Part 5: Mayo to Hmong
Mysterious Ways
We all have questions to which there seem to be no answers. And I’m pretty sure that most of us also harbor some fantasy about a place or person or a set of conditions which will reveal the secrets of those unanswerable questions.
Maybe your unanswerable question concerns a troubled relationship and you fantasize that when your partner finally sees how much you care about them they will finally reveal to you the secrets of their heart.
Or maybe your unanswerable question concerns the meaning of your existence, and you imagine that you’ll receive the ultimate answers when you are finally in the presence of God.
That’s what I was told when, as a child growing up in the Mormon church, I pestered the adults around me for answers to my many questions about the confusing points of Mormon doctrine. The answer, I was told (with gradually increasing annoyance), would be revealed to me in the afterlife.
It would have been comforting to be able to accept this explanation. I tried. I tried to generate a simple faith that “God has a plan.” I tried to ease my anxieties by telling myself that God moves in mysterious ways.
But I couldn’t. so I kept asking questions, even after it was suggested to me that my attempt to try to understand such things in this life was bordering on sin.
This is all to say that for me, when things get hard, I don’t have a spiritual tradition I can turn to for either comfort or answers.I’ts not to say that I’m opposed to spirituality or religion in general. I don’t mind at all when people tell me that they’re praying for me. In fact, I like that. Just don’t ask me to pray for myself.
And I understand that some people would say that this is precisely my problem. I know more than a few people who would argue that disease can be the physical a manifestation of a spiritual malaise.
For me though, at least at this point in my journey, the fantasy of an ultimate answer to my diagnostic questions was grounded firmly in this world. Specifically, in Rochester, Minnesota. At the Mayo Clinic.
Defending your life
You know, when you find yourself scheduling an appointment at Mayo, that you have officially reached the point of taking desperate measures. Certainly nothing makes you feel like more like a patient. Showing up at Mayo’s complex of buildings, woven through downtown Rochester, you feel like you’re stepping into a realm where everything has suddenly become symbolic. It’s like you’ve stepped onto the set of the afterlife in Albert Brooks’ “Defending Your Life.”
What does it mean to be a patient at Mayo? Perhaps it means that you are a such a difficult case that this is the only place that can treat you. Or perhaps it means that you are so special that you can only be treated by the very best doctors in the country.
For me, Mayo symbolized a bleak sort of hope. If not for a cure, at least for an answer to the question of what was going on with me. Bad news or good news, at least they could give me some news.
But it proved not to be so simple. We were able to get a relatively timely appointment with a neurologist because of the concern that I might have ALS. This turned out to be both a blessing and a curse. While it got me seen quickly, it also focused all my appointments so specifically on ALS that it seemed to severely limit the diagnostic question being asked.
Instead of asking what was the cause of my symptoms, they merely asked: is this ALS or not?
A month or so before Mayo, I’d gone off all of my medications. This was an effort to do a little quick and dirty diagnostic testing of my own. My wife had often wondered whether my symptoms might be caused by some combination of the medications I was taking. So I went off all of it – the statin , the anti-depressant, the testosterone cream, the thyroid supplement.
It didn’t seem like it could make things much worse. And it didn’t. I stayed off of everything for several months and aside from resetting my thyroid, testosterone and cholesterol levels to their premedication state, going off of my medications didn’t have any significant effect on how I felt.
At Mayo, when they weighed me at the beginning of the appointment the scale landed at 164 pounds. This was May of 2009. Down from 187 in January. Four or five pounds lighter than I’d thought I was when I left Missoula. This unnerved me. But I was nervous anyway. I was worried about what might be wrong with me of course. But I was also anxious about my ability to make use of what seemed like an exceptionally important appointment.
I was working hard to be a clear presenter of my symptoms. I’d written a narrative account of everything that I could remember, which I gave to the doctor. And I tried to articulate those symptoms verbally as clearly as I could.
Narrative and translation
It matters how you structure the narrative of your illness. Not just in terms of the personal meaning you assign to your experience. Your narrative has a significant effect on how a physician perceives both the weight of each piece of information and the relationship between each element. So do you describe things in chronological order? Or do you describe symptoms in order of importance? What’s your opening sentence? What do you leave in and what do you omit? Or do you try to include everything?
In fact, there’s an even more primal function that your narrative serves. Like any author, you are trying to get your audience hooked into your story. No one wants to acknowledge this, but your doctor is as human as anyone else and the truth is that a compelling story is more likely going to get his or her full attention.
