ANTH 2280 The Spirit Catches You – Flashcards
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Tvix neeb
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Shaman who was believed to have the ability to enter a trance, summon familiars, ride a winged horse, cross an ocean inhabited by dragons, and negotiate for his patient's he alt with spirits that lived in the realm of the unseen
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Dab
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malevolent spirit
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How would a pregnant hmong woman assure the health of her baby?
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by paying close attention to her food cravings
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Where would the father bury the placenta?
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Girl-under the parents' bed Boy-near the base of the central wooden pillar of the house where a male spirit geld up the roof of the house and watched over its residents (more honorable)
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What Hmong word is the same as the word for placenta? Why?
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Jacket The placenta is considered one's first and finest garment
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What does one's soul do after death?
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The soul travels back place to place, retracting the life's geography, to the house where its placenta is buried. It then puts on this garment and continues on the dangerous journey until it is reunited with its ancestors from where it can be reborn as a new baby. If it can't find its placenta, it is condemned to an eternity of wandering naked and alone.
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What would Foua's experience of giving birth in Laos look like?
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-Squatted on the floor and pulled the baby out with her own hands -labored in silence -husband would cut cord -husband would bury placenta -Foua would drink warm water to make the blood in the womb flow freely -eat steamed rice and chicken boiled in water with give postpartum herbs
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Hu plig
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"soul calling" -naming ceremony that takes place after birth
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What do the Hmong believe to be the most common cause of illness?
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Soul loss
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What are two signs that indicate one's soul is pleased to take up residence in one's body?
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Chickens' (dead and previously in the cooking pot) skulls are translucent and tongues are curled upward
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hais cuaj txub kaum txub
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"to speak of all kind of things"
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What does the history of the Hmong reveal about their people?
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-they do not like to take orders or lose -they would rather flee, fight, or die rather than surrender -they are not intimidated by being outnumbered -they are rarely persuaded that the customs of other cultures are superior -they are capable of getting very angry
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Hmong folktale of the Orphan
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the Orphan, a young man whose parents have died, leaving him alone to live by his wits. He is usually clever, energetic, brave, persistent, and a virtuoso player qeej (Hmong instrument). Though he lives by himself on the margins of society, reviled by almost everyone, he knows in his heart that he is actually superior to all his detractors. This character is a symbol of the Hmong people.
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What caused Lia to start having epileptic seizures?
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Her soul was frightened out of her body and became lost after her sister slammed the front door of the Lee's apartment.
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Quag dab peg
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"the spirit catches you and you fall down" -Lia's parents recognized her epileptic symptoms as this
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Hmong view of epilepsy
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They acknowledge that it is potentially dangerous and life threatening, but they also consider it to be an illness of some distinction, an illness in which a healing spirit enters the body. -The Hmong saw it as divine, because many of their shamans were afflicted with it. As a result, it conferred a great deal of social status in their community and marked the victim as a person of high moral character since a healing spirit would never choose someone of no -account.
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What "type" of medicine did the doctors at MCMC conclude must be practiced with the Hmong?
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"veterinary medicine"
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American doctors vs. Hmong shamans
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-A shaman might spend eight hours in a Hmong home while an American doctor demanded the patient come to the hospital where the doctor might only see him for twenty minutes -Shamans never asked the rude questions American doctors did -Shamans could render an immediate diagnosis while the doctors had to run many tests and then sometimes didn't know what was wrong anyway -Shamans never undressed their patients; doctors even put their hands and fingers into body orifices -Shamans knew you had to treat the soul as well as the body -Shamans could not be blamed for their patients not getting well, because it was the fault of the spirits; doctors were blamed in America for the patient's death.
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Why do the Hmong believe that medical procedures were more likely to threaten their health than to restore it?
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-The Hmong believe that there is only a finite amount of blood in the body, doctors are continually taking it. -When people are unconscious, their souls are at large, so anesthesia may lead to illness or death. -Surgery is taboo and so are autopsies and embalming. -The only form of medical treatment that was gratefully accepted by the Hmong was antibiotics. -They had no fear of needles and frequently practiced dermal treatments like acupuncture, massage, pinching, scraping the skin, heating a cup to the skin or even burning the skin.
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What other problem contributed to Lia's epilepsy problem?
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Her obesity -It made intravenous access difficult and threatened her life, as a result
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Why did Lia's father like her fat?
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A plump Hmong child was perceived as healthy and especially well cared for
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Why were the Lees were non-compliant with the medical professionals' and their instructions?
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-They didn't understand the instructions -They also didn't want to give the drugs. They had come to the conclusion that the medicines were causing the seizures and also Lia's fever.
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How do the doctors have to handle the Lees' non-compliant attitude?
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-They had to understand that if they pushed their western ideas too hard, they risked running up against the stubborn strain in the Hmong character that for thousands of years had preferred death to surrender -The key was to find a way to allow the parents to back down without loss of face.
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How did not administering Lia's medications affect her development?
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-Lia was a victim of developmental delay. -She was showing a regression in the number of words she used -they saw a steady decrease in intellectual capacity if the parents didn't begin to follow directions in administering Lia's medications
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Why was the Hmong people's deepest fear about life in the U.S. the doctors?
