Cultural Collision Quotes

Like all people, we perceive the version of reality that our culture communicates. Like others having or living in more than one culture, we get multiple, often opposing messages. The coming together of two self-consistent but habitually incomparable frames of reference causes un choque, a cultural collision.

If you can’t see that your own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else’s culture?

Our view of reality is only a view, not reality itself.

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.

You can miss a lot by sticking to the point.

The action most worth watching is not at the center of things, but where edges meet.

If the soul cannot find its jacket. it is condemned to an eternity of wandering--naked and alone

Every illness is not a set of pathologies but a personal story

The Hmong have a phrase, hais cuaj txub kaum txub, which means “to speak of all kinds of things.” It is often used at the beginning of an oral narrative as a way of reminding the listeners that the world is full of things that may not seem to be connected but actually are; that no event occurs in isolation; that you can miss a lot by sticking to the point; and that the storyteller is likely to be rather long-winded.

The Hmong never had any interest in ruling over the Chinese or anyone else; they wanted merely to be left alone, which, as their later history was also to illustrate, may be the most difficult request any minority can make of a majority culture.

It is well known that involuntary migrants, no matter what pot they are thrown into, tend not to melt.

Timothy Dunnigan: The kinds of metaphorical language that we use to describe the Hmong say far more about us, and our attachment to our own frame of reference, than they do about the Hmong.

Cultural humility” acknowledges that doctors bring the baggage of their own cultures—their own ethnic backgrounds along with the culture of medicine—to the patient’s bedside, and that these may not necessarily be superior.

I have always felt that the action most worth watching is not at the center of things but where edges meet.

You know Anne,' he said quietly, 'when I am with a Hmong or a French or an American person, I am always the one who laughs last at a joke. I am the chameleon animal. You can place me anyplace, and I will survive, but I will not belong. I must tell you that I do not really belong anywhere.

The collision between a Christian mind and a solidly earthbound culture ought to be a violent one.

I'll meet some people who'll treat me mean and I'll just pray that I'll never be like them. And then I'll meet some very nice people and I will take a little bit of them and make myself a better person.

So, if you're a doctor, how can you recognize that you're having a feeling? Some tips from Dr. Zinn: Most emotions have physical counterparts. Anxiety may be associated with a tightness of the abdomen or excessive diaphoresis; anger may be manifested by a generalized muscle tightness or a clenching of the jaw; sexual arousal may be noted by a tingling of the loins or piloerection; and sadness may be felt by conjunctival injection or heaviness of the chest.

Create Safe, Collision-Rich Spaces:

It is worth noting that the standard American tests of success that they have flunked are almost exclusively economic. If one applied social indices instead—such as rates of crime, child abuse, illegitimacy, and divorce—the Hmong would probably score better than most refugee groups (and also better than most Americans), but those are not the forms of success to which our culture assigns its highest priority.

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.

The kinds of metaphorical language that we use to describe the Hmong say far more about us, and our attachment to our own frame of reference, than they do about the Hmong.” So much for the Perambulating Postbox Theory.

In these remote corners, I have discovered a center point, where East met West, and although there has been a collision of cultures, there is now a new Christian identity that is distinctly Chinese. The circuitous mountain path in Yunnan province is red because over many years it has been soaked with blood.

When Pang was barely out of toddlerhood, she zoomed in and out of the apartment unsupervised, playing with plastic bags and, on occasion, with a large butcher knife.

You go from the north of Laos and then you go across the Mekong, and when the Pathet Lao soldiers fire, you do not think about your family, just yourself only. When you are on the other side, you will not be like what you were before ou get through the Mekong. On the other side you cannot say to your wife, I love you more than my life. She saw! You cannot say that anymore! And when you try to restick this thing together is is like putting glue on a broken glass.

It was also true that if the Lees were still in Laos, Lia would probably have died before she was out of infancy, from a prolonged bout of untreated status epilepticus. American medicine had both preserved her life and compromised it. I was unsure which had hurt her family more.

