Why was Lia taken away from her parents? The doctors, infuriated that the Lee parents were flushing the girl’s meds down the toilet, eventually had Lia taken away from them and placed in foster care. This trauma damaged both the parents and the child, but Lia eventually returned home to her parents.
Why was Lia removed from her parents?
When she was not quite 3, in frustration at what he viewed as her parents’ refusal to administer her medication, Dr. Ernst had Lia legally removed from the family home. She spent a year in foster care — a time, Ms. Fadiman reported, of great trauma for Lia and great bitterness for her family — before being returned to her parents.
Why did the Lees not want Lia to be taken?
The Lees loved Lia very much and were doing their best to be good parents, so it didn't seem fair that Lia should be taken. The Hmong believe that parents, not doctors, are ultimately responsible for deciding the treatment of a child.
How long did Lia Lee live?
But Lia’s underlying medical issues were more complex still, for she had lived the last 26 of her 30 years in a persistent vegetative state. Today, most people in that condition die within three to five years. Lia Lee in 1988. Anne Fadiman Acclaimed by reviewers, “The Spirit Catches You and You Fall Down” won a National Book Critics Circle Award.
How did Lia Lee change the world?
But Lia Lee’s life bridged worlds and changed American medicine. Lia, the subject of Anne Fadiman’s 1997 book “The Spirit Catches You and You Fall Down,” died Aug. 31 in Sacramento at the age of 30, after living decades longer than doctors said was possible.
What caused Lia Lee to die?
Why did the Lees not give Lia her medication?
How many times was Lia admitted to the hospital?
Why did Lia have no seizures?
What did Lia's parents give her?
When did Anne Fadiman meet Lia Lee?
Where was Lia Lee born?
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Who helped the Lees regain custody of Lia?
Because of the love she showed them, Foua accepted her help and learned to administer Lia's medication, which led to regaining custody.
Was Lia's life ruined by cross cultural misunderstandings?
It cannot quite be argued that the cross-cultural misunderstanding “ruined” (262) Lia's life, since the outcome may very well have been the same even if the misunderstanding was resolved, or even worse. However, Fadiman seems to believe that the cross-cultural misunderstanding indeed “ruined” (242) Lia's life.
What was Lia's diagnosis by her American doctors?
When Lia Lee Entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication. Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different.
What did Lia Lee suffer from?
epilepsyMs. Lee — who in July celebrated her 30th birthday in that bed, surrounded by her mother, brother, seven sisters and numerous nieces, nephews and cousins — died Aug. 31 after a lifelong battle against epilepsy, cerebral palsy, pneumonia and sepsis, a toxic reaction to constant infection.
What happened to Lia in the spirit catches you?
Lia, the subject of Anne Fadiman's 1997 book “The Spirit Catches You and You Fall Down,” died Aug. 31 in Sacramento at the age of 30, after living decades longer than doctors said was possible.
What is the main theme of the book The Spirit Catches You and You Fall Down?
The Spirit Catches You and You Fall Down is a moving story that highlights the importance of acknowledging and respecting people's beliefs as part of their health care — in other words, cultural competence. And thanks in part to this book, cultural competence is now a required lesson in many medical schools.
Was Lia Lee in a vegetative state?
But Lia's underlying medical issues were more complex still, for she had lived the last 26 of her 30 years in a persistent vegetative state.
Why did Lia's family think she was transferred to a different hospital in Chapter 11?
She went to the emergency room and Dr. Neil Ernst could not do anything. He talked to Lia's parents about transferring her to Fresno, California, because Lia would need further treatment that Ernst could not provide. Lia's parents believed their daughter was transferred because of the Ernsts' vacation plans.
What did Lia do when she seemed to know a seizure was coming?
Foua and Nao Kao knew when a seizure was coming on, because Lia knew. The aura, a sense of premonition common to all epileptics, could be seen in Lia in a strange, scared expression, and they would pick her up and gently lay her down on a mattress in the living room, placed there just for that purpose.
How many siblings did Lia Lee have?
Lia has twelve brothers and sisters. Her parents Foua Yang and Nao Kao love her very much and are totally committed to her care. Hmong believe that a child is the most treasured possession a person can have. The refugee family traveled a great distance from Laos to Thailand, and now resides in Merced, California.