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-medicine was religion, religion was society, and society was medicine. ---the Hmong preoccupation with medical issues was nothing more than a preoccupation with life and death and life after death
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What produced the quarter-sized round lesions on the abdomens and arms of the Hmong children that prompted Neil and Peggy to call Children's Services?
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lesions were the result of dermal treatments like cupping, a treatment common among Southeast Asian ethnic groups
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In what way did the complaints among the Hmong to the doctors pose an issue?
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-their complaints had no organic basis though their pain was perfectly real -they were feeling somatization, emotional problems expressing themselves as physical problems
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Why did the Hmong women in the United States refuse to have their babies at home?
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they believed the children would then not be an American citizen -they often gave birth in the parking lot or the elevator
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What do the Lees believe is the reason for Lia's worsening sickness once she is in foster care?
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-the Lees believed that Lia became even sicker, because she missed them so much.
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Why did Nao Kao not trust Su Xiong (the interpreter)?
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He didn't trust her, because she had married an American and the Hmong almost never married outside of their clan. -He also believed, because she scolded him, that she was not accurately translating what he said.
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Why did Sukey (a psychologist at Merced Community Outreach Services) describe herself as a "fixer of hearts?"
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-psychological problems did not exist for the Hmong, because they did not distinguish between mental and physical illness -Everything was a spiritual problem.
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How was the author able to be accepted by the Lees?
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"With May Ying at her side, she was not an official, not a threat, not a critic, not a person who was trying to persuade the Lees to do anything they did not wish to do, not even someone to be taken very seriously. Her insignificance was her saving grace."
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Why was asking the Lees questions involving time not helpful?
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The Lees did not tell time in the same way hospital record-keepers did. Years were described as "when the spirits caught Lia and she fell down" or "the year Lia became government property." -They also had no calendar, but followed the lunar cycles and how they affected agriculture, their traditional work.
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neeb
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soul -Fao believed that Lia needed a little medicine and a little neeb in her encounters with malevolent dabs
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What does the author conclude Fao meant when she says she is stupid?
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she meant that none of her former skills were transferable to the United States except for the ability to be an excellent mother to nine surviving children.
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What does Fao say she misses about Laos?
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"What I miss in Laos is that free spirit, doing what you want to do. You own your own fields, your own rice, your own plants, your own fruit trees. I miss that feeling of freeness. I miss having something that really belongs to me."
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What (traditional medicine) measures did the Lees take to try to increase Lia's health?
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-spent large amounts of their money on such things as amulets -tried every known cure in their medical library even to the point of changing Lia's name to Kou on the premise that the dab that stole her soul would be tricked into thinking she was someone else, and the soul could return -took her to a shaman in Minnesota for help.
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Why did the doctors never ask the Hmong how they treated their illnesses?
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because they dressed in American clothing, had American driver's licenses and shopped in supermarkets, it never occurred to the medical staff that they might practice unconventional healing arts
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When Lia went four months with only one seizure, what did her parents attribute the success to?
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-the Lees thought it was because of the Shaman they had taken her to in Minnesota -Jeanine attributed it to the use of Depakene and no other seizure medication
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Status epilepticus
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condition in which her seizures continued one right after the other -Lia went into status epilepticus after falling off a swing in 1986 -There were no intervals of consciousness -She was found to have adequate levels of Depakene in her system so non- compliance was not the issue.
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What do the Lees believed caused Lia's status epilepticus?
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The Lees believed that the teacher had made her fall from the swing, and when she became afraid, her soul went away, and she became sick again
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When Lia was having a terrible seizure, why did Nao Kao have his nephew come over and call 911 instead of running three blocks to the hospital?
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They feared if they took her to the ER themselves, they wouldn't be taken as seriously -However, an ambulance was always taken seriously
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tsoy tom people
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"tiger bite people" -Nao Kao thought of the doctors in the ER as this -because the tiger represented in Hmong folktales wickedness and duplicity, this was a very serious curse
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What was Lia diagnosed with once transferred to the hospital in Fresno?
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-"profound shock, probably of septic origin" -the septic bacteria had invaded her bloodstream, and her organs were now shutting down -The mortality rate for this kind of bacteria is between 40-60%
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Why did seeing Lia have a spinal tap distress Nao Kao?
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because he believed that by sucking her backbone like that they had lost Lia
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What did the Lees think the invasive test procedures were?
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"sleeping shots"
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In what condition did Lia leave Fresno to be transferred back to MCMC?
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Lia was effectively brain dead
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Why does Fou feel that their escape from Laos was nowhere near as sad as after Lia went to Fresno and got sick?
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"violence, starvation, destitution, exile and death were, however horrific, within the sphere of the known, or at conceivable tragedies. What had happened to Lia was outside that sphere."
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What did Nao Kao do when forced to sign a piece of paper that said his daughter was going to die?
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he did what the Hmong have done for centuries: he fled -saying that his daughter was going to die was an offensive comment and was perceived as threatening
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What did the Lees do when they got home with Lia?
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-they boiled some herbs and washed her body -She had been sweating constantly in the hospital, but after washing Lia's body, the sweating stopped and she didn't die.
