L48 Anthro 3283 Chapter Notes - Chapter 17: Neonatal Encephalopathy, Septic Shock, Valproate
Fadiman Ch.17 (p. 250-261)
• Lia’s siblings were athletic, doing well in life
• Lia returned to special education center
• Jeanie had an acute asthma attack, went into respiratory failure, and suffered oxygen
deprivation
o Developed hypoxic ischemic encephalopathy (the same thing Lia did)
o She died 3 days later
• Lee’s son Toby diagnosed with Leukemia
o When Foua heard, she hugged Peggy and they cried → sorrows of motherhood
cut through all cultural barriers
• Toby went through 3 years of chemotherapy and achieved permanent remission
• Since Lia’s brain death, her parents trust in American medicine was almost gone (still
trusted Neil and Peggy)
o When their daughter May broke her arm, the doctors in the ER said it needed a
cast, her dad took her home and bathed her arm in herbs and it fully recovered
o Waited for other injuries too
• Lia was routinely vaccinated; about the same time, she developed occasional seizurelike
twitches
o Parents thought the vaccines caused these twitches and told Neil they didn't want
her to be immunized for anything ever again
• Dan said if you fail one Hmong, you fail the entire community
o Everyone in Merced’s Lee and Yang clans knew what happened to Lia (those bad
doctors) just like everyone on the pediatric floor knew what happened to Lia
(those bad parents)
o Lia’s case had confirmed the Hmong community’s worst prejudices about the
medical profession and the medical community’s worst prejudices about the
Hmong
• Lia cost the government about $250,000
o Nurses complained the Lees had been ungrateful for their daughter’s free medical
care
o Why had the Lees always insisted on doing everything their way?
o Why (the worst sin) had the Lees been so non-compliant?
• Medications had nothing to do with her final seizure
o Septic shock caused the seizures
o Don't know how she got the septic shock
o If Lia did not have the seizures, she would have been in a coma and the outcome
probably would have been the same, except that her problem might have been
more easily recognized
o Parents non-compliance had nothing to do with it; the only influence that the
medications could have had is that the Depakene might have compromised her
immune system and made her more susceptible to the Pseudomonas (still believe
Depakene was the right drug to give her)
• Dr. Hutchinson said that her parents’ belief that they gave her too much medicine causing
her more problems, might be kind of true
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