What are epileptic seizures?
In epilepsy the brain's electrical rhythms have a tendency to become imbalanced, resulting in recurrent seizures. In patients with seizures, the normal electrical pattern is disrupted by sudden and synchronized bursts of electrical energy that may briefly affect their consciousness, movements or sensations.
How many kids did FOUA Lee have?
twelve childrenHaving given birth to twelve children in her native Laos, Foua and her family fled to a refugee camp in Thailand to escape the dangerous communist forces that had won control of her country in 1975. She gave birth there to her thirteenth child, Mai.
How did cultural differences contribute to the misunderstanding?
Since different cultures have very different worldviews, cross-cultural communication is especially likely to change meaning between sender and receiver, as the sender may have a very different worldview from the receiver.
Why do cross-cultural misunderstandings happen and why do you think they occur so often?
A second common reason for cross-cultural misunderstandings is that we tend to interpret others' behaviors, values, and beliefs through the lens of our own culture. To overcome this tendency, it is important to learn as much as you can about the other party's culture.
What are some examples of cultural misunderstandings?
So, here are some of the most common cultural misunderstandings one may have to face.1 - Hand Gestures: It is always advised to mind your body language when in an unknown company especially if you in a foreign country. ... 2 - Embracing: ... 3 - Mind your feet: ... 4 - No Shoes: ... 5 - Using Words Carefully:
What is cross-cultural misunderstandings?
What is cultural misunderstanding? Cultural misunderstanding happens when two or more people speak the same language, but they mean or understand different things. This is usually due to their cultural background and experiences. We often don't realize how much our experiences shape our understanding of words.
In Western medicine, what is "quag dab peg"?
wy did lees trust, Jeanine? why did Jeanine succeed where so many had failed.
Who filed a report about Lia to Child Protective Services?
n April 1985, after receiving word that the Lees were once again modifying Lia's medical treatment, Neil sent a note to Child Protective Services r...
Why was Lia transferred to a different hospital in Chapter 11?
MCMC didn't have a children's Intensive Care Unit, so they transferred her to Valley Children's Hospital in Fresno.
The story of Lia Lee: why empathy matters
The Spirit Catches You and You Fall Down. Lia, who suffered from severe epilepsy, was constantly jostled by two conflicting forces. Her parents, deeply superstitious and adhering to Hmong traditional beliefs, believed that the hospital’s invasive procedures and medications were harming their daughter’s soul.
Lia Lee obituary: Figure in cultural dispute over epilepsy treatment ...
Lia Lee was born July 19, 1982, in Merced. When she was 3 months old, she had her first seizure. American doctors eventually diagnosed epilepsy.
Lia Lee's A Hmong Family And The American Doctors At... | Bartleby
You and You Fall Down is a story about the Lee family and their daughter Lia who was suffering from seizures. The Lee family was the minority in this situation and the government affected the Lee family by not having cross-cultural programs in use, however because of what the Lee family went through they ended up affecting the government by becoming an inspiration for the implementation of ...
What is Lia Lee's medical case?
Lia ’s medical case challenged the Merced hospital by presenting difficult... (full context) Chapter 1: Birth. Lia Lee was not born in the highlands of northwest Laos, where twelve of her older... (full context) Lia was the first Lee child born in America.
What happened to Lia in 1986?
On the night before Thanksgiving in 1986, Lia had a massive seizure and went into status epilepticus. Sensing that this episode was more... (full context)
What chapter does Fadiman describe Lia's life?
Chapter 18: The Life or the Soul. Fadiman considers whether or not Lia ’s life would have been better if she had been treated by somebody like Arthur Kleinman... (full context) Chapter 19: The Sacrifice. Fadiman describes a healing ceremony for Lia that she attended at the Lees’ apartment in Merced.
What chapter does Foua give birth to?
Foua gave birth to her in Merced... (full context) Chapter 3: The Spirit Catches You and You Fall Down. Three months after her healthy birth, Lia went into a seizure after her older sister Yer loudly slammed the apartment door. Foua... (full context) ...Jeanine Hilt, a social worker who worked closely with the Lees, once said, ...