Structuring my story was difficult for me for several reasons. First, I was trying to use my story to expand the diagnostic question. Of course I wanted to rule out ALS. But truth be told I was growing gradually less worried that this was what I had. I wanted to make sure that I left Mayo with more than just a rule-out.
The other problem I faced in constructing my narrative was that I’d reached the point where everything in my experience had started to look like a symptom. I couldn’t distinguish between ordinary, harmless bodily occurrences and potentially important symptoms. I had no reliable filter for my experience. (That little white spot on my foot could be nothing, or it could be the key to the entire puzzle.) And I know that when you reach the point where you’re trying to include every potentially important piece of information in your story, you can start to sound a little crazy.
In the end of course I had to trust the doctor to be a good diagnostic listener. No matter how well told my story was, I had to rely on his ability to translate my phenomenological description of my symptoms into an etiological account of my illness.
He did seem to listen attentively. And his neurological exam was careful and thorough. He observed the spasms rippling through the muscles in my leg, just beneath the surface of my skin. He said that, although he couldn’t account for many of my symptoms, he suspected this wasn’t ALS. The EMG I had scheduled next would be definitive.
I sensed that he was attributing my symptoms to psychological causes. And sure enough he suggested that my weight loss was the result of anxiety. This was maddening, because I knew that the more I protested, the more he would feel confirmed in this diagnosis. Still, I tried. I tried to explain, as I had to other doctors, how familiar I am with my own anxiety and depression, how I have never in my life lost weight like this, even when I’ve been in the throes of much more intense anxiety.
He seemed unmoved. He ordered a set of blood tests, and an MRI of the cervical spine (the only important part of me that hadn’t yet been scanned). He said that because of the erectile dysfunction that he would throw in a few tests of my autonomic nervous system as well.
This was a whole new area for me. I hadn’t even known that there were such things as disorders of the autonomic nervous system. But there they were, with their tongue-twisting names. Postural Orthostatic Hypotension Syndrome. Chronic Inflammatory Demyelinating Polyneuropathy. And of course when I started looking up the symptoms of these disorders, it was frighteningly easy to match them up with my own experience. Especially since I had in fact been experiencing orthostatic hypotension, an unusually intense light-headedness whenever I stood up after having been crouched down.
Benign
As expected, the doctor who performed the EMG gently reassured me that he didn’t see any sign of ALS.
So, I thought, now what? The big news had been delivered on the first day, but I had a series of tests scheduled during the week. Although I knew I shouldn’t, I allowed myself to start worrying about autonomic nervous system disorders. I had my blood drawn and got my scan. I met with the physical medicine doctor, which I discovered too late was premised on the idea that I actually had ALS. She looked at my chart, smiled, and congratulated me. She told I should go out and celebrate, take a vacation to Hawaii. I tried, fruitlessly, to explain that while ruling out a disorder, especially a particularly nasty one like ALS, was great, it still left me with the same conditions I started with.
She handed me some pamphlets on relaxation.
On our last day in Rochester, I had the autonomic nervous system tests. First was a tilt test, which looked at how my blood pressure reacted under different sorts of stress. Normal. Then, finally, the most bizarre test I’ve done yet, in which I was covered with a gold-colored material then placed inside what can only be described as an oven. The technician turned on the heat and over the course of an hour, my body temperature gradually elevated. Every place where I sweated, the gold colored material turned to red. They were looking for spots where I didn’t sweat, which could be a signal of autonomic dysfunction. It turned out there were a few spots on my feet that weren’t sweating. Which sort of made sense to me, since I’d begun feeling numbness in the same places, on the tops of my feet.
“You’ve got some small fiber neuropathy there,” the technician said.
What did that mean? Was it a symptom of something larger? Did it have any significance in relation to the rest of my symptoms? Or was it, as the name implied, something small?
I really wasn’t sure and she wasn’t going to say.
Back home, we waited for Mayo’s report. I read more about disorders of the autonomic nervous system, which was frightening and unhelpful. Still, I couldn’t help trying to solve the mystery for myself.
Something was beginning to shift, though. Something about the way I understood my condition. It felt less and less like I might be on the verge of some horrible, sudden death. That was good, but that fear was being replaced by the concept of a slow-motion decline.
Weeks went by. And the longer we waited for the report from Mayo, the more likely it seemed that they hadn’t found anything truly awful. If that were the case, it would be unconscionable to wait this long to tell us.
