Ernst, Toby
Estevez, Luis
faith healing
Fang, Thai
Fang clan
Farr, Francesca
febrile seizures
Fife, Roger
Finck, John
Flaubert, Gustave
Ford Motor Company
Forster, E. M.
France: Hmong in, Indochinese colonies of
French Guiana
Fresno State University
Frontline
Gaddis, John Lewis
gangs
Garcia, Dominica
Geddes, William Robert
Geneva Accords on Indochina (1954)
Geneva Conference (1961–62)
Geneva Convention on status of refugees (1951)
Geneva Protocol on chemical weapons (1925)
grand mal seizures
Greeks, ancient
Gulf War
Haig, Alexander
Hamilton-Merritt, Jane
Han dynasty
Hang clan
harelip
Hartwig, Kris
Harvard University, Medical School
Harwood, Jan
Hawkes, Phillip
Health and Human Services, U.S. Department of
Helms, Richard
Hennepin County Medical Center
Her, Doua
Her, Koua
Her, Pa Kao
Her, Soua
herbalism
Her clan
Hider, Michael
Highland Lao Initiative
Hilt, Jeanine, death of, and foster care placement, and Lia’s return home in persistent vegetative state
Hin Heup Massacre
Hippocrates
History of the Hmong (Mottin)
Hmong: agricultural practices of, animal sacrifices of, attitude toward children of, beliefs about epilepsy of, and bridging of cross-cultural gulf, calendar of, childbirth among, childhood mortality rate of, in Laos, child-rearing practices of, in China, clan names of, clothing of, under communists, dance of, escape from Laos of, folktales of, and foster care placement, under French colonial rule, funeral customs of, hierarchy of, intermarriage among, marriage customs of, and MCMC, in Merced, Merced health department and, migration to Indochina of, Murphy and, names of, New Year celebration of, opium cultivation by, oral narratives of, preference for sons among, in refugee camps, repatriation of, resettlement in U.S. of, somatization among, soul-calling ceremonies of, stature of, taboos among, textile arts, of, see paj ntaub; traditional medicine of, Waller and, during war in Laos, Western accounts of, and Western medicine
Hmong National Development
Hoang-ti, Emperor of China
Ho Chi Minh
holism
hu plig, see soul-calling ceremonies
Hutchison, Terry
Hutterites
hyperactivity
Ik
Immigration and Naturalization Service
immunizations
Indochinese Psychiatry Clinic (Boston)
infant mortality
International Organization for Migration
International Rescue Committee
Internet
isoniazid
Jackson, Robert
Jehovah’s Witnesses
Jesuits
Johnson, Charles
Johnson, Lyndon B.
Johnson, U. Alexis
Journal of Ethnobiology
Karen
Kee, Moua, see Moua Kee
Kennedy, John F.
Khang, Maj. Wang Seng
Khmer Rouge
Khmu
Kierkegaard, Søren
Kilgore, Martin
Kirton, Elizabeth
Kissinger, Henry
Kleinman, Arthur
Kong clan
Kopacz, Maciej
Korda, Dee
Korda, Julie
Korda, Maria
Korda, Tom
Korda, Wendy
Kue clan
!Kung
Language and Orientation Resource Center
Lao
Lao Family Community
Laos, under communists, French colonial rule of, migration of Hmong to, refugees from (and see specific ethnic groups); war in
Lee, Cha Koua
Lee, Cheng
Lee, Chong
Lee, Evelyn
Lee, Ge
Lee, Joua Chai
Lee, Kia
Lee, Lia, begins suffering seizures birth of, brain damage diagnosed in, catastrophic seizure suffered by, developmental deficits of, foster placement of, and gulf between traditional and Western medicine, healing ceremony for Hilt’s relationship with, and Hmong beliefs about epilepsy, hospitalized at MCMC, hyperactivity of, medical records of, medication regimen for, obesity of, as parents’ favorite, in persistent vegetative state, returned to parents, septic shock suffered by, soul-calling ceremonies for, state coverage of medical care of, in status epilepticus, traditional medicine for, at Valley Children’s Hospital
Lee, Mai
Lee, May
Lee, Nao Kao, arrival in U.S. of, brings Lia home, cares for Lia in persistent vegetative state, and catastrophic seizure, court order obtained by, and cousin’s arrival in U.S., Dan Murphy and, description of village in Laos by, distrust of Western medicine, escapes from Laos, and foster care placement, group ethic of, gulf between Western medicine and beliefs of, health problems of, Hilt’s relationship with, during hospitalizations, Lia as favorite child of, Lia returned to, and Lia’s birth, and Lia’s obesity, at MCMC emergency room, and medication regimen, during neeb ceremony, in refugee camp, and soul-calling ceremony, and traditional medicine for Lia
Lee, Pang
Lee, Phua
Lee, True
Lee, Yee
Lee, Yer
Lee, Zoua
Lee clan
Lemoine, Jacques
Lennox-Gastaut Syndrome
levirate marriage
Life magazine
Lincoln Hospital (Bronx, N.Y.)
