly faultless feelings towards the Lee's social worker are biased to the positive. Events leading up to an almost year long transfer of Lia to foster care (the goal being- achieving parental compliance with the proper dispensing of medicine), life with the foster family, a catastrophic bout of sepsis and the aftermath-notably including the almost miraculous, almost beyond reproach treatment and care provided, and transformation and healing achieved by the Lees are are detailed. Additionally, facts about the Hmong: history, culture, and religious beliefs and practices are included. Although Fadiman readily admits that Lia would probably not have survived beyond infancy without the intervention of western medicine (to the tune of $250,000 plus hospital-employee salaries in free medical care), she lays the blame for the girl's ultimate condition squarely on the shoulders of the treating doctors. A compelling though biased story of a clash of cultures in beliefs about the causes and treatment of diseases.

This is a well written book on a very interesting topic about the difficulties that immigrants face who are brought from basically "stone-age" to the modern American society. The story is centered about a Hmong child with what looks like one of the "catastrophic epilepsy of childhood" and definitely not the kind of benign Rolandic epilepsy that children outgrow without long term sequelae by the time of puberty.

It made me think about cross-cultural differences and ways to solve this problems, however several questions kept popping up when reading this:

1. if Lia's family distrust Western medicine so much, why on earth keep they bringing her back to the hospital's ER over and over again? the author never addresses this question.

2. what would have been the outcome of Lia's epilepsy had they stayed in Laos without any medical treatment? she most likely would have died shortly after the disease's onset in prolonged status epilepticus or her cognitive abilities would have slowly but steadily regressed over the years due to the seriousness of her illness leaving her in a permanent vegetative state.
The author never mentions this either.

and in the last chapter of the book the author really loses it when comparing the "American and the Hmong way" culmulating in the following passage: "Once several years ago, when I romanticized the Hmong more (though admired them less) than I do now, I had a conversation with a Minnesota epidemiologist at a health care conference. Knowing she had worked with the Hmong, I started to lament the insensitivity of Western medicine. The epidemiologist looked at me sharply. "Western medicine saves lives", she said. Oh. Right. I had to keep reminding myself of that."

This is a well written book on a very interesting topic about the difficulties that immigrants face who are brought from basically "stone-age" to the modern American society. The story is centered about a Hmong child with what looks like one of the "catastrophic epilepsy of childhood" and definitely not the kind of benign Rolandic epilepsy that children outgrow without long term sequelae by the time of puberty.

It made me think about cross-cultural differences and ways to solve this problems, however several questions kept popping up when reading this:

1. if Lia's family distrust Western medicine so much, why on earth keep they bringing her back to the hospital's ER over and over again? the author never addresses this question.

2. what would have been the outcome of Lia's epilepsy had they stayed in Laos without any medical treatment? she most likely would have died shortly after the disease's onset in prolonged status epilepticus or her cognitive abilities would have slowly but steadily regressed over the years due to the seriousness of her illness leaving her in a permanent vegetative state.
The author never mentions this either.

and in the last chapter of the book the author really loses it when comparing the "American and the Hmong way" culmulating in the following passage: "Once several years ago, when I romanticized the Hmong more (though admired them less) than I do now, I had a conversation with a Minnesota epidemiologist at a health care conference. Knowing she had worked with the Hmong, I started to lament the insensitivity of Western medicine. The epidemiologist looked at me sharply. "Western medicine saves lives", she said. Oh. Right. I had to keep reminding myself of that."

Have a book discussion group that likes to read non-fiction? This is a biography of a Hmong child (a culture whose origins are in China/Vietnam) with a rare and profound seizure disorder, her parents, and her doctors. The story, told from multiple perspectives, brings out issues of immigration (The Hmong aren't "assimilating" well? Why not? Should they?), medical ethics (Who decides what care this child should have?) and spirituality (What should the doctors make of the spiritual beliefs of the family? What should the parents make of the medical claims made by the doctors?) This is a hard book, with no clear answers. If you are sitting down with it, you are accepting a challenge. Like any challenge, it has its rewards, but be prepared to be a little unsettled after reading it.

I, as an American healthcare professional, thoroughly enjoyed reading ths book. It was dramatic, engaging, and educational--but mostly infuriating. This one quote sums up my experience:

"...I had a conversation with a Minnesota epidemiologist at a health care conference. Knowing she had worked with the Hmong, I started to lament the insensitivity of Western medicine. The epidemiologist looked at me sharply. 'Western medicine saves lives,' she said. Oh. Right. I had to keep reminding myself of that."

Obviously, Ms. Fadiman knows nothing of pharmacology or physiology or she would have more respectfully detailed the effors of the American doctors to treat the focus of this story, a poor Hmong girl-baby with a terrible seizure disorder. Instead, she writes 300 pages that attempt to justify the incompetence and stupidity of the girl's parents, who disregard science and instead believe that a "lost spirit" has caused the girl's disease. Frankly, no "culture" is important enough to justify killing or permanently disabling one's own child. Read this for an informative insight into how terribly 2 cultures can clash. But expect for yourself to be voting like a red state on issues like immigration and welfare afterwards.

