Because the Lees—like most Hmongs—came to the United States to escape war-torn Laos, their relationship to assimilation is complicated. The United States thinks of itself as a nation made up of many diverse populations, a “melting pot” of ethnicity. In the 20th century, though, being part of this “melting pot” seemed to require melting into the preexisting American culture. Historically resilient to coercive cultural changes, the newly-arrived Hmong had no interest in becoming Americans; they came to the United States for safety, not to adopt a new lifestyle. By examining the Hmong’s resistance to integration and assimilation, Fadiman widens the scope of The Spirit Catches You And You Fall Down, simultaneously illustrating the circumstances of Lia Lee’s medical crisis and creating an ethnographic document of Hmong immigrants in America.
The Lees’ story is the focal point of Fadiman’s ethnography. “When I first met them,” she writes, “during their eighth year in this country, only one American adult, Jeanine Hilt, had ever been invited to their home as a guest. It would be hard to imagine anything further from the vaunted American ideal of assimilation, in which immigrants are expected to submerge their cultural differences in order to embrace a shared national identity.” The word “submerge” is important in this passage, as it powerfully illustrates what, exactly, is being asked of Nao Kao and Foua Lee; because they brought their sick child to an American hospital, they were suddenly expected to blindly accept practices that starkly crossed their own beliefs and bury any tension that arose from “cultural differences”—all in the name of “embrac[ing] a shared national identity” in which they had no interest at all.
It’s worth emphasizing that the Hmong didn’t come to America to melt into a “shared national identity.” The Hmong came to the United States “for the same reason they had left China in the nineteenth century: because they were trying to resist assimilation.” Cast in this light, the Lees actually begin to look somewhat accommodating and flexible. After all, they did bring Lia to an American hospital, they did try using the prescribed medications, and they even cooperated with Jeanine Hilt, a social worker who worked for the American government—an institution insistent upon forcing its customs onto Hmong people in the name of integration and assimilation. Stubborn as they may have appeared to MCMC’s medical staff, the Lees allowed doctors to put Lia through many procedures that were directly antithetical to their own beliefs, some of which they believed would endanger Lia’s soul in the afterlife. Nonetheless, Nao Kao and Foua still brought her to the hospital during her seizures, a testament to their willingness to try anything in the name of helping their daughter, even if that meant indulging a medical practice that posed constant threats to their own principles.
The general effect on Hmong people of forced American assimilation was, simply put, unsuccessful and morally degrading. With very few resources and no frame of reference for urban and suburban modes of existence, this largely agrarian community had little chance of becoming the Americanized citizens the government hoped to create. While their children were able to learn English and successfully integrate their own cultural identities into a broader American identity, most Hmong adults found themselves disenfranchised, their traditional familial hierarchies destabilized by the fact that a young daughter proficient in English suddenly became the family’s spokesperson over the father or grandfather. Hmong culture, it seems, was not so much integrated as it was disarrayed in such a way that made it even more difficult for them to join the American community. Fadiman comments on this when she says: “none of [Foua’s] former skills were transferable to the United States—none, that is, except for being an excellent mother to her nine surviving children. It then occurred to me that this last skill had been officially contradicted by the American government, which had legally declared her a child abuser.” The government’s inability to accept that an immigrant might not want—or even be capable of—integration thus stripped Foua of the very reason she came to the United States in the first place: to safely raise her children.
Integration and Assimilation ThemeTracker
Integration and Assimilation Quotes in The Spirit Catches You and You Fall Down
I have always felt that the action most worth watching is not at the center of things but where edges meet. I like shorelines, weather fronts, international borders. There are interesting frictions and incongruities in these places, and often, if you stand at the point of tangency, you can see both sides better than if you were in the middle of either one. This is especially true, I think, when the apposition is cultural. When I first came to Merced, I hoped that the culture of American medicine, about which I knew a little, and the culture of the Hmong, about which I knew nothing, would in some way illuminate each other if I could position myself between the two and manage not to get caught in the cross fire.
The history of the Hmong yields several lessons that anyone who deals with them might do well to remember. Among the most obvious of these are that the Hmong do not like to take orders; that they do not like to lose; that they would rather flee, fight, or die than surrender; that they are not intimidated by being outnumbered; that they are rarely persuaded that the customs of other cultures, even those more powerful than their own, are superior; and that they are capable of getting very angry. Whether you find these traits infuriating or admirable depends largely on whether or not you are trying to make a Hmong do something he or she would prefer not to do. Those who have tried to defeat, deceive, govern, regulate, constrain, assimilate, intimidate, or patronize the Hmong have, as a rule, disliked them intensely.
Although the inklings Dan had gathered of the transcendental Hmong worldview seemed to him to possess both power and beauty, his own view of medicine in general, and of epilepsy in particular, was, like that of his colleagues at MCMC, essentially rationalist. Hippocrates’ skeptical commentary on the nature of epilepsy, made around 400 B.C., pretty much sums up Dan’s own frame of reference: “It seems to me that the disease is no more divine than any other. It has a natural cause just as other diseases have. Men think it is divine merely because they don’t understand it. But if they called everything divine which they do not understand, why, there would be no end to divine things.”
The MCMC nursing staff came to know Lia well—better, in fact, than most of them would have wished. After she was old enough to walk, whenever she was well enough to get out of bed she ran up and down the corridor in the pediatric unit, banging on doors, barging into the rooms of other sick children, yanking open the drawers in the nursing station, snatching pencils and hospital forms and prescription pads and throwing them on the floor.
The idea that the drugs prescribed to cure, or at least attempt to treat, an illness are in fact causing it is not one that most doctors ever encounter. Doctors are used to hearing patients say that drugs make them feel bad, and indeed the unpleasant side effects of many medications are one of the main reasons that patients so often stop taking them. But most patients accept the doctor’s explanation of why they got sick in the first place, and even if they resist the recommended treatment, they at least believe their doctor has prescribed it in good faith and that it is not designed to hurt them. Doctors who deal with the Hmong cannot take this attitude for granted. What’s more, if they continue to press their patients to comply with a regimen that, from the Hmong vantage, is potentially harmful, they may find themselves, to their horror, running up against that stubborn strain in the Hmong character which for thousands of years has preferred death to surrender.
While Foua was telling me about the dozens of tasks that constituted her “easy” work in Laos, I was thinking that when she said she was stupid, what she really meant was that none of her former skills were transferable to the United States—none, that is, except for being an excellent mother to her nine surviving children. It then occurred to me that this last skill had been officially contradicted by the American government, which had legally declared her a child abuser.
At this point, [Lia’s sister], who was three at the time, ran over to Lia and started banging her on the chest.
“Don’t do that, there’s a good boy,” said Martin, addressing the little girl in English, of which she did not speak a word. “[… P]lease tell them they have got to watch these other little children. Lia is not a doll.”