The Spirit Catches You And You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

TLDR: The Spirit Catches You and You Fall Down is a profound and lovely book that should be read on several levels, and be read as a metaphor for the care of all patients, for the lessons of Lia's story apply, in many ways, to every patient.

Abstract: The Spirit Catches You and You Fall Down is a profound and lovely book that should be read on several levels. It is, of course, the story of the illness of one Hmong patient who has been inserted into the American medical culture. Illness aside, it is the story also of the cultural clash and the consequences of that clash for her care and the care of her family. Interspersed with these stories are chapters of Hmong history, ancient and contemporary, particularly of the Hmong during the last few decades. Beyond all of these dimensions, read the book as a metaphor for the care of all patients, for the lessons of Lia’s story apply, in many ways, to every patient. Broadly speaking, The Spirit Catches You And You Fall Down tells a great deal about what it’s like to be a patient and what it’s like to be a physician, the physicianpatient relationship, language and communication, uncertainty, personal and professional values, and what can go wrong in the medical transaction. As you read the book, think about a series of five steps which characterize each medical encounter as an opportunity to learn and to add to one’s experience:  the story—what really happened and how the patient experienced it;  the medical history, the abbreviated, edited and reshaped version of the story, what physicians use to deliberate, reason and communicate;  the issues, critical diagnostic and treatment questions raised by the story and the history;  the doctor-patient relationship, which becomes the vehicle for care; and  the question, “What did I learn?” the most important step in the physician’s professional growth. The questions raised in this Guide should help you to focus your reading.