The preface prepares the reader for what will be told in each chapter by hinting at the basic conflict and how she became a part of it. Ms. Fadiman begins by discussing a carton of cassette tapes that sits under her desk and which she listens to from time to time. Some are the voices of American doctors and the rest are the voices of the Lees, a family of Hmong refugees from Laos who came to the United States in 1980. The author mentions one aspect that she likes to hear: the eight tones of the Hmong language. Listening brings her a whoosh of sense-memories: the coolness of the red metal chair, reserved for guests that was always set up as soon as she arrived at the Lee apartment; the shadows cast by an amulet that hung from the ceiling and swung in the breeze; and the tastes of the unusual Hmong food.
She had come there for the first time on May 19, 1988 - to Merced, California - when she had heard there were some strange misunderstandings going on at the county hospital between its Hmong patients and its medical staff. She says the doctors call these problems “collisions” as if two different kinds of people had rammed into each other, head on, to the accompaniment of squealing brakes and breaking glass. The encounters were messy, but rarely frontal. Both sides were wounded, but neither side seemed to know what had hit it or how to avoid another crash. Her intent in coming there had been to somehow position herself between the two adversaries and hope she didn’t get caught in the crossfire.
This had all taken place nine years before this book was published when she had heard about the Lee’s daughter, Lia, whose case had occasioned some of the worst strife the Merced Hospital had ever seen. After she got past the tendency to lay blame at one door or the other, she started to think less like an American and a little more like a Hmong. Ironically, during the year she was writing this book, she also had many medical problems emerge among her family members, and she spent a great deal of time in hospitals, herself. It allowed her to gnaw on two important questions: What is a good doctor? And what is a good parent?
She has now known the people of this book for most of her adult life, and she believes that if she hadn’t met Lia’s doctors, she would be a different kind of patient, and if she hadn’t met Lia’s family, she would be a different kind of mother. She says to end the preface that now and then, late at night, she imagines what the voices on the tapes would sound like if she could somehow splice them together so that the voices of the doctors and the voices of the Hmong could be heard on a single tape, speaking a common language.
This entire chapter foreshadows the conflict that Ms. Fadiman entered in 1988 - the clash of cultures. She introduces us to the two sides and implies that it perhaps was never resolved. She leaves the reader with a kind of poignant wish that she had found a way to create a common language the two sides might have spoken.