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The Soul Catcher

Anne Fadiman Captures the Spirit of Hmong Culture in Her Book About an Epileptic Girl and the Immigrant Family Who--in the Face of a Bewildering American Medical Establishment--So Lovingly Tends Her


ACRAMENTO — Lia Lee is not like the other children in this lively household. She doesn't laugh or cry. She doesn't join in games with her young cousins, nieces and nephews, or gossip with her 12-year-old sister, Pang, reading People magazine on the couch. She's 15 but looks only 6 or 7. Her small bony body--back arched, eyes rolling, hands seized in a perpetual clench--lies on a bed around which the life of her large family revolves.

When Lia was 4, she had "the big one," a grand mal epileptic seizure that starved her brain of oxygen for two hours. Since then she has existed in what her American doctors call "a persistent vegetative state." Her family would tell you differently. They would say that Lia's soul is wandering, that it is lost.

Lia and her family, Hmong refugees from the highlands of Laos, are among the central characters in "When the Spirit Catches You and You Fall Down" (Farrar, Straus & Giroux), Anne Fadiman's complex and haunting new work of nonfiction. Today, in this worn living room in suburban Sacramento, there's evident mutual affection between the New York-based author and her Hmong friends. Fadiman, sitting cross-legged on the floor, presents a copy of her book to Lia's mother, Foua, and her father, Nao Kao. Her interpreter sits close by, translating.

Lia's parents admire the book's cover, adorned with the photo of their invalid daughter as a plump, beautiful, healthy toddler. They will not read it because they neither speak nor read English, but they know the book will tell the world that their daughter is important.

The physician-memoirist Abraham Verghese calls Fadiman's new book "a cautionary tale." It tells us what can happen when a technically advanced medical system clashes with a rural people who believe that when a person is sick the whole world is out of balance, that there is no such thing as a body without a soul, that there can be no curing without healing.

Fadiman, an award-winning former medical reporter for Life magazine, learned about Lia from an old college friend, then chief resident of the Merced Community Medical Center in the San Joaquin Valley. An estimated 60,000 Hmong refugees, the highest concentration in the nation, have settled in Merced. Fadiman's doctor friend told her about the case of the little Hmong girl who had caused enormous turmoil at the hospital.

She proposed a piece to then-New Yorker Editor Bob Gottlieb, who assigned the story (which, because of editorial turnover, never ran) in 1988. "I had a fair amount of confidence in my reporting by then," Fadiman confesses ruefully, "which turned out to be completely unfounded because I got to Merced [where the Lees then lived] and I felt like a total fool. I'd spent nine years learning how to be a reporter, and I arrived and I couldn't even find a Hmong. I was just incompetent beyond belief until May Ying came along."

May Ying Xiong (now May Ying Xiong Ly) was the "cultural broker" Fadiman desperately needed to approach Lia's family. Doctors and social workers had warned Fadiman that the family would never speak to her. Luckily, Ly, by virtue of her family status, possessed impeccable credentials in the Hmong community.

"May Ying was very smart and knew instinctively what both sides of a mediated conversation needed," Fadiman says. "I went to the Lees with absolute fear and not much hope. But I went in with May Ying, and I just instantly adored the Lees. They were so different from how the doctors had described them: warm, articulate, friendly, smart."

Ly demurs, laughing. "Actually, it was Anne. She was very gentle and patient, and from the beginning it was clear that she really wanted to understand Hmong culture."

The Hmong are an ancient Asian hill tribe who have resisted assimilation for millenniums. To avoid subjugation by the Chinese, about half a million Hmong migrated from China to Laos in the early 19th century. A stateless people, for the last hundred years they have kept to themselves in high, inaccessible mountain villages ("Fish swim in the water; birds fly in the air; the Hmong live in the mountains," goes one proverb), where, as slash and burn farmers, they grew rice and corn for their own consumption and, with encouragement from the French colonial government in Laos, opium as a cash crop.


During the Vietnam War, the CIA recruited the Hmong, who had a historic reputation for toughness and valor, to fight the Viet Cong and Pathet Lao. They endured the highest casualty rates of that sorry war. When the Americans withdrew, the Hmong paid for their loyalty with more misery. (To this day, Hmong veterans have not received the military benefits promised them by the CIA.)

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