The Spirit Catches You and You Fall Down (37 page)

In form and intent, this book resembles the Hmong-style Fish Soup described at the beginning of the second chapter. When a Hmong makes Fish Soup, or tells a story, the ingredients tend to come from many different places. My own Fish Soup is similarly eclectic.

The material on Lia Lee is based mostly on interviews. (I relied on these sources for all the chapters about Lia, so I have not repeated their names under the individual chapter headings below.) Family members: Foua Yang, Nao Kao Lee, May Lee, True Lee, Yer Lee. Foster parents: Dee and Tom Korda. Merced Community Medical Center: Teresa Callahan, Benny Douglas, Neil Ernst, Kris Hartwig, Evelyn Marciel, Dan Murphy, Peggy Philp, Gloria Rodriguez, Dave Schneider, Steve Segerstrom, Bill Selvidge, Sharon Yates. Valley Children’s Hospital: Terry Hutchison. Merced County Health Department: Effie Bunch, Koua Her, Martin Kilgore, Kia Lee. Child Protective Services: Jeanine Hilt. Schelby Center for Special Education: Zeb Davis, Sunny Lippert. I also drew on Lia’s case log at the Merced County Health Department; her file at Child Protective Services, including legal records from the California Superior Court; her medical records at Valley Children’s Hospital and Merced Community Medical Center; and her mother’s medical records at MCMC. (Since this book was completed, Merced Community Medical Center was leased by a nonprofit corporation called Sutter Health and is now named Sutter Merced Medical Center.)

Conversations with the following people provided insights into various aspects of Hmong culture: Dwight Conquergood, Eric Crystal, Koua Her, Annie Jaisser, Luc Janssens, Kia Lee, Linda Lee, May Lee, Nao Kao Lee, True Lee, Pheng Ly, Blia Yao Moua, Chong Moua, Dang Moua, Moua Kee, Lao Lee Moua, Yia Moua, Court Robinson, Long Thao, Pa Vue Thao, Lee Vang, Peter Vang, Jonas Vangay, Sukey Waller, John Xiong, Mayko Xiong, May Ying Xiong, Xay Soua Xiong, Yia Thao Xiong, and Foua Yang.

A good deal has been written about the Hmong during the last two decades. The Refugee Studies Center at the University of Minnesota publishes three Hmong bibliographies and a newsletter that reviews recent publications about refugees. These resources helped me navigate the labyrinth of Hmong scholarship.

I would like to single out three books, all of which reappear in more specific contexts below, to which I am especially indebted—and also which I especially enjoyed.

My indispensable historical reference was Keith Quincy’s lucid and comprehensive
Hmong: History of a People
.

My understanding of the Hmong character was immeasurably deepened by F. M. Savina’s
Histoire des Miao
, an ethnographic and linguistic monograph, unfortunately long out of print, by an empathetic French missionary in Laos and Tonkin. Translations from Savina are mine.

Finally, for inspiration and sheer pleasure, I found myself returning again and again to Charles Johnson’s
Dab Neeg Hmoob: Myths, Legends and Folk Tales from the Hmong of Laos
, a bilingual anthology of oral literature, with a splendid introduction and extensive explanatory notes on Hmong culture, collected by a language professor who helped sponsor Minnesota’s first Hmong family.

In the notes that follow, I have cited each work’s title in full the first time it is mentioned, and used a shortened title on subsequent mentions. The
Bibliography
contains complete references for all cited sources.

1. Birth

Foua Yang, Kia Lee, Blia Yao Moua, Chong Moua, Lao Lee Moua, Yia Moua, and John Xiong told me about many of the customs mentioned in this chapter.

Hmong shamanism is described in Jean Mottin, “A Hmong Shaman’s Séance” Dwight Conquergood et al.,
I Am a Shaman: A Hmong Life Story with Ethnographic Commentary;
and Charles Johnson, ed.,
Dab Neeg Hmoob: Myths, Legends and Folk Tales from the Hmong of Laos
. (I used Johnson’s 1983 edition; an edition with an updated introduction was published in 1992.) The latter two works also discuss traditional methods for preventing and curing infertility.

Hmong pregnancy, birth, and postpartum customs are explained in Kou Vang et al.,
Hmong Concepts of Illness and Healing with a Hmong/English Glossary;
Gayle S. Potter and Alice Whiren, “Traditional Hmong Birth Customs: A Historical Study” Ann Bosley, “Of Shamans and Physicians: Hmong and the U.S. Health Care System” and George M. Scott, Jr., “Migrants Without Mountains: The Politics of Sociocultural Adjustment Among the Lao Hmong Refugees in San Diego.” Scott’s dissertation contains a wealth of information on many topics; I have used it throughout this book. The description of the placenta as a Hmong’s first and finest garment is from Charles Johnson,
Dab Neeg Hmoob
, and the account of its posthumous journey is from Ruth Hammond, “Tradition Complicates Hmong Choice.”

