Yet the nightmare continued, because the communication problems were not resolved. During the next four years, her anticonvulsant medicines were changed about 25 times, which would have been hell for any family. The Lees questioned the value of so many prescriptions, especially with their Hmong mindset, and did not follow directions. Of course, this was exacerbated by the fact that they did not understand the dosages. The doctors inaccurately concluded that the Lees were endangering their child and placed Lia in foster care. She had a massive seizure several months later and was left brain dead. She continued to live, being cared for by her parents, despite doctors' expectations.

A major reason for this terrible situation was that the hospital did not have the right people on staff from the very start of the problem. The Lees should have been told what was being done and why and what would happen if their directions were followed incorrectly or not at all. The hospital should have learned about the cultural changes and the reason for the Lees behavior.

In some cases, some good comes out of a bad situation. In this case, when Lia's story in the Spirit Catches You was published it encouraged a number of medical schools and healthcare facilities to investigate what they were doing in similar situations. Since then, studies show that much progress has been made. A number of American medical schools are addressing this issue in their curriculum and hospitals are hiring...

The U.S. government, private and public foundations and organizations have given grants for better service delivery. For example, the U.S. Health Resources and Services Administration created the Centers for Excellence to implement an educational program for the purpose of integrating cultural and linguistic improvement approaches and assessment.
However, much more still needs to be done. In too many cases, there are still ethnocentric medical staff and centers who feel that their directions need to be followed religiously. There are also those individuals who come from varying backgrounds and cultures and are not willing to adapt at all to the ways of their new country. Humans can be stubborn animals, which often protects them from danger, but can also put them in danger as well. This is such a complex problem, that it will only improve slowly over time. No country can make radical changes, especially when available funds have to go to other things than translators and social service workers. The hope is that as the United States becomes more culturally diverse in the coming decades, increasing amounts of funds and focus will be placed in the area of communication and human understanding, so the number of situations like Lia's will decrease signficantly.

Fadiman, Anne (1997) the Spirit Catches You, and You Fall Down. New York: Farrar, Straus and Giroux.