Lippert, Sunny
Lo clan
Lor, Yeng
Lor clan
Lue, Lt. Ly
Lundman, Ian
Lunney, Pat
Ly, Pheng
Ly clan
Mae Jarim refugee camp
Magaillans, Gabriel de
Mai, Vue
managed care
Manchu dynasty
Marciel, Evelyn
Marino, Karen
McDoniel, John
McKown v. Lundman
McMahon, Jeff
Medi-Cal
Medically Indigent Adult program
Medicare
Mennonites
Merced Chamber of Commerce
Merced College
Merced Community Medical Center (MCMC), catastrophic seizure at, and foster care placement, Hmong at, interpreters at, Lia admitted to, Lia’s birth at, outpatient care for Lia in persistent vegetative state at, and traditional healing
Merced Community Outreach Services
Merced County Anti-Japanese Association
Merced County Health Department
Merced County Mental Health Department
Merced County Office of Refugee Services
Merced Human Services Agency
Merck Manual of Diagnosis and Therapy
Meselson, Matthew
Metropolitan State University
Middle Ages
Mien
Migrants of the Mountains (Geddes)
Ming dynasty
Minnesota, University of
Mitchell, Roger
Mochel, Marilyn
Mockus, Mari
Mollica, Richard
Mongolian spot
Mormons
Morris, Eric E.
Mottin, Jean
Moua, Blia Yao
Moua, Chong
Moua, Dang
Moua, Yia
Moua clan
Moua Kee
Murphy, Cindy
Murphy, Dan
Nam Yao refugee camp
National Institute of Mental Health
Nationalities Service of Central California
Native Americans
neeb ceremonies
Neo Hom (United Laotian National Liberation Front)
New Yorker
New York Times
nitroprusside
Nixon, Richard M.
Nord, Steve
Ntuj Khaib Huab (mythical Hmong homeland)
Office of Refugee Resettlement, U.S.
Olmos, Karen
opium production
Oregon Human Resources Department
Osler, William
Other Side of the Asian American Success Story, The (Walker-Moffat)
paj ntaub (embroidered cloth)
Pake, Catherine
Palauans
Pao, Vang, see Vang Pao, Gen.
Paris Agreement (1973)
Pathet Lao
Peace Corps
Pediatric Infectious Disease Journal
Pennsylvania, University of
Phanat Nikhom refugee camp
phenobarbital, side effects of
Philadelphia Commission on Human Relations
Philp, Peggy, cares for Lia after brain damage, and catastrophic seizure, communication difficulties with Lia’s parents, on development deficits, and foster care placement, and Foua’s pregnancy, leukemia of son of, on nosocomial infection, and prescription of Depakene, and septic shock, and traditional healing
Planned Secondary Resettlement Program
Plasmanate
polygyny
Post-Traumatic Stress Disorder
Proposition
qaug dab peg (epilepsy)
Quiet War, see Laos, war in
rabies
Ranard, Donald
Ratcliff, Martha
Ravens, The (Robbins)
Reader’s Digest
Reagan, Ronald
Refugee Cash Assistance (RCA) program
retardation
retinoblastoma
Rhode Island Office of Refugee Resettlement
Ritalin
Robbins, Christopher
Robinul
Rodriguez, Gloria
role loss
Romans, ancient
Rosenblatt, Lionel
Royal Lao Army
sacrifice, ritual, see animal sacrifice
San Francisco General Hospital
Santería
Savang Vatthana, King of Laos
Savina, François Marie
Schelby Center for Special Education
Schneider, Dave
Scott, George M., Jr.
Segerstrom, Steve
Selvidge, Bill, depressed Hmong treated by, Hutchison and, Lia admitted to MCMC by, on Lia’s prognosis after brain damage, Waller and
Senate, U.S.: Armed Services Committee, Judiciary Subcommittee on Refugees and Escapees, Subcommittee on Immigration and Refugee Affairs
septic shock
shamanism, see also txiv neebs
Shapler, Robert
Shee Yee, tale of
Singlaub, John
slash-and-burn agriculture, see swidden agriculture
Small, Robert
somatization
Sonom
soul-calling ceremonies
soul loss
Souvanna Phouma, Prince
Soviet Union
spinal deformity
Ssu-ma Ch’ien
Stanford Medical School
State Department, U.S.
status epilepticus
Sult, Tom
Superior Court of the State of California
Supplemental Security Income (SSI)
Supreme Court, U.S.
taboos, Hmong
Tegretol, side effects of
Temkin, Owsei
Thailand, U.S. military training camps in, escape from Laos to, Hmong settlements in, refugee camps in, traditional medicines imported from
Thao, Mao
Thao, Pa Vue
Thao clan
thiopental
Thueson, Gary
Todorov, Tzvetan
Tragic Mountains (Hamilton-Merritt)
trichothecene mycotoxins
Truman, Harry S.
