Nonfiction RA Matrix: The Spirit Catches You and You Fall Down: A Hmong child, her American doctors, and the collision of two cultures by Anne Fadiman

Note: I read this book about 25 years ago. It has stayed with me ever since. 

1. Where is the book on the narrative continuum?

    A mix (combines highly narrative moments with periods of fact-based prose)

2. What is the subject of the book?

    A Hmong immigrant family in California has a daughter with epilepsy. The family believes in an animist, holistic treatment for what they believe to be a spiritual problem; American doctors prescribed western medicines. These disparate approaches, both equally rigid, are a source of exasperation for all parties involved.

3. What type of book is it?

    Ethnographic science writing

4. Articulate appeal

    What is the pacing of the book?  Thoughtful and patient

    How does the story feel?  Earnest, compelling

    What is the intent of the author? To introduce readers to the Hmong culture and history and to encourage cross-cultural understanding in the medical community.

    What is the focus of the story?  The Lee family's predicament in particular, Hmong history for context, Western medicine policies and practice

    Does the language matter?  Yes, the writing both describes and provokes strong emotions as two cultures collide and emphatically disagree about what is happening and what should be done about it.

    Is the setting important and well described?  Very, starting with a description of a Hmong woman's childbirth experience (in total silence) to the American clinical setting to the Lees' apartment where the family sacrifices a pig in an attempt to return Lia's spirit to her body.

    Are there details and, if so, what? So many! Fadiman makes use of lists to convey a sense of overwhelming differentness, writes in detail about the history of the Hmong in Laos and beyond including their involvement with the CIA, Hmong spirituality, ethics, customs, and etiquette; she covers Lia's medical treatments (27 prescription changes in 4 years) and hospital practices and policies.

    Are there sufficient charts and other graphic materials? Are they useful and clear?  There might be maps; I don't recall

    Does the book stress moments of learning, understanding, or experience? Experiences are described in detail, but it's actually the lack of learning or understanding each other (the Lees and the doctors) that makes this story so compelling.

5. Why would a reader enjoy this book (rank appeal)

    1 Authenticity

    2 Ideas

    3 Plot