The Spirit Catches You and You Fall Down centers on a young Hmong girl, named Lia Lee, and her medical treatment. The treatment her doctors deem necessary to save her life violates certain Hmong beliefs concerning Lia’s spirit (similar to a soul) and the afterlife. The story chronicles the clash between American medical culture and Hmong culture, and the implications this has on Lia’s life (both earthly and otherwordly).
In the opening chapters, Fadiman gives the reader some insight into Foua Yang’s (Lia’s mother) upbringing in Laos. Foua, as per Hmong custom, births almost all of her fourteen children by herself. Lia, in contrast is born in the United States, in a hospital in Merced, California. Her family moves to the U.S. to flee conflict in their homeland. Traditionally, a child’s placenta is saved after their birth and buried either under the parents’ bed or under the family home. It is believed that the placenta is a kind of “jacket” for the soul. After death, the soul travels to all the places the person lived in during their life, and eventually settles back into its placental jacket. Once it has done this, the soul can reach “heaven”, where it reunites with ancestors and may later be reborn as the soul of a new baby. If the soul does not find its placental jacket, it is doomed to wandering alone for eternity. According to Hmong belief, illness can be caused by eating the wrong foods, doing wrong, or the interference of evil spirits, among other things. For Lia and her family, then, her medical care not only has implications for her earthly life, but also her eternal life. As the story progresses, this idea will certainly be the focal point of the clash between American medical culture and Hmong culture.
Fadiman posits that the best vantage point from which to examine an issue is not in the center of things, but at the edges, where the opposing sides meet. As she puts it, it is here that there are “interesting frictions and incongruities” where you can “see both sides better than if you were in the middle of either one” (vii). In other words, the ideal position is to be an involved third party observer: a part of the conflict, but not so involved as to be directly in the middle.
In this novel, the two opposing cultures are American medicine and the Hmong culture. Fadiman comes into the situation not knowing much about either culture, which gives her a unique point of view. She is directly involved in the clash between these two cultures, but she does not identify with either side at the outset. Her vantage point is important to consider in examining her depiction of events, because it influences the account the reader is given. Although I have only read the first couple of chapters so far, I agree that this is the ideal vantage point. The reader is given a relatively objective account, but due to her direct involvement in the events, she understands the situation and the motivations of everyone involved in a way that a third-party (completely removed from the situation) could not.
While my own particularity as a Christian will influence my discussion of this novel, (Thank you, Kant, for pointing this out to me. Sic ‘em World Cultures III.) I think discussing this from a Christian perspective is exactly the kind of “involved third-party” vantage point Fadiman believes is ideal. Christians are called to be in the world, but not of it. In other words, to live in the world and be directly involved in it (ie to not seclude oneself from the world), but to not let worldly values influence and distort your Christian values. As a Christian pre-health student, I am not yet directly involved in the American medical culture, and I have not come into direct contact with anyone from the Hmong culture. I hope coming from this perspective (and analyzing the issue from this perspective) will help me remain an “involved-but-objective” third party.
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