tuberculosis
txiv neebs (shamans), banned by communists, sacrifices performed by, Western medicine and
typhoid
Uebner, Rick
United Nations High Commissioner for Refugees
U.S. Agency for International Development (USAID)
U.S. Committee for Refugees
U.S. Council of World Freedom
vaccination, see immunizations
Valium
Valley Children’s Hospital (Fresno)
Vang, Arnie
Vang, Chao Wang
Vang, Seng
Vangay, Jonas
Vang clan
van Gogh, Vincent
Vang Pao, Gen., and CIA, and Merced Hmong community, resettlement proposal of, resistance group of
Vientiane Agreement (1973)
Vietnam, Hmong in, refugees from, war in
VOLAGs
Vue clan
Walker-Moffat, Wendy
Waller, Sukey
Wall Street Journal
Washington Post
Wat Tham Krabok monastery
Welch, Richard
Wells, Marvin
Willem, Jean-Pierre
Wisconsin, University of, at Eau Claire
World War II
World Wide Web
Xeu, Vang
Xieng Khouang Air Transport
Xiong, Bravo
Xiong, Chaly
Xiong, Ching
Xiong, John
Xiong, May Ying
Xiong, Sue
Xiong, Yia Thao
Xiong clan
Yale University
Yang, Foua, arrival in U.S. of, brings Lia home, cares for Lia in persistent vegetative state, and catastrophic seizure, court order obtained by, doctors’ relationship with, escapes from Laos, and foster care placement, gives birth to Lia, gulf between Western medicine and beliefs of, Hilt’s relationship with, during hospitalizations, in Laos, Lia as favorite child of, Lia returned to, at MCMC emergency room, and medication regimen, Murphy and, during neeb ceremony, pregnancies of, in refugee camp, and soul-calling ceremony, and traditional medicine for Lia
Yang, Xou
Yang clan
Yang Dao
Yang family
Yanomamo
Yates, Sharon
yellow rain
Yosemite National Park
Youth Conservation Corps
zij poj niam (marriage by capture)
Zinn, William M.
Reader’s Guide
The Spirit Catches You
and You Fall Down
A Hmong Child
Her American Doctors
and the Collision of Two Cultures
Anne Fadiman
About This Guide
This guide is intended to enrich your experience of reading The Spirit Catches You and You Fall Down, winner of the National Book Critics Circle Award. This moving chronicle of a very sick girl, her refugee parents, and the doctors who struggled desperately to treat her becomes, in Anne Fadiman’s deft narrative, at once a cautionary study of the limits of Western medicine and a parable for the modern immigrant experience.
Lia Lee was born in the San Joaquin valley in California to Hmong refugees. At the age of three months, she first showed signs of having what the Hmong know as qaug dab peg (the spirit catches you and you fall down), the condition known in the West as epilepsy. While her highly competent doctors saw the best treatment in a dizzying array of pills, her parents preferred a combination of Western medicine and folk remedies designed to coax her wandering soul back to her bo
dy. Over the next four years, profound cultural differences and linguistic miscommunication would exacerbate the rift between Lia’s loving parents and her caring and well-intentioned doctors, eventually resulting in the loss of all her higher brain functions. Fadiman weaves this personal tragedy, a probing medical investigation, and a fascinating look at Hmong history and culture into a stunningly insightful, richly rewarding piece of modern reportage.
Questions and Subjects for Discussion
What do you think of traditional Hmong birth practices? Compare them to the techniques used when Lia was born. How do Hmong and American birth practices differ?
Over many centuries the Hmong fought against a number of different peoples who claimed sovereignty over their lands; they were also forced to emigrate from China. How do you think these upheavals have affected their culture? What role has history played in the formation of Hmong culture?
Dr. Dan Murphy said, “The language barrier was the most obvious problem, but not the most important. The biggest problem was the cultural barrier. There is a tremendous difference between dealing with the Hmong and dealing with anyone else. An infinite difference”. What does he mean by this?
The author says, “I was struck…by the staggering toll of stress that the Hmong exacted from the people who took care of them, particularly the ones who were young, idealistic, and meticulous”. Why do you think the doctors felt such great stress?
Dr. Neil Ernst said, “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. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior”. Do you think the Hmong understood this message? Why or why not? What do you think of Neil and Peggy?
Dr. Roger Fife is liked by the Hmong because, in their words, he “doesn’t cut”. He is not highly regarded by some of the other doctors, however. One resident went so far as to say, “He’s a little thick.” What do you think of Dr. Fife? What are his strengths and weaknesses? The author also speaks of other doctors who were able to communicate with the Hmong. How were they able to do so? What might be learned from this?
How did you feel about the Lees’ refusal to give Lia her medicine? Can you understand their motivation? Do you sympathize with it?