Chapter 9: A Little Medicine and a Little Neeb
The time after Lia returned home from foster care, though uninteresting to the doctors, was, for her family, one of the richest in Lia's life. First, they sacrificed a cow to celebrate her return home and to bolster her health. The Hmong consider animal and human souls connected, with animal souls offered as a sort of ransom for fugitive human souls. While the animals are arguably killed in a much more humane fashion than in most slaughterhouses, many Americans have reacted to such ritualized animal killing with legal sanctions, including Merced residents who, beginning in the mid-nineties, banned the slaughter of livestock and poultry within the city. The Hmong paid little attention, their need to heal sick relatives outweighing their respect for the law, and few neighbors cared enough to report them. There was, however, a long-standing rumor that the Hmong sacrificed dogs. The rumor was untrue - a fireman putting out a stove fire had mistaken a pig for a dog - but the rumors were spread nonetheless.
The Hmong of Merced do not sacrifice dogs, but they do routinely sacrifice pigs and chickens. To sacrifice a cow is a much bigger event. The cow cost $300, a huge sum for a family of nine living on $9,480 per year, and was paid for with three and a half months' worth of Lia's Supplemental Security Income (SSI). Since Nao Kao couldn't transport a live cow to his apartment, he purchased one from a rancher outside the city, had it slaughtered, and brought it home in pieces. A tvix neeb performed the ritual chant with the cow's head sitting on the Lee's front stoop. A feast of traditional beef dishes followed the ceremony.
The mood declined, however, when the Lees realized how Lia's mental capacity had declined. She acted as if she didn't know people, and she could only speak a little. The Lees believed the court had returned Lia to them because foster care had made her sicker. Neil and Peggy, on the other hand, felt her decline had begun before she had been removed from the Lees, had ceased during her regular drug regimen, and had been aggravated by the seizures she had after her weeklong visit in September when her family had failed to give her any medication. They were also surprised to learn that the Lees thought Lia had been taken from them not to protect her health, but because the doctors were angry with them for their noncompliance and wished to punish them. Foua and Nao Kao considered themselves reasonable and willing to compromise with "a little medicine and a little neeb" (110), and considered the doctors to be the uncompromising ones.
The Lees engaged in a number of traditional healing methods to try to keep Lia's condition from deteriorating. They spent $1000 on amulets with sacred healing herbs from Thailand, which Lia wore around her neck. Foua inserted a silver coin into the yolk of a boiled egg, wrapped the egg in cloth, and rubbed it on Lia's body; when the egg turned black, it was supposed to have absorbed the sickness. She massaged Lia with a spoon and sucked the pressure out of her body by pressing a small heated cup against her skin, creating a vacuum as the air inside the cup cooled. She pinched her to draw out noxious winds and gave her tea made from the herbs from her garden. She and Nao Kao even tried changing Lia's name to Kou, in order to trick the dab who stole her soul to think she was someone else. (The trick didn't work, they believed, because her doctors insisted on continuing to call her Lia.)
Nao Kao also took Lia to visit a particularly renowned tvix neeb in Minnesota, driving for three days and then flying home using SSI money. The tvix neeb tied spirit strings around her wrist and gave her medicine from roots and other natural materials, some boiled and some crystalized and eaten.
Most of Merced's doctors, including Neil Ernst and Peggy Philp, never thought to ask how the Hmong treated their illnesses. Since the Hmong dressed in American clothes, drove cars, and shopped in supermarkets, it didn't occur to them that they might practice esoteric healing arts. The only American who did think to ask was Jeanine Hilt. The Lees liked Jeanine, whom they saw not as a representative of the agency who took their daughter away but rather as the person who gave Lia her disability money. Jeanine was small and unpretentious, learned the names of all of the Lee's children, and used their daughter May, who learned English in high school, as her interpreter. She had a lot of empathy for the Lees, perhaps because she lived with a chronic illness (asthma) herself, and perhaps because she admired the closeness of their family, so different from her own. Unlike many of the nurses, she thought Lia was a delightful child, adorable and affectionate. She was a staunch advocate for the Lees, asking the doctors to be notified of any change in Lia's condition, nagging them for medical equipment, and even arranging for Lia to be bussed to the Schelby Center for Special Education three days a week. She was less successful at implementing a daily schedule for Lia and teaching the Lees to administer Tylenol and Valium when Lia had a temperature. However, she achieved her most important goal, to persuade the Lees to administer Lia's daily medication. In her first four months at home, Lia had only one seizure. Jeanine attributed this to the Depakene; the Lees attributed it to the tvix neeb in Minnesota.
