23 Mar 2015
I have expanded my cultural experiences by relocating from the Midwest to the Phoenix metropolitan area. The facility where I work offers a fairly mixed spectrum of cultural diversity in an intimate and professional healthcare facility. Since several of my colleagues come from unique cultural backgrounds, I wanted to better understand their perspective on how their ways of life are accepted by or incorporated into today's health care practices. This paper includes interviews that focus on Buddhism, Shintoism, and the Navajo Indian.
The first question I posed to Kamm was about the spiritual perspective on healing in the Buddhist way of life. She told me that this comes through an end of suffering through wisdom, acts of compassion, and peace. A person who shows great compassion is able to draw on inner strength to overcome pain. She continued by explaining, "At a physical level, that person may suffer from pain, but their mental disposition is calm." His/her mental level is able to subdue the physical pain. Because of that person's mental disposition, the body's immune system becomes more active to fight the disease. She elaborated further to say that sometimes it also means that a person is at peace in accepting physical pain or death in an optimal way, without suffering from it. A Buddhist prefers a calm and peaceful environment.
I asked Kamm about the critical components of healing of a Buddhist. She explained that diet and exercise are critical components of healing or preventing disease. She also added that Buddhists pray and meditate regularly to promote relaxation and healing. If illness does occur, many believe that using the mind can help overcome it. Kamm stated, "Everything constantly changes and change is the only constant. If certain events happen, people believe it is because a person has sowed those seeds that caused that event to occur." Kamm elaborated further by saying that following death, Buddhists prefer not to disturb the body for as long a time as possible. The first 49 days following a person's death are very important. It is during that time when many prayers are offered before the new life, reincarnation, begins.
Kamm explained that reincarnation occurs over and over and a follower can be reborn as any living thing. Karma is important in reincarnation and is defined as an intentional mental, verbal, or physical action and this is very important to the Buddhist (Sayadaw, 2008). Good karma is based on showing compassion and doing the right thing; this helps determine how a person will be incarnated. If a person generates bad karma by hurting or killing others, negative consequences will occur in this or another lifetime ("Karma and rebirth," n.d.). Kamm briefly reminisced when she said, "The people cherish ancestry. During a specific time of the year, they take a vacation to go back home to pay respect for the dead."
I asked Kamm to define what is important to a Buddhist person when cared for by health care providers with other spiritual beliefs. She explained that if a physician is very knowledgeable but not compassionate, their medicine is not very effective. The basis of trust comes with a commitment, a sense of responsibility, and a genuine sense of concern. She also added that Buddhist physicians treat their patient as if he/she was their own child.
My second interviewee, Taki, grew up in Japan. In her early 20s she met her future husband, an American, who was temporarily working there. Following their marriage, she moved with him to the United States. Taki explained that in Japan, Shintoism is another way of life, not a religion. There is a great respect for nature and when Shintoists are close to nature they are close to their kami. Kami are spirits with supernatural powers they worship that are often depicted as a variety of objects in nature such as trees, rocks, and animals (Blanford, 2009). Taki elaborated further to say that there is a strong aspiration for purification in all aspects of their life and this can be observed through their rituals or in their way of thinking. Like Buddhist beliefs, when someone passes away Shintoists believe that the person is reincarnated.
Taki explained the spiritual perspective on healing from the Shintoist perspective. Shinto followers are accepting of some of the difficult things that come their way because they believe it is the kami's way of getting their attention. She also told me that though they may seek medical attention at medical facility, they also use other methods for healing such as in the use of herbal remedies. According to Taki, Shinto followers are very accepting of the care they receive but they are more uncomfortable when it comes down to decisions regarding complex treatment. She continued by explaining that because they are very respectful of nature and following a natural path in life, this type of complex treatment goes against their beliefs in following a natural life. They also see the dying process as one goes against their aspiration for purity in life.
