Chapter 4 - Do Doctors Eat Brains?

In 1982, Mao Thao, a Hmong woman living in St. Paul, Minnesota, returned to Laos and visited the Ban Vinai refugee camp. She was asked to speak to the people of the camp about life in the United States. The people assembled there en masse and spent four hours questioning her. Most of their questions concerned the American medical system. They wondered why Americans took so much blood, why doctors, after death, opened the patient’s head and removed his brains, why doctors eat livers, kidneys and brains, and why dead bodies were cut into pieces and sold for foods. The general drift of these questions suggest that the information about the medical system in America had filtered back in a less than enthusiastic manner to Laos.

There was obviously a great difference between American doctors and Hmong shamans. A shaman might spend eight hours in a Hmong home while an American doctor demanded the patient come to the hospital where the doctor might only see him for twenty minutes; shamans never asked the rude questions American doctors did; shamans could render an immediate diagnosis while the doctors had to run many tests and then sometimes didn’t know what was wrong anyway; shamans never undressed their patients; doctors even put their hands and fingers into body orifices; shamans knew you had to treat the soul as well as the body; shamans could not be blamed for their patients not getting well, because it was the fault of the spirits; doctors were blamed in America for the patient’s death.

Besides the differences between doctors and shamans, there was a feeling among the Hmong that doctors’ procedures were actually more likely to threaten their health than to restore it. The Hmong believe that there is only a finite amount of blood in the body, doctors are continually taking it. When people are unconscious, their souls are at large, so anesthesia may lead to illness or death. Surgery is taboo and so are autopsies and embalming. The only form of medical treatment that was gratefully accepted by the Hmong was antibiotics. They had no fear of needles and frequently practiced dermal treatments like acupuncture, massage, pinching, scraping the skin, heating a cup to the skin or even burning the skin. Catherine Pake, a public health nurse, spent six months in a refugee camp where the Hmong taught her about twenty medicinal plants which were used in various forms to treat or cure all kinds of ailments. Wendy Walker-Moffat, an educational consultant who spent three years teaching and working on nutritional and agricultural projects in the refugee camps, suggested that the one reason the Hmong avoided the camp hospitals was that so many of the medical staff were excessively zealous volunteers from Christian charitable organizations who were also there to convert the Hmong to Christianity. They soon discovered that converting them to Western medical habits was all but impossible.

In 1985, the International Rescue Committee assigned Dwight Conquergood, a young ethnographer with a special interest in shamanism and performance art, to design an environmental health program for the Ban Vinai camp. He noted that the medical staff never tried to work in cooperation with the shamans, but instead did everything they could to disconfirm them or undermine their authority. As a result, the Hmong totally underutilized the hospital services. So, one day, after spending the night in a Hmong hut, he awoke to see an old woman singing folk songs with stars and moons stickers on her face. The stickers were used to tell illiterate patients whether to take their medicine during the day or night. Conquergood saw this as creative rather than non-compliant and also saw it as a way to create cooperation between the two sides. When a rabies scare cropped up, to get the Hmong to bring in their dogs for vaccines, he organized a Rabies Parade in which there were three characters - a tiger, a chicken, and a dab - which told the people by loudspeaker to bring in their dogs. The next day, the Hmong brought their dogs in so fast that the health workers had their hands full. He considered his relationship with the Hmong to be a form of barter where neither side dominated or won outright. The doctors and nurses saw the relationship as one-sided with the Westerners holding all the knowledge. He felt as long as the Westerners held this attitude they would continue to be rejected, because the Hmong would not be coerced.

Notes

This chapter is a further examination of the uneasy relationship between the Hmong and western medication. It is once again a foreshadowing of the problems that will crop up between the doctors at Merced and the Lees.