In 1988, when Anne Fadiman met Lia Lee, then 5, for the first time, she wrote down her impressions in four spare lines that now read like found poetry:


barefoot mother gently rocking silent child


diaper, sweater, strings around wrist


like a baby, but she’s so big


mother kisses and strokes her


The story of Lia, the severely brain-damaged daughter of Hmong refugees who had resettled in California, became the subject of Ms. Fadiman’s first book, “The Spirit Catches You and You Fall Down,” published in 1997.


Its title is the English translation of the condition known as qaug dab peg (pronounced “kow da pay”), the Hmong term for epilepsy, from which Lia had suffered since infancy.


In traditional Hmong belief, qaug dab peg, like many illnesses, is spiritual in origin, caused when the soul becomes separated from the body. A traditional cure might entail visits from a shaman, who would attempt to reunite body and soul.


A work of narrative nonfiction, Ms. Fadiman’s book is a cautionary tale about the cultural chasm between Lia’s family, with its generations-old animist beliefs, and her rationalist American doctors.


“In some sense, I was trying to provide a way of controlling her seizures with Western methods and Western medicines,” said Dr. Neil Ernst, who with his wife, Dr. Peggy Philp, was one of the pediatricians who treated Lia early on. “And in some sense, the Lees were giving up control of their child to a system that they didn’t understand.”


That cultural divide — despite the best intentions of both sides, Ms. Fadiman wrote — may have brought about Lia’s condition, a consequence of a catastrophic seizure when she was 4.


Over the years, whenever Ms. Fadiman lectured about the book, readers would press a single question on her before any other: “Is Lia still alive?”


Lia Lee died in Sacramento on Aug. 31. (Her death was not widely reported outside California.) The immediate cause was pneumonia, Ms. Fadiman said. But Lia’s underlying medical issues were more complex still, for she had lived the last 26 of her 30 years in a persistent vegetative state. Today, most people in that condition die within three to five years.


Acclaimed by reviewers, “The Spirit Catches You and You Fall Down” won a National Book Critics Circle Award. It has sold almost 900,000 copies, according to its publisher, Farrar, Straus & Giroux, and remains widely assigned in medical schools and in university classes in social work, anthropology, journalism and other fields.


As a result, Lia’s story, as few other narratives have done, has had a significant effect on the ways in which American medicine is practiced across cultures, and on the training of doctors.


“A lot of people in medicine were talking about that book for a very long time after it was published,” Sherwin B. Nuland, the physician and National Book Award-winning author, said on Wednesday. He added:


“There’s a big difference between what we call ‘disease’ and what we call ‘illness.’ A disease is a pathological entity; an illness is the effect of the disease on the patient’s entire way of life. And suddenly you read a book like this and you say to yourself, ‘Oh, my God; what have I been doing?’ ”


A labor of eight years, “The Spirit Catches You and You Fall Down” is also the story of the immense benefits of tradition, which can furnish, Ms. Fadiman makes clear, a level of familial devotion less often seen among modern Americans. Lia spent her entire life at home, assiduously cared for by her family, and it was this devotion, Ms. Fadiman came to feel, that kept her alive for so long.


“She was never shunted to the periphery,” Ms. Fadiman, the daughter of the author and television personality Clifton Fadiman and the journalist Annalee Jacoby Fadiman, said on Wednesday. “I remember her most in her mother’s arms. Family life went on around her and in some ways revolved around her.”


The 14th of 15 children born to her mother, Foua Yang, and her father, Nao Kao Lee, Lia Lee was born on July 19, 1982, in Merced, Calif. — the first of her parents’ children born in the United States, and the first born in a hospital. She was plump, porcelain-skinned, lively and beautiful.


The Lees had arrived in the United States two years earlier with their seven living children, a blanket, a mortar and pestle and little else. They had been farmers in their native Laos; three of their children died there when they were very young.


During the Vietnam War, many Hmong were recruited by the United States to fight the North Vietnamese in Laos; after Laos fell to the Communists in 1975, 150,000 Hmong, in fear of their lives, fled the country. The Lees were among them.