What happened to Neil when he saw Lia?
The first time Neil saw Lia in a routine checkup after her final seizure, he found himself very emotional. He expected... (full context)
Where did Lia arrive?
Unfortunately, Lia arrived at Valley Children’s Hospital in the middle of another grand mal seizure. The doctors... (full context)
Who taught Foua to give Lia the proper amount of medication?
Jeanine Hilt continued to work with Foua, teaching her how to correctly give Lia the proper amounts of medication. This task was made slightly easier by the fact that... (full context)
Why can't Lia be left alone?
She couldn't be left alone, as she could get out of anything and hurt herself even with tied wrists. At the same time, she was very affectionate and always wanted to be held. Lia disliked swallowing her medications, and her parents were also uncertain about what they were supposed to give her.
Why did Lia have to be tied to her crib?
Lia was quite overweight, which compounded the problem of administering intravenous medications. Doctors had to cut open and tie off several of her veins in an attempt to place a needle. They would tie the limb with the needle to a board and sometimes even tie Lia to her crib so that the IVs would last longer.
What did Neil and Peggy feel about the Lees?
Neil and Peggy felt a lot of anger at the parents for their noncompliance , even though they recognized that what they really needed was compassion. It was difficult to work so hard and to face resentment rather than appreciation. Furthermore, the Lees hadn't paid for any of Lia's medical care, yet they didn't seem to appreciate the generosity either of the state insurance program, Medi-Cal, nor of Neil and Peggy's services, which Medi-Cal reimbursed at a very low rate. Lia's parents showed no deference to the doctors' many years of schooling, their awards, or even the hours they spent educating themselves about the Hmong. It was also agonizing for them to watch Lia fail to receive the treatment they believed would let her live a normal life.
What do Hmong believe about medical care?
When asked their opinions of medical care in Merced, educated Hmong expressed their beliefs that you must let doctors examine your body in order to stay in the United States, that the rich are treated right away while the poor have to wait, that they will get sent to jail if they change their mind about having surgery, and that the doctors look down on refugees, want to study them rather than cure them, and ignore their wishes. Some even believe the student doctors kill the poor. None of these beliefs are true, of course. Most of the doctors went into family medicine for altruistic reasons. They know the Hmong don't like them, though, and this upsets them - enough that some doctors jokingly suggested treating the Hmong with ‘high-velocity transcortical lead therapy’ -- i.e., shooting the patient in the head.
What happened to Lia after she stopped taking phenobarbital?
After they stopped giving her medication for three months, Lia had a seizure so severe that the phenobarbital given in treatment caused her to stop breathing. The resident on duty, Dan Murphy, had to place a breathing tube down her throat and have her transferred to a better-equipped facility 65 miles away.
How long did Lia stay unconscious?
In the most serious episodes, Lia would remain unconscious for twenty minutes or longer as she seized, a condition labeled "status epilepticus.". She would remain in this state until she received large doses of anticonvulsant medication intravenously, which, in her convulsing state, was very challenging to do.
What did Foua and Nao Kao learn from Lia?
Foua and Nao Kao learned to recognize the signs signaling the onset of Lia's seizures, such as twitching, staring, or hallucinating.
Where did the Lees get Lia's records?
The Lees gave Fadiman access to all of Lia's records at MCMC, Valley Children's Hospital in Fresno, the Merced County Health Department, and CPS. However, it wasn't helpful to ask them about particular events, as they lumped all of Lia's doctors together and the diagnoses meant little to them.
When did Lia go to foster home?
In May 1985 , Lia was placed in a foster home with a pair of Mennonite sisters who would strap her into a car seat in the living room every time she became hyperactive. Two weeks later, she went home and her parents were given one more chance.
How did Foua get married?
Once, she decided to get her married by dressing her as a Hmong bride for her boyfriend. She was adorned in piece after piece of paj ntaub, or embroidered cloth: a long sash to fatten her up and make her look strong, a skirt with hundreds of pleats that had probably taken several years to make, an apron, a jacket, four bags decorated with dangling silver coins, a five-tier necklace of silver, puttees, and a pagoda-shaped hat covered with silver coins. Fadiman's boyfriend George was stunned. While he didn't appreciate the beauty of the attire, a week later he asked Fadiman to marry him, which didn't surprise Foua at all.
