1. Emanuel M. Thomas May 23, 2014
The Spirit Catches You and You Fall Down
This story can be understood in several different ways. It can be seen as a tribute to
the Hmong people, an autobiography of Lia Lee’s life, or a testament of how public health
system can fail. Anne Fadiman started out the story with the strange birth of Lia. Her
parents were refugees that had fled Thailand. It was the first time that Foua Yang and Nao
Kao Lee had given birth to any of their 13 children within the Untied States and a hospital.
In chapter 1, page 10 Anne Fadiman told us how Nao had traditionally buried the placenta
of their children in the dirt floor within their house but because Foua was in a new place
(American hospital), lived in an apartment with carpet and wooden floors, they didn’t ask
for it and burry it as they would have traditionally done. Instead they went along with the
typical American practice of allowing the hospital dispose of it.
Anne took a lot of time to inform us of many of the traditions that the Hmong people
choose to observe. She informed us in the second chapter how the Hmong would take their
time and tell stories. No conversation was short, instead the Hmong people choose to tell
elaborate longer stories and included all details. On page 19 she told us how a Hmong
student gave a five-minute oral essay in French that turned into a forty-five minute essay.
Through out the book Anna went back and forth with the chapters telling us about Lia Lee’s
life and the Hmong people’s traditions.
Anne took great detail to make sure we understood the many traditions that the
Hmong had. The Hmong believe in herbs and traditional healthy healing, where as the
American doctors believe that bio-meds are the best cure. Because of a lack of
communication between the Lees and the medical staff at MCMC Lia was unable to receive

2. a lot of the proper treatment that she needed. Lia was an epileptic who started having
seizures at about three months. The Lee’s believed that in order for a person to make a
medical decision about another they must be apart of the family. Faua Yang and Nao Kao
Lee didn’t see the head doctors at MCMC, Neil Erenst and Peggy Philp, as family instead as
people who forced meds on their daughter and didn’t take the proper time out to get to
know them or understand why they didn’t believe in the techniques they were trying.
Foua Yang and Nao Kao Lee did see Jeanine Hilt as family. On page 274 of chapter
17, Foua told Anne that when Jeanine died she lost her American daughter. Jeanine had
been in the Lee’s life for several years. Jeanine was a social worker that was assigned to the
Lees after Lia had been in the court systems because MCMC had called child protective
services on them. Jeanine was the first American welcomed into the Lee’s home. Lia was
placed into foster care with the Korda’s and given her meds regularly. In chaper 7,
Government Property, Anna desired how well a home they provided for Lia during her stay
with them. On page 98, Anne recalls from reports, that Dee Korda would carry Lia on her
back and youngest child on the front of her in a backpack, breastfeed her, and at night Lia
slept in her foster parents bed, as she did at home. Lia’s seizures didn’t get better rather
they got worse as she lived with the Korda’s and took her meds regularly.
The Lee’s didn’t give her the meds because they didn’t believe that she had a
sickness instead, they believe that her illness was a gift and that she maybe a shaman in the
Hmong tribe. The Lee’s thought of Lia as their princess. They took a great deal in making
sure she was well kept, clean, and smelling good. The crazy thing is none of the medical
staff at MCMC took time to realize this until after they had taken her away from her parents
and she was in a vegetable state. The symbolic interaction theory tells us that people place

3. meanings on and categorize importance by whom the information comes from. The Lee’s
didn’t feel a close connection with Niel and Peggy, therefore they didn’t place any
importance on following their directions. The Lee’s however did follow the orders of
Jeanine, in chapter 7 page 103, when she opted to go to the Lee’s home and help them with
giving the Depakene properly, they did along with the order meds Lia needed.
When we look thru the symbolic interaction scoop we can see that the Lee’s didn’t
feel any closeness to the medical staff at MCMC. They felt that the staff looked down on
them and wanted to force their American meds onto them. The Lee’s believe that it was
Lia’s soul that need help not her body. The staff at MCMC wanted to treat her body. Many of
the Hmong went to the hospital complaining of aches that were untreatable they were
more physiological. MCMC offered the “Hmong Cocktail” as a cure for the people to get
them out of the ER as stated on page 82. The Lee’s preferred their shaman to doctors. Anne
also noted that another reason for the Lee’s disconnect was the fact the doctors were on
rotations and every visit they would encounter different physicians.
The physicians that the Lee’s encountered throughout much of the story seemed not
to care about their beliefs or what they wanted for Lia’s healthcare. It was only when she
was in a vegetable state and the physicians believe that she about to die, did they allow the
parents to do what they felt was best. The first disconnect was the language barrier. The
medical staff at MCMC didn’t have the best interrupters, nor did the interrupters
understand everything that the Lee’s were saying to them. Another thing is the Hmong
were unwilling to learn any of the American Medical ways of treatment and the American
doctors had no interest in to home cures the Lee’s were trying. Anne made it clear through
out the book that the Hmong were really only questioned or were observed at home with

4. Lia, by Jeanine. None of the medical staff seemed to care why they didn’t give her meds or
only certain ones instead they assumed that the Lee’s were stubborn and unwilling to
cooperate.
There are a lot of great things that we can draw from this story and unfortunately
there are some not so good things that we can take away as well. One thing that stands out
is the importance to understand another persons’ position or point of view. I think that
very often in life we prefer things go our way and people do as we say, instead of
questioning why do they choose to do the things the way they do and how did they come to
their decision. The doctors never understood the difference in treating Lia’s soul and the
Lee’s never understood that Lia’s body needed to be treated as well. Anne said even after
she invited the two American doctors out to dinner on page 300 that Bill felt the life is more
important and Sukey believed that the soul is more important. Because Sukey knew more
about the importance of a shaman in the Hmong culture he knew the importance of the
soul to them over the importance of their life.
The Lee’s suffered a great deal from culture shock. Their unwillingness to embrace
the new culture that is around them and incorporate a new life in with some of their
traditions left them in constant conflict with the staff at MCMC. As much as the doctors
were unwilling to learn the Hmong ways and traditions the Hmong were uninterested in
learning about medical treatment they were receiving. I think it’s very interesting that even
though the Lee’s didn’t believe in the American doctors they continued to take her back to
MCMC time and time again. Why not just call the shaman and allow things to be as they
would. Something I realize is we can’t expect to do the same things and expect a better out
come. Things change, times change, and hopefully it gets better as time go on.

5. Unfortunately we don’t know how thing would have went for Lia Lee but after
finishing this book I can say that I believe that her life was prolonged and more comfortable
because of the American doctors that cared for her. I believe some of her pain possible
came from her parents not giving her meds as instructed. Thing is we’ll never know
because she was given so much in such a short amount of time without knowing if the
drugs were working or not. If nothing more, this is a cautionary story of what could
possibly happen within the medical community when doctors don’t have a proper
understanding of their patients and what they expected to treat. The doctors were treating
Lia for being epileptic. In chapter 3 page 28 the Lee’s went seeking treatment because her
sister Yer had slammed the front door and her soul had fled her body, a condition they saw
as quag dab peg, which means “the spirit catches you and you fall down.” The failure to
convey to each other the condition they suspected and they wanted treat lead to the
misguided decisions on both sides.