"The Spirit Catches You and You Fall Down" - "The Big One"

Here is the chapter that is just awesome, even to a pharmacy student! Again, Lia Lee, the little Hmong girl, suffers a refractory epilepsy.

From "The Spirit Catches You and You Fall Down," by Anne Fadiman,

Chapter 11. The Big One

On November 25, 1986, the day before Thanksgiving, the Lees were eating dinner. Lia, who had had a mild runny nose for several days, sat in her usual chair at the round white Formica table in the kitchen, surrounded by her parents, five of her sisters, and her brother. She was normally an avid eater, but tonight she had little appetite, and fed herself only a little rice and water. After she finished eating, her face took on the strange, frightened expression that always preceded an apileptic seizure. She ran to her parents, hugged them, and fell down, her arms and legs first stiffening and then jerking furiously. Nao Kao picked her up and laid her on the blue quilted pad they always kept ready for her on the living room floor.

"When the spirit caught Lia and she fell down," said Nao Kao, "she was usually sick for ten minutes or so. After that, she would be normal again, and if you gave her rice, she ate it. But this time she was really sick for a long time, so we had to call our nephew because he spoke English and he knew how to call an ambulance." On every other occasion when Lia had seized, Nao Kao and Foua had carried Lia to the hospital. I asked Nao Kao why he had decided to summon an ambulance. "If you take her in an ambulance, they would pay more attention to her at the hospital," he said. "If you don't call the ambulance, those tsov tom people wouldn't look at her." May Ying hesitated before translating tsov tom, which means "tiger bite." Tigers are a symbol of wickedness and duplicity - in Hmong folktales, they steal men's wives and eat their own children - and tsov tom is a very serious curse.

It is true that, whether one is Hmong or American, arriving at an emergency room via ambulance generally does stave off the customary two-hour wait. But any patient as catastrophically ill as Lia was that night would have been instantly triaged to the front of the line, no matter how she had gone there. In fact, if her parents had run the three blocks to MCMC with Lia in their arms, they would have saved nearly twenty minutes that, in retrospect, may have been critical. As it was, it took about five minutes fro their nephew to come to their house and dial 911; one minute for the ambulance to respond to the dispatcher's call; two minutes for the ambulance to reach the Lee residence; fourteen minutes (an unusually, and in this case perhaps disastrously, long time) for the ambulance to leave the scene; and one minute to drive to the hospital.

Ok, I will continue tomorrow. My therapeutics midterm is coming up next week! You know, it's the title of the chapter. "The Big One."