The Spirit Catches You and You Fall Down (15 page)

Once I asked Bill Selvidge why Merced’s doctors never seemed to ask their Hmong patients how
they
treated their illnesses, and he replied that because the Hmong dressed at least approximately in American clothes, had driver’s licenses, and shopped in supermarkets, it never occurred to his colleagues—and only rarely to him—that they might practice esoteric healing arts. “If you went down to the rain forest and talked to the Yanomamo,” he said, “you’d be surprised if they
didn’t
come up with all sorts of fantastic spirit stories. You’d be surprised if they sat there and started saying, you know, ‘Where is the penicillin for my impetigo?’ But if you took them to this setting, the way the Hmong have come here, and you dressed them up and they drove a car and came to MCMC, you wouldn’t expect to hear those spirit stories anymore.”

Neil and Peggy had no idea what the Lees were doing to heal Lia because they never thought to ask. The only American who did ask, and who therefore learned of the $1,000 amulets and at least some of the animal sacrifices, was Jeanine Hilt. I would have expected the Lees to focus the most burning rays of their resentment on Jeanine, an official representative of the very agency that had confiscated their daughter. On the contrary, the Lees chose to categorize her not as Lia’s abductor but as her patron, “the person who gave Lia her disability money.” Aside from Dee Korda, Jeanine was the only American I talked to who didn’t describe the Lees as closemouthed and dim; not coincidentally, she was also the only American I ever heard Foua or Nao Kao refer to by name. They called her Jenny. She responded by learning the names of all eight of Lia’s siblings: Chong, Zoua, Cheng, May, Yer, True, Mai, and Pang. Compared to the Olympian Drs. Ernst and Philp, who never volunteered their first names, Jeanine seemed warm and unpretentious. Even her size—five feet one and comfortably rounded—was closer to the Hmong scale. Neil and Peggy were respectively six two and five nine, and seemed even taller because they had such perfect posture. Jeanine also had more success keeping the lines of communication snarl-free, partly because, as a social worker, she was able to make house calls. (In all their years of dealing with the Lees, Neil never visited their home and Peggy visited only once.) She took the sensible step of using May, the Lees’ most Americanized daughter, as her interpreter. Not only was May’s English excellent—like my interpreter, May Ying Xiong, she had learned it in an American high school, so her grammar and vocabulary were superior to those of almost any Hmong adult—but after Jeanine left, Foua and Nao Kao were able to ask May, as often as was necessary, “Explain what Jenny said again.”

Jeanine’s empathy for the Lees may have been deepened by two factors: she understood what it was like to live with a chronic illness, because she had severe asthma herself; and she admired the closeness of Hmong families, because her relations with her own family, who were fundamentalist Christians, had been strained for many years, ever since they had learned she lived with a lesbian partner. She had no children of her own. Unlike the MCMC nurses who considered Lia a burden and a pest, Jeanine thought she was a delightful child. “I just totally fell in love with her,” Jeanine recalled. “Lia wasn’t your typical kid that would play appropriately with toys and, you know, do all the right things. She was like a little blowfly flitting about, just totally out of control and wild and unsocialized but—well, absolutely adorable. Physically, I found her a very attractive child. She was real cute and real huggable. I mean, this kid could give you a hug like no other kid could. She would climb into your arms and sit in your lap and just give you a terrific bear hug and grab your glasses and pinch your cheeks until they hurt.”

Jeanine’s involvement in Lia’s case rapidly escalated from a professional assignment to an obsession. A typical Hilt letter, written with cheerful officiousness to Judith Eppley, a counselor at a regional agency for the developmentally disabled:

In Neil’s opinion, Jeanine was “a large pain in the ass.” He remembered innumerable times when she had nagged him for information about Lia or for prescriptions for medical equipment he considered unnecessary, such as an electronic digital thermometer that she hoped to teach Foua to use, with May’s help in reading the numbers. Whatever she requested was always needed “
immediately
” and at no cost to the Lees. “Jeanine took on the Lees like a crusade,” said Neil. “She always wanted to be notified about any change in Lia’s condition, and, my God, it wasn’t like we didn’t have six billion other things that we had to think of. If you forgot to call her she’d read you the riot act. I think she had trouble understanding that Lia was just one of hundreds or thousands of patients that we took care of and we couldn’t drop everything and do exactly what she wanted. But it was a double-edged sword. She was good, too. Jeanine was an incredible patient advocate. There was nothing she wouldn’t do for this kid.”