During the late 1910s and early ’20s, immigrant workers at the Ford automotive plant in Dearborn, Michigan, were given free, compulsory “Americanization” classes. In addition to English lessons, there were lectures on work habits, personal hygiene, and table manners. The first sentence they memorized was “I am a good American.

A sponsoring pastor in Minnesota told a local newspaper, “It would be wicked to just bring them over and feed and clothe them and let them go to hell. The God who made us wants them to be converted. If anyone thinks that a gospel-preaching church would bring them over and not tell them about the Lord, they’re out of their mind.

her father had built from ax-hewn planks thatched with bamboo and grass. The floor was dirt, but it was clean. Her mother, Foua, sprinkled it regularly with

You either surrender voluntarily to Shakespeare's genius or delay the inevitable collision with that cultural colossus later.

We do not see the world as it is. We see it as we are.

I'm the smartest thing for a hundred light years radius, and by a factor of about a million ...... but even I can't predict where a snooker ball's going to end up after more than six collisions.

Your soul is like your shadow," she said. "Sometimes it just wanders off like a butterfly and that is when you are sad and that's when you get sick, and if it comes back to you, that is when you are happy and you are well again.

During the late 1910s and early ’20s, immigrant workers at the Ford automotive plant in Dearborn, Michigan, were given free, compulsory “Americanization” classes. In addition to English lessons, there were lectures on work habits, personal hygiene, and table manners. The first sentence they memorized was “I am a good American.” During their graduation ceremony they gathered next to a gigantic wooden pot, which their teachers stirred with ten-foot ladles. The students walked through a door into the pot, wearing traditional costumes from their countries of origin and singing songs in their native languages. A few minutes later, the door in the pot opened, and the students walked out again, wearing suits and ties, waving American flags, and singing “The Star-Spangled Banner.

After they returned home, a txiv neeb performed the ritual chant that accompanied his journey to the realm of the unseen. During the chant, the cow’s severed head was sitting on the Lees’ front stoop, welcoming Lia’s soul. When I asked the Lees whether any American passersby might have been surprised by this sight, Foua said, “No, I don’t think they would be surprised, because it wasn’t the whole cow on the doorstep, only the head.” Nao Kao added, “Also, Americans would think it was okay because we had the receipt for the cow.

Conquergood considered his relationship with the Hmong to be a form of barter, “a productive and mutually invigorating dialog, with neither side dominating or winning out.” In his opinion, the physicians and nurses at Ban Vinai failed to win the cooperation of the camp inhabitants because they considered the relationship one-sided, with the Westerners holding all the knowledge. As long as they persisted in this view, Conquergood believed that what the medical establishment was offering would continue to be rejected, since the Hmong would view it not as a gift but as a form of coercion.

In Laos, a baby was never apart from its mother, sleeping in her arms all night and riding on her back all day. Small children were rarely abused; it was believed that a dab who witnessed mistreatment might take the child, assuming it was not wanted. The Hmong who live in the United States have continued to be unusually attentive parents. A study conducted at the University of Minnesota found Hmong infants in the first month of life to be less irritable and more securely attached to their mothers than Caucasian infants, a difference the researcher attributed to the fact that the Hmong mothers were, without exception, more sensitive, more accepting, and more responsive, as well as “exquisitely attuned” to their children’s signals. Another study, conducted in Portland, Oregon, found that Hmong mothers held and touched their babies far more frequently than Caucasian mothers. In a third study, conducted at the Hennepin County Medical Center in Minnesota, a group of Hmong mothers of toddlers surpassed a group of Caucasian mothers of similar socioeconomic status in every one of fourteen categories selected from the Egeland Mother-Child Rating Scale, ranging from “Speed of Responsiveness to Fussing and Crying” to “Delight.

In the collision between the remoteness and purity of the rainforest realms and the crassness of consumer culture, the difference is so extreme that for the most part there has been no authentic or practical method for this medicine system as traditionally practiced to integrate and adapt to the changing times.

The European immigrants who emerged from the Ford Motor Company melting pot came to the United States because they hoped to assimilate into mainstream American society. 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.

The highly moralistic and uncompromising outlook of the Puritans eventually put them and their descendants on a collision course with the institution of slavery and produced. among others, Harriet Beecher Stowe, who was called by Abraham Lincoln the little lady who started the Civil War" because of her novel Uncle Tom's Cabin.

