Spirit Catches You and You

Spirit Catches You and You Fall Down

The Lee family came to the United States from Houaysouy, Laos which is located in Southeast Asia. After the Vietnam War, the country became overrun with communist forces that set out to punish the Hmong due to their support of the United States during the war. The Hmong soon found themselves enemies of the state. Hmong were forced to assent to the wishes of the new regime or suffer severe consequences including death, separation of family, and ruins to their village. Hmong were expected to assimilate and, by doing so, were no longer allowed to practice their rituals or speak their language.

In 1976 the Lees made their first attempt to escape to Thailand, but they were captured by Vietnamese soldiers after only three days and were returned at gun point to their village where they remained for three years before attempting to escape again. In 1979, they made the twenty six day trip to Thailand by foot. While in Thailand they lived in two separate concentration camps. The Lees were then cleared to immigrate to the United States and boarded a plane that landed in Honolulu, Hawaii arriving on December 18, 1980. From Hawaii they moved to Portland, Oregon where they lived for two years before moving to Merced California where they have been for the last 15 years. They have lived in the United States for approximately the last 17 years.

The Lee's fourteenth child Lia developed epilepsy in infancy. They initially attribute her health problem initially as being of a spiritual nature and then they begin to attribute her worsening and eventual devastation to American medicine and doctors that gave her too much medicine. When Lia has her first seizure it is after her sister, Yer, slammed the door to the family home. The Lees believe that she was so frightened by the noise that her spirit left her body causing her to fall to the floor. This is due to the Hmong belief in the ability of baby's soul to leave the body more readily than an adult's, placing them at greater risk of being taken by the dab, evil spirit. The continued seizures are viewed as additional times when Lia's soul has left her body. The Lees perceived the medical interventions as leading to the decomposition of Lia's condition. On her last hospitalization when she is transferred to Fresno, Lia's father believes that the spinal tap, as well as, the introduction of massive quantities of medication are the catalyst to her brain damage (Fadiman, 1997).

The family attempted to make Lia feel better in the hospital by having her sleep next to them in the same manner in which she was accustomed to at home in order to soothe her when she became upset. At various time during the course of her illness and hospitalizations, the family utilized Hmong medicines and traditions such as shaman visits and ceremonies to make her feel better. If Lia had gotten sick in Laos, the family would have made their own remedies from herbs. The Lees would have enlisted the help of a shaman healer who would have spent a great deal of time with Lia in the family's home. The treatment regiment would have included animal sacrifices, rituals, and other ceremonies to bring her back to health.

Rather than being taken care of by spiritual interventionists, the majority of Lia's care was provided by hospital staff, health care providers, and visiting nurses. Lia's parents also played a significant role in her care when she was not in the hospital. However, these hospital visits were not a comfortable experience for the Lees who were often not allowed to touch their child and who had little say in the course of her treatment (Fadiman, 1997).

The family would certainly have been more comfortable if the hospital made more of an effort to understand their culture and beliefs. The Lees were treated as if they were indignant and unresponsive to the needs of their child which was not the case at all. The hospital could have enlisted the help of affluent Hmong natives who have become more accustomed to American traditions. This person could have helped both parties, the Lees to understand medical necessities and the hospital staff to understand the importance of cultural traditions. Both parties could have used a trusted intermediary, Fadiman (1997) refers to this as a "cultural broker" (p. 265).

Another factor that would have made this experience easier for the Lees would have been if the medical professionals had an understanding of some of the important religious rituals and beliefs of their culture. Of particular importance to the Hmong is the concept of death. The doctor's told the Lees several times during Lia's last hospitalization that she was going to die in a few hours. For the Hmong, predicting a death is unthinkable, they believe that it makes the dab come closer to the dying person. The Hmong believe that it means that one is accepting of the person's death (Fadiman, 1997).

The Lee family is completely illiterate. They are unable to read either English or Hmong but they can write their names, a skill they had to learn in order to immigrate to the United States. The family can speak Hmong but that is the extent of their ability to communicate with others. Therefore, when attempting to communicate with the Lees hospital staff could benefit from an understanding of Hmong culture and language. Medical information would be more easily communicated to the Lees if the conditions that they were attempting to describe existed in Hmong language. The reality that there were often not Hmong equivalents made communication difficult. However, if the health care providers had been able to learn about Hmong culture they may have been better able to explain the situation to them. This would have also helped to ensure that the manner in which they did explain things was not misinterpreted or offensive in nature.