The Spirit Catches You and You Fall Down
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Acknowledgments
Ib tug pas ua tsis tau ib pluag mov los yog ua tsis tau ib tug laj kab.
One stick cannot cook a meal or build a fence.
I would like to thank some of the people who enabled me to write this book:
Bill Selvidge, who started it all by telling me stories about his Hmong patients, and who became my host, intermediary, teacher, and sounding board.
Robert Gottlieb, who assigned the germinal story. Robert Lescher, my literary agent, who always knew I had a book in me somewhere. Jonathan Galassi and Elisheva Urbas, extraordinary editors who at every stage were able to see both the forest and the trees.
The John S. Knight Fellowship program at Stanford University, which, among many other boons, allowed me to study at Stanford Medical School. The classes I audited deepened both my medical knowledge and my understanding of what it means to be a doctor.
Michele Salcedo, who helped gather written sources during the embryonic phases. Michael Cassell, Nancy Cohen, Jennifer Pitts, and Jennifer Veech, who checked facts with skill and enterprise. Tony Kaye, researcher nonpareil, who tracked down answers to hundreds of questions that had stumped me for years.
The dozens of people, cited under individual chapter headings in my Notes on Sources, who were willing to pass on their knowledge.
The doctors and nurses at Merced Community Medical Center who helped and educated me, with especial thanks to Dan Murphy.
Sukey Waller, who introduced me to Merced’s Hmong leaders. They trusted me because they trusted her.
The Hmong community of Merced, whose members were willing to share their sophisticated culture with me and who earned my passionate respect.
Jeanine Hilt, whose death was a terrible loss.
Raquel Arias, Andrea Baker, John Bethell, Dwight Conquergood, Jim Fadiman, Abby Kagan, Martin Kilgore, Pheng Ly, Susan Mitchell, Chong Moua, Dang Moua, Karla Reganold, Dave Schneider, Steve Smith, Rhonda Walton, Carol Whitmore, Natasha Wimmer, and Mayko Xiong, for help of many kinds.
Bill Abrams, Jon Blackman, Lisa Colt, Sandy Colt, Byron Dobell, Adam Goodheart, Peter Gradjansky, Julie Holding, Kathy Holub, Charlie Monheim, Julie Salamon, Kathy Schuler, and Al Silverman, who read part or all of the manuscript and offered criticism and enthusiasm, both equally useful. Jane Condon, Maud Gleason, and Lou Ann Walker, priceless friends who not only read the book but let me talk about it incessantly for years.
Harry Colt, Elizabeth Engle, and Fred Holley, who meticulously vetted the manuscript for medical accuracy. Annie Jaisser, who clarified many aspects of the Hmong language and corrected my Hmong spelling. Gary Stone, who set me straight on some important details of the wars in Laos and Vietnam. Any errors that remain are my fault, not theirs.
May Ying Xiong Ly, my interpreter, cultural broker, and friend, who built a bridge over waters that would otherwise have been uncrossable.
Blia Yao Moua and Jonas Vangay, two wise and generous men who taught me what it means to be Hmong. Nearly a decade after we first met, they were still answering my questions. Would that everyone could have such teachers.
My brother, Kim Fadiman, who in dozens of late-night telephone calls responded to faxed chapters and weighed nuances of phrasing so minute that only another Fadiman could possibly appreciate them. Kim also read aloud the entire manuscript into a tape recorder so our father, who lost his sight four years ago, could listen to it.
My mother, Annalee Jacoby Fadiman, and my father, Clifton Fadiman, who through love and example taught me most of what I know about good reporting and good writing.
My children, Susannah and Henry, for the joy they have brought.
Monica Gregory, Dianna Guevara, and Brigitta Kohli, who allowed me to write by caring for my children with imagination and tenderness.
There are three debts that are unpayable.
I owe the first to Neil Ernst and Peggy Philp, physicians and human beings of rare quality, who spent hours beyond count helping me understand a case that most doctors might prefer to forget. Their courage and honesty have been an inspiration.
