The Spirit Catches You and You Fall Down: Preface Summary & Analysis

Fadiman begins by calling attention to a carton of cassette tapes she keeps beneath her desk. Recorded on these tapes are the many conversations she had with American doctors and the Lee family, who came to the United States from Laos as refugees in 1980. She remarks that, even though these recordings have already been transcribed, she sometimes likes to listen to them, hearing the Lee family speak in the Hmong language and remembering their apartment and the food they served her. She recalls her first visit to Merced, California, in the spring of 1988, when she arrived in the small city after hearing there were “strange misunderstandings” taking place at the county hospital between Hmong patients and American doctors. By being there, she “hoped that the culture of American medicine […] and the culture of the Hmong […] would in some way illuminate each other […].”

Admitting that her desire to explore the intersection between medicine and Hmong spirituality was originally “all theory,” Fadiman explains how Lia Lee’s story changed her perspective. Lia’s medical case challenged the Merced hospital by presenting difficult cross-cultural misunderstandings, causing the doctors and family to clash with one another. Fadiman admits that she eventually came to grow quite fond of both the doctors and the Lees, asserting that it was nearly impossible to determine whom to blame for the strife caused by Lia’s illness and treatment complications. After spending a lot of time with the Hmong, though, she stopped “parsing the situation in such linear terms” and started thinking “a little less like an American and a little more like a Hmong.” She also explains that while working on this book she experienced many medical difficulties in her own life, as she, her husband, her father, and her daughter all suffered from various ailments that further encouraged her to ask, “What is a good doctor?” and “What is a good parent?”