In Minneapolis, tires were slashed and windows smashed. A high school student getting off a bus was hit in the face and told to “go back to China.” A woman was kicked in the thighs, face, and kidneys, and her purse, which contained the family’s entire savings of $400, was stolen; afterwards, she forbade her children to play outdoors, and her husband, who had once commanded a fifty-man unit in the Armée Clandestine, stayed home to guard the family’s belongings. In Providence, children walking home from school were beaten. In Missoula, teenagers were stoned. In Milwaukee, garden plots were vandalized and a car was set on fire. In Eureka, California, two burning crosses were placed on a family’s front lawn. In a random act of violence near Springfield, Illinois, a twelve-year-old boy was shot and killed by three men who forced his family’s car off Interstate 55 and demanded money. His father told a reporter, “In a war, you know who your enemies are. Here, you don’t know if the person walking up to you will hurt you.

I only vaguely understood at the time the ways that I myself was on my knees, how in need I was of taking back my soul as a woman. The episode propelled me into a collision with the patriarchal underpinning of my church, my faith tradition, my culture, my marriage, and, most illuminating of all, me. It sent me in search of the feminine dimension of God. It began a spiritual cataclysm. My old life dissolved and a new life, a new consciousness, rose up.

Medicine was religion. Religion was society. Society was medicine. Even economics were mixed up in there somewhere (you had to have or borrow enough money to buy a pig, or even a cow, in case someone got sick and a sacrifice was required), and so was music (if you didn't have a qeej player at your funeral, your soul wouldn't be guided on its posthumous travels, and it couldn't be reborn, and it might make your relatives sick). In fact, the Hmong view of health care seemed to me to be precisely the opposite of the prevailing American one, in which the practice of medicine has fissioned into smaller and smaller subspecialties, with less and less truck between bailiwicks. The Hmong carried holism to its ultima Thule. As my web of cross-references grew more and more thickly interlaced, I concluded that the Hmong preoccupation with medical issues was nothing less than a preocupation with life. (And death. And life after death).

individual can fully exercise his or her abilities and skills. “We shall distribute the company’s surplus earnings to all employees in an appropriate manner, and we shall assist them in a practical manner to secure a stable life. In return, all employees shall exert their utmost effort into their job.” Finally, his new company would help his country. Its formally stated national intent was to help “reconstruct Japan, and to elevate the nation’s culture through dynamic cultural and technological activities.” Yet

When you think about Laos and about not having enough food and those dirty and torn-up clothes, you don't want to think. Here it is a great country. You are comfortable. You have something to eat. But you don't speak the language. You depend on other people for welfare. If they don't give you money you can't eat, and you would die of hunger. What I miss in Laos is that free spirit, doing what you want to do. You own your own fields, your own rice, your own plants, your own fruit trees. I miss that feeling of freeness. I miss having something that really belongs to me.

If you put a frog in water that is already boiling, it will jump right out from the sheer pain and collision of senses. But if you put a frog in water at room temperature, then steadily raise the heat one degree at a time until it is boiling, the frog will slowly but eventually die. Our culture–us–we’re that frog right now, thinking, This is nice and cozy, but the heat has been climbing. This book is me saying, Wait a minute. It’s starting to get a little warm in here. The values and pace of our culture, the speed at which it is moving, the demands and pressure we all collectively feel, the ethos of hustle injected into us all at birth–it’s boiling us alive. But we don’t notice it because it has happened steadily over the last century or so.

Also, although the great majority of the letters I’ve received from Hmong readers have been positive, most of the negative ones have criticized me for telling a story that was not mine to tell. I am no lover of identity politics; I believe that anyone should be allowed to write about anyone. Still, I would have harbored the same proprietary resentment had I been they. It was exactly how I felt thirty years ago, when women’s voices were harder to hear because men were drowning them out. Now that young Hmong writers are starting to publish—including Mai Neng Moua, who edited a landmark literary anthology called Bamboo Among the Oaks, and Kao Kalia Yang, who wrote a fierce, sad memoir called The Latehomecomer—I am happy to shut up and listen. I hope The Spirit Catches You and You Fall Down is settling into its proper place not as the book about the Hmong but as a book about communication and miscommunication across cultures.