I owe the second to the Lee family, who changed my whole way of looking at the world when they welcomed me into their home, their daily lives, and their rich culture. Nao Kao Lee was a patient and eloquent educator. Foua Yang was a loving guide and at times a surrogate parent. I thank all the Lee children, but especially True, who helped me immeasurably during the final stages of my research and also became my friend. And to Lia, the gravitational center around which this book revolves, I can only say that of the many sadnesses in the world that I wish could be righted, your life is the one I think of most often in the small hours of the night.
I owe the greatest debt to my husband, George Howe Colt, to whom this book is dedicated. In both a metaphorical sense and a literal one, George has been everything to me. Over the years, he has made fact-checking calls, helped me file thousands of particles of research, taken care of our children while I worked, and talked over every twist and turn of character, style, structure, and emphasis. He read every word—except these—at least twice, and his editing was brilliant. When I got discouraged, knowing that George cared about Lia Lee made me believe others would as well. Were it not for him, my book would never have been written, and my life would be unimaginably dimmer.
Index
acupuncture
Air America
Air Force, U.S.
Aleman, John
Allman, T. D.
American Academy of Family Physicians
Americanization
animal sacrifice
antibiotics
Anti-Chinese Association of Merced
anticonvulsants, see specific drugs
Apgar score
Arias, Raquel
Armée Clandestine
Ativan
BaFá BaFá (simulation game)
Ban Vinai refugee camp
Befriend-a-Refugee Program
Bernatzik, Hugo Adolf
Bertrais, Yves
Biological and Toxin Weapons Convention (1972)
Bliatout, Bruce Thowpaou
breech birth
British East India Company
Buell, Edgar “Pop,”
Bunch, Effie
Burma
California, University of: at Berkeley, at Davis
California Custom Social Services
California Department of Human Resources
California Department of Motor Vehicles
California Department of Social Services
California Southeast Asian Mental Health Needs Assessment
Callahan, Teresa
Cambodia, refugees from
Carroll, Lewis
Carter, Jimmy
Carter,
Stephen L.
Center for Applied Linguistics
Central Intelligence Agency (CIA)
Central Pacific Railroad
Chao Fa (Lords of the Sky)
chemical weapons
Cheng clan
Ch’ien-lung, Emperor of China
Child Protective Services (CPS)
China: Hmong in, opium introduced to, People’s Republic of
Chinese-Vietnamese refugees
Christianity, conversion to, fundamentalist
Christian Science Monitor
Christian Scientists
clans
Clifford, Clark
Coelho, Tony
Collazo, Yasmin
conjoint treatment
Conquergood, Dwight
contraception
Cooper, Robert
cross-cultural medicine
Crouse, Vonda
Crystal, Eric
Culhane-Pera, Kathleen Ann
Cullen, John
Dab Neeg Hmoob: Myths, Legends and Folk Tales from the Hmong of Laos (Johnson)
dabs (spirits), animal sacrifices to appease, illness caused by, and New Year celebration, Shee Yee and, soul-stealing, and Sudden Unexpected Death Syndrome, and taboo on foretelling death
Dao, Yang, see Yang Dao
Defense Department, U.S.
DeLay, Paul
dengue fever
Denver Developmental Screening Test
Depakene
dermal treatments
developmental deficits
Dien Bien Phu, Battle of
Dilantin, side effects of
dobutamine
dopamine
Dostoyevsky, Fyodor
Douglas, Benny
Douglas, Eugene
Dunnigan, Timothy
ectopic pregnancy
Egeland Mother-Child Rating Scale
Eisenhower, Dwight D.
Elizabeth I, Queen of England
Elmhurst Hospital Center (Queens, N.Y.)
Emanuel Medical Center (Turlock)
epinephrine
Eppley, Judith
Ernst, Neil, and catastrophic seizure, communication difficulties with Lia’s parents, on cost of Lia’s treatment, on developmental deficits, and foster care placement and Foua’s pregnancy, Hilt and, leukemia of son of, on nosocomial infection, and prescription of Depakene, and septic shock, and traditional healing