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Themes in The Spirit Catches You and You Fall Down that are Relevant to Neurobiology

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Biology 202
2006 Book Commentaries
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Themes in The Spirit Catches You and You Fall Down that are Relevant to Neurobiology

Jen Lam

Just northeast of Thailand and west of Vietnam lies a small country comparable in size to the state of Utah. Laos is home to several different ethnic groups including the Hmong, who are seen by the Chinese as lowly life forms but who view themselves as "free men." History has dealt the Hmong tumultuous times of coercion and oppression by numerous invading cultures, yet their tenacious nature and innate desire for freedom has persisted throughout their journey. This Hmong determination brings us to a present day story about Lia Lee, an epileptic, young Hmong girl whose family's sheer willpower to get her the "best" possible medical treatment in the United States results in titanic clash of cultures and beliefs. Anne Fadiman, author of The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and The Collision of Two Cultures, juxtapositions the Hmong culture with the American way, providing, in extensive detail, the trials, tribulations and triumphs of learning from cross-cultural differences. Specifically relating to neurobiology is the topic of epilepsy, a neurological disorder that causes seizures; a deeper analysis of the Hmong culture, as illustrated by Fadiman, reveals a society deeply rooted in the myths and stories that is no different from the society in which we live.

Born in 1981 at the Merced Community Medical Center in Merced, California, Lia Lee was only three months old when she had her first epileptic seizure. Her parents, Nao Kao and Foua Lee, quickly diagnosed her with quag dab peg, which is literally translated to "the spirit catches you and you fall down." Nao Kao and Foua quickly blamed Lia's older sister for her condition since it was her sister who has slammed the door to their apartment, disturbing the dab, or malevolent spirit, who took Lia's soul and thus gave her epilepsy. According to most people in the Western world, epilepsy can be caused by a variety of factors: head injury, genetic predisposition, even an "electrical storm" in the brain but an evil spirit stealing away one's soul? For me, it is difficult to think of epilepsy being caused by an evil spirit although it's not totally unperceivable that some people may believe that this actually happens.

While I am by no means well read on the subjects of Hmong spirituality and culture, I felt that Fadiman dedicates a sufficient portion of the book trying to describe these areas to an audience like me that are approaching this book from a Western society standpoint. Although I can never really say if her description is accurate, for she is receiving all information from the Lee's through a Hmong-American interpreter, Fadiman gets across the idea that spirituality and myths play a huge role in Hmongs' lives. For example, throughout the book, Nao Kao and Foua are constantly battling Lia's medical caretakers since Lia's parents are inconsistent with giving Lia her medication as prescribed by the doctors. The parent's outlook on their daughter's condition is simple: if an evil spirit taking away her soul causes quag dab peg, then she must be treated with neeb, or healing spirit. Too much medicine will interfere with neeb and, therefore, must be taken in small quantities and not in the full amount prescribed. This obviously presented a difficult situation for Lia's American doctors, who, according to Foua, if they had just understood more about the soul would have been able to appreciate Nao Kao and Foua's efforts to help their daughter.

In some ways, myths can be seen as the product of brain; not only does it process all stimuli perceived by the body whether conscious or not, but it also has the ability to make up stories in order to make sense of the world in which it exists. The bizarre thing behind this is that we are unaware of this story telling as performed by our "subconscious selves." For example, as with the case of vision, the picture on the back of the retina is not the same picture painted in our head. This is due to the brains clever way of filling in the blanks and using other information to derive the best-fit picture that corresponds to the information being received by the eye and other senses. So, if this occurs on an individual basis and society consists of many individuals with a similar geographical location then perhaps the idea of the bipartite brain can help explain why we have myths in our culture. The innate desire to find explanations for phenomena occurring in our world could possibly stem from our brains own mechanism of story telling.

Similarly, if our brains are making up the majority of what we perceive reality to be, then how can we establish a system of absoluteness? Is one's brain story better than another's? And, if so, how can we tell? Fadiman inadvertently addressed this question during her analysis of Hmong and American culture. In my opinion, she was successful in establishing a no right or wrong policy when it came to comparing the Hmong approach to curing quag dab peg and the American way of treating epilepsy. Without belittling the Hmong's ideals or downplaying the medical importance of epilepsy, Fadiman narrates the story as best she could without portraying the characters as a hero or villain. I didn't feel as though she offered any bias perception using words that would skew the reader's own judgment or interpretation. If anything, perhaps, I approached this book with my own predispositions even though I read it with a clean slate. The collision of the two cultures reminded me of a concept that was one of the first ideas brought to our attention in class: nothing is absolute; there is no truth, only "getting it progressively less wrong." Science as well as society is constantly evolving, adapting to new observations and information. In the grand scheme of things, if the Hmong's view of the world works for some people, then it should be respected as one. However, when two cultures collide, ideally both sides will approach the situation with equal regard for the other's ideas and beliefs. Fadiman's nonbiased writing brings about the idea that there's unity in diversity; this concept seems to be an underlying theme throughout the book.

The Hmong have a phrase, hais cuaj txub kuam txub; it means "to speak of all kinds of things." I feel as though this phrase summarizes my experiences in Neurobiology and Behavior. To the Hmong, "to speak of all kinds of things" symbolizes an interconnectedness of everything in the universe. Usually used in the beginning of an oral narrative, it reminds listeners to scratch the surface of the obvious to discover that, although things may seem totally detached and isolated from each other, they are actually connected. If the audience approaches the story with a specific goal or point in mind, they will miss out on a lot, possibly losing sight of the bigger picture. Our reality, our world mirrors the very nature of our nervous system, how one thing is somehow related to another, and specifically, in the case of this course, how neurobiology is connected to other academic disciplines such as philosophy and psychology. If there's one thing I learned in this course is that, in order to begin to understand the nervous system and the relationship among brain, body and reality, I must approach science as well as life with an open mind, welcoming the idea of being "wrong" and evolving my outlook so as it becomes "progressively less wrong."


Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus and Giroux, New York; 1997.