Healing by Heart: Clinical and Ethical Case Stories of Hmong Families and Western Providers

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Clinical and Ethical Case Stories of Hmong Families and Western Providers Edited by Kathleen A. Culhane-Pera, Dorothy E. Vawter, Phua Xiong, Barbara Babbitt, and Mary M. Solberg FROM THE CASE STORIES: Mrs. Thor’s father was the most vocal family member, explaining to the doctors that taking the medicine was unnecessary because his daughter’s contractions had subsided. He explained how he had helped his wife deliver six healthy children without any sort of medical assistance—in some cases, under very difficult circumstances. . . . His assessment was that his daughter’s child was fine and did not need any interventions. Mrs. Yang’s oldest son and daughter pleaded with her to follow the doctor’s advice. They told her how much they needed her and wanted her to have a long life. They tried to convince her to give up her fears about surgical interventions and encouraged her to become Christian. Neither the shaman’s intervention nor the herbs were working. Mrs. Yang decided to convert to Christianity and to undergo a (cervical) biopsy. The shaman told Mr. Vang that he was being chosen by the helping spirits to become a shaman. He was startled and worried at first, but over several weeks he and his family accepted the diagnosis. Mr. Vang gave up Christianity, and he started his apprenticeship with the shaman; as he learned to shake and to enter the shaman’s trance, he became stronger and stronger. He reported to the doctor that for the first time, with the assistance of the insulin and becoming a shaman, he felt like himself again. The parents stated that although Pam might have a hole in her heart, she was clearly doing well and did not have a problem. They recognized she was “a crooked cucumber” and they loved her “as much as every cucumber in their patch.” They opposed surgery because of the accompanying risks of soul loss and bad spirits entering her body. Moreover, they rejected the physician’s assertions that not correcting the hole in her heart would result in serious problems . . . and that if problems developed, it would be too late to intervene. Mai Neng decided to go ahead with the biopsy despite her family’s objections because she wanted to know why her kidneys were failing. Her Hmong pastor supported her decision. The morning of her biopsy, her uncle called and told her not to go through with the procedure and to try Hmong medicine first. . . . As Mai Neng was rolled away on a cart into the operating room, her mother sobbed on her knees, begging Mai Neng to turn back. In the ICU, the family members called on a healer to perform a strong type of khawv koob to release the swelling in Mrs. Her’s brain. To burn incense as part of the ritual, they needed the doctor’s permission to turn off the supplemental oxygen in her room. Knowing that he had little left to offer her, and conceiving of the ritual like a Catholic’s last rite, the resident agreed to discontinue the oxygen during the ritual, but told the family that the ritual would have to stop if she had trouble without the oxygen. Cover photograph: Kathleen A. Culhane-Pera Design: Dariel Mayer ISBN 0-8265-1431-6 ™xHSKIMGy514318z Vanderbilt University Press Nashville, Tennessee 37235 www.vanderbilt.edu/vupress This is a “must read” book for anyone interested in providing more culturally competent health care and addressing cross-cultural ethical conflicts. The writing is fascinating, informative, practical, and provocative. Congratulations on what I am sure will become a seminal text in the field! —Robert C. Like A spectacular work of scholarship and collaboration among authors of varying backgrounds, professions, and ethnicities. It covers a very broad range of medical and ethical issues in an accessible format, based on actual medical cases in all their frustrating and fascinating complexity. The views of both health professionals and patients/families are represented, along with steps in negotiating mutually acceptable courses of action. This unique and important work will quickly become indispensable to all who teach about, study, or practice crosscultural health care and medical ethics. —Bonnie B. O’Connor Healing by Heart VANDERBILT Culhane-Pera • Vawter Xiong • Babbitt • Solberg Healing byHeart Clinical and Ethical Case Stories of Hmong Families and Western Providers HealingByHeartcover 1 8/1/03, 1:44:48 PM Healing by Heart ...