THE SPIRIT CATCHES YOU AND YOU FALL DOWN: CRITICAL ANALYSIS

CHAPTER SEVEN - Government Property

Summary

Neil Ernst constantly questioned himself over whether his uncompromising standard of care had actually compromised Lia’s health. He wondered which would have been more discriminatory - to deprive Lia of optimal care that any other child would have received or fail to tailor her treatment in such a way that the family would have been most likely to comply. A decade before when Lia had first come to him such thoughts would never have entered his head. His job, as he saw it, was to practice good medicine and the Lees’ job was to comply. To fail to comply was, as he saw it, child endangerment, and a form of child abuse. That thought was what made him finally decide that he had no choice but to request that Lia be placed in foster care. He said, “I felt it was important for these Hmongs to understand that there were certain elements of medicine that we understood better than they did and that there were certain rules they had to follow with their kids’ lives. I wanted the word to get out in the community that if they deviated from that, it was not acceptable behavior.” (pg. 79) The truth was that in US law, Neil might have committed a crime himself if he hadn’t filed a report about Lia. This idea dated from a 1943 Supreme Court decision where the state has the right - indeed has the obligation - to remove children from parents who fail to comply with a life-saving treatment. Justice Robert Jackson wrote, “Parents may be free to become martyrs themselves, but it does not follow that they are free, in identical circumstances, to make martyrs of their children.”

Neil had never had any intention of prosecuting Lia’s parents, and so legal action was ever taken against them. However, on May 2, 1985, Lia was temporarily placed in a foster home. It was run by two Mennonite sisters who would strap her into her car seat whenever she became too active. So, after two weeks, she was returned home, and her parents were given one more chance. Unfortunately, on June 26th, Lia was once again removed from her home into placement that was intended to last six months. The CPS workers along with an interpreter arrived without any advance notice to Foua or Nao Kao. Foua was visiting relatives and Nao Kao became infuriated at the interpreter, Sue Xiong, who he said had lied to the doctors and made Lia government property. He almost killed her.

Interestingly, Neil had told no one else at MCMC that he had brought CPS into Lia’s case. All of them disagreed with his decision, thinking it was the first time they had ever heard of child being taken away from good caretakers. As for the Hmong community, everyone knew what had happened and realized that it was just as they had suspected - doctors were not to be trusted and that they were in league with other coercive authorities. As summarized by Kathleen Ann Culhane-Pera, the Hmong believe parents are responsible for their children’s welfare and deciding their medical treatment. Physicians cannot make these decisions, because they are not family members. The conflict as it existed was confined to differences in belief systems. Once the police and CPS were called in, Lia’s case escalated to another level. Then, the differences became about power. Nonetheless, the judge approved CPS’s petition to detain Lia. Her parents were granted weekly visits which did not start until after she had been in foster care for one month. She would be reunited after six months only if the court was persuaded that her parents would comply with the medication regimen. If after a year, the court was not persuaded that this order was being followed, it would permanently remove her from the Lees’ home.

Then, CPS had to find Lia a home which had specialized foster care which could facilitate Lia’s health in all sorts of areas, especially behavioral ones. Lia had failed the checklist for proper behavior for her age other than giving and accepting affection. So, Lia was placed into the home of Dee and To Korda. They had four children of their own and were expecting a fifth. They were the perfect choice, because they were so eager to help care for children no one else wanted. When the author met them for the first time, she was amazed at how positively they spoke about Foua and Nao Kao. No one else ever had. Unfortunately for them, life with Lia was difficult from the beginning. She cried continuously for ten days, calling out for her mother. The only thing that helped was constant physical contact, so Dee carried Lia on her back and her own baby in a pouch on her front. She also breastfed Lia right along with her own child. However, there were still many problems that required constant supervision. Jeanine Hilt, a CPA worker, successfully petitioned the court to pay the Kordas $1000 a month just because of all the problems Lia presented.

Dee Korda took Lia to the doctors between two and five times a week, but the little girl was still seizing; in fact, she was seizing more with them than she had at her own home. When she was hospitalized in the Korda’s hometown, Dee felt everything was well. However, when she was transferred once to MCMC, Dee became angry with how Lia was treated. She claimed the nurses never spoke to her softly or quietly, and they always tied her down. Dee felt it was demeaning. The doctors in Dee’s home hospital began eliminating her meds and trying them in various combinations. Dee said the combination of Phenobarbital and Tegretol was the worst for little Lia, who seemed to be in a drunken state all the time.

The relationship which developed between the Lees and the Kordas was very positive, because the Kordas tried to understand the Hmong culture. Dee even came to the point where she left her own baby with the Lees when she had to take Lia to medical appointments. It did not take the Kordas long to realize that CPS had made a mistake in taking Lia away from her mother and father. She was the only foster child for whom she ever had recommended reunification. The Lees believed that Lia became even sicker, because she missed them so much.

After the six-month period in which Lia was in foster care, the court decided the Lees had still not shown they had the ability to comply with her medication regimen. So Lia remained in foster care. Two reasons were given for this decision - the Lees had refused to sign a Social Services Plan which stated where they must comply. Second, when Lia had been permitted a weeklong visit in her home, the Lees had failed miserably. They had opted for traditional healing methods and had “trashed the meds.” Four days after she returned to the Kordas, she had three grand mal seizures and six petit mal seizures after which her developmental deficits became more pronounced. Nonetheless, Jeanine Hilt became determined to educate the Lees and spent dozens of hours working with Foua. It helped that her drug regimen for the epilepsy was finally reduced to just one drug: Depakene. Because it tastes of cherries, it was easier to get Lia to swallow. Lia practiced with the syringe until she had it just right. As a result, she and Jeanine began to develop a friendship although Nao Kao was still wary of her. Furthermore, he was still infuriated with Su Xiong, the interpreter. He didn’t trust her, because she had married an American and the Hmong almost never married outside of their clan. He also believed, because she scolded him, that she was not accurately translating what he said. He told the CPS workers to keep the woman out of his home or he’s beat her to death. When questioned about Nao Kao’s threats, Sue Xiong, who spoke the most elegant English, denied she even knew them at first and then finally said that the Lee family didn’t appreciate her services and so she had left.

Jeanine Hilt made sure the threats Nao Kao made didn’t affect Lia’s return, and the little girl finally came home on April 30, 1986.

Notes

This chapter explains the consequences when the CPA takes Lia away from her parents at the suggestion of Neil Ernst. She didn’t do well even in a good foster home, and her developmental delays became more pronounced. Her seizures increased and only the hospital in Turlock, where the Kordas lived, was finally able to reduce her medication and stabilize her enough that she went home. The unfortunate aspect of this situation is that Lia almost seems like a guinea pig upon home the American medical system was trying to find its way through medical and cultural problems while the Hmong were just trying to be respected and taken seriously.

The Spirit Catches You and You Fall Down by Anne Fadiman: Free BookNotes Summary

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