One of the things Jeanine arranged was to have Lia bused three days a week to the Schelby Center for Special Education, the county school for retarded and disabled children. She hoped that Schelby would help socialize Lia as well as giving Foua an occasional respite. Lia’s teacher, Sunny Lippert, recalled, “Lia was very spoiled. Jeanine Hilt told us the family felt that she talked to the gods during her seizures and that they had this euphoric idea that she was a princess. They fixed her special things to eat, and whatever she wanted, they did. If she raised her arms her mother would carry her through the house. She got rather chubby, and the more she sat around and let people do things for her, the heavier she got. She was a beautiful child. Her mother just groomed her until she was immaculate. Lia could charm the hair right off a dog. She was the type you’d just want to pick up, but I had a rule in my room:
No one could pick up Lia
. Of course, as soon as she went home, her family kept right on catering to her.”

Believing that Lia’s behavioral problems stemmed partly from a lack of daily structure, Jeanine posted the following on the Lees’ wall:

Despite May’s help in reading it, this schedule never fully took hold, partly because of Foua’s and Nao Kao’s orientation to the cock-crow system rather than to the clock. Another fruitless effort was a list of instructions about how to administer Tylenol and Valium to prevent febrile seizures when Lia spiked a temperature. Jeanine went to great trouble to have it translated into swirly Lao script, failing to realize that no one in the Lee family spoke or read Lao. But in her most important goal—persuading the Lees to administer Lia’s medicine—Jeanine achieved a stunning success. Blood tests showed that Lia was regularly maintaining a therapeutic level of Depakene. During her first four months at home, she had only one seizure, her best record since infancy. Jeanine attributed this period of unusual health to the Depakene; the Lees attributed it to the successful intervention of the
txiv neeb
in Minnesota.

In September of 1986, Lia fell off a swing at the Schelby Center, hit her head, and went into status epilepticus, the condition, dreaded by all her doctors, in which her seizures, instead of spontaneously resolving after a few minutes, continued one after another with no intervals of consciousness. It was unclear whether Lia fell because she seized or whether she seized because she fell, but in any case, when she was taken to the hospital, she was found to have adequate levels of Depakene in her bloodstream. Parental noncompliance, for once, was manifestly not a factor. Nao Kao’s diagnosis was that “the teacher made her drop from the swing and when she fell she was scared and her soul went away too, so she got sick again.” In Lia’s MCMC admission summary, her medical history was noted to be “complicated” and her social history to be “very complicated.”

Neil remembers this admission, Lia’s fourteenth stay at MCMC, to be the most harrowing she had ever had. “She’d been doing real well
—real, real
well—and then came this unbelievable set of problems. She had a bad seizure, all of this food crap started coming out of her mouth and she aspirated a lot of it into her lungs, she went into respiratory failure, she couldn’t breathe for herself so we had to intubate her, then the breathing tube caused some local irritation of the trachea, so after we pulled it out she started breathing with a lot of difficulty and we had to reintubate her, and then she got this very unusual infection of the airway from the irritation. The parents had to go along with a lot of stuff, an oxygen mask, lots of IVs, blood work, an arterial line to measure the oxygen and carbon dioxide in her blood, real invasive stuff.” Nao Kao remembered this as the time when Lia “had a lot of plastic all over her.” He or Foua slept by Lia’s side every one of the fourteen nights she spent in the hospital. He recalled, “The doctors made Lia stay so long in the hospital, and it just made her sicker and sicker.”

Neil and Peggy co-authored an article in the
Pediatric Infectious Disease Journal
, called “Bacterial Tracheitis Caused by
Branhamella catarrhalis
,” about Lia’s tracheal infection. “Lia got published!” is how Neil put it when he showed me the article several years later. In it, they wrote:

Not every doctor would choose to publicize a nosocomial, or hospital-acquired, infection, especially if, as was the case here, it was he rather than an inexperienced resident who had been responsible for inflicting the “local injury.” When I read the article, I was struck, as I had often been before, by how much more interested Neil and Peggy were in the truth than in making themselves look good. I was also struck by the fact that Nao Kao was absolutely right: the hospital
had
made Lia sicker.

Only three weeks after Lia was discharged, she was admitted again, despite adequate levels of medication, with severe seizures and fever. Neil and Peggy were horrified. “I had been really impressed that she was having such good control with the Depakene,” recalled Neil, “and then she had two seizures within a month and I said, Oh God, here we go again. The Depakene is not working! I couldn’t think of any good way to keep her seizures from getting worse. I remember we thought about putting her under anesthesia to stop her shaking the next time she came in, so we could at least get an IV in. And I remember Dan Murphy and I had a few conversations about whether we should try surgery, to try to cauterize part of Lia’s brain. I really didn’t know what to do. I was just grabbing at straws.”

