A spiritual model of healing or: why doctors should learn about culture

There are so many things we take for granted living as men and women in the United States. Does your health insurance cover birth control? In Ecuador, most insurance policies will not cover oral contraceptives even if it is for a properly diagnosed medical condition. Perhaps you or a loved one has had to use emergency contraception, Plan B? In Ecuador, you cannot find it. The closest thing that comes to plan B here is the rigorous prescription of progestin pills (and this is only used by the most "rogue" of doctors). It seems that the heavy influence of Catholicism in Latin America has put restrictions on the access to certain levels of family planning. Enter machismo. I have spoken to many women who have had difficulties with their boyfriends, husbands, and lovers because they refuse to wear condoms; largely having something to do with the idea that condoms take away your virility. Because of this, the incidence of early pregnancy and the transmission of sexually transmitted diseases is particularly high in Ecuador (if you see any sort of STD statistics in Ecuador, you should assume it's higher because most cases go unreported and just as condoms are looked down upon, so are getting blood tests).

At one point since I've been here, I found myself serving as an ally to a young woman (I will refer to her as "Rosa" throughout this entry, which is obviously not her real name) who became pregnant due to a condom malfunction. Living in an extremely traditional and machista family, Rosa feared that her family would beat her and disown her for getting pregnant out of wedlock. The partner was out of the picture as a supportive figure as he preferred to be unfaithful and verbally abusive. If this type of situation were to arise in the US, an abortion would be a feasible option. In Ecuador, however, such procedures are illegal. This forces many women to go underground in search of "rogue" doctors and in some cases people unqualified to perform such procedures. This woman was determined to go to a doctor and have a "procedure." This put me in a difficult position because I wanted to be supportive of her, yet I was concerned about the doctor she was going to visit, so we went together to have a consultation before any procedure. The doctor had excellent bedside manner, was responsible, and most of all, knowledgeable in practice.

Despite knowing what to expect from the procedure, Rosa was very nervous. The procedure went smoothly and she went under with anesthesia. It usually takes approximately 30 minutes for someone to come out from anesthesia, typically experiencing nausea and hallucinations. Rosa had a particularly strong reaction to the anesthesia, and it took her nearly 3 hours to come out. As she was coming out of the anesthesia and could begin to talk again, she was complaining of the inability to see, that she had "gone blind." It was at this moment that I was unfamiliar of how people respond differently to medicine (the doctor had to leave the room to release a patient from the hospital), so I used my privilige to the best of its ability and called my doctor father in the United States. He mentioned that often when people undergo traumatic procedures, they often experience psychological symptoms, such as temporary blindness. He told me briefly of a patient of his who lost a child while giving birth and subsequently lost her ability to see. My father knew that she was very religious, so he asked her to look out in the direction of the window and try to focus on seeing Jesus. After several moments of intense focus and prayer, the woman was able to see again.

I made sure to check to see if Rosa's eyes constricted by flashing a light into her pupils. Sure enough, they constricted, indicating that physiologically, she was "fine." When one is coming out of anesthesia, they often do not have the ability to show much emotion, it is what is typically called "la indifference," so the emotions one would feel about having had an abortion (coming from a machista and Evangelical family) were suppressed. Rosa is a very devout Evangelical Christian (Pentecostal), and I had known from previous conversations that she would often talk of experiences of going to Church and becoming healed by just a touch or a breath of air in prayer. I was left with no choice; either allow Rosa to continue feeling like she was going blind, or to "puppet" an Evangelical laying of hands and prayer healing moment. I should mention here that I do not identify myself as religious at all, perhaps slightly spiritual in that I believe in the power of energy (yes, somewhat woo-woo) and I respect people's various religious beliefs, especially when they are used in healing contexts. So, I felt rather uncomfortable at first with the idea of praying and talking to Jesus. But it was clear that this would hopefully help Rosa in her process.

So I took a deep breath, trying my best to recall some charismatic healing techniques I had read about in various anthropology texts and using what woo-woo knowledge I have grown up with regarding energy healing and meditation, and I put my hand on her heart and her forehead. I have to stray for a moment and mention that I have spent the majority of my academic life reading and problematizing the so-called boundary between anthropologists studying religion and the idea of "belief;" it is a very tricky line to cross. There have been many anthropologists who have indeed "crossed that line," (lines of 'objectivity' are overrated) and have actually had moments of belief or embodied experiences (Michael Taussig and Ayahuasca, Roy Wagner and the human hologram, Thomas Csordas and charismatic healing, to name a few off the top of my head). But at this point, I was not playing the anthropologist role (however this does not stop me from trying to make sense of this experience using what I know, which is anthropology). I was a concerned ally and willing to do whatever it took to make Rosa feel comfortable.

