Lia’s doctors Did not have instruction in cross-cultural medicine. They say Lia’s parents refusal to accept the basic tools of modern medicine as ignorance.

Lia’s parents Saw Lia’s doctors attitude as arrogant.

Some Hmong medical practices Dermal treatments: –Acupuncture –Massage –Rubbing coins against the skin –Igniting alcohol-soaked cotton under a tiny cup to create a vacuum

Some of these practices left marks on the skin that Western doctors interpreted as abuse.

Dr. Roger Fife Not respected in the medical community One of the only doctors trusted by the Hmong, because: –“He doesn’t cut” –He didn’t force his patients to comply with conventional American medical practices –He handed over babies’ placentas upon request.

Would Lia have been better off if she had been treated by Dr. Fife instead of Dr. Ernst? We don’t know. Dr. Ernst was uncompromising, and would not apply two different standards of care to his patients.

Neil Ernst decided that he had no choice but to request that Lia be placed in foster care, so she could get her medications according to his instructions.

Lia’s parents were not notified in advance that she was going to be taken.

Her mother almost went crazy when she came home and found out that Lia had been removed. She cried every day. Her father was very angry.

Every other doctor at MCMC disagreed with Neil’s decision when Anne Fadiman brought it to their attention. They all considered that Foua and Nao Kao were very good, loving parents.

The Hmong emphasize that back in Laos, parents have 100% responsibility over the child, and that they cannot be taken away.

Hmong parents, who are very loving and caring toward their children, are utterly confused and enraged when they are stripped of their power in a country to which they have fled because of its reputation for freedom.

Lia in Foster Care Lia had severe behavioural problems at the time she was placed in foster care: –Self-injurious behaviour –Aggressive and hostile when frustrated –Hyperactive –Resistive –Temper tantrums

When Lia arrived at her foster parents’ place, she cried every day. She began to engage in more severe self-injurious behaviour such as banging her head.

Dee Korda, her foster mom, soon realized it was a serious mistake that Lia had been placed in foster care. She even asked Foua to baby-sit her kid when she took Lia to the doctor.

When Lia was allowed to spend time with her parents, instead of giving her the medications, they opted for traditional healing techniques. This prevented them from regaining custody.

Lia did not return home at the 6 month mark. Parents had also refused to sign an agreement, demanding that she be returned immediately.

Despite the fact that Dee followed the anticonvulsant prescriptions to the letter, Lia seized more frequently at the Korda’s than she had when she was living with her parents.

Lia was taken to a different hospital, and this time doctors substituted all of her medications with Depakene.

With the help of social worker Jeanine Hilt, the Lees were able to learn how to administer the new medication, which was much easier than the ones prescribed by Neil.

This allowed them to regain custody of Lia.

When Lia returned home, she was in damaged condition, presenting severe symptoms of delayed mental development. Her parents decided to try a little medicine and a little neeb.

Neeb Healing spirit Shorthand for ua neeb kho, the shamanic ritual, performed by a txiv neeb, in which an animal is sacrificed and its soul bartered for the vagrant soul of a sick person.

Animal Sacrifice Propitiates ancestors. Cures illnesses by offering the souls of the slaughter animals as ransom for fugitive souls. Is a sacred act performed with respect and reverence.

The souls of sacrificed animals are precious and vitally connected to human souls. Animals are not considered to be as far removed from the human species ast hey are in our world view.

Lia’s Neeb A cow was sacrificed A txiv neeb performed the ritual chant that accompanied his journey to the realm of the unseen. Relatives were invited to have a large, festive meal, where all parts of the cow were consumed.