Every Hmong has a different version of what is commonly called “The Promise”: a written or oral contract, made by CIA personnel in Laos, that if they fought for the Americans, the Americans would aid them if the Pathet Lao won the war. After risking their lives to rescue downed American pilots, seeing their villages flattened by incidental American bombs, and being forced to flee their country because they had supported the “American War,” the Hmong expected a hero’s welcome here. According to many of them, the first betrayal came when the American airlifts rescued only the officers from Long Tieng, leaving nearly everyone else behind. The second betrayal came in the Thai camps, when the Hmong who wanted to come to the United States were not all automatically admitted. The third betrayal came when they arrived here and found they were ineligible for veterans’ benefits. The fourth betrayal came when Americans condemned them for what the Hmong call “eating welfare.” The fifth betrayal came when the Americans announced that the welfare would stop.

In the past, the states best able to manage events beyond their borders have been those best able to avoid the temptation to overreach. Great powers remain great in large measure because they posses wisdom to temper active involvement in foreign interventions - to remain within the limits of a national strategy that balances ambition with military resources. The first principle of the strategic art states simply that the greatest weight of resources be devoted to safeguarding the most vital interests of the state. If a vital interest is threatened, the survival of the state is threatened. Generally, the most vital interest of a liberal democracy include, first and foremost, preservation of the territorial integrity of the state. The example of the attacks on New York and Washington should send a message to those of similar ambitions that the surest way to focus the wrath of the American people against them would be to strike this country within its borders again. The second strategic priority is the protection of the national economic welfare by ensuring free and open access to markets for vital materials and finished goods. Other important but less vital interests should be defended by the threat of force only as military resources permit. Outside the limits of U.S. territory, the strategic problem defining the geographic limits of U.S. vital interests becomes complex. While the United States may have some interests in every corner of the world, there are certain regions where its strategic interests, both economic and cultural, are concentrated and potentially threatened. These vital strategic "centers of gravity" encompass in the first instance those geographic areas essential to maintaining access to open markets and sources of raw material, principally oil. Fortunately, many of these economically vital centers are secure from serious threat. But a few happen to be located astride regions that have witnessed generations of cultural and ethnic strife. Four regions overshadow all others in being both vital to continued domestic prosperity and continually under the threat of state-supported violence. These regions are defined generally by an arc of territories along the periphery of Eurasia: Europe, the Middle East, South Asia, and north East Asia. For the past several centuries, these regions have been the areanas of the world's most serious and intractable conflicts. Points of collision begin with the intersection of Western and Eastern Christianity and continue southward to mark Islam's incursion into southeastern Europe in the Balkans. The cultural divide countries without interruption across the Levant in an unbroken line of unrest and warring states from the crescent of the Middle East to the subcontinent of South Asia. The fault-line concludes with the divide between China and all the traditional cultural competitors along its land and sea borders. Other countries outside the periphery of Eurasia might, in extreme cases, demand the presence of U.S. forces for peacekeeping or humanitarian operations. But it is unlikely that in the years to come the United States will risk a major conflict that will involve the calculated commitment of forces in a shooting war in regions outside this "periphery of Eurasia," which circumscribes and defines America's global security.

Berlin is a city that is truly 24/7, where creativity, sensory overload and hedonism roar with unapologetic abandon. Where New York might be the ‘Big Apple’, the German capital is the ‘Big Appetite’, and the hunger for experimentation and challenge is rarely sated. It’s a city where you can fairly hear and feel the collision between past and future, what is possible and what is realistic and the cultural hopes and the culture clashes between people who’ve joined together from around the globe in one big experiment.

The formal definition of impact is a forcible contact between two things, and God has designed our lives for a collision course with the world.

