1. One of the ways by which Fadiman places the doctors and the Lee family on equal footing is her choice to refer to all of them by their first names (instead of saying, for instance, “Dr. Ernst”). What are some other ways?
2. The only American who fully won the Lees’ trust was Jeanine Hilt, their social worker. Why did Jeanine succeed where so many others had failed?
3. The book contains brief but important sections on three Hmong leaders–Jonas Vangay, Blia Yao Moua, and Dang Moua–who are multilingual and gainfully employed. What did they teach Fadiman? Why did she include them?
4. In Chapter Fifteen, Foua, who has heard that one of the Ernst sons has leukemia, embraces Peggy. After all the conflict between them, why are they finally able to resolve their differences? Do you think this could have happened earlier?
5. Fadiman describes May Ying Xiong as not just an interpreter but a cultural broker. What’s the difference? What were May Ying’s contributions to the book?
6. Were you surprised by the quality of care and affection given to Lia by her foster parents? How did Lia’s foster parents feel about Foua and Nao Kao? Was foster care ultimately to Lia’s benefit or detriment?
7. Neil Ernst says, “I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids’ lives.” Why didn’t this message get through to the Lees? If you were Neil, would you feel this way too? Is this an ethnocentric attitude? Why or why not?
8. How do you feel about the Lees’ reluctance to give Lia her medicine as prescribed? Can you understand their motivation? Do you sympathize with it?
9. The Spirit Catches You and You Fall Down revolves around a small child who for much of the book is too young to speak for herself, and at the end is unable to. Do you nonetheless feel you know Lia Lee? Do you believe that even though she cannot walk or talk, she is a person of value–and if so, why?
10. In Chapter Eight, after describing Foua’s competence as a mother and farmer in Laos, Fadiman quotes her as saying, “I miss having something that really belongs to me.” What has Foua lost? Is there anything that still “really belongs” to her? Are there other groups we have discussed that have experience similar loss?
11. In her preface, the author says that while she was working on this book, she often asked herself two questions: “What is a good doctor?” “What is a good parent?” How do you think she might have answered her own questions? How would you answer them? How is each identity constructed by each group. Which social construction is taken more seriously in the United States? Why?
12. What relevance does this book have to your potential career (i.e., medicine, health, law, social work, politics, religion, communications, education, linguistics)? In the context of your future career, how do you think you would handle similar situations, if faced with them?
13. What was the “role loss” many adult Hmong faced when they came to the United States? What is the underlying root cause? How does this loss affect their adjustment to America?
14. Fadiman writes, “During the last decade, shocked Americans have responded to the ritual killings performed by devotees of other religions by invoking legal sanctions.” (p. 107) What do you think of the Hmong’s religious beliefs and practices, as presented in the book? Should the Hmong be expected to assimilate to the culture of the United States?
15. How are the Hmong refugees similar or different from other immigrants to the United States?
16. The Hmong were blamed, at least partially, for Merced’s “economic catastrophe.” (p. 232) How did they strain Merced’s economy? What could the United States have done to alleviate some of this stress? Is there anything the Hmong could have done? Do you think the economic pressure the locals felt affected how they treated the Hmong?
17. Fadiman writes, “I had been trying all day to decide whether I thought the Hmong were ethical or unethical and now I saw it: they were-in this case, it was a supremely accurate phrase, differently ethical.” (p. 242) Do you agree with Ms. Fadiman? Why or why not?
18. What does this book say about multiculturalism in the United States? Is there such a thing as “too much” cultural difference? What are the rights and responsibilities of the majority and minority cultures?
19. How do you think the issues raised by this book should affect your education at Purdue and/or your life as a citizen today?
20. When polled, Hmong refugees in America stated that “difficulty with American agencies” was a more serious problem than either “war memories” or “separation from family.” Why do you think they felt this way? Could this have been prevented? If so, how? What does the author believe?
21. What did you learn from this book? Would you assign blame for Lia’s tragedy? If so, to whom? What do you think Anne Fadiman feels about this question?