Chapter 3 - The Spirit Catches You and You Fall Down

Lia began having epileptic seizures when she was about three months old. Her older sister, Yer, slammed the front door of the Lees’ apartment. The Lees knew immediately what had happened. Despite the careful installation of her soul during the hu plig ceremony, the noise of the door had frightened out of Lia’s body, and it became lost. The resulting symptoms they recognized as qaug dab peg or “the spirit catches you and you fall down.” This is, of course, translated as epilepsy. The Hmong regard this disease with ambivalence. They acknowledge that it is potentially dangerous and life threatening, but they also consider it to be an illness of some distinction, an illness in which a healing spirit enters the body. For example, Merced’s congressman, Tony Coelho, was epileptic and was denied the right to become a priest by the Catholic Church, because he was seen to be unfit for divine office. However, the Hmong saw it as divine, because many of their shamans were afflicted with it. As a result, it conferred a great deal of social status in their community and marked the victim as a person of high moral character since a healing spirit would never choose someone of no -account. The Lees were no different than any other Hmong in their attitude toward Lia’s illness - a mixture of concern and pride.

The Hmong are exceptionally well known for the gentleness with which they treat their children. They consider them as the most treasured possession a person can have. In Laos, the Hmong mothers are never apart from their babies, carrying them on their backs during the day and sleeping with them in their arms at night. They have continued to be just as attentive parents in the United States. It had been noted in more than one scientific study that Hmong parents hold and touch their babies far more frequently than Caucasian mothers. Lia had been nurtured this way as well. They were especially concerned that anything would compromise her health and happiness. Jeanine Hilt, a social worker who worked with the Lees, said that they considered Lia an anointed one and her illness more of a blessing than an affliction. The doctors at MCMC vaguely understood the concept of the spirits that were a part of epilepsy for the Hmong, but she was the only one who had actually ever asked the Lees what they thought was the cause of Lia’s disease.

Lia was her parents’ favorite child and they kissed, caressed, and loved her extravagantly. They always dressed her in exquisitely embroidered clothes. They later they even blamed her sister, Yer, for her seizures since it was the slammed door that had seemed to initiate them. For a long time, they treated Yer differently than other children as well but at the other end of the spectrum than Lia. Over the first few months of her life, Lia had over twenty seizures which made her parents take her to the emergency room at MCMC three times. The problem at the MCMC was lack of financial support. They had to compete with two other larger hospitals for high paying patients, and to add to that, there were few if any interpreters to help with communicating with the Hmong patients. Doctors there came to the conclusion that with the Hmong they had to “practice veterinary medicine.” This set up problems with Lia’s illness from the beginning. The first two times she came to the hospital, she showed signs of cough and pneumonia (later realized to be the result of aspiration during the seizures), and the doctors just sent her home with antibiotics. However, the third time, she was in the middle of a grand mal seizure when her parents brought her to the ER, and Dr. Dan Murphy saw her. Murphy and his wife had come to Merced with no idea who the Hmong were. But they were interested in learning and eventually became actively involved with the Hmong community. At this ER visit, Murphy noted that the parents seemed frightened, but not terribly so, at least not as frightened as he would have been if it had been his child. He diagnosed the little girl immediately and realized why there had been problems on the previous visits. However, he had no way of knowing that Foua and Nao Kao had already diagnosed their daughter’s problem as an illness where the spirit catches you and you fall down, and Lia’s parents had no way of knowing that Dan had diagnosed it as epilepsy.

Dan had learned in medical school exactly what caused epilepsy and how there was no cure short of surgery whose risks consigned it to the category of last resort. He also had his own ambivalence about the disease, because so many people of renown and great artistic and literary talent had been epileptics. Like the Hmong shamans, these kinds of people “experienced powerful senses of grandeur and spiritual passion during their seizures and powerful creative urges in their wake.” Nonetheless, Dr. Murphy was essentially a rationalist when it came to his view of medicine. Like Hippocrates, the great Greek physician, he saw epilepsy as a disease foremost, and as a result, when it came to Lia, he just wanted the seizures to stop. He admitted her to the hospital and ran every kind of test to try to determine what was causing her epilepsy. However, in the end, no cause was ever found, and she was discharged on March 11, 1983. Foua and Nao Kao were sent home with ampicillin for the pneumonia in her lungs and Dilantin for the seizures.

Notes

The important aspect of this chapter is the two-sided nature of epilepsy among the Hmong. The fact that it has a divine nature to them and the fact that the doctors see it only as a disease to be either cured or controlled foreshadows problems yet to come between the two cultures.