The Spirit Catches You And You Fall Down frequently evokes Hmong history to illuminate the circumstances of Lia Lee’s medical crisis. Writing both a literary profile and an in-depth ethnography, Fadiman devotes whole chapters to the history and context of the Hmong ethnic identity, which she characterizes as “independent, insular, antiauthoritarian, suspicious, stubborn, proud, choleric, energetic, vehement, loquacious, humorous, hospitable, generous.” This is a characterization that she draws from tracing the Hmong all the way back to 2700 B.C., when they refused to be ruled by China. Since then, she argues, they have been extraordinarily unwilling to bow down to any form of power that might compromise their traditions and ways of life. This sheds light on Nao Kao and Foua’s unwillingness to simply acquiesce to Neil and Peggy’s treatment plan, which clearly contradicted their own beliefs.
Far from saying that all Hmong are exactly the same, Fadiman highlights culturally salient historical landmarks to give readers a framework for understanding the beliefs and decisions of the Lee family and other Hmongs—beliefs that might otherwise seem inscrutable and lead to bigotry. For example, Fadiman sheds light on the origins of the Hmong tendency in America to readily accept welfare checks without seeking paying jobs. Rather than this being a symptom of laziness (as non-Hmongs frequently assume), many Hmong immigrants were members of a CIA-backed guerilla army that fought the spread of communism in Asia. Vang Pao, the Hmong leader of this army, promised his fellow Hmong all sorts of benefits in exchange for fighting—one of which, according to many Hmong living in the United States, was that they would receive welfare assistance upon reaching America after the war. As such, Hmong veterans see government benefits as a well-earned result of having risked their lives for the United States. By looking at history, then, Fadiman eschews cultural bias in favor of empathetic inquiry.
Fadiman also sheds light on culturally significant Hmong folktales and myths, many of which illuminate the attitudes and behaviors of the Lee family that that American doctors like Neil and Peggy find so difficult to understand. One significant myth is the story of the Orphan, an underdog who triumphs despite the mistreatment society shows him—obviously, this is a story that glorifies the resilience of immigrants. Another folktale tells of an “arrogant official” who is “turned into a mouse,” which evokes the arrogance of the doctors, who frequently wield their authority against the Lees. These archetypal characters shed light on the cultural context for Nao Kao and Foua’s resistance to authoritative doctors who discount their traditional beliefs; they have been raised in a culture that champions the disenfranchised and admonishes powerful bureaucrats.
Many of these myths and folktales are intertwined with the Hmong peoples’ health-related beliefs. Because their conception of health has more to do with religion than biology, the Hmong view health as being tied to the stories passed down through generations about evil or beneficent spirits. There are countless stories of dabs (evil spirits) who prey upon the human soul, and in response to these tales the Hmong have developed methods of healing that deal primarily with whatever metaphysical phenomenon these spirits are causing. This belief is crucial to understanding Nao Kao and Foua’s decisions to forego certain medically-advised treatments for Lia; since the Hmong believe that epilepsy can make a person spiritually distinguished by enabling them to negotiate with dabs, the Lee family felt that Lia’s “crisis was the treatment, not the epilepsy.” By showing readers the actual origins of Hmong beliefs, Fadiman enables Western readers to understand that the Lee family’s behavior was not blind stubbornness nor disregard for their child; they were doing what seemed best within their own cultural context.
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History and Ethnic Identity Quotes in The Spirit Catches You and You Fall Down
The Hmong have a phrase, hais cuaj txub kaum txub, which means “to speak of all kinds of things.” It is often used at the beginning of an oral narrative as a way of reminding the listeners that the world is full of things that may not seem to be connected but actually are; that no event occurs in isolation; that you can miss a lot by sticking to the point; and that the storyteller is likely to be rather long-winded.
The history of the Hmong yields several lessons that anyone who deals with them might do well to remember. Among the most obvious of these are that the Hmong do not like to take orders; that they do not like to lose; that they would rather flee, fight, or die than surrender; that they are not intimidated by being outnumbered; that they are rarely persuaded that the customs of other cultures, even those more powerful than their own, are superior; and that they are capable of getting very angry. Whether you find these traits infuriating or admirable depends largely on whether or not you are trying to make a Hmong do something he or she would prefer not to do. Those who have tried to defeat, deceive, govern, regulate, constrain, assimilate, intimidate, or patronize the Hmong have, as a rule, disliked them intensely.
The idea that the drugs prescribed to cure, or at least attempt to treat, an illness are in fact causing it is not one that most doctors ever encounter. Doctors are used to hearing patients say that drugs make them feel bad, and indeed the unpleasant side effects of many medications are one of the main reasons that patients so often stop taking them. But most patients accept the doctor’s explanation of why they got sick in the first place, and even if they resist the recommended treatment, they at least believe their doctor has prescribed it in good faith and that it is not designed to hurt them. Doctors who deal with the Hmong cannot take this attitude for granted. What’s more, if they continue to press their patients to comply with a regimen that, from the Hmong vantage, is potentially harmful, they may find themselves, to their horror, running up against that stubborn strain in the Hmong character which for thousands of years has preferred death to surrender.
Hmong patients might not understand the doctors’ diagnoses, but if they had summoned the courage to visit the clinic, they wanted to be told that something was wrong and to be given something, preferably a fast-acting antibiotic, to fix it. The doctors had a hard time meeting these expectations when the Hmong complained, as they frequently did, of vague, chronic pain.