Why did the Lees explain Hmong culture to Lia?
Doctors can fix some sicknesses involving the body and the blood, Foua explained, but sometimes people get sick because of their soul and therefore need spiritual things. She felt with Lia it was important to do both a little medicine and a little neeb, or shamanic ritual, but to limit the medicine as it could cut the neeb's effect . The doctors wouldn't let them give just a little medicine, she explained, because they didn't understand about the soul. Nao Kao likewise explained that the Hmong often get sick because they encounter a dab, but that doctors didn't understand this and therefore didn't treat them effectively. For instance, a man's son was once made sick by a dab living in a creek; the doctors tried to cure him with shots and medicines, but the only thing that would have saved him would have been to sacrifice a dog.
What is the theme of Chapter 7 of The Hmong?
Chapter 7 continues the theme of power , as the Lees were rendered completely powerless. The entire Hmong community felt the injustice. Foua and Nao Kao were doing their very best for their daughter (who was quite a challenge behaviorally as well as medically), showering her with love and administering what they felt was the best regimen to make her get better, and her doctors - who had not yet been able to cure her - took her away. The only way the parents could get their daughter back was to follow the doctors' instructions to the letter, and yet this meant they had to capitulate and give medications that they honestly believed were hurting Lia. There is a philosophical question here. Who should have the power when it comes to making decisions for a child? Doctors have scientific knowledge, yes, but the fact that Lia's seizures continued and even increased in frequency despite her foster parents following the doctors' instructions shows that their knowledge is fallible. There is something to be said for the Hmong view: that because they gave birth to the child, provide for his or her needs, and love the child, they are in the best position to make decisions.
How difficult was it to get to know the Hmong?
The Hmong were notoriously difficult to get to know. Fadiman's physician friend Bill Selvidge, a Peace Corps veteran with an interest in anthropology, still hadn't had an extended conversation with a Hmong over the age of 14 after two years of working in Merced. A Hmong-speaking nurse’s aide at MCMC set up Fadiman’s first meetings with Hmong families; this fact alone nearly guaranteed mistrust because the families associated her with the hospital. Her first two interpreters, older and well-respected men, were also a failure; while they would talk animatedly with the Hmong they were interpreting for, they would give Fadiman only a few words as translation.
Why did the Hmong take Lia?
The Lees loved Lia very much and were doing their best to be good parents, so it didn't seem fair that Lia should be taken. The Hmong believe that parents, not doctors, are ultimately responsible for deciding the treatment of a child. The fact that doctors can call the police and remove a child from her parents illustrates the power differential between doctors and refugees, despite the United State's reputation for freedom.
Who is Mai Lee's sister?
But when her parents removed her feeding tube, Ms. Lee cried out. Her sister Mai Lee, 32, said Ms. Lee’s strong will to live, nurtured by her family’s love, faith and constant care, proved the doctors wrong.
Why did the Lee family spend a year in foster care?
But because of language and cultural differences, the family had trouble administering her medicine, and she spent a year in foster care. Fadiman said there are no villains here — that both the Lee family and the doctors had the best intentions.
How old was Lee when she had a seizure?
At 4-foot-7 and 47 pounds, Ms. Lee could speak only with her eyes and her cries. Stricken by seizures since she was a few months old, she battled through, singing Hmong folk songs and joyfully running around her neighborhood. At 4, she suffered a grand mal seizure that stole her speech and her ability to move.
Where did Foua Yang live?
Foua Yang crumpled in tears on the staircase in her south Sacramento home, just feet from the empty hospital bed where her daughter Lia Lee lived most of her life.
What do the Hmong believe?
Her parents, like most traditional Hmong, believe in ancestor spirits. They asked a shaman to travel to the highest level in the spirit world and strike a bargain: “Give us our daughter’s life, and we’ll give you a life in exchange.” They sacrificed a pig and got their wish, said their oldest daughter, Zoua Lee, 48.
Why did Lia take her parents away?