Background on the Hmong clan system is from Tou-Fou Vang, “The Hmong of Laos,” and Timothy Dunnigan, “Segmentary Kinship in an Urban Society: The Hmong of St. Paul-Minneapolis.”

Five works by Bruce Thowpaou Bliatout, the leading Hmong authority on health issues, examine traditional views on the causes of illness, including soul loss: “Causes and Treatment of Hmong Mental Health Problems” “Hmong Beliefs About Health and Illness” “Traditional Hmong Beliefs on the Causes of Illness” “Guidelines for Mental Health Professionals to Help Hmong Clients Seek Traditional Healing Treatment” and
Hmong Sudden Unexpected Nocturnal Death Syndrome: A Cultural Study
. Other sources on this topic are Xoua Thao, “Hmong Perception of Illness and Traditional Ways of Healing” Elizabeth S. Kirton, “The Locked Medicine Cabinet: Hmong Health Care in America” Nusit Chindarsi,
The Religion of the Hmong Njua;
Ann Bosley, “Of Shamans and Physicians” Kou Vang et al.,
Hmong Concepts of Illness and Healing;
and Charles Johnson,
Dab Neeg Hmoob
. On infant soul loss and soul-retaining clothing, see Eric Crystal, “Buffalo Heads and Sacred Threads: Hmong Culture of the Southeast Asian Highlands” Jane Hamilton-Merritt, “Hmong and Yao: Mountain Peoples of Southeast Asia” and Paul and Elaine Lewis,
Peoples of the Golden Triangle
.

The baby-naming ceremony is described in Nusit Chindarsi,
The Religion of the Hmong Njua
, and Gayle S. Potter and Alice Whiren, “Traditional Hmong Birth Customs.”

2. Fish Soup

Luc Janssens told me the Fish Soup story.

My summary of Hmong history from ancient times until the early twentieth century is deeply indebted to Keith Quincy’s
Hmong: History of a People
. (I relied primarily on the 1988 edition; a revised edition was published in 1995.) Were I citing the source of each detail, Quincy’s name would attach itself to nearly every sentence in the pages on the Hmong in China.

I drew many ideas from F. M. Savina’s
Histoire des Miao
. The story of King Sonom, also retold by Quincy, comes from an extraordinary contemporary document, a 1775 letter by a French missionary in China named Joseph Amiot, which Savina reproduces in full.

Other useful works on Hmong history include Jean Mottin’s charming
History of the Hmong;
W. R. Geddes,
Migrants of the Mountains: The Cultural Ecology of the Blue Miao (Hmong Njua) of Thailand
, the standard anthropological study of the Hmong; Hugo Adolf Bernatzik,
Akha and Miao: Problems of Applied Ethnography in Farther India;
Sucheng Chan,
Hmong Means Free: Life in Laos and America;
and Yang See Koumarn and G. Linwood Barney, “The Hmong: Their History and Culture.”

Background on the terms “Miao,” “Meo,” and “Hmong” is from the above sources (Bernatzik is the most detailed), and also from Yang Dao,
Hmong at the Turning
Point
, and Christopher Robbins,
The Ravens: The Men Who Flew in America’s Secret War in Laos
.

The passage by anthropologist Robert Cooper is from his
Resource Scarcity and the Hmong Response
.

3. The Spirit Catches You and You Fall Down

Delores J. Cabezut-Ortiz,
Merced County: The Golden Harvest
, recounts how Tony Coelho was rejected by the Jesuits because of his epilepsy. Blia Yao Moua told me about the offer to perform a Hmong healing ceremony for Coelho in Merced.

On becoming a
txiv neeb
: Dwight Conquergood,
I Am a Shaman
; Jacques Lemoine, “Shamanism in the Context of Hmong Resettlement” Bruce Thowpaou Bliatout, “Traditional Hmong Beliefs” and Kathleen Ann Culhane-Pera, “Description and Interpretation of a Hmong Shaman in St. Paul.”

On how Hmong parents treat their children: Hugo Adolf Bernatzik,
Akha and Miao
; Nusit Chindarsi,
The Religion of the Hmong Njua
; Brenda Jean Cumming, “The Development of Attachment in Two Groups of Economically Disadvantaged Infants and Their Mothers: Hmong Refugee and Caucasian-American” E. M. Newlin-Haus, “A Comparison of Proxemic and Selected Communication Behavior of Anglo-American and Hmong Refugee Mother-Infant Pairs” Charles N. Oberg et al., “A Cross-Cultural Assessment of Maternal-Child Interaction: Links to Health and Development” and Wendy Walker-Moffat,
The Other Side of the Asian American Success Story
.