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E. pluribus Unum
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"from many, one" -a matter of embracing a shared national identity
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nyias
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apron-shaped baby carrier -Lia was carried on Foua's back in one of these
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What was Lia's condition at age 7?
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she was quadriplegic, spastic, incontinent, and incapable of purposeful movement. Her condition was termed a 'persistent vegetative state.'
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Plig
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soul
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What caused Lia to regain a normal temperature, regular breathing, and gag reflexes?
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The doctors attributed it to reduced swelling in her brain while her parents attributed it to the herbal infusion with which they bathed their daughter.
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Why did Medi-Cal refuse to pay for a pediatric hospital bed?
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The doctor who made the decision said the Hmong sleep on the floor anyway so they didn't need it. -Jeanie says this is racist
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What do the hmong believe are the source of deformities?
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deformities are the consequences of past transgressions on the part of the parents and this must be borne with equanimity and treated with kindness as a means of expiation
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Kleinman's 8 Questions: (1) WHAT DO YOU CALL YOUR ILLNESS (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Quag dab peg. A dangerous problem but also an illness of honour if it leads to becoming a txiv neebs. b. Lennox syndrome- a severe and difficult to treat form of childhood-onset epilepsy
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Kleinman's 8 Questions: (2) WHAT HAS CAUSED THE ILLNESS (a) How would Hmong respond? (b) How would Merced doctors respond?
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Kleinman's 8 Questions: (2) WHAT HAS CAUSED THE ILLNESS (a) How would Hmong respond? (b) How would Merced doctors respond? a. Soul loss. While doctors can fix sicknesses that involve the body and blood, for illnesses that are caused by "soul loss," spiritual healing is required. Spiritual healing is performed by a txiv neeb. Furthermore, too much Western medicine will diminish the neeb's healing efforts. b. No uniform cause -often associated with brain damage or other diseases and/or developmental disorders
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Kleinman's 8 Questions: (3) WHY AND WHEN DID THE ILLNESS START? (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Lia's sister, Yer, slammed the door, causing Lia's soul to be frightened out of her body. b. October 24th, but by the time the Lees got her to the MCMC ER the seizure had stopped. She was misdiagnosed with bronchopneumonia -wasn't able to be directly diagnosed until her 3rd visit because of language barrier on March 3rd when Lia was 8 months old
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Kleinman's 8 Questions: (4) HOW DOES THE ILLNESS WORK -WHAT DOES IT DO? (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Lia's parents attribute to a spirit called a dab. Lia's parents believe that the sickness makes Lia shake and fall down. The shaking and falling down are caused by a spirit called a dab that is catching her and shaking her. b. Abnormal discharge of electrical activity in the brain.
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Kleinman's 8 Questions: (5) HOW SEVERE IS IT? WILL THE ILLNESS HAVE A SHORT OR LONG COURSE? (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Why are you asking us those questions? Doctors should know the answers. b. Quite severe, it is a life-long condition that is resistant to medication. However, through trial and error doctors can usually develop a good treatment plan which includes a laundry-list of anticonvulsants, anesthetics, steroids etc.
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Kleinman's 8 Questions: (6) WHAT KIND OF TREATMENT SHOULD THE PATIENT RECEIVE? (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Medicine to take for a week but no longer. After she is well, she should stop taking the medicine. Long-term treatment should be spiritual and involve restoring her soul (ex. Tried to change her name do that the dab would be tricked into thinking she was someone else. Plan was foiled because doctors continued to call her Lia) b. Anticonvulsants, anaesthetics, steroids such as prednisone, immunoglobulins, and various other pharmacological agents that have been reported to work in individual patients. Because the these types of seizures are treatment resistant, a variety of drugs should be tried to find the best treatment for the individual.
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Kleinman's 8 Questions: (7) WHAT ARE THE CHIEF PROBLEMS THE ILLNESS HAS CAUSED? (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Saddness at Lia's condition and anger at her sister, Yer. b. Neurological and development delays on top of the injuries caused by the seizures
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Kleinman's 8 Questions: (8) WHAT DO YOU FEAR MOST ABOUT THE ILLNESS? (a) How would Hmong respond? (b) How would Merced doctors respond?
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a. Lia's soul would never return. Most of their actions involved trying to protect her (feeding her herbal remedies through the nasogastric tube b. Death.
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What are Bliatout's suggestions for doctors working with Hmong patients?
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female doctors should treat female patients and vice versa; involve the patient's families; use bilingual or bicultural interpreters; enlist the support of family and community leaders; minimize blood drawing; allow relatives and friends in the room; allow shamans to perform ceremonies; encourage Hmong traditional arts; acknowledge the Hmong contribution to US military operations in Laos; promote clan reunification, never undercut the father's authority; give refugees more opportunities; fuss over them less; and most importantly, integrate Western medicine with traditional healing arts. -Bliatout actually felt that the shaman was the ideal collaborator. No one was better qualified to span the gap between the medical and spiritual. He would always recognize the patient as a victim of an assault from outside powers or of an accidental separation from one part of his self. When this situation has identified and overcome by the shaman, health is recovered.
