Going Home

Last summer, as part of my job as a health educator, I visited a woman at her home who had recently given birth. Newborn tests showed that the baby may have had a serious hemoglobin disorder. The woman spoke no English, and in fact her native language was spoken by such a small population that it had taken a lot of work to find an interpreter, who I had on speaker phone. At one point I asked the interpreter to define hemoglobin, explain that her child’s red blood cells weren’t making enough hemoglobin, and tell her that we thought the baby had a disease called beta thalassemia. The interpreter paused, and then said to me, “Ma’am, we don’t have those words in our language.”

As I was rereading The Spirit Catches You and You Fall Down, I was reminded of that day and the enormous gap I was attempting to bridge. The Spirit Catches You and You Fall Down is the story of a Hmong family living in California. The family’s daughter Lia had a seizure disorder, and the book chronicles the cultural clash that occurred between her healthcare providers and her parents. Lia’s parents were refugees who spoke no English and were unable to read and write in their own language. To the doctors, Lia’s disorder was incredibly serious and, if not treated promptly and with great care, might someday result in an uncontrollable seizure that would render her brain dead. To Lia’s parents, her seizure disorder was a sign of great favor from the gods, and possibly meant that she would become a shaman someday. You can see that this is not heading anywhere good.

At the home visit that day, I ended up drawing a lot of pictures, although of course since the interpreter was on the phone, he couldn’t see what I was drawing, so I had to explain my drawing to him before he could explain it to the mother, and even then, how on earth do you pictorially represent a hemoglobin disorder (the answer is, not very well)?  It was incredibly frustrating, especially to realize as I left the house that I had no idea if anything I had said had made sense to her. A few weeks later, when the baby’s test results came back normal, I breathed a huge sigh of relief. I was relieved that the baby was healthy, of course, but I have to admit I was also relieved that I wouldn’t have to attempt any more education with this family. The mother was kind and friendly and her children were adorable, but the frustration, the worry and fear that she wouldn’t understand me and something awful would happen to her child as result, were great. Thinking about that day as I read this book really made me empathize with Lia’s doctors, yet at the same time, Anne Fadiman does a great job of describing Hmong culture and what it was like for Hmong refugees when they first arrived in the United States and were expected to assimilate and think of the US as their home. This book doesn’t contain any right or wrong answers, but it sure is thought-provoking.