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As I read Anne Fadiman's book, The Spirit Catches You and You Fall Down (Farrar, Straus and Giroux, $14, paper), which describes the clash between a Hmong immigrant family and their California health-care providers, a nagging thought gnawed at my conscience. Will the sick aliens I care for with slim-to-no command of English and little appreciation of American medicine see the love of God mirrored in the way I carry out my art of practice? Despite vestigial remnants of Judeo-Christian ethics in American health care, loving the sick stranger in our medical midst is the exception today, not the rule. When health care is functioning at its secular best, human tolerance is substituted for divine love, and government entitlement is offered instead of godly neighborliness. In the end, all too many recipients of health care today feel neither tolerated nor entitled, let alone loved.Award-winning journalist Fadiman (who succeeded Joseph Epstein as editor of The American Scholar) tells the story of Lia Lee and her family with gusto and uncommon literary grace. When Lia was three months old, she began to suffer from chronic seizures. Her family attributed the malady to evil spirits, in keeping with the animistic beliefs of traditional Hmong culture. Hence the arresting title of Fadiman's book, a translation of quaug dab peg, the Hmong term for epilepsy: the spirit catches you and you fall down.As Fadiman chronicled the family's medical misadventures, she chose to stand at a point of cultural tangency where she hoped to see both sides more clearly than if she were to stand in the middle. Come to a modern American hospital if you want to see faith marginalized. The separation of church and hospital today often feels like a higher barrier than the separation of church and state. Don't expect most American hospital workers to think about your faith when next you roll through the Emergency Room door, unless you're a member of a sect notorious for not seeing eye-to-eye with the medical profession. Even then it's a toss up whether the legal department gets a call before the department of pastoral care.Fadiman did not expect to find God in the Hmong American medical story. Nor did she find anyone or anything in Merced Community Memorial Hospital who brought a loving God to her mind. Most of the spirits Fadiman describes are anything but holy. And too often, the alien experienced the unholiest aspects of an impatient health care system."Love the alien as yourself," God told the Jews when they were almost to their own promised land. The alien was special. "You were once aliens in Egypt" (Leviticus 19:34). By the time the Jews had finished their wandering, they had learned firsthand what it meant to be both insider and outsider. They were not to treat aliens who chose to live with them the same way they had been treated by the Egyptians. In the name of God, the alien deserved their love. The alien also deserved the health benefits of the dietary and hygenic laws that Yahweh had given them. Yahweh's people were to be a light to the nations.Several historians have pointed to the remarkable analogies between the diasporized Jews and the wandering Hmong. For one brief period in their history, the Hmong had an independent homeland in China, but for most of their history they have migrated throughout Southeast Asia, resisting assimilation. With the fall of Indochina to the communists, 150,000 Laotian Hmong highlanders fled to Thailand, and later resettled in the United States.One Catholic missionary called the Hmong "allergic to all kinds of authority." Perhaps it was inevitable that this allergy would intensify when they wandered to a country where medicine has taken on a godlike form of authority.Like every other immigrant group, Hmong Americans live within short view of two dramatically different cultures. And where the edges meet, change is bound to happen. The author portrays the Hmong as a people resistant to change. Here, Hmong Americans would disagree. There are assimilators in their midst as well, newcomers who listen and measure and wait for someone who can listen to their struggle.As generous as Fadiman is in her tolerance of animistic beliefs, she permits her own stereotyped opinions to flavor her account of any Christian interaction with the Hmong. Without further research, she accepts at face value a social worker's assertion that there is no such thing as a genuine Hmong conversion to Christianity. A network of Hmong Christian churches throughout the part of central California where Fadiman performed her research was in easy reach.Not only are Christians set in a critical light at every mention, but also Fadiman fails to recognize how the Christian story fulfills the Hmong belief that a messianic figure will come and save them. This "good leader" will be a savior sent to earth from heaven by the "King of kings" to save all the world. The relevance of this "shadow truth" to the Christian message has not escaped the notice of animistic shamans who wish to control the Hmong with threats of evil spirits, or communist ideologues who feel threatened by the message of hope that the Hmong find in "welcoming the King."Among their own gods, the Hmong have not found a welcome:

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January (Web-only) 2000, Vol. 44