In September 1986, Lia fell off a swing at the Schelby Center, hit her head, and went into status epilepticus, in which her seizures continued one after another without stopping. Nobody knew whether she fell because she seized or she seized because she fell. Parental noncompliance was not a factor, as she had adequate medication in her bloodstream. Nao Kao believed the teacher let her fall from the swing and her soul left when she got frightened, causing her to get sick again.
This visit to the MCMC was the most harrowing yet. She had a bad seizure, aspirated food into her lungs, couldn't breathe, had a tube inserted, and then got an infection from irritation caused by the tube. She stayed in the hospital for fourteen nights, during which her parents believed the doctors were making her sicker. In fact, the hospital did make her sicker this time, due to the infection. Three weeks after being discharged, Lia was admitted again. Neil was at his wit's end about what to do. The Depakene was not working, and he couldn't think of what to do to keep her seizures from getting worse. He and Peggy were afraid that one day they wouldn't be able to get in an IV. They were both fearful that the day would come that she would have a seizure they couldn’t stop, and that she was going to die.
Chapter 10: War
According to a Hmong folktale, a king once resolved a land dispute between the Hmong and neighboring tribe by declaring that each tribe would select an envoy that would walk as far as he could between sunset and sunrise. (This was when they lived in the northern territory where days and nights were each six months long.) All the territory he covered would belong to his tribe. If he failed to reach the palace by sunrise, his tribe would live where he stood at the moment the sun came up. The Hmong envoy was standing on a high pinnacle when the sun rose, which is why the Hmong have always lived in the mountains. Consequently, the history and the character of the Hmong are dependent upon them being mountain-dwellers.
In Laos, the various ethnic groups were very stratified, with the Lao living in the lowlands, the Karen and Khmu above 50 meters, the Mien above 400 meters, and the Hmong highest of all, between 1,000 and 2,000 meters. There they maintained a strong sense of identity. They rarely visited the plains, believing it would make them sick (as it may have, given the incidence of tropical diseases). Nobody passed through their territory en route to anywhere else, and they kept trade to a minimum because they were so self-sufficient. The high incidence of onomatopoeic expressions describing sounds of the natural world gives a hint of their intimate relationship with their environment.
The Hmong were farmers and had no need for literacy, with everything the next generation needed to know passed down orally and through example. While they grew rice, corn, and vegetables for their own use, their main cash crop was the opium poppy, introduced to China at the end of the eighteenth century. The crop grew well in the cold mountain climates, and the Hmong were masters at cultivation. They knew how to choose the best soil, plant seeds in cornfields so the cornstalks would protect the young plants, cut the pods open, scrape out the sap once it coagulated and turned brown, wrap it in poppy petals or banana leaves, knead it, and make it into bricks. The Hmong kept only a small portion of the crop for medicinal and ceremonial purposes; there were few addicts, and those few brought shame upon themselves and their families. Instead, they used it to pay their taxes (in Laos during French colonial rule) and to trade for silver.
The Hmong practiced slash-and-burn (‘swidden’) agriculture. In the dry season, they cut the underbrush and felled the trees, then ignited the vegetation with torches. Families would clear the debris and then plant in the remaining fields. This form of agriculture required no plowing, irrigation, terracing, or fertilizing. However, the topsoil, rich with nutrients from the ashes, would wash away in a few years, and the remainder of the soil could require twenty years to become productive again. Opium was particularly harmful as old fields became covered in a coarse grass that even animals wouldn't eat. (Rice fields, at least, eventually reforested.) The practice also resulted in massive erosion, enough to change the course of rivers.
This agricultural practice was linked to the Hmong's migratory patterns. Since a field could only be tilled for a few years at a time, every few years they would adopt new fields slightly farther away, until eventually they moved the village. Their homes were designed to be easily dismantled, moved, and reassembled. There culture was likewise portable, with no monumental works of art but rather textiles, jewelry, music, and storytelling. "Home" was where the tribe was. This arduous adaptation rested upon a belief in abundance -that there would always be another mountain to migrate to.
