In the larger community, the clash was about money and community services strangled by welfare costs. In the medical community, however, the clash was about opposing belief systems righteously dismissive of each other. The doctors were concerned with saving lives; the Hmong with saving souls. Fadiman, in a single case study, traces how misunderstanding can degenerate into paranoia. Although Western medicine has long given lip service to treating the "whole patient," in practice patient care is generally compartmentalized into isolated subspecialties. For the Hmong, however, subspecialties are fictitious. Their cosmology, which has served as a guiding cohesive force for several centuries, rests on the assumption that all life is interconnected—virtue and vice, good luck and bad, health and illness. Each individual’s soul is in constant danger of being compromised by dabs, opportunistic spirit thieves who rob life of its value, opposed by tvix neebs, shamans experienced in spirit rescue. Medical commonplaces such as blood tests, surgery, and anesthesia trespass sacred Hmong taboos, and disrespect of those taboos is both offensive and dangerous. Most Hmong come to an American doctor only as a last resort and with little tolerance for medical failure.