I began to speak to her, asking her to remember that God and Jesus were with her, that they will always be with her and will never stop loving her. I had her focus on each part of her body, starting at her toes, and I asked Jesus to fill her toes with love, strength, and health. I repeated this little phrase for each part of her body, something like this: "Imagine Jesus filling your toes, now your toes and your feet, now your toes, your feet, and your legs with the warmest love, strength, and health. He will always live inside of you. Feel the warmth of love radiating from your heart." I have to say that while I was focusing on helping her through this prayer exercise, my discomfort with "acting" like I was speaking in tongues (because I myself am not Evangelical, nor a "believer") totally disappeared. It was a meditative exercise, so I found myself actually being embodied by a warm sensation - it actually felt like my energy was different. After finishing this prayer/meditative exercise, I asked if Rosa could see. And to my surprise (or not), she regained her vision AND was talking with improved clarity.

Certainly, this is not a technique they teach you at medical school. I did find it interesting, however, that catering the healing process to this woman's identity as a devout Evangelical Christian actually helped her when conventional medicine or treatment would have failed. I am not claiming myself to be an energy healer nor an evangelical one at that, but definitely having an understanding of her religious and cultural background helped make her experience in the clinic a less traumatic one. Even if you're not a believer or a practitioner, reading a little bit about other cultures and belief systems could indeed come in handy one day! So go out and do some reading or better yet, learn from and listen to the people around you!

Thesis Reveries

I'm going to take a risk today. While I think the blogosphere often serves as a space for annoying rants and discussions that go nowhere, I remain somewhat in awe of the ability to create an accessible space for sharing information, engaging in productive discussions, and pushing the limits. I sit here as a recent college graduate who, for the past three weeks, has been thinking about the ways in which I can continue putting the fruits of my education into [some/good] use. Having emerged from a liberal arts education into the midst of an economic recession has a tendency to produce much anxiety within me and many of my peers. I have spent numerous hours searching job postings on and extending the feelers through personal networking and the interweb.

While all of this is to be expected, I can't help but reminisce over the conference-style settings of my college classroom experience, where the success of the class and intellectual pursuit is contingent upon everyone bringing something (be it a question, a critique, or in some cases, a hands on experience) to the table. That, and the fact that I spent an entire year (more than that actually), researching and writing a thesis that is currently bound and collecting dust in a brick tower in Portland, Oregon (all allusions toward an ivory tower intended). While there is hope in the future that I will chop it up into pamphlets and essays that are accessible to diverse communities, I am feeling like I would like to revisit it and put it into the web 2.0 context.

As I will be going back down to Ecuador early July, I think it might serve as a way to put some of this material to use and up for discussion. While travel writing is often successful at describing a place, people and is easily accessible, yet much of the time, it tends to lack direction and a focus. Writing a thesis (we hope) has direction, but is often inaccessible. What I'd like to do here is to continue exploring themes that came up in my thesis, while simultaneously making some of that information accessible. I realize that this exercise might just be a shot in the dark as a way of resisting post-college stagnance, but if there's a small chance that people read it and do learn something, then it's worth it to me.

I'm going to get the ball rolling by posting the title and abstract to my thesis:

Title:
Fuera de la Oscuridad: Shifting Subjectivities among Evangelical and Catholic Kichwa through Discourses of Illness and Modernity

Abstract:

In this study, I argue that indigenous Kichwa in Ecuador use both illness and conversion narratives as practices and ways of understanding a new type of subjectivity that emerges from discourses of modernity and medical pluralism. Drawn from fieldwork and library research over the course of two and a half years in the Highland community of La Esperanza, this project explores how social change is largely understood in terms of religious transformation, and how the resulting conversion to Evangelical Christianity has produced a shift in the ways in which people conceptualize and approach healing alternatives as a medically plural system of values. This thesis examines the ways in which structural inequalities and power asymmetries are inscribed onto and experienced within Kichwa bodies through illness, and how these experiences are influenced by and rearticulated through religious language and metaphors of social and self-transformation.