Stacy Rivera

ANTH 443: Medical Anthropology

02/15/2021

Report #1: Traditional Hmong Ideas of Health and Life

In Anne Fadiman’s book, The Spirit Catches You And You Fall Down, we see the

juxtaposition of Hmong ideals and values regarding healing and Western ideals and approaches

to healing. We are introduced to the Lee family and their infant daughter Lia who suffers from

epilepsy and we follow them on their journey with the medical team at Merced Community

Medical Center (MCMC) as they work to manage Lia’s condition. We can immediately see that

Hmong ideas of health and life are largely spiritual and extend beyond the scope of medicine and

medical care that Western ideals value regarding health. Fadiman describes the many customs

and practices Hmong women carry out to prevent potential harm to their babies such as soul loss,

bloodsucking by dabs, and eternal wandering after death. Among these practices Fadiman

explains the importance of a hu plig, or soul calling, to prevent soul loss which infants are

particularly vulnerable to. Fadiman states, “The life-souls of newborn babies are especially prone

to disappearance, since they are so small, so vulnerable, and so precariously poised between the

realm of the unseen, from which they have just traveled, and the realm of the living” (Fadiman,

p. 10). In order to prevent soul loss Hmong families throw a soul calling party to guide the

baby’s soul home. The newborn phase in Western culture certainly does not include these

potential dangers and we’re more likely to fear a child passing from Sudden Infant Death

Syndrome (SIDS). However, it is important to note that the Hmong culture believes that illness is

caused by a variety of reasons aside from physical or physiological factors alone. With respect to

Lia Lee’s case, her parents strongly believed that when her sister slammed their front door the
loud noise frightened Lia’s soul which was subsequently lost to a soul-stealing dab. As we

learned in lecture, although spirit intrusion is not necessarily malicious it can also lead to similar

symptoms that manifest as epilepsy such as a lizard trapped in the body and attempting to shake

itself out. The Hmong have their own beliefs regarding epilepsy and while they acknowledge the

seriousness of the condition they also have feelings of pride due to the significance of the

condition. The Hmong culture highly values shamans as healers and they respect the connection

they have to the spiritual world. Since it is not uncommon for Hmong epileptics to become

shamans the news of Lia’s epilepsy leaves her parents feeling conflicted about her diagnosis.

Fadiman explains, “Their seizures are thought to be evidence that they have the power to

perceive things that other people cannot see, as well as facilitating their entry into trances, a

prerequisite for their journeys into the realm of the unseen” (Fadiman, p. 21). There is a stark

contrast between the Hmong ideas regarding epilepsy and the Western ideas regarding epilepsy.

In Western culture we firmly believe that there is nothing divine about epilepsy and while there

is no known cure for the condition we should exhaust all measures possible to prevent any future

seizures. However, as readers we must set aside our ethnocentrism and accept that our culture

and beliefs are not superior to the Hmong culture and their beliefs regarding Lia’s condition. On

the contrary, Fadiman presents an explanation of the Hmong fascination with epilepsy which is

entirely rational in their culture: “many Hmong shamans, experienced powerful senses of

grandeur and spiritual passion during their seizures, and powerful creative urges in their wake”

(Fadiman, p. 29). The Hmong believe shamanism is not a choice but rather a divine calling and

an epileptic shaman receives creativity and clarity from their seizures so why would one want to

interfere with that sacred gift? With that being said, Lia’s parents were still very attentive and

brought her to the hospital every time she was seizing as their intentions were never for their
daughter to suffer. Nonetheless, as readers we struggle to understand how their actions could

have possibly been in Lia’s best interest as they regularly made it harder to treat her condition.

For example, in Hmong culture a chubby child is viewed positively as it means the child is well

fed and therefore healthy and loved. However, the fact that Lia was overweight was a barrier in

her medical care as it made it difficult to treat her intravenously as her veins were covered by fat.

Lia’s doctors didn’t believe her parents were doing her any good by keeping her overweight but

culturally this was a sign of love and it was a blessing to be able to keep her well nourished and

healthy in their eyes. We continue to see the collision between the two cultures as the Lees try to

comply with their daughter’s medical regimen but fear they are actually doing her harm rather

than helping her. Fadiman shares the nurse’s notes which state, “Reluctant to give meds but has

been giving Phenobarb & Tegretol but refuses to give Dilantin. States it changes the child’s

‘spirit’ & makes face look different” (Fadiman, p. 49). The Lees didn’t want to contribute to

Lia’s soul loss and they felt the medications were changing her spirit. In addition, Lia’s parents

suspected that the medications prescribed to her were actually the cause of her continued seizures

and fevers and they felt it was unnatural for one to remain on medication for the rest of their

lives. The idea that lifelong medication is unhealthy or unnatural can be attributed to the fact that

the Hmong usually only ever use short courses of antibiotics. Lia’s medical team grows

increasingly frustrated with her progress or lack thereof especially when they begin to notice

developmental delays which they believe were preventable had the Lees followed Lia's medical

plan. Despite this, the doctors acknowledged that her parents truly cared about her and that in

their own way they were doing the best they could. In short, the Hmong culture doesn’t

necessarily believe modern medicine is the greatest gift and while we might consider this to be

ignorant the Hmong might likewise consider our blind faith in medicine to be arrogant.