My patient, a 40-something Hmong woman, didn’t speak English.
While working for a hospice in the 1990s, I was assigned to be her chaplain. Before meeting the family, I knew one of her teen daughters would have to translate any words I shared. I also knew, based on information from a nurse, that the patient and her husband were animists.
Animism, according to “The Split Horn,” a PBS documentary on Hmongs in America, is: …the belief in the spirit world and in the interconnectedness of all living things. At the center of Hmong culture is the Txiv Neeb, the shaman (literally, “father/master of spirits”).
According to Hmong cosmology, the human body is the host for a number of souls. The isolation and separation of one or more of these souls from the body can cause disease, depression and death. (www.pbs.org/splithorn)
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A wife and mother, cancer was killing my patient. She’d seemed “fine” a month before. Feeling “fine” was now a faded memory.
Frankly, I didn’t do much. I asked if I could pray with her and she – responding through the eldest daughter’s translation – said yes. I stroked her hand while a nurse tended to her physical needs, or tried to engage with and comfort other family members. I think I was only truly helpful because of two conversations.
The first took place in a shopping center’s parking lot with the patient’s youngest daughter. I learned she hadn’t visited her family in months. This daughter wasn’t unsettled by her mother’s cancer diagnosis. Instead, she rejected her parents’ old, boring, boorish ways. If her parents worshipped as traditional Hmong animists, this daughter bowed before the altar of American consumerism. Why time travel back to odd beliefs and weird customs when she’d rather make money, buy clothes, and party-hardy with friends? The daughter literally didn’t know her mother was weeks away from death.
This mother was dying in her rented apartment “home.” Several of the family had explained to the nurse and me that her death might force the family to leave the apartment. Long-standing traditions demanded a move.
I found out where she worked. With shoppers swirling around us, with cars hunting for parking spots, I told her about her mother’s cancer. I didn’t sugarcoat the explanations. She needed to understand the urgency. I guessed I’d only get her attention for a few seconds and didn’t want to waste any time as a sensitive, nice guy chaplain. Amazingly, she listened. Amazingly, she grasped the seriousness of her mother’s illness.
Though not present when it happened, the daughter did visit her mother while they could still talk and share.
The second conversation occurred with my hospice colleagues.
This mother was dying in her rented apartment “home.” Several of the family had explained to the nurse and me that her death might force the family to leave the apartment. Long-standing traditions demanded a move. In the foothills of Laos, where many Hmong were from, dying at home meant abandoning that particular place. After a family member died, the spirits within the once-safe rooms made remaining impossible.
For centuries the Hmong were nomadic, and their shelters were simple structures. Leaving one home because of death, or relocating an entire village for better farmland, was a relatively easy task. However, a move in modern Fresno would be far from easy. Security deposits, first and last month rents, and other expenses could financially wreck a family.
Along with several other staff, I advocated for the mother to die in a hospital. The hospice I then worked for didn’t have a separate in-patient facility, but was under the umbrella of a major medical center. We quickly negotiated with administrators to allow our patient to have a room in her final days. She died in a private hospital bed, comfortable and pain-free, encircled by family and friends.
Many of those supporting her during those last breaths, especially her children and their peers, weren’t concerned about where she died. But she was. Her husband was. Other Hmong elders were. As hard as her death was on her loved ones – and death is always hard, regardless of culture, beliefs, or practices – her whole family could return to their home to grieve without facing a sudden, disruptive relocation.
Disagreements as vast as the Sierra Nevada may exist for those from different faith traditions, or for members of the same family. Other cultures confuse us. Religions unlike mine feel peculiar and alien. One person’s priorities can seem trivial to another. Children and parents engage in generational battles where everyone loses.
But I hope, in the scary – and sacred – time of dying, that individuals and families risk seeking a common path through their differences.