Quoting page 85: The OCR [Office for Civil Rights] in the early 1970s in effect experienced an internal capture shift. The black agenda activists who had dominated the office between 1965 and 1970 were joined and to some extend displaced by a new cadre of Latino activists. Not content with the transitional model of bilingual education, which used native-language instruction as a bridge to English language proficiency, the Latino nationalists called for Spanish-based cultural maintenance programs of indefinite duration. La Raza Unida’s 1967 founding statement captured the Chicano spirit of cultural nationalism and linguistic ethnocentrism: “The time of subjugation, exploitation, and abuse of human rights of La Raza in the United States is hereby ended forever,” the manifesto proclaimed. “[We] affirm the magnificence of La Raza, the greatness of our heritage, our history, our language, our traditions, our contributions to humanity and culture.

Quoting Page 87: In 1978 a four-year study by the American Institutes for Research, sponsored by the USOE [U.S. Office of Education], concluded that most of the Hispanic students involved [in bilingual/bicultural programs[ were native speakers of English, that those who needed to learn English competence were not in fact acquiring it, that most bilingual programs were aimed at linguistic and cultural maintenance rather than learning English, and that the segregated Hispanic students who were already alienated from school simply remained so.

Well, it is really better not to use those pills on a regular basis. It would be better to give her fiber, in the form of Metamucil, because if you keep using the medicine, then Lia will lose the ability to move her bowels by herself and she will always have to have the medicine, and that is a bad thing.” When Koua translated this, Foua and Nao Kao stared at him. For four years, they had been told to give Lia medicine that they didn’t want to give her. Now they were being told not to give her medicine that they did want to give her.

Collisions - defined as serendipitous personal encounters - the lifeblood of any organization, the key driver of creativity, community, and cohesion.

Waber has also overseen interventions in company cafeterias: Merely replacing four-person tables with ten-person tables has boosted productivity by 10 percent. The lesson of all these studies is the same: Create spaces that maximize collisions.

Beneath Hsieh’s unconventional approach lies a mathematical structure based on what he calls collisions. Collisions—defined as serendipitous personal encounters—are, he believes, the lifeblood of any organization, the key driver of creativity, community, and cohesion. He has set a goal of having one thousand “collisionable hours” per year for himself and a hundred thousand collisionable hours per acre for the Downtown Project. This metric is why he closed a side entrance to Zappos headquarters, funneling people through a single entrance.

My job is to architect the greenhouse. This is a useful insight into how Hsieh creates belonging because it implies a process. “I probably say the word collision a thousand times a day,” Hsieh says. “I’m doing this because the point isn’t just about counting them but about making a mindset shift that they’re what matters. When an idea becomes part of a language, it becomes part of the default way of thinking.

In my opinion, consensual reality is better than facts." (Sukey Waller)

One of the earliest and most pleasing demonstrations of complex behaviors emerging from agents following local rules was Craig Reynolds’s simulation of the motions of flocks of birds as they fly around in the evening sky feeding on insects. The fluid and flowing motions of these flocks wheeling around the sky, sometimes separating and then coming back together, avoiding collisions with each other, looks to be a supreme act of purposeful cooperation on the wing. But Reynolds achieved a surprisingly realistic simulation by assigning the individual birds just three simple rules: one is to stay near to and steer in the same direction as your nearest neighbor; the second is to follow the main heading of the group; and the third is to avoid crowding. Add to these rules a small amount of randomness to individuals’ behaviors, and flocks of “boids,” as Reynolds called them, elegantly and sublimely fly around computer screens. No one bird is directing the flock and the birds are not actively cooperating to produce it. It emerges from the simple rules.

Fremen possessed a highly evolved conscience which centered on their own welfare as a people. It was only to outsiders that they seemed brutish-just as outsiders appeared brutish to Fremen. Every Fremen knew very well that he could do a brutal thing and feel no guilt. Fremen did not feel guilt for the same things that aroused such feelings in others. Their rituals provided a freedom from guilts which might otherwise have destroyed them. They knew in their deepest awareness that any transgression could be ascribed, at least in part, to well recognized extenuating circumstances: "the failure of authority," or "a natural bad tendency" shared by all humans, or to "bad luck," which any sentient creature should be able to identify as a collision between mortal flesh and the outer chaos of the universe.

