She had gone to a voodoo priest for help in interpreting this dream. Each of the lumps had significance, said the priest. They represented ‘the three mysteries,’ and to be cured she would have to travel to a clinic where doctors ‘worked with both hands’ (this term suggesting that they would have to understand both natural and supernatural illness).
– Paul Farmer, “An Anthropology of Structural Violence” in Partner to the Poor: A Paul Farmer Reader
I feel so conflicted some days about my medical training because I have yet to reconcile a personal tension that is floating on the surface of my mind.
- How can I be both an indigenous woman and a western medicine doctor?
- How can I hold my spiritual beliefs regarding illness/disease and my belief in evidence-based medicine at the same time?
- How do I practice traditional forms of diagnosis and healing through prayer, singing, ceremony, communion in a medical culture that doesn’t acknowledge indigenous epistemology, spirituality, or traditional forms of healing in its training, science, or practices?
I feel that my cultural values and spiritual beliefs are not “allowed” in this culture of medicine in which I am being trained, and that makes it hard to envision how I can be what I’m being taught a “doctor” is. This task feels daunting, as it requires that I map my own way mostly unassisted. Surely someone has come before me on this path… but where are they? Who are my mentors?
I’m reminded of a young Hmong woman, Mrs. W, who I met while on my internal medicine clerkship. Mrs. W is a woman who came into the hospital in a state of crisis: hemorrhage. Surgery saved her from internally bleeding to the point of hemorrhagic shock, and for that she is grateful. But now science, by way of the various teams of physicians caring for her, cannot explain why she is experiencing a whole host of issues including hemolytic anemia almost a week after her surgery. Despite throwing every analytical test at the problem– everything just short of a bone marrow biopsy, I should say– and finding no compelling explanations, there are no answers for Mrs. W and her husband. After weeks in the hospital and little relief from her situation, she told our team of trainees and students supervised by the attending physician that she wanted to go home to consult with the shaman with whom her family calls upon in times of sickness. She said that her husband believed that the recent passing of his parents might be the reason she was getting more sick; it might be because the parents were trying to communicate something to her or her husband. The shaman, she explained, would be able to pass along messages and instruct her and her husband in what offerings to give.
This moved me. Here was a patient to whom I could relate! I deeply wanted to swap notes: What it feels like to be held by your rituals and ceremony. What dreams show of the spirit world. What songs or chants you sing in praise or in prayer. What an adequate offering looks like. What healing the spirit, mind, and body feels like, looks like, sounds like, and smells like.
Maybe my work as a physician is meant to be among other people who hold spiritual beliefs about healing. Perhaps this is what Mrs. W taught me. I‘d like to heal with both hands.
karuṇā 