L48 Anthro 3283 Chapter Notes - Chapter 5: Child Protective Services, Status Epilepticus, Palpation
Fadiman Chapter 5 (p. 38-59)
• Between 8 months and 4 years old, Lia visited MCMC 17 times and made 100 outpatient
visits to the ER and pediatric clinic
• Had hallucinations, seizures got worse; in most serious episodes, she would seize without
regaining consciousness – status epilepticus (seizures that last 20 min or longer)
• Lia is overweight, made it difficult to deal with the seizures
o Father didn’t think it was bad; a plump Hmong child was perceived as healthy and
well cared for
o A vein hidden under fat is hard to palpate
• She eventually lost the veins in her arm, because they have been needled so much
• The less she moved the longer the IVs would last
• Dad didn’t understand why the nurses tied her up
• Lia got hurt under the supervision of people who claimed to know more than the Lees on
how to keep her healthy, but they responded in a way, from the Lee’s point of view, that
was sadistic
o She had a huge bump on her forehead as a result of falling out of her bed
• Hospital is a hard place for any parent; takes all the autonomy of being a parent away;
even harder if you are from a different culture and don’t understand these experiences
• Hmong fathers loved sons more; okay if girl died; but Lia’s family wanted so much for
her to live, and adored her
• Lia was bold, not afraid, a character; even though frustrating and caused grief
• She did not like taking medicine; spit it out; family had an even harder time giving to her
than the nurses, since they were reluctant to force her
o Drug regimen became very complicated
• By the time she was 4, she was taking a long list of medications; her prescription changed
23 times in less than 4 years
• Her family could not read the instructions, illiterate in Hmong and English; and because
their prescriptions changed so frequently, they forgot what the doctors told them
o Did not occur to the doctors that her parents would fail to give her meds correctly
o Couldn’t tell if they couldn’t understand them or if they didn’t want to give her
the meds
• June 1983 – MCMC sent a nurse home with then, accompanied by a Hmong interpreter,
to try to improve the family’s compliance with her medicine regimen
o Non-compliant mom
o Parents happy with her medication and treatment as reported by the nurses
• Parents reluctant to follow medications, because thought it caused more problems,
seizures, fevers
o The idea that the drugs prescribed to cure, or at least attempt to cure an illness are
in fact causing it is not one that most doctors ever encounter
o Doctors not used to patients not listening or believing them
• Arnie – 2-year-old little boy with cancer; went through chemo and lost all his hair, and
puked every time he took his meds, so parents didn’t want to continue with the treatment
o Doctors gave them 3 days warning, and called Child Protective Services, for child
abuse; social workers and police officers came
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