Shock Waves

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Anyone who has ever visited another country and found the food unidentifiable, the language incomprehensible and the rules of behaviour bizarre has experienced some degree of culture shock. Sometimes it’s exciting, often it’s disconcerting, and if you get ill or lost or inadvertently cause offence it can be frightening. Anne Fadiman’s book The Spirit Catches You and You Fall Down is about culture shock of a different order altogether. It is the story of what can happen when, even with the best of intentions on both sides, two cultures collide.

The focus of the book is Lia Lee, the daughter of a Hmong refugee couple who settled in California in the 1980s. Originally from central China, the Hmong are a proud, tough, self-reliant people who, according to Fadiman, have only ever wanted to be left alone, ‘perhaps the most difficult request any minority can make of a majority culture’. Over several centuries relentless persecution forced the Hmong to retreat from the Yellow and Yangtze river valleys into the highlands of southern China from where, in the nineteenth century, about half a million fled over the border into French Indo-China. Some settled in Thailand and Vietnam; most ended up in the mountains of what is now Laos.

Here, for two or three generations, the Hmong found sanctuary. They built timber houses in the forests; they ate only what they could grow, produce or catch; they treated themselves with herbs when they got sick and performed elaborate rituals to placate the spirits which had caused the illness. They had no formal education and little or no contact with the outside world – until the Vietnam War.

Many of their remote mountain villages lay on what came to be known as the Ho Chi Minh Trail, along which the Communists moved arms and supplies from the north to the south of Vietnam via Laos. Since the Americans had promised to respect the neutrality of Laos, they could not deploy their own ground troops in the area. An

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Anyone who has ever visited another country and found the food unidentifiable, the language incomprehensible and the rules of behaviour bizarre has experienced some degree of culture shock. Sometimes it’s exciting, often it’s disconcerting, and if you get ill or lost or inadvertently cause offence it can be frightening. Anne Fadiman’s book The Spirit Catches You and You Fall Down is about culture shock of a different order altogether. It is the story of what can happen when, even with the best of intentions on both sides, two cultures collide.

The focus of the book is Lia Lee, the daughter of a Hmong refugee couple who settled in California in the 1980s. Originally from central China, the Hmong are a proud, tough, self-reliant people who, according to Fadiman, have only ever wanted to be left alone, ‘perhaps the most difficult request any minority can make of a majority culture’. Over several centuries relentless persecution forced the Hmong to retreat from the Yellow and Yangtze river valleys into the highlands of southern China from where, in the nineteenth century, about half a million fled over the border into French Indo-China. Some settled in Thailand and Vietnam; most ended up in the mountains of what is now Laos.

Here, for two or three generations, the Hmong found sanctuary. They built timber houses in the forests; they ate only what they could grow, produce or catch; they treated themselves with herbs when they got sick and performed elaborate rituals to placate the spirits which had caused the illness. They had no formal education and little or no contact with the outside world – until the Vietnam War.

Many of their remote mountain villages lay on what came to be known as the Ho Chi Minh Trail, along which the Communists moved arms and supplies from the north to the south of Vietnam via Laos. Since the Americans had promised to respect the neutrality of Laos, they could not deploy their own ground troops in the area. And since the whole ideology of communism was anathema to the independent-minded Hmong, they were easily persuaded to fight for what the Americans promised them would be ‘freedom’. Of the estimated 250,000 Hmong living in Laos before the war, as many as 75,000 are thought to have died as a result of the war. Some died fighting; many were killed by the bombs that fell on their villages or by landmines; more still died of hunger and disease when they fled. And when the war was over and the Americans withdrew, leaving Laos in the hands of a Communist government, the Lao People’s Party declared the Hmong ‘enemies of the state’ for having fought on the wrong side.

The Americans airlifted about 3,000 Hmong to safety and, for a while, arranged food-drops for those who remained. But when the relief flights stopped, the Hmong were left to survive by their wits, to die, or to flee the country. Most fled, heading for the safety of Thailand, travelling on foot and by night, carrying their children on their backs, muffling their babies for fear their crying would attract attention; some were caught and shot, and many of the very young and very old died from disease, starvation and exhaustion along the way. Those who made it to Thailand then often spent years in refugee camps before being allowed to emigrate, a few at a time, to the United States.

