What struggles did Qian's family face after immigrating to the United States?

Qian and her parents avoided going to the doctor, as they had no health insurance. They also had very little money for food, and they often struggled with malnutrition. At one point, Qian’s mother became very sick and required surgery. She became sick again later; she was diagnosed with pancreatitis, and the doctors said that improper nutrition was the likely cause.