When writing on the subject of civilization, one must understand that the ability to read or write a European language does not create a superior civilization. Nor does the ability to point exploding sticks that cause instantaneous death or injury, or to launch missiles that could blow the world apart, provide a moral basis to declare one’s culture more civilized than another. The question to ask when judging the values and merits of a civilization must always be: “How does the civilization respond to the human needs of its population?” By this standard, because they created social and political systems that ensured personal liberty, justice and social responsibility, most Amerindian civilizations must be given very high marks. When making an unbiased assessment, and comparing the values of early American civilizations with those of European civilizations, one cannot but find that the suppression and wanton destruction of American civilizations by European civilizations was in many ways a case of inferior civilizations overcoming superior ones. This is especially true in the area of respect for human rights. Although they were not as technologically advanced as the Europeans were by 1492, many Amerindian Nations possessed democratic political practices that were light years ahead.

When the month of the Twins had ended, the men said to their shadows: ‘You are I’…Thus the two became one, and through this collision the formidable broke out, precisely that spring of consciousness that one calls culture and which lasted until the time of Christ. But the fish indicated the moment when what was united split, according to the eternal law of contrasts, into an underworld and upperworld…But the separated cannot

Just as the Five Tribes and others were formalizing their tribal governments and running their own programs, legal aid groups were helping nonrecognized tribes do the same: the two were on a collision course. One result was the Federal Acknowledgment Process, establsiehd within the BIA in 1978. Its rigorous criteria and evaluation process reflected the desires of the Five Tribes and many other reservation tribes to have a stringent regimen, on that protected their rights, economic resources, and overall ability to define ‘Indians” and “tribes.” Throughout these debates pulsed questions of “authenticity” and being “real” or “bona fide” Indians and tribes. While academics and unrecognized tribes questioned the ability of any party to accurately define “Indian” and “tribe,” as a practical political and cultural matter tribes and their federal allies groped toward a way to measure and define these highly problematic terms. By 1978 leaders of federally recognized tribes felt they had found the answer in the new Federal Acknowledgment Process, with many unrecognized groups agreeing that finally a way had been found to determine what group were “real” tribes.

We're sitting on a hill, reminiscing about our deeds. These are mesmerising moments of ease; scenes are harmonising in keys. But we're in a state of oblivion, shunned from the view of fate in this period. We think about the nice days from our teens; the things that we did at our free will. We're in sync with the future and past tensions. Indeed, we could enjoy the present intentions. But we're in a state of oblivion, shunned from the view of fate in this period. We envision our problems gone; with collisions exposed and pawned. Oh! We could enjoy this peaceful time, on this hill, watching the sunrise. But we're in a state of oblivion, shunned from the view of fate in this period. The beautiful birds stride pass our face. Thick cuticles blurred, striped by hours of grace. They flap their wings, forming art; tail lamps for us, bleeding hearts. But we're in a state of oblivion, shunned from the view of fate in this period. People of different cultures come to us. Simple, they offer their services; no Judas. Wave their hands with care; give their food to share. But we're in a state of oblivion, shunned from the view of fate in this period. What a sad case this is; our mindfulness is butchered. Heads are swimming between the past and the future. Opportunities to love others in truth are being missed. Communities could share true love; limiting the rifts. But we're in a state of oblivion, shunned from the view of fate in this period.

This approach extended to the raucous all-employee street hockey games in the parking lot (“No one held back when fighting the founders for the puck,” recalled one player) and to the all-company Friday forums, where anyone could challenge the founders with any question under the sun, no matter how controversial—and vice versa. Like the hockey games, the Friday forums often turned into collision-filled affairs.

Dan Murphy's diagnosis added Lia Lee to a distibguished line of epileptics that has inlcuded Soren Kierkegaard, Vincent van Gogh, Gustave Flaubert, Lewis Carroll, and Fyodor Dostoyevsky, all of whom, like many Hmong shamans, experienced powerful senses of grandeur and spiritiual passion during their seizures, and powerful creative urges in their wake.

I remember having a little bit of a feeling of awe at how differently we looked at the world. It was very foreign to me that they had the ability to stand firm in the face of an expert opinion.