Peggy said, “The seizures were getting very, very long. Before, sometimes they used to stop on their own, but these didn’t. It seemed like it took more medication to stop them, and we were afraid that one day we were going to try to get in an IV and just not be able to do it, because Lia was so fat and because we’d already cut down so many of her veins. If she seized long enough she was going to gork her brain out. Early that fall we started to get this feeling of doom. We talked about it a lot. It was hard to imagine that the Lia era would ever be over, but I remember thinking it was going to be. We were just waiting for the big one.”

Neil said, “I felt like there was this giant snowball that was coming down the mountain and we were trying to hold it up there and it just kept pushing us. I remember talking to the parents and telling them that Lia’s seizures were getting worse and more frequent and that someday she might have one we couldn’t stop. It was so haunting. I started to have nightmares that it was going to happen, and I would be the one on call, and I couldn’t stop it and she was going to die right before my eyes. It was inevitable. It was just a matter of when.”

A folktale collected in 1924 by François Marie Savina, the French missionary, reports that when the Hmong lived in the primordial northern homeland where the days and nights were six months long, they were once involved in a land dispute with some neighboring tribes. Their king resolved it as follows. Each tribe would select an envoy who would walk as far as he could during the six months between sunset to sunrise, returning to the king’s golden palace at the end of his journey. All the territory he covered would belong to his tribe. If one of the envoys failed to reach the palace, his tribe would be commanded to live wherever he stood at the moment the sun rose. At daybreak, the Hmong envoy was standing on a high pinnacle, and this is why, ever since then, the Hmong have always lived in the mountains, where they are the first to see the sun rise and the last to see it set.

If that footsore walker had ended up standing on the plains instead, the fate of the Hmong would have been entirely different. Almost every aspect of the tribe’s history and character proceeds from the essential fact that they are montagnards. As a Hmong proverb puts it, “Fish swim in the water; birds fly in the air; the Hmong live in the mountains.” The Hmong language has dozens of terms for mountains of different shapes, different slopes, different elevations. “Ask a Miao [Hmong] the name of his country of origin,” wrote Savina, “and he will answer with the name of a mountain. Such-and-such is the mountain where I was born, he will say. Ask him where that mountain happened to be, and he will indicate whether it was to the north, the south, the east, or the west, instead of telling you whether it was in China, in Tonkin, or in Laos.” When a Hmong was obliged to descend to the lowlands, Savina observed, he could easily be identified by his peculiar gait. “Accustomed to frequenting steep, rocky paths…he would forget he was walking on a smooth, flat road, and he would raise his foot too high with each step, as if he were climbing a staircase or feared he were going to trip. On the plain, a Miao was as much out of his element as a sailor on dry land.”

In prewar Laos, the various ethnic groups were as stratified as a pousse-café. The Lao lived in the plains. The Karen and the Khmu lived above the altitude of 50 meters. The Mien lived above 400 meters. “And finally,” wrote Father Jean Mottin, “at the highest altitudes for the people of these regions, between 1,000 and 2,000 meters if it is possible, live the Hmong. Seek among the highest and most inaccessible mountains and there you will find them, for it is there they find themselves at home!” The lowland Lao may have been richer, more numerous, and politically more powerful, but the Hmong, peering down at their putative masters like eagles looking at mice, always managed to maintain an unbudgeable sense of superiority. As it had in China, their ethnic identity remained pure. Assimilation was easy to resist because their contacts with the dominant culture were so few. They rarely visited the plains, which they called “the land of leeches,” believing—with some justification, given the greater incidence of tropical diseases at low elevations—that doing so would make them sick. No one passed through their territory en route to anywhere else. And although they were occasionally visited by Yunnanese traders bringing silver, cloth, thread, shoes, and cooking pots, they were able to keep trade to a minimum because they were so self-sufficient. They produced all their own food as well as all the fodder for their livestock. Using homemade flintlock rifles, or crossbows made of wood, bamboo, and hemp, they hunted birds, rats, monkeys, gibbons, deer, wild pigs, and tigers. They fished the mountain streams. They gathered fruits, greens, wild mushrooms, tubers, and bamboo shoots. They picked slow-moving grasshoppers from the undersides of leaves in the early morning cold, and roasted them. They tied chicken feathers around the thoraxes of bees, followed them back to their hives, smoked out the bees, removed the honey, picked out the bee larvae, and steamed them. When they got thirsty in the forest, they plucked large upturned leaves shaped like dishes and drank the dew.

