Modern Medicine and Neeb

The Spirit Catches You and You Fall Down | Chapter 9 : A Little Medicine and a Little Neeb | Summary

Lia's family celebrates her permanent return home in April 1986 by sacrificing a cow. Animal sacrifice, a reverent occasion for the Hmong, is more difficult in America but still part of Hmong American life.

However, the Lees become discouraged when they notice Lia's verbal skills have regressed. They think Lia was given too much medicine in foster care. The family takes Lia to a txiv neeb in Minnesota and tries other traditional cures. Pediatricians Neil Ernst and Peggy Philp notice Lia's decline too, but they feel it is because her family didn't comply with the prescribed dosages of medication. They're upset to learn Foua and Nao Kao thought they were being punished when Lia was taken away.

Social worker Jeanine Hilt remains dedicated to the Lees. She makes repeated house calls, helps Lia enroll in school, and ensures Lia sticks to her medication. Lia's health temporarily improves.

But another bout of status epilepticus in September 1986 sends Lia back to the emergency room. This time the doctors are baffled. Lia has been taking her prescribed medication, but it's not working. And Lia acquires an infection in the hospital, getting sicker from treatment just as her parents feared. Neil and Peggy, devoted to finding out the truth, admit their own mistakes in treating Lia. The doctors grow increasingly anxious, convinced Lia will soon have a seizure they won't be able to stop.

Analysis
The title suggests the ideal course of treatment would combine Western medicine and Hmong healing traditions. The word neeb refers to a healing spirit in Hmong culture. The Lees don't think Lia can truly recover without "a little neeb." Animism, or belief in spiritual beings that intervene in human lives, is central to their understanding of her illness.

Nor does animism sit well with non-Hmong residents of Merced, California. The Hmong ritual of animal sacrifice is an example of a divisive cultural tradition. While animal sacrifice has deep meaning to those who practice it, other community members may regard it as unusual or even repulsive. The narrative indicates the spread of rumors—often based on kernels of truth and heightened for dramatic effect—contributes to Westerners' distrust of the Hmong.

Moreover, many Merced residents subconsciously expect immigrants to adopt the practices of the dominant Western culture. Even doctor Bill Selvidge is surprised to learn people in his community, who seem to have blended into American life, have cultural practices he regards as foreign. The Lees keep their own distance from Western cultural priorities. Nao Kao remarks Americans would accept the Lees' cow sacrifice since the Lees have a receipt to prove they paid money for the cow.

Cultural misunderstandings become more poignant as the Lees and the MCMC medical team members blame each other for Lia's declining condition. Each party doubts the other's good intentions. The Lees view Neil and Peggy as authorities who want to punish them, not as partners in treatment who care first and foremost about Lia's well-being. Other MCMC doctors view Hmong parents as negligent caregivers who don't bring their children for follow-up appointments, not as parents who make financial sacrifices to cure their children. The narrative's quest is to discover if and how Western doctors and Hmong patients can see one another in a more accurate light.

Lia's hospital-acquired infection adds a tension-building twist to the narrative. For perhaps the first time, the doctors don't have an answer. They can no longer blame the parents' lack of compliance. Instead Neil and Peggy discover Lia's illness may be more complex than they imagined. Their dedication to uncovering the truth shows an important aspect of ethical medical practice. Good doctors acknowledge what they don't know and seek to learn more, even if they're proved wrong.