LitCharts assigns a color and icon to each theme in The Spirit Catches You and You Fall Down, which you can use to track the themes throughout the work.
Cultural Values, Spirituality, and Medicine
Blame and Power
History and Ethnic Identity
Integration and Assimilation
Summary
Analysis
When Lia came home in 1986, Nao Kao and Foua held a sacrificial ceremony in which they killed a cow. Fadiman gives a survey of sacrificial events in Hmong culture, explaining that rumors spread throughout Merced that the Hmong residents were eating dogs and cats. During the Lees’ ceremony, the cow’s head was placed on the front stoop. When Fadiman asked them if they thought this might disturb non-Hmong Americans, Nao Kao said, “Americans would think it was okay because we had the receipt for the cow.”
Two cultural assumptions rise to the surface of this section: the first is that the Hmong eat dogs and cats; the second assumption is that Americans only care about money and thus would be unperturbed by the sight of a severed cow’s head on a doorstep as long as the cow had been fairly purchased. Though both of these assumptions have relatively low stakes, they both show the Hmong’s and American’s mutual tendency to over-simplify the other culture in the name of easily disregarding one another.
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Despite the ceremony they held for Lia, Foua and Nao Kao began to feel that she was in a worse condition than before she left their care, believing that the doctors gave her “too much medicine.” Neil and Peggy also noticed her decline, but attributed it to the Lees’ original failure to properly administer her medications. Desperate to restore her, the Lees redouble their neeb efforts, even flying to Minneapolis to visit a respected txiv neeb.
Yet again, a fundamental disagreement regarding the origins of Lia’s illness exists between the Lees and the doctors. Unfortunately, neither party makes any attempt to remedy this disagreement, instead throwing themselves further into their own beliefs.
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Jeanine Hilt continued to advocate for Lia, arranging for her to attend the Schelby Center for Special Education in order to give her parents some rest and to increase the child’s social skills. One day Lia fell off a swing set at the Center, hitting her head and sending her into status epilepticus. At MCMC, she required extensive and invasive care as a breathing tube was put down her throat, eventually causing a tracheal infection. Recalling the event, Nao Kao said, “The doctors made Lia stay so long in the hospital, and it just made her sicker and sicker.”
Although non-Hmong may have a hard time conceptualizing the idea that doctors made Lia “sicker and sicker,” it’s worth noting that, in this particular instance, Nao Kao was right: Lia developed an infection due to an instrument inserted into her body by doctors, meaning that she did get “sicker” as a result of the treatment they provided (though, of course, these things sometimes happen and it was certainly not Neil’s fault).
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Not long thereafter, Lia was admitted to MCMC once again, at which point Neil saw that the Depakene—which seemed to have been so effective—wasn’t working. He began to worry that someday they would be unable to set up an IV to stop her seizures, since Lia was so overweight. As this tension mounted, Neil began to dread the day that Lia would arrive in the throes of a massive seizure he’d be unable to stop. “I started to have nightmares that it was going to happen […],” he said. “It was inevitable. It was just a matter of when.”
In this moment, Neil’s worry exemplifies the sense of dread that hovers on the edge of every page of the book—a feeling that no doubt further agitated the complicated intrapersonal and cross-cultural relationships at play. With both sides so eager to cure Lia, it became harder and harder to focus on various anthropological and social considerations.
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