The Spirit Catches You and You Fall Down is the story of a Hmong Family, the Lees, their journey to America, and their struggles following their immigration. The Lee family were political refugees fleeing their home country of Laos in response to the "Silent War" and the subsequent loss of livelihood and starvation its inhabitants faced. The parents, Foua (mother) and Nao Kao (father), traveled through rough terrain and literally dodged the bullets of political enemies to bring their twelve children to safety in a refugee camp. While at the refugee camp, Foua delivered their thirteenth child. They were then relocated to California, a place chosen not by the family but by the US immigration officials who were trying to evenly spread the great number of immigrants across the country. While in America, Foua delivered their fourteenth child, Lia.

Unlike all of her previous births, which occurred at home in a peaceful setting, Lia's birth occurred at Merced Community Medical Center (MCMC), because that was what the Lees mistakenly believed was necessary to obtain citizenship for their daughter. At her birth, Lia appeared to be a healthy, eight pound seven ounce girl and the delivery was uncomplicated. However, in infancy, Lia was diagnosed with what American doctors called epilepsy, a physical disease of the nervous system. In the Hmong culture, seizures were believed to occur in a spiritual realm and symbolized a condition deserving of reverence. According to their beliefs, Foua and Nao Kao thought that a spirit known as a dab had captured Lia's spirit and wouldn't return it. Their difference in belief systems as well as the language barrier prevented proper communication between the Lee family and their physicians. Over time, the doctors became exasperated and at times apathetic. The Lees also complained of feelings of frustration, as well as being misunderstood and blaming the doctors for intervening in ways that appeared to make Lia more sick instead of better. In a final insult, the doctors recommended Lia be removed from her parents' home and placed in foster care because her parents were unable to read the English directions on her prescription bottles and Lia was not taking her anti-seizure medication according to the prescribed schedule.

Lia continued to suffer from seizures, which became worse in nature. After years of uncontrollable seizures, Lia regressed. She lost her ability to speak and interact with people. An especially bad episode of seizures rendered her brain-dead and paralyzed. The book delves into the question of who was to blame—the doctors who could possibly have saved her with their western medicine but didn't, or her parents who were unable to understand the doctors' directions. The book examines this issue but makes no conclusion. Instead, it uses Lia's case as a study in anthropology and makes an argument for the inclusion of cross-cultural training and empathy in medical school as well as increased presence of interpreters and social workers in medical settings.