After a few months went by, Dee started leaving her own baby with Foua when she took Lia to medical appointments-perhaps the first instance in the history of Child Protective Services that a foster mother has asked a legally abusive parent to baby-sit for her.

Now I only have one rule. Before I do anything I ask, Is it okay? Because I'm an American woman and they don't expect me to act like a Hmong anyway, they usually give me plenty of leeway.

In 1965, Johnson commented sanctimoniously that "the problem of Laos is the refusal of the Communist forces to honor the Geneva Accords," What he failed to mention was that his own country wasn't honoring them either; it was just doing a better job of keeping its violations secret.

They told us what we wanted to hear. What we really knew about them wouldn’t fill the bottom of a cup.

When no interpreter was present, the doctor and the patient stumbled around together in a dense fog of misunderstanding whose hazards only increased if the patient spoke a little English, enough to lull the doctor into mistakenly believing some useful information had been transferred. When an interpreter was present, the duration of every diagnostic interview automatically doubled. (Or tripled. Or centupled. Because most medical terms had no Hmong equivalents, laborious paraphrases were often necessary. In a recently published Hmong-English medical glossary, the recommended Hmong translation for “parasite” is twenty-four words long; for “hormone,” thirty-one words; and for “X chromosome,” forty-six words.) The prospect of those tortoise-paced interviews struck fear into the heart of every chronically harried resident.

they’d just load him up with opium so he’d fall asleep.” DeLay pointed out that although few refugees are rejected for medical reasons, it is a terrible crisis for the ill person’s family when this does happen, especially because once an applicant is “medically excluded” by one potential country of asylum, he is unlikely to be accepted anywhere else. “All of this means that the refugees have one more reason to be afraid of doctors,” said DeLay.

And doctors could lose the respect of their patients if they didn’t act like authority figures. The young residents at MCMC did not enhance their status by their propensities for introducing themselves by their first names, wearing blue jeans under their white coats, carrying their medical charts in little backpacks, and drinking their coffee from Tommee Tippee cups. Doctors could get into trouble if they failed to take the Hmong’s religious beliefs into account. For example, it was important never to compliment a baby’s beauty out loud, lest a dab overhear and be unable to resist snatching its soul.

Most old people prefer not to go to doctor. They feel, maybe doctor just want to study me, not help my problems. They scary this. If they go one time, if they not follow appointment and do like doctor want, doctor get mad. Doctor is like earth and sky. He think, you are refugee, you know nothing.

There were hundreds of pages whose proper home I was at a loss to determine. Should they go in the Medicine folder? The Mental Health folder? The Animism folder? The Shamanism folder? The Social Structure folder? The Body/Mind/Soul Continuum folder? I hovered uncertainly, pages in hand, and realized that I was suspended in a large bowl of Fish Soup. Medicine was religion. Religion was society. Society was medicine. Even economics were mixed up in there somewhere (you had to have or borrow enough money to buy a pig, or even a cow, in case someone got sick and a sacrifice was required), and so was music (if you didn’t have a qeej player at your funeral, your soul wouldn’t be guided on its posthumous travels, and it couldn’t be reborn, and it might make your relatives sick).

Neil was pretty sure, however, that because Lia’s condition was progressive and unpredictable, he could treat it best by constantly fine-tuning her drug regimen. If he had chosen a single pretty-good anticonvulsant and stuck with it, he would have had to decide that Lia wasn’t going to get the same care he would have given the daughter of a middle-class American family who would have been willing and able to comply with a complex course of treatment. Which would have been more discriminatory, to deprive Lia of the optimal care that another child would have received, or to fail to tailor her treatment in such a way that her family would be most likely to comply with it?

When I asked Dan Murphy why he thought caring for the Hmong caused so much stress, he said, “People in the early years of their medical careers have invested an incredible amount of time and energy and pain in their training, and they have been taught that what they’ve learned in medical school is the only legitimate way to approach health problems. I think that is why some young doctors go through the roof when Hmong patients reject what we have to offer them, because it intimates that what Western medicine has to offer is not much.