In The Spirit Catches You and You Fall Down, there is a collision of cultures. Lia’s family lives in America for hopes of curing Lia from her epilepsy. Lia’s family are originally from Lao where the Hmong tribe resides. Culture collision is when two or more cultures and values are consolidated into one. Hmong and American traditions are utterly different, but can western medicine save her? The medical community did not understand the Lees and the Lees did not understand them. No one in the hospital spoke their language so it was really hard for Lia’s parents to give Lia her medication. This goes far beyond miscommunication, the doctors did not understand the Lee’s religious and social activities. The collision of the two cultures is a fail, which puts a toll on Lia’s health.

After a child is born, the Hmong only eat ice and ice water. This ritual is said to make the blood thicker in the womb after giving birth.The intake of food was said to irritate skin or cause diarrhea. This ritual is experience in American culture. From one’s experience many mothers before and after childbirth only eat ice. This could be for other health reasons other than what the Hmong originally believe. At Merced Community Medical Center, Foua (Lia’s mother) accepted that the hospital had hot black water instead of their traditional ice and cold water. So Nao (Lia’s father) brought Hmong foods which the hospital had to accept the smell of their foods. But, this created stereotypes and opinions toward other Hmongs that the hospital may have in the future.

When Lia was three months old, her sister slammed the door which caused qaug dab peg, translation for epilepsy. Her parents thought this was because her spirit was lost. The Hmongs consider epilepsy as an "illness where the spirit catches you and you fall down" (28), yet a gift. Western doctors said epilepsy is "an electrochemical storm… that had been stirred up by the misfiring of aberrant brain cells" (28). Epileptics in their culture is said to have a third eye; see things that other cannot see. Hmongs also believe epileptics have symptoms because they are the chosen neeb.

The Lees were very skeptical on western american medical practices. One of their children died because they didn’t receive hospital care like the other children. The Lees are still headstrong with their belief about sickness and diseases. They thought the reason for losing their child was because someone who lived at their old house was buried underneath and their spirit was not at rest. Americans often do this as well. It is very common for Americans to leave after some form of supernatural events happen. Also when buying / moving into a new house a preacher often comes to expel spirits or bless the house. Outside of moving, the Lees have adjusted their Hmong traditions to western doctors because Lia’s condition is getting worse.

The Hmong originally mistrust western medical practices, so when the doctor assign Lia to take medication for her epilepsy. “If [doctors] continue to press their patients to comply with a regimen that, from the Hmong vantage, is potentially harmful, they may find themselves, to their horror, running up against that stubborn strain in the Hmong character which for thousands of years has preferred death to surrender. “ (51). In Hmong culture, the doctor makes house calls. The doctor spend all the time with the ill patient, could diagnose the patient immediately, and treat / cure the condition. However, western doctors do not spend that much time on the patient, do not make house calls, ask personal questions, and other “dehumanizing” things. In Professor Davis lecture she states that “cultural relativism makes moral decisions more difficult because it requires us to take many things into account before we make up our minds” (Davis, in lecture). The Lees faced cultural relativism when their the level of trust they have with western doctors decreases. Many of the western doctor procedures seem harmful than their tradition doctors. Hmongs also believe that spirits wonder when patients are under medication or anesthesia. “The doctors can fix some illnesses that involve the body and blood, but for us Hmong, some people get sick because of their soul, so they need spiritual things. With Lia it was good to do a little medicine and a little neeb, but not too much medicine because the medicine cuts the neeb's effect. If we did a little of each she didn't get sick as much, but the doctors wouldn't let us give just a little medicine because they didn't understand about the soul.” (101). Both Hong and Americans can say that this can lead to more illnesses or even death. Hmongs also believe that western hospitals house spirits of dead people. Hmongs usually just treat the ill with shamanism, herbalism, and dermal procedures.

In Fadiman’s The spirit Catches You and You Fall Down had many collisions. The differences between both Hmong and Western had played a huge role in Lia’s life. Each traditions have been problematic to both societies. Accepting is the first step of collision. Lia’s medication changed more than twenty times in the four years after being diagnosed. The Lees were very sure that the medicine prescribed to Lia was harmful. But, with a lack in communication and translation they could not give feedback about the medication. American families do not have that problem. It is easier for Americans to site their differences to their doctor. Lia’s parents and doctor just wanted the best for her. But, cultural collision and miscommunication led Lia’s health to unresponsiveness or brain dead.