Taki explained that a critical component on healing includes silent prayer to one of the kami requesting a favor. The Shinto people believe that kami want their people to be happy so they pray for good health, a good life. Taki continued by explaining that they also pray during major life events such as birth, marriage and death. Sometimes they write their prayer on a plaque and leave it at the shrine. She also noted that the Shinto people keep a small shrine in their home where offerings are made to a particular kami.
In response to the question regarding what is important to the Shinto follower when cared for by health care providers, Taki explained that often, the Shintoists are advocates of a natural way of healing and typically are not in favor of artificial means to live. Some patients will rely on the doctor and will be very accepting of the results, no matter how serious.
My final interview was conducted with Carmen, a Navajo Indian, who has lived her entire life in the Phoenix, Arizona area. Carmen explained that the Navajos also do not have a religion that traditionally worship a god. Their way of life, which stems from their sacred beginnings, serves as their belief system which strives for balance and harmony. Carmen went on to say that Navajos believe they are connected to the land and are relatives to every living thing. Their way of life is full of ceremonial rituals and traditions that connect them to their sacred past. "Throughout our life we strive for holistic wellness for which many of our rituals are based," she explained.
Carmen believes that illness occurs when a person has an imbalance between body, mind, and spirit. A Navajo healer might be sought out to diagnose this imbalance by interpreting dreams, star gazing, or understanding the vibrations in nature. Following that, a healing ceremony can be planned to assist the mind in healing the body. Carmen went on to tell me that the ceremonies are conducted in their ceremonial attire and include chants, which are a form of prayer. Several days are observed for holiness and the healing process to continue following the healing ceremony. Carmen elaborated on this further to say that during this time the person needs to avoid certain activities, one of which includes bathing. This shows evidence the Navajo's seriousness for a deep desire for healing to occur. The Navajo may also use herbs for treatment or seek a medical doctor for some care.
Carmen relayed that in the United States, there are hospitals specifically designed to integrate the Native American practice for healing with modern medicine. She happily reported that healing ceremonies are sometimes conducted on public land before any ground breaking for a health facility. A ceremonial hogan, a Native American family dwelling that faces the east, is included in some hospitals to accommodate this way of healing ("Hogan: Dine (Navajo)," n.d.). Carmen also noted that if a Navajo is hospitalized, Navajo healers are sometimes brought to the patient's hospital room.
Carmen admitted that the Navajo are often wary of the western medicine practice. She emphasized that they want their doctors to understand their beliefs. The Navajo would like to see more medical facilities consider the Native American way of life as plans for medical facilities are made. Carmen continued explaining that the Navajo find most facilities are too business like and cold which creates stress and anxiety. This often makes it difficult to regain wellness through harmony and balance.
Collectively, the people interviewed all had a consistent message for how they value the care provided to them by health care providers whose spiritual beliefs were different from their own. The care they receive needs to align with their values which might include the medical team approach that respects their beliefs, a calm and serene environment, or incorporation of healing practices unique to their ways of life. They do not want healthcare workers to assume that what is important in western medicine is necessarily shared by all peoples.
When patients see health care providers let go of their own beliefs, patients feel more comfortable in their care. A sense of trust develops. Patients have greater comfort knowing that their ways of life are understood, respected, and incorporated into their care. All of these efforts promote their healing process.
The Christian philosophy of faith and healing often refers to God's power to heal. God's will is interpreted by some as being punished for their sins, or as a way to bring a person closer to God because of a lack of faith. Today's belief in healing integrates God's will through faith with traditional medical practices. God has given people the ability to acquire knowledge and skill to pursue and employ scientific advances to help treat or cure diseases. However, in contrast to other faiths this may not include a belief in the same god or what is important in a person's life.
In conclusion, I have learned a lot in gaining a better understanding of the beliefs and values of other cultures. It has significantly increased my awareness to never assume that the care I typically provide is in agreement with the beliefs and wishes of my patient. I am more aware of the importance to first understand my patient's beliefs so I can assist in their healing process that respects their culture and best meets their needs.
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