Chapter 11 - The Big One

On the day before Thanksgiving, Lia had a mild runny nose, but little appetite. Just after she finished eating, her face took on the strange, frightened expression that always preceded a seizure. The Lees placed her on the mat on the floor where they always placed her at these times. They expected that it would last ten minutes or so, and then she would get up and begin to play again. However, this time she was so sick that Nao Kao had his nephew who spoke English come over and call 911. This, in retrospect, might have been a mistake. They feared if they took her to the ER themselves – a three block run from their apartment – they wouldn’t be taken as seriously. However, an ambulance was always taken seriously. Nao Kao was generally correct in this case, but the ER would have triaged Lia immediately ahead of any other patients given her situation. Nao Kai thought of the doctors in the ER as tsov tom people, or “tiger bite people.” Because the tiger represented in Hmong folktales wickedness and duplicity, this was a very serious curse.

Unfortunately for Lia, the EMT, who took care of her from home to hospital, was in way over his head. She was on the verge of death. He used forced oxygen and attempted to insert an IV line, but failed time and time again, because Lia’s veins were so blown, and she was so fat. She was immediately taken to the cubicle in the ER reserved for the most critical cases. It took twenty minutes to insert a butterfly needle to the top of her foot, but any movement could cause them to lose that line. Valium was given in large doses, but had no effect on Lia’s seizures. In fact, they got worse. She aspirated her vomit which compromised her ability to breathe, and her blood oxygen levels were so low that she was essentially asphyxiating. Finally, one of the residents was able to insert a breathing tube and she was placed on a hand ventilator.

Neil Ernst was called at 7:35 on Thanksgiving Eve and as soon as the ER explained Lia’s condition, he knew it was the big one. When he arrived, Lia was literally jumping off the table. Steve Segerstrom, an ER doctor, thought it was worth trying a sapehnous cutdown which meant he would use a scalpel to cut into Lia’s vein and insert the necessary tubes to get medicine into her system. It worked! The atmosphere in the cubicle was now charged as people literally lay on Lia’s legs to keep her on the table. The gave her lots and lots of medicine, and Lia finally stopped seizing.

This was Lia’s sixteenth admission to the ER. The tests showed that her parents had been giving her the medicine correctly. They also showed that he had an elevated temperature, diarrhea, and a low blood platelet count. Even those these statistics were noted on her chart, no one ordered antibiotics, because no one suspected an infection. She had seized for two straight hours when a twenty minute continuous seizure is continued life-threatening. She had to be transferred to Valley Children’s Hospital in Fresno. In all that time, no one had said a word to Fous and Nao Kao. They had to have seen what was going on as people ran in and out of the critical care cubicle, but still no one stepped out to comfort them.