Written by Jennie
The subtitle of this book, originally published in 1997, presents the story in a nutshell: “A Hmong Child, Her American Doctors, and the Collision of Two Cultures”.
Lia Lee was born in Merced , CA in 1981, the first of her refugee parents’ 10 children to be born in a hospital. The Lees were Hmong, part of a Southeast Asian mountain-dwelling ethnic group who were persecuted for their support of the U.S. side during the Vietnam War. The Lees, along with many other Hmong, made their way from war-torn Laos to a refugee camp in Thailand , and finally to the U.S.
Lia suffered her first epileptic seizure at the age of three months; her parents took her to the emergency room at Merced County Hospital. From then on, Lia’s life, and the lives of her family, became inextricably bound up with American medical and bureaucratic systems that they did not understand and were virtually incapable of effectively dealing with. The doctors and caseworkers that the Lees encountered were no less frustrated and bewildered by the Hmong.
Part of what makes this such a heartbreaking story is that everyone involved in Lia’s life – both her family and the doctors who treated her – had the best intentions. But their perspectives on the causes of and treatments for her illness were so different that strife was inevitable. The Hmong viewed all illnesses as spiritual in origin; the Lees believed that Lia’s epilepsy was brought on by her sister slamming the door in their apartment when Lia was a few months old, an act that caused her soul to flee from her body. The doctors wanted to put Lia on a complicated regimen of medications, while Lia’s family organized animal sacrifices to coax Lia’s spirit back. The conflict between the two sides grew deeper when it became clear that Lia’s parents were not giving her the prescribed medications; Lia’s seizures, many severe in nature, continued.
Fadiman presents the culture clash in such a way that for the most part, the reader can understand and sympathize with both sides. At times it feels as though the things that went wrong were inevitable; there truly was no solution or possibility of true understanding on the parts of the Lees or of their doctors and the various other agencies that became involved in Lia’s case. The customs and beliefs on each side were simply too deeply entrenched.
While my frustration with the Lees’ stubbornness and, in my view, wrong-thinking often made me want to reach into the book and shake them, their devotion to Lia – the extreme love they bore their favorite child – was undeniable and softened my view of them. They did not see Lia’s illness as a burden – at least not entirely – and took exquisite care of her. (Fadiman’s claim that epileptics were considered special among the Hmong and would often become shamans was contradicted by some Hmong sources that I found online, however.)
One of the things that may be difficult for an American reader to understand (and perhaps to sympathize with): Fadiman portrays the Hmong as very different from the stereotypical immigrants grateful to have landed in America, the land of freedom and opportunity. As a group, they have a history of fiercely resisting assimilation. The Hmong refugees in the United States are not (or at least were not) here because they wanted to be; they were here because they had nowhere else to go. The CIA-led “quiet war” in Laos had destroyed their villages and made life in their homeland untenable. The life they found in the United States was startlingly different from anything they’d ever known. In the author’s view, the culture shock caused many to cling more assiduously to the old ways. This explains, I guess, why after being in the United States for a number of years, the Lees appear to speak virtually no English. (Fadiman’s claim that Lia’s mother, even after many years in the U.S., had no idea how to operate the family telephone strains the bounds of credulity, however.)
Over all, the book gives a very balanced portrait of the opposite perspectives of the Lees’ and Lia’s American doctors. The only place where I perceive a prejudice on Fadiman’s part is in her expectation that the Americans should or could have done more to understand the Hmong view, that there were a number of things that could have been done differently to lessen the clash of cultures. She has a fair point, but she seems to have no such expectations of the Hmong. I wondered if this perspective did not contain a germ of unwitting racism in it – the “civilized” Americans were expected to learn and grow from their encounter with the Hmong, but the Hmong could not be expected to do the same. I’m still not sure how I feel about that. To be fair, or perhaps to play devil’s advocate, I think that a reasonable argument can be made that the Americans were more worldly and familiar with other cultures – not smarter but simply more sophisticated, in a sense – and thus had the greater responsibility to understand, as best they could, the Lees’ point of view. But Fadiman never makes that argument, and so left me as a reader feeling that she simply expected less of the Lees for some unspecific reason.
I do think Fadiman had the best intentions in her championing of the Hmong and their perspective, but ultimately this aspect of the story felt at best a little condescending toward the Hmong and the Lees.
I’d recommend this book to anyone who enjoys well-written non-fiction, particularly those interested in learning about different cultures or those with an interest in medical stories. Going into it with an open mind (as I said, I found myself frustrated with the Lees at times) will ensure a rewarding reading experience.