The Spirit Catches You and You Fall Down


Anne Fadiman

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The Spirit Catches You and You Fall Down: Chapter 4 Summary & Analysis

Fadiman further explores Hmong distrust of Western medicine by describing one woman’s experience returning to Ban Vinai, a refugee camp in Thailand that she used to live in before relocating to Minnesota. Apparently, her fellow Hmong—all of whom had yet to come to the United States—were eager to ask her questions regarding rumors they’d heard; they asked if it’s forbidden to use shamans in the United States, why doctors extract so much blood from patients, why doctors dissect bodies after death, and if doctors eat the organs of Hmong patients.
These questions underlined the anxiety surrounding the differences in the two cultures’ medical practices, of which there were clearly many. By including these anxieties, Fadiman provides a glimpse at how the Hmong view American hospitals—it is, of course, easy to write these questions off as absurd, but it’s important to consider the fact that the people who asked them harbored wildly different conceptions of how health operates. With no basis of understanding Western medicine, it’s no surprise that rumors proliferated as a way of reflecting fears of the unknown.
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To make matters worse, Fadiman writes, the Hmong believe that many Western medical practices run the risk of harming patients. For example, the Hmong maintain that each person contains a finite amount of blood, so any blood extraction is viewed as dangerous. Furthermore, they believe that the soul is vulnerable when somebody is unconscious, meaning that to undergo anesthesia is to invite dabs—evil spirits—to draw near and steal the soul. Based on these practices, which appear so egregiously dangerous to the Hmong, rumors spread wildly throughout the Hmong community about how American doctors treat patients. As such, hospitals were not considered restorative, healing places. Nonetheless, the Lees were willing to take Lia to MCMC because of their own conviction that Western medicine could, in certain very straightforward ways, treat basic maladies.
In this passage Fadiman further legitimizes Hmong fears about Western medicine by explaining the roots of their misgivings. Just as she uses history to illustrate the nature of the contemporary Hmong ethnic identity, she examines the culture’s most fundamental beliefs to show that their fears aren’t as irrational as they might otherwise seem. This is a perfect example of the kind of cultural curiosity and attentiveness that can enable somebody to relate with people who come from drastically different backgrounds.
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