The Lee family arrived in America from Thailand in 1980. They might as well have arrived on the moon. They spoke no English. They didn’t know about electricity. ‘They had never seen a toilet before and thought the water in it was to drink or cook with, then when told what it was they didn’t know whether to sit or to stand on it. They didn’t know that the cans and packets in the grocery store had food in them.’ Other newly arrived Hmong refugees ‘cooked with motor oil and furniture polish, ate cat food, covered the floors of their apartments with soil and planted vegetables in it and hunted pigeons with crossbows in the streets’.

As culture shock goes, this was severe enough. But at the age of three months Lia Lee started to have seizures. Her parents, Nao Kao and Foua, held traditional Hmong views about the causes and cures of illness and had serious doubts about the efficacy of Western medicine. But before arriving in America they had spent two years in a refugee camp in Thailand, where three of their older children had become very sick. Their only son had died but, after being treated by Western doctors, their two daughters had recovered. So eventually and reluctantly, when Lia’s seizures became more frequent and more severe, they took her to hospital where she was diagnosed with epilepsy.

The Hmong know about epilepsy. They call it quag dab peg, which literally translates as ‘the spirit catches you and you fall down’; the spirit in this case being a soul-stealing dab. The Lees concluded that during Lia’s soul-installing ceremony, performed when she was three days old, her soul had not been sufficiently firmly attached to her body. A loud noise must have frightened her soul, which had fled in terror and had been stolen by a dab. The cure, they told the doctors (through an interpreter), was to bring in a shaman to placate the dab in a succession of elaborate ceremonies that would restore Lia’s soul.

Highly trained professionals dedicated to relieving suffering and saving lives, the doctors knew nothing of Hmong tradition, but they did know that Lia’s epilepsy was treatable with medication. And since Nao Kao and Foua loved their children dearly – the afflicted Lia perhaps most of all – they agreed to let the doctors treat her. The collision was under way. Even with interpreters the Lees couldn’t understand what the doctors were telling them. They didn’t know what Lia’s pills were for, how many they should give her and when; they couldn’t read the labels on the bottles; they couldn’t take her temperature or fill in her charts; they couldn’t understand why if one pill was good, two pills weren’t better and three not better still; when Lia showed no sign of improvement they stopped giving her pills at all, treating her instead with herbs grown in an oil drum on a parking lot and seeking advice from a shaman.

Because the Hmong answer to any question is whatever they think the questioner wants to hear (in other words, mostly ‘yes’), the doctors didn’t realize that the Lees had no idea what they were doing and couldn’t understand why Lia’s condition wasn’t improving. Having changed her medication several times – each time leaving the Lees more confused – they eventually decided that it must be because the Lees were being careless or deliberately obstructive. The doctors got angry; the Lees got scared; and Lia got worse. Eventually her seizures became so severe that the doctors called in the social services; Nao Kao and Foua were accused of child-abuse and – the cruellest of punishments for the family-centric Hmong – Lia was taken away from them and put into care. After a year, when her condition had stabilized under a steadier medical regime, she was allowed home. And the whole agonizing cycle started all over again.

This is a mesmerizing and deeply disturbing story of love, pain, dedication and, ultimately, of almost unbearable irony. Somehow Anne Fadiman (a writer and literary editor rather than an anthropologist) manages to tell it without passing judgement on any of the parties involved. The Spirit Catches You should be required reading not only for doctors but for everyone, traveller or stay-at-home, who might ever encounter a culture different from their own.

Extract from Slightly Foxed Issue 11 © Julia Keay 2006


About the contributor

Julia Keay was a writer and editor; her Alexander the Corrector was published in paperback in 2005 and together with her husband John she revised Macmillan’s London Encyclopaedia for a third edition, published in 2010.

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