The Geneva Accords of 1954 had recognized three independent states in what used to be French Indochina: Laos, Cambodia, and Vietnam, temporarily divided into northern and southern territories which were supposed to be reunited within two years. Laos, an economic backwater, was supposed to be neutral. However, it was hard not to be influenced by the more powerful and populous countries surrounding its territory. Aided by the Vietminh, the North Vietnamese communist forces, the communist Pathet Lao and the anticommunist Royal Lao government became entangled in a struggle over control of the country.
The United States, under President Kennedy, was convinced that if Laos fell to communism, the same would happen to South Vietnam, Cambodia, Thailand, and Burma. They were eager to support the anticommunist government and to cut the military supply line the North Vietnamese ran to South Vietnam along the Ho Chi Minh Trail. However, they could not do so openly, as they had pledged not to send troops to Laos at the Geneva Conference of 1961-62. Their solution was to send a cadre of CIA "advisors" who recruited, trained, and armed a guerilla army of Hmong men. Unlike the Royal Lao army, who had a reputation for being peaceful and laying down their arms rather than fighting, the Hmong were excellent fighters and had already proven themselves as guerrillas during and after World War II. This secret army, or Armee Clandestine, eventually grew to over 30,000 soldiers and, at its peak, was the largest CIA operation in the world. Its soldiers fought on the ground, directed air strikes, fought behind enemy lines, gathered intelligence on communist forces, sabotaged roads and bridges, and more.
The Hmong had their own reasons for fighting against the communist forces. Capitalism was less likely to interfere with their way of life and challenge their methods of slash-and-burn agriculture. Because the Hmong had sided with the French before the collapse of colonial Indochina, they feared reprisals from the North Vietnamese. They also stood to gain status with their lowland neighbors through military victory. Finally, many lived in the mountains surrounding the Plain of Jars, a plateau through which communist troops would have to travel in order to occupy the capital of Vientiane, and therefore had a personal stake in the war.
For the U.S., using Hmong soldiers made economic as well as strategic sense. In 1971, while soldiers in Vietnam earned between $197.50 and $339 a month, Hmong soldiers were paid around $3. They ate rice as rations, didn't take vacations, and never finished their "tour of duty." Hmong soldiers died at a rate of about ten times that of American soldiers in Vietnam.
Not all Hmong became soldiers by choice. Some did so because bombing in Laos forced them to give up their fields, and there was no other work. Others were coerced or recruited by force.
General Vang Pao was the CIA-supported Hmong leader of the Armee Clandestine. He passed the entrance exam for officer training school because the captain overseeing the exam gave him the answers, adding to his reputation as someone who wouldn't be held back by rules. He had wives from three major clans, sealing his influence over the Hmong. He had many modern ideas - he supported education, criticized slash-and-burn farming, and encouraged assimilation with the Lao - but also followed traditional customs and once postponed a bombing mission because some chicken bones were inauspiciously positioned. He tortured his enemies yet also served as a provider for hundreds of war widows and orphans. He was indisputably courageous, often accompanying soldiers to the front lines.
The U.S. recognized that the best way to secure Hmong cooperation was to support their opium trade. Therefore, the CIA used its own aircraft to pick up opium bricks in remote villages and gave Vang Pao his own airline to fly opium from the secret Hmong military base at Long Tieng to markets in Vientiane. It is estimated that around 30,000 American soldiers in South Vietnam became addicted to heroin as a result.
Recruits were sent to Thailand or to Long Tieng in Laos for training. They quickly learned to launch rockets, fly bombers, operate radio transmitters, and shoot rifles. Demonstrating their adaptability, they built houses out of rice sacks, old ammunition crates, and flattened oil drums, fished with grenades, and roped water buffaloes with parachute cord.
The conflict in Laos was nicknamed the "Quiet War" in the United States, but for the Hmong, it was anything but quiet. There was an average of one bombing every eight minutes for nine years. Between 1968 and 1972, more tons of bombs were dropped on the Plain of Jars in Hmong territory than had been dropped by American planes in both Europe and the Pacific during World War II. This area is still full of unexploded cluster bombs, ready to detonate if prodded by a hoe or a curious child. As the war continued, younger and younger Hmong were recruited as soldiers. In 1968, a witness noted that 60% of new recruits were sixteen or younger, with some as young as ten.