I, as an American healthcare professional, thoroughly enjoyed reading ths book. It was dramatic, engaging, and educational--but mostly infuriating. This one quote sums up my experience:
"...I had a conversation with a Minnesota epidemiologist at a health care conference. Knowing she had worked with the Hmong, I started to lament the insensitivity of Western medicine. The epidemiologist looked at me sharply. 'Western medicine saves lives,' she said. Oh. Right. I had to keep reminding myself of that."
Obviously, Ms. Fadiman knows nothing of pharmacology or physiology or she would have more respectfully detailed the effors of the American doctors to treat the focus of this story, a poor Hmong girl-baby with a terrible seizure disorder. Instead, she writes 300 pages that attempt to justify the incompetence and stupidity of the girl's parents, who disregard science and instead believe that a "lost spirit" has caused the girl's disease. Frankly, no "culture" is important enough to justify killing one's own child. Read this for an informative insight into how terribly 2 cultures can clash. But expect for yourself to be voting like a red state afterwards.

Going for my MSW at Rutgers., we have been assigned this book to read and do a group presentation upon. It is heartbreaking, yet at the same time, extremely revealing how the conflict of cultures can hinder medical treatment in the U.S.A. Particularly, the arrogance of Western educated medicine comes into play on how the
this family is treated by many, except a handful, who come into their path while treating
the daughter with severe epilepsy. Also, the U.S. involvement in the Hmong massacre during the Vietnam war is eye-opening, and makes you wonder, again, what is
Iraq really all about (as if I don't know)., NOT ABOUT SPREADING
"democracy" OR prosperity....A MUST READ....

This book was purchased for my Cross-Cultural Psychology class and is just amazing! It has brought tears to my eyes. The storyline is about a family from Laos who comes the US as refugees, and as their daughter becomes ill, you see how culture really affects the decisions made about life and death. A wonderful read.

Highly Recommended for anyone who wants to expand their knowledge on cultural awareness.

Anne Fadiman is eloquent, engaging, knowledgeable, compassionate, and extremely meticulous. The research that must have gone into this work is staggering. Although no one should pick this book up expecting a novel, the strength of Fadiman's storytelling draws her reader in from the very first page, and she proves that truth is sometimes more startling than fiction.

Anne Fadiman did an unbelievable job of remaining non-judgemental in this tragic account of a Hmong family facing culture clash in California while trying to manage the epilepsy of a beloved daughter.

The interesting story of the Hmong people and their journey bringing them to the US helped shape my understanding of their difficulty assimilating here. The author clearly (and in an entertaining fashion) illustrates that the Hmong language, culture (and cultural "laws"), diet, religion and medical practices are all enmeshed. As a reader, I really felt for this family, who wanted so desperately to help their child in such a foreign culture.

The author's non-biased account evoked great empathy from me for all involved - the child, her parents (and family and community), the doctors, social workers and other caregivers. I really felt that I came away from reading this novel with a greater understanding for those from other cultures who have difficulty adapting to a new one.

The book really reads like a novel, and I found myself looking for the "bad guy"...but the unbiased account ultimately never provides one. I really feel that anyone in the health care industry would be well-served to read this book. The author presents a solution to situations like these involving the need of a "cultural broker", which is far more than a simple interpreter.

In this melting pot we live in, this is a very worthwhile read for anyone, but a must for healthcare professionals.

Many of the reviews here praise the book for its balance in presenting two sides of a serious cultural clash- one that leaves a little girl brain dead by the end. Ostensibly, neither side is right nor wrong, and well, the fact that this girl ends up as a vegetable is just how it goes in this awkward dance between the Hmong family and the American doctors treating her.

Phooey. A little girl gets treated by competent, caring doctors, who do their damnedest to insure that this girl gets the care she deserves, and her superstitious family stymies their every attempt at healing. They throw vital anti-seizure medicine away, ignore it on the shelf, double dose when they do remember, and otherwise cling to their animistic beliefs in trying to cure her. There is no doubt that the family loves this girl, but it breaks my heart to see such utter negligence in caring for a child. I don't care that they have these charming native ceremonies or are a proud, downtrodden race. Presented with the best medicine the world can offer, they prefer to sacrifice chickens instead- and wonder why their girl falls apart at the seams.

If anything, this book is a stark, yet unconscious, advertisement for missionaries to go and "tame the savages". On every page I wanted to slap the parents silly, and have their custody terminated by the state.

I generally feel uncomfortable at making jingoistic statements about how we in the west know what's best for the world, but my god, what more obvious illustration can there be than this book?