Lia Lee, the little Hmong girl whose epilepsy was forcibly treated in the Western way by California doctors, has died after nearly three decades in a vegetative state.

Lia Lee in 1988, by Anne Fadiman

Her story is the case study for the treatment across cultures of refugees from genocide and mass killing. This history of medical malfeasance begins with Robert Jay Lifton’s astonishing psychodynamic assertion that the survivors of the Nagasaki and Hiroshima bombings felt something he called survivor guilt. On every page of his book about it, the survivors can be found denying that they feel it. As an early reviewer of Lifton’s book noted, it takes some nerve to bomb the Japanese back into the stone age and then accuse them of being guilty for living through the assault.

Miss Lee’s parents did not adhere to the Western doctor’s orders, which they felt were threatening to the child’s life and well-being. He had Lia removed from her family’s care and put into a foster home for a year. Once returned to them,

For 26 years, her days varied little: her parents bathed her, fed her, flexed her stiffened limbs, kissed, caressed and tenderly talked to her. There were visits to doctors in Merced and later in Sacramento, where the family moved in 1996. There were periodic visits from a shaman, intended not so much to cure Lia as to ease her suffering.       

“Everything that my parents had done for her is all manual labor,” Mai Lee said on Wednesday. “Carrying her from place to place, transporting her to appointments here and there, it was all done manually. They did that for a very long time.”

Medical anthropologists and other humane experts have begun to work on the problem of appropriate cross-cultural treatment for survivors of genocide. Anne Fadiman’s book about Lee is required reading for incoming Yale Medical school students and Healthy House, a social service agency which facilitates medical care, including Hmong shaman treatment, for immigrants has been founded, mainly due to Lia Lee’s fate, in Merced County, CA, where she lived. Arthur Klein’s eight questions for patients was the beginning of a medical practice more closely based on the Hippocratic oath.

Whether Lia Lee was the victim of war, genocide, or Western medicine is a question that a world full of refugees needs an answer to sooner rather than later.