These chosen individuals may be called upon by tribal members to intercede on behalf of an individual in need. Often, these practices are conducted in the privacy of the individual’s home or designated place. If an individual is hospitalized, usually the prayer will be conducted at the bedside. Information is often shared openly but to inquire would be considered rude. This religion is not practiced by all American Indians/Alaskan Natives but is a way of life for many and has been around for thousands of years.
Medicine men and women are treated with the utmost respect throughout the American Indian/Alaskan Native community. It may be helpful to ask a coworker who knows the local customs or authorities what to do when such a person is in their presence. It is always important to acknowledge and respect their importance in the community and among the people.
The service and assistance of a medicine man/woman might be sought by a patient for many reasons. Typically, this is neither something the patient will tell you nor is it recommended that a provider directly ask the patient if they are having or have had a ceremony. Depending on the relationship you have with your patient, allow them to volunteer this information. However, there might be something unusual noticed with the patient that might catch a provider’s attention. Before directly asking the patient what is going on, we would recommend excusing yourself from the exam room or waiting until after the medical visit is completed. As a medical provider, you could seek a tribal community member who is on staff to inquire of what was seen—without breeching HIPAA. As with any form of healing methods, adverse outcomes can occur. However, because the spiritual and mental impact on the patient is unknown, we should not judge negative outcomes of these alternative healing methods. If you show respectful concern, tribally affiliated staff will be more willing to assist in your understanding of their culture and methods of healing.
One of our contributing pharmacists provides an intriguing example of the incorporation of cultural beliefs and practices along with “western medicine”.She mentions,
“Many tribes have cleansing rituals prior to ceremonies. In one particular patient I have been dealing with for over 20 years, each time he danced (and he loved to dance in ceremonies) he was hospitalized for atrial fibrillation, edema, and has since developed CHF, as we would have anticipated. However, he is 88 now, and still dances twice a year, with the full fasting and preparation of herbs. He is himself a medicine man. We developed an agreement over the years, that he would substitute herbs, for his meds. My job was to tell him exactly what his benefit was from the white medicine, and he would match it with his herbal remedies. We did pretty well, actually. He takes our medication, unless he is cleansing, and he understands that his herbs, although they give him about the same results, cardiac wise, impair his anticoagulation. We just discontinue his warfarin for fasting, after we have worked him up to the higher level of normal, and he restarts it immediately. He drinks more tea, with aspirin like qualities, the days he is fasting, as it is allowed. It took about 3 years to get to the sharing point, but I feel quite sure together we have made it possible for him to reach his soon to be 89th birthday, and still participate with dignity in his tribal rituals”.She continues on to share,
“We did have another medicine man, who worked out of his car in the hospital parking lot, talking about what shysters and killers of Indians we were! … I just stopped by each evening and visited with him. We began talking, and once or twice I asked about a treatment and commented about his treatment that seemed to help one of the patients, and… about how I was SURE he was aware that anticoagulation drugs were affected by herbs and that caused stroke, etc. He educated me, and I educated him. We did not always agree, but we did communicate with each other and probably the most important thing was we were seen communicating. That meant I was NOT the enemy any more. He even offered to smoke my daughter’s horse prior to the national finals rodeo…This helped a great deal. People began to ASK if their medicine man medications would help or interfere, or could be a problem. When it came right down to it, few things are ingested, and there is lots of positive reinforcement through the medicine man”.
http://www.ihs.gov/pharmacy/index.cfm?module=awareness
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