In the Hmong language, there are hundreds of lyrical two-word expressions—not the stuff of poetry but of everyday speech—that onomatopoeically describe various sounds. These alliterative expressions, collected by the linguist Martha Ratcliff, give some inkling of the intimate relationship the Hmong of Laos had with the natural world. Some samples:
zuj ziag
, a cicada singing;
lis loos
, bees buzzing;
nplhuj nplhoos
, a boar grunting;
mig mog
, tigers playing;
ig awg
, wild pigs fighting in close combat;
txij txej
, a rat or mouse crying out in a snake’s mouth;
xuj xuav
, a snake undulating;
txiv txev
, birds chirping;
rhuj rhuav
, birds shuffling through leaves looking for insects;
plig plawg
, a bird rising from its nest on the ground;
zig zuag
, monkeys swishing through the treetops with a continuous noise;
tsig tsuag
, monkeys leaping through the treetops with separate noises;
nruj nreev
, a tree popping fast before it falls;
nrhuj nrhawv
, a tree popping slowly before it falls;
vig vag
, a tree brushing through other trees and underbrush while it falls;
nqaj nqug
, many trees falling one right after another;
pij pauj
, fruit falling on the ground;
pliv ploov
, fruit falling in water;
xuj xuav
, a long, easy, all-day rain.

Like most people who live close to the land, the Hmong were farmers. Foua Yang once told me that everyone in her village did the same work, so no one was more important than anyone else. There was no class system. Since no one knew how to read, no one felt deprived or inconvenienced by the lack of literacy. Everything the next generation needed to know was passed on orally and by example: how to venerate the ancestors, how to play the
qeej
, how to conduct a funeral, how to court a lover, how to track a deer, how to build a house, how to embroider a skirt, how to butcher a pig, how to flail a load of rice.

Although they harvested enough rice, corn, and vegetables for their own needs, the only crop the Hmong could indisputably grow better than the lowland Lao, because it was specifically suited to the cool temperatures and alkaline soils of the highlands, was the opium poppy. There is, of course, a legend about it. Once, long ago, there was a wanton Hmong beauty whose libertinage led to her early death. From her grave grew a flower. Its pod exuded a sap whose fragrance enabled anyone who inhaled it to reexperience the ecstasy her lovers had once enjoyed. Through the medium of dreams, she initiated her posthumous acolytes into the mysteries of opium cultivation and preparation. The dreams must have been highly instructive, for ever since the end of the eighteenth century, when the British East India Company introduced the opium poppy to China, the Hmong have been master opium growers, drawn willy-nilly into an international trade they neither created nor controlled. In Laos, the French colonial government encouraged them to pay their taxes in raw opium in order to supply the official lowland network of government-licensed opium dens. The Hmong complied with ease. They knew how to choose the best soil for growing opium by tasting it for its lime content. They knew how to broadcast the poppy seeds in cornfields so the young plants would be protected by the corn stalks. They knew how to incise the pods with triple-bladed knives (cutting neither so deep that the sap dripped to the ground nor so lightly that it was trapped inside the pods), wait until the extruded sap coagulated and turned brown, scrape it, wrap it in poppy petals or banana leaves, knead it, and form it into bricks. My Hmong dictionary lists twenty-nine terms related to opium cultivation and smoking, from
riam yeeb
(the knife used to score the pods) to
yeeb tseeb
(the needlelike tool used to hold the wad of opium while preparing it for smoking). Surprisingly few Hmong aside from the chronically ill and the elderly were addicts. Opium was reserved mainly to facilitate the ceremonial trances of
txiv neebs
; to dull the pain of headaches, toothaches, snakebites, and fever; to stanch diarrhea; and to ease the discomforts of old age. Young addicts, most of whom were men, shouldered a heavy burden of shame. Stigmatized by their diminished ability to work, they not only had trouble finding brides themselves but blackened the marital prospects of their brothers and cousins.

