But here is the issue:
Designed to defuse the Hmong fear of Western medicine, the program has “built trust both ways,” said Dr. John Paik-Tesch, director of the Merced Family Medicine Residency Program, which trains resident physicians at Mercy Medical Center.Oookay...
Since the refugees began arriving 30 years ago, health professionals like Marilyn Mochel, a registered nurse who helped create the hospital’s policy on shamans, have wrestled with how best to resolve immigrants’ health needs given the Hmong belief system, in which surgery, anesthesia, blood transfusions and other common procedures are taboo.
The result has been a high incidence of ruptured appendixes, complications from diabetes, and end-stage cancers, with fears of medical intervention and delays in treatment exacerbated by “our inability to explain to patients how physicians make decisions and recommendations,” Ms. Mochel said.The consequences of miscommunication between a Hmong family and the hospital in Merced was the subject of the book “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and The Collision of Two Cultures” by Anne Fadiman (Farrar, Straus and Giroux, 1997). The book follows a young girl’s treatment for epilepsy and the hospital’s failure to recognize the family’s deep-seated cultural beliefs. The fallout from the case and the book prompted much soul-searching at the hospital and helped lead to its shaman policy.
The Hmong believe that souls, like errant children, are capable of wandering off or being captured by malevolent spirits, causing illness. Mr. Lee’s ceremony for the diabetic man was a spiritual inoculation, meant to protect his soul from being kidnapped by his late wife and thus extending his “life visa.”
But then, it is about patients getting better - even with placebo:
This again shows the complexity of how people incorporate/manifest beliefs. But these kind of exceptions by hospitals can open the door to all sorts of medical quackery to get a foothold in hospitals.
A turning point in the skepticism of staff members occurred a decade ago, when a major Hmong clan leader was hospitalized here with a gangrenous bowel. Dr. Jim McDiarmid, a clinical psychologist and director of the residency program, said that in deference hundreds of well-wishers, a shaman was allowed to perform rituals, including placing a long sword at the door to ward off evil spirits. The man miraculously recovered. “That made a big impression, especially on the residents,” Dr. McDiarmid said.
Social support and beliefs affect a patient’s ability to rebound from illness, Dr. McDiarmid added, pointing out that over half of the people who respond to antidepressants do so because of the placebo effect.One of the goals of the new policy, Ms. Mochel said, is to speed up medical intervention by having a healing ceremony coincide with a hospital stay, rather than waiting days for a patient to confer with family and clan leaders after a ceremony at home.
At the hospital in Merced, Dr. Lesley Xiong, 26, a resident physician, grew up as the granddaughter of two distinguished shamans. Though she chose to become a doctor, she said there was ample room for both approaches. “If I were sick, I would want a shaman to be there,” Dr. Xiong said. “But I’d go to the hospital.”
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