Chapter 19 of Fadiman’s The Spirit Catches You and You Fall Down concludes with a sacrifice conducted by a txiv neeb and the Lee family in honour of Lia. This scene truly highlights the rich culture of the Hmong with regards to how they interpret the happenings of the world and how they must deal with the negative consequences it may bring. In this case, the community had believed Lia’s condition was the result of her soul being scared out of her body and being compromised by an evil spirit, called a dab. Subsequently, a Hmong shaman was called upon to lessen her suffering through an organized healing ceremony. Animals were sacrificed, cleansing waters of gold and silver were consumed, special healing tools were used, and spirit-money was burned in hopes of cutting Lia’s sickness out of her. This method of alleviating illness contrasts heavily with American customs of curing the afflicted. While it may seem bizarre to those who did not grow up in a culture where sickness was dealt with in this way, one cannot deny it does promote a great sense of community and truly brings everyone together in what would be considered a very strong support system, which has proven to be immensely beneficial under emotional and physical burden. Though certain Hmong medicinal practices may be considered questionable by outsiders, it feels “warmer” in some ways comparable to the cold, clinical nature of just being dropped off at the doctor’s office.
Fadiman’s afterword details the lives of Lia, her parents, her siblings, and her doctor more than 24 years later. At the time of writing, Lia was still alive, years after many in vegetative states would have passed on. However, it was not long before news outlets had reported she had died at the age of 30. Nao Kao had since also moved on, as a result of congestive heart failure; however, Foua, her children, and her grandchildren have continued to adapt to living in America and have achieved great success. Though Lia’s siblings have grown up, graduated college, found jobs, gotten married, and had kids, all under a heavy American influence, they still maintained portions of Hmong culture. Fadiman points out that as stubborn as Hmong were known to be, the culture of Hmong living in the United States have not stayed static in the last two or three decades. Although certain cultural beliefs have been preserved, the modern Hmong generation has further assimilated to American customs and have shown decreased traditional Hmong behaviour, such as the frequent slaughtering of sacrificial animals and speaking Hmong better than English. With regards to health, this acculturation may make it significantly easier for doctors and Hmong patients to communicate effectively, thereby increasing the quality of care received. However, as mentioned in Unnatural Causes and class readings, acculturation, especially at a young age, has been linked to poorer overall health the longer an immigrant would stay in the United States. Hence, there appears to be a trade-off and it would be interesting to see the future of Hmong Americans both socially and in health. Overall, this biography opened up my eyes to the issue of culture with regards to health and assimilation. I felt that over the course of the book, I was able to feel the frustration of a foreigner, but learned to not only understand but feel empathy, for the Lee family’s customs. By the end, I was very sad Lia never did recover, but I was happy knowing that her siblings had become successful and were able to take care of their mother, who, while labeled an abusive parent by the state, had worked so hard to take care of so many children.