The information on Merced Community Medical Center was provided by Vi Colunga, Arthur DeNio, Doreen Faiello, Ed Hughell, Liz Lorenzi, Betty Maddalena, Marilyn Mochel, Dan Murphy, Theresa Schill, Bill Selvidge, Betty Wetters, and Janice Wilkerson.

The Hmong population of Merced City is an estimate based on projections from the 1990 census. It attempts to take into account new refugees from Thailand, secondary migrants from other parts of the United States, and births (using Hmong, not American, birthrates). The Demographic Research Unit of the California Department of Finance and Rhonda Walton at the Merced Human Services Agency provided assistance.

Much of the information here and elsewhere on the medical aspects of epilepsy is drawn from conversations with neurologist Elizabeth Engle of Boston Children’s Hospital and with Neil Ernst and Peggy Philp of Merced Community Medical Center. I also found these works helpful: Owen B. Evans,
Manual of Child Neurology
; Orrin Devinsky,
A Guide to Understanding and Living with Epilepsy
; Robert Berkow, ed.,
The Merck Manual of Diagnosis and Therapy
; Alan Newman, “Epilepsy: Light from the Mind’s Dark Corner” and Jane Brody, “Many People Still Do Not Understand Epilepsy.” Eve LaPlante discusses the relationship between epilepsy and creativity in
Seized: Temporal Lobe Epilepsy as a Medical, Historical, and Artistic Phenomenon
. Owsei Temkin recounts the history of epilepsy in his fascinating work
The Falling Sickness: A History of Epilepsy from the Greeks to the Beginnings of Modern Neurology
. The Hippocrates quotation is from
On the Sacred Disease
, quoted in Richard Restak,
The Brain
; the Dostoyevsky quotation is from
The Idiot
.

4. Do Doctors Eat Brains?

Mao Thao’s visit to Ban Vinai is recounted in “Hmong Medical Interpreter Fields Questions from Curious,” and in Marshall Hurlich et al., “Attitudes of Hmong Toward a Medical Research Project.”

Hmong health care taboos, and the differences between
txiv neebs
and doctors, are discussed in Charles Johnson,
Dab Neeg Hmoob
; Dwight Conquergood et al.,
I Am a Shaman
; Ann Bosley, “Of Shamans and Physicians” Elizabeth S. Kirton, “The Locked Medicine Cabinet” John Finck, “Southeast Asian Refugees of Rhode Island: Cross-Cultural Issues in Medical Care” Joseph Westermeyer and Xoua Thao, “Cultural Beliefs and Surgical Procedures” Marjorie Muecke, “In Search of Healers: Southeast Asian Refugees in the American Health Care System” Scott Wittet, “Information Needs of Southeast Asian Refugees in Medical Situations” and two works by Bruce Thowpaou Bliatout, “Hmong Refugees: Some Barriers to Some Western Health Care Services” and “Hmong Attitudes Towards Surgery: How It Affects Patient Prognosis.” See also the five Bliatout sources on the causes of illness cited under Chapter 1.

Asian dermal treatments are described in Donna Schreiner, “Southeast Asian Folk Healing” Lana Montgomery, “Folk Medicine of the Indochinese” and Anh Nguyen et al., “Folk Medicine, Folk Nutrition, Superstitions.” Koua Her, Kia Lee, Chong Moua, and Foua Yang also explained these treatments to me.

Jean-Pierre Willem tells the story of the typhoid epidemic at Nam Yao in
Les naufragés de la liberté: Le dernier exode des Méos
. Catherine Pake presents her research at Phanat Nikhom in “Medicinal Ethnobotany of Hmong Refugees in Thailand.” Dwight Conquergood describes his health program at Ban Vinai in my hands-down favorite account of working with the Hmong: “Health Theatre in a Hmong Refugee Camp: Performance, Communication, and Culture.”

5. Take as Directed

I first met the concept of “angor animi” in
Migraine
, by Oliver Sacks.

The side effects of anticonvulsant drugs are noted in Orrin Devinsky,
A Guide to Understanding and Living with Epilepsy
; Warren Leary, “Valium Found to Reduce Fever Convulsions” and
Physicians’ Desk Reference
. (I used the 1987 edition of the
PDR
here and elsewhere because it is roughly contemporaneous with Lia’s case.) In the opinion of pediatric neurologist Elizabeth Engle of Boston Children’s Hospital, the studies on phenobarbital’s association with lowered I.Q. scores are not conclusive. She believes it is a safe drug.

Blia Yao Moua, Dia Xiong, Vishwa Kapoor, and Vonda Crouse told me about the case of Arnie Vang. It is also described in Pablo Lopez, “Hmong Mother Holds Off Police Because of Fear for Her Children.”

6. High-Velocity Transcortical Lead Therapy

Most of the works cited under Chapter 4 were also useful here. Two particularly helpful introductions to Hmong health care issues are Ann Bosley, “Of Shamans and Physicians,” and Elizabeth S. Kirton, “The Locked Medicine Cabinet.”