There is disagreement about what proportion of Hmong died in the war, with estimates ranging from a tenth to half. Some died in battle, but most were civilians killed by bombs, land mines, grenades, massacres, hunger, and disease. A far greater percentage of Hmong were killed than South Vietnamese, yet they were nearly absent from the press, in part because reporters were banned from Long Tieng. When the Hmong were mentioned, any mention of US involvement was usually missing. Even those who survived suffered from the war. Ninety percent of all villages in northern Laos were affected, with inhabitants losing their lives, being displaced, or both. Entire villages fled after their houses were burned and their headmen beaten or killed by communists, while others left to avoid incidental bombing by American or Royal Lao aircraft. Some were evacuated by the US, while others collapsed because not enough people were left to work the fields. By 1970, over a third of the Hmong in Laos had become internally displaced refugees.
Many Hmong responded by reviving traditional customs. Polygyny became more common in response to the mismatch between numbers of single men and women. The practice of levirate marriage, in which a widow married her dead husband's younger brother, was also revived. This practice kept the children and property in the father's clan, but it could often put crushing responsibilities on the younger brother, who might already have a large family or still be a child himself. At the same time, the war altered Hmong culture completely. It became more common to see Hmong with camouflaged clothing than their traditional black clothes, and many of the forests had been destroyed. Many Hmong saw cars, bicycles, radios, clocks, cigarettes, and other modern items for the first time when they were temporarily relocated. They could no longer engage in swidden farming, but began using Lao currency as soldiers received wages and there were manufactured goods to purchase. Long Tieng became a sewer-less city of over 30,000 with makeshift businesses. Many Hmong women began wearing lowland Lao clothes, and some children went to school. Even the language changed to accommodate new concepts from the war. The biggest change was the loss of self-sufficiency, with the US airdropping bags of rice to compensate for the loss of their tillable fields.
In January 1973, the US signed the Paris Agreement and promised to withdraw all forces from Vietnam. Prince Souvanna Phouma, the Prime Minister of Laos, begged Secretary of State Henry Kissinger to continue American support of Laos so that their neighbors would leave them in peace. However, the Vientiane Agreement of February 1973 called for a cease-fire and the end of American air support. In May 1975, the communist Pathet Lao crossed into territory held by Vang Pao. Without American combat support, the Hmong were forced to surrender. Between 1,000 and 3,000 were airlifted to Thailand; the rest, over 10,000, had no choice but to walk.
Chapter 9 continues Lia's story, sharing events from both Lia's parents' and doctors' points of view. The Lees believed Lia had been returned to them because foster care had made her sicker; Neil and Peggy felt that foster care had improved her condition. The Lees thought Lia had been taken from them to punish them for noncompliance; Neil and Peggy felt it was to protect Lia's health. When Lia had just one seizure during her first four months at home, the Lees attributed it to their visit to a powerful tvix neeb in Minnesota; Jeanine attributed it to their correct administration of Depakene. We see how what appear to be straightforward events can be given very different meanings.
This chapter also reveals how at times the Hmong use the American system to their advantage. The Lees paid for both a cow to be sacrificed and the trip to the tvix neeb in Minnesota with money from Lia's Supplemental Security Income (SSI), a use for which it was probably never intended.
Neil's premonition at the end of the chapter foreshadows the impending tragedy. "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," he says, using figurative language to express his despair at being unable to improve Lia's condition. "I started to have nightmares that [she would have a seizure we couldn't stop]… 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" (118).
Chapter 10 outlines Hmong involvement in the Vietnam War. Despite the great sacrifices they made to fight for the United States - between ten and fifth percent of all Hmong in Laos lost their lives, and many more were forced to leave their homes - only a small percentage were airlifted to safety, the rest left to risk their lives walking through enemy territory. Having thus witnessed the United States break its promises, it is no wonder that the Lees did not completely trust their American doctors.
Ironically, the same determination that led to medical noncompliance was considered an admirable trait in Laos during the war.