The Hmong kept less than ten percent of their opium yield for their own use, and sold the rest. It was their only cash crop. One could hardly invent a more perfect commodity for mountain transport: easily portable, immune to spoilage, and possessing a stratospherically high value-to-weight ratio. One kilogram of opium was worth as much as half a ton of rice. The saddlebags of a single modest caravan of ponies, led by a lowland merchant, could carry a village’s entire annual output of crude opium bricks. The Hmong accepted no paper currency for their opium, only silver bars or piasters, which they melted down to make jewelry or hoarded for brideprices. Opium production equaled wealth. No wonder that when Christian missionaries first came to Laos, they often found small, meticulously wrapped balls of opium in their offering plates. No wonder that the parents of my interpreter believed that May Ying—Opium Poppy—was the most beautiful name they could give their daughter.

The Hmong grew their opium, as they grew their rice and corn, as a slash-and-burn crop. (The more polite agricultural term is “swidden.”) In the dry season the women cut away the forest underbrush with knives, and the men felled the trees with axes. Then the men sprinted down the hillsides, igniting the piles of vegetation with torches. The flames often rose four hundred feet in the air, and the swirling smoke could be seen for miles. When the charred brush had cooled enough to touch, entire families worked together to clear the debris before they planted, leaving only boulders and tree stumps. Swidden farming required no plowing, no irrigation, no terracing, no fertilizing. The topsoil was briefly enriched by the wood ashes, but four or five years of monsoons washed it away, and the remaining soil was so exhausted that twenty years could pass before it was once again productive. In the 1950s, it was estimated that the Hmong of Laos were burning about four hundred square miles of land a year and, by letting the topsoil leach away, causing enough erosion to alter the courses of rivers. Opium was a particularly egregious offender, since instead of eventually reforesting like rice swiddens, old opium swiddens became covered in a coarse grass called imperata, which even animals refused to eat.

The practice of swidden farming is inextricably intertwined with the migrant identity of the Hmong. The residents of a village would farm the contiguous land, abandon it in a few years when the soil became depleted, farm the land within walking distance, abandon that, build overnight shelters in order to farm even more distant land, and then, finally, move the entire village. Like Elizabeth I of England, who scheduled her progresses from castle to castle in the pre-plumbing era by departing whenever the smell became unbearable, the Hmong moved when a village’s accumulation of garbage and animal feces grew unpleasant or began to make people sick. If a village got overcrowded, extended family groups sometimes established satellite villages nearby. Hmong houses—split bamboo or wooden planks lashed together with ropes and sinews—were designed to be easily dismantled, portaged, and reassembled. Hmong arts were portable too: no monumental sculpture; highly evolved textiles, jewelry, music, and storytelling. Because they always moved in groups rather than as individuals, their clan structure, their religion, and their cultural identity accompanied them wherever they went, constituting an essential sense of “home” that inoculated them against perpetual homesickness.

The life of the swidden migrant bespoke a certain prodigal faith in the earth’s inexhaustible abundance, the confidence that if one field lost its fertility, one village its health, or one region its plenty, no matter: as the Hmong proverb declared, “There’s always another mountain.” It was not a lazy attitude. Moving is difficult. When the Hmong left China for Indochina, they had committed themselves to migration as a problem-solving strategy on the most arduous scale they could imagine, and in the 1960s and 1970s, when Laos became a battleground for the Vietnam War, they found themselves repeating the process yet again, even more drastically, first within the nation’s borders and eventually far beyond them.

In 1961, King Savang Vatthana of Laos, a well-meaning but sinewless intellectual who traced his lineage to the eighth century, quoted Proust, and drove an Edsel, lamented, “Our country is the most peaceful in the world…. At no time has there ever arisen in the minds of the Lao people the idea of coveting another’s wealth, of quarreling with their neighbors, much less of fighting them. And yet, during the past twenty years, our country has known neither peace nor security…. Enemies of all sorts have tried to cross our frontiers, to destroy our people and to destroy our religion and our nation’s aura of peace and concord. Foreign countries do not care either about our interests or peace; they are concerned only with their own interests.”

The Geneva Accords of 1954, signed after the French lost the battle of Dien Bien Phu, had recognized three independent states in what had formerly been French Indochina: Laos, Cambodia, and Vietnam, which was temporarily partitioned into northern and southern zones that were supposed to be reunited within two years. Laos was to be neutral. But this economically piddling backwater, which in 1960 had one stoplight in its capital and only three million dollars of exports (not counting opium), was cursed by its strategic location. With Thailand and Burma to the west, Vietnam to the east, and Cambodia to the south—all of them stronger and more populous, and none of them walled off by natural barriers—Laos was unlikely to stay neutral for long. Aided by the Vietminh, Ho Chi Minh’s North Vietnamese military forces, the communist Pathet Lao became entangled in a protracted struggle with the anticommunist Royal Lao government for control of the country.