I really enjoyed this book and would recommend it to just about anyone! You will learn a great deal about a fascinating culture, and you will see the challenges facing doctors who treat patients from other cultures, as well as the challenges faced by patients from other cultures being seen in the American medical system.


I think any medical student, resident, or physician that is, or plans on, working with a multi-cultural population should read this book.

“I don’t want any doctor to treat any human being like an animal”

From an angry Hmong parent: “No matter how much we don’t know about technology, about human health, physical, but we have seen a lot in experience too. I don’t want any doctor to treat any human being like an animal. Animals, they don’t understand, but human beings do, we do know how to talk. We do understand like anyone who is a human being. We are just refugees but we are human beings like any doctor too”


This quote reminded me of discussions my Biological Anthropology class has had on anthropological research in developing countries. Often, the papers are incredibly offensive because they describe the human population that they are studying as if they were animals, not humans. The researchers assume superiority, and their resulting work is biased because of it. I see a strong parallel with that sentiment to the way some doctors may have been treating Hmong refugees.



Thoughts on page 70

“Afraid that medicines designed for large Americans were too strong for them, some Hmong cut the dosage in half; others double-dosed so they would get well faster”


This is a great example of how the Hmong were disadvantaged when it came to the American medical system. As an American who has lived in the US my whole life, I know that the amount of medicine I am supposed to take is important and should be followed. I know that there are dangers of taking too much medication and I know that taking too little may not get the job done.  This also points to the distrust that doctors had with the Hmong. They had no way of knowing if a patient would take the prescribed amounts, or take any of the medication at all.

Thoughts on page 37

“In his opinion, the physicians and nurses at Ban Vinai failed to win the cooperation of the camp inhabitants because they considered the relationship one-sided, with the Westerners holding all the knowledge. As long as they persisted in this view, he believed that what the medical establishment was offering would continue to be rejected, since the Hmong would view it not as a gift but as a form of coercion.”


This discussion of why Western Medicine ‘didn’t work’ on the Hmong gets at the heart of medical anthropology. A better understanding of the Hmong, or any group with different culture, would result in better health outcomes. If a physician understood that involving discussion of tvix neeb or asking the patient what they wanted to do to treat their ailment, a Hmong person might be more inclined to buy into the treatment plan prescribed by their doctor. The final sentence is also very important. It could be crucial to the way a doctor treats a patient if they understood that their patient would be more willing to be treated if the doctor framed the treatment as more of a gift than an order. While this may be difficult to do, the knowledge of that mindset would be important.




Welcome to my Website! My name is Will Connolly and I am using this website to present a brief summary of Anne Fadiman’s book, “The Spirit Catches You and You Fall Down”. I will also provide my review of the book and some important things I learned from reading it.