Lia, who would become a symbol for incorporating cultural understanding into medical care, was the first American-born daughter of a fiercely loving Hmong family. When she started suffering epileptic seizures, her parents turned to their traditions to help her. Authorities took their daughter away from them for a year for not properly giving her prescriptions which came with dizzyingly complicated instructions. Language and cultural barriers fostered misunderstandings on both sides.
What happened to Lia?
Shortly afterward, she had a grand mal seizure. She lost all higher brain functions and was sent home to die. Her family had cared for her ever since, keeping her at the center of their home and activities.
How old was Lia Lee when she had her first seizure?
Lia Lee was born July 19, 1982, in Merced. When she was 3 months old, she had her first seizure. American doctors eventually diagnosed epilepsy. Her mother, Foua Yang, and her father, Nao Kao Lee, called it qaug dab peg (pronounced “kow da pay”). To them it was a spiritual illness: They thought their daughter’s soul was wandering and needed to be called back from the farthest reaches of the spirit world.
What caused Lia to die?
31 in Sacramento at the age of 30, after living decades longer than doctors said was possible. The immediate cause was pneumonia, although it was epilepsy and sepsis, a toxic reaction to infection, that had left her in a vegetative state for much ...
How long did Lia's funeral last?
Lia’s doctors were long since forgiven and embraced by her family. They were invited to Lia’s traditional three-day Hmong funeral, where her soul was guided home.
What tribe did Lia's family belong to?
Lia’s family, like so many Hmong, fled Communist Laos after the Vietnam War. The Hmong, an ancient, agrarian tribe who lived high in the Laos mountains, were recruited by the CIA to fight the North Vietnamese. After Saigon fell in 1975, the Hmong were persecuted and many were killed. About 150,000 fled the country.
Where did the Hmong settle?
After perilous flights and years in sodden Thailand refugee camps, many Hmong settled in California’s Central Valley, new immigrants with little exposure to the modern world who believed deeply in a world of spirits and shamans. Lia Lee was born July 19, 1982, in Merced.
What caused Lia Lee to die?
The immediate cause was pneumonia, Ms. Fadiman said. But Lia’s underlying medical issues were more complex still, for she had lived the last 26 of her 30 years in a persistent vegetative state. Today, most people in that condition die within three to five years. Image. Lia Lee in 1988. Credit... Anne Fadiman.
Why did the Lees not give Lia her medication?
The Lees did not always give Lia her medication, Ms. Fadiman wrote, because they did not want to interfere with qaug dab peg entirely. To encourage her soul’s return, her parents gave her herbs and amulets.
How many times was Lia admitted to the hospital?
The seizures worsened; by the time Lia was 4 ½, she had made more than 100 outpatient visits to medical facilities and been admitted to the hospital 17 times. When she was not quite 3, in frustration at what he viewed as her parents’ refusal to administer her medication, Dr. Ernst had Lia legally removed from the family home.
Why did Lia have no seizures?
Lia no longer had seizures, because she now had vastly reduced electrical activity in her cerebral cortex, the brain’s outermost layer. She grew only slightly, as is typical of children with severe brain damage: by the age of 30, she was 4 feet 7 inches and weighed 47 pounds.
What did Lia's parents give her?
To encourage her soul’s return, her parents gave her herbs and amulets. She was sometimes visited by a Hmong shaman, who performed a ritual that included chanting, beating a gong and sacrificing a chicken or pig. (The strings around Lia’s wrist noted by Ms. Fadiman are used in Hmong tradition to help protect people from malevolent spirits.)
When did Anne Fadiman meet Lia Lee?
In 1988 , when Anne Fadiman met Lia Lee, then 5, for the first time, she wrote down her impressions in four spare lines that now read like found poetry: barefoot mother gently rocking silent child. diaper, sweater, strings around wrist. like a baby, but she’s so big. mother kisses and strokes her.
Where was Lia Lee born?
The 14th of 15 children born to her mother, Foua Yang, and her father, Nao Kao Lee, Lia Lee was born on July 19, 1982, in Merced, Calif. — the first of her parents’ children born in the United States, and the first born in a hospital. She was plump, porcelain-skinned, lively and beautiful.