Nothing came and nothing came. We called. And called again. Finally I faxed a letter to the clinic, using language meant to alert them to the liability associated with medical negligence. They then sent us a single page with the doctor’s initial note. A paragraph. The diagnostic essence of which was summed up in the statement: “The patient does not have ALS.”
Weeks later we finally got the full report, containing the results of all the tests. The diagnostic summary read like this:
- Probably benign fasciculation-cramp syndrome
- Erectile dysfunction
- Hyperlipidemia
- Anxiety and possible depression
This was comical. At least that’s what my doctor back home thought when he saw the report.
“Benign fasciculation-cramp syndrome? What’s that? That’s not a diagnosis. They just made that up!”
Well, more or less. It is a description of a set of symptoms, an invented categtory, a convenient way to refer to people who have constant ALS-like muscle spasms, without having ALS. It exists in the sense that there are web sites dedicated to it and on-line forums in which to discuss it. But it’s not an ICD diagnosis.
It’s the word “benign” that really irks me. It means, technically, that the muscle spasms you experience aren’t associated with the death of tissue as they are in ALS. But it doesn’t mean that those fasciculations aren’t associated with a different condition which isn’t benign. In fact, it doesn’t tell you anything at all about the meaning of the symptom. It simply says that you experience this thing and we don’t know how to explain it.
To be fair, the Mayo Clinic clearly sees more than its share of patients with fasciculations who don’t have ALS. They have a right to call it something. But what I object to is the diagnostic failure that this “diagnosis” represents. It was as if I’d told them that I had a sore throat and a runny nose and they came back with a diagnosis that read:
- Esophogeal inflammation
- Excessive nasal liquid syndrome
The diagnosis they’d given me, in other words, was no diagnosis at all.
The particular pleasure of almost understanding
The gods of western medicine had no answer for me.
So who was I to turn to for answers? How was I supposed to make sense of my symptoms, which continued to evolve and worsen whether they were diagnosable or not?
I began, for the first time in all of this, to contemplate the possibility that there simply might not be an answer for me.
I heard a few stories, along the way, about people who had all these strange and mysterious symptoms, that took over their life and then eventually went away.
I also heard stories about people who went for years without getting a diagnosis.
I hadn’t heard a story yet in which someone was simply, permanently, undiagnosable.
It’s an experience which makes a pretty good psychological test: how does a person hold in mind an unanswerable question? Or more importantly, can a person hold such a question in mind? Or do they revert to strategies like denial, or superstitious beliefs in order to force their view of the world into a semblance of order?
In general, I’m pretty good at staying open to the unanswerable. There are many mysteries in life towards which I am able to remain peacefully agnostic. In fact I actually sort of enjoy the feeling that irresolvable contradictions give me. I like the creative energy that arises in the unsettled space between contradictory ideas. If I have a single, unified belief about life it’s that being human is hard in subtle and ambiguous ways, and that being truly honest with ourselves requires us to hold ourselves openly in a state of unknowing.
But I was having trouble with this one. I was afraid of being undiagnosable. I was afraid on a pretty mundane level. I wanted to be able to tell people what I had. I wanted to be able to give a sensible explanation for what I was going through. I didn’t want to look crazy. And without a diagnosis, that’s exactly how your suffering can start to look.
But I had no choice but to start edging myself toward acceptance of the possibility that there was no name for what I was experiencing. And as I did that, I began to become more open to other ways of understanding what was going on.
Which is not to say that I altogether abandoned western medicine. We ran through a list of potentially relevant specialists I hadn’t seen: an allergist, a rheumatologist, a gastroenterologist, a sleep specialist. I made appointments with one of each. But honestly, I didn’t have much hope for any of these. They seemed like shots in the dark.
Given the experience I was having with western medicine, I did become more open to exploring alternative medical approaches. I’d never been a big fan of naturopaths and alternative medicine people before this. It all just seemed a little flaky and ungrounded. But I had done acupuncture.
In fact, I’d been seeing an acupuncturist long before my symptoms started. My wife had started seeing this woman long before I had, and had encouraged me to try her as well. Eventually I did and I found the acupuncturist to be one of the most gentle, accepting and understanding people I’d ever met. We spent most of our time talking, and no matter what was going on in my life, she conveyed the deep conviction that what was happening to me was exactly what should be happening. Where I was, at that moment, was exactly where I was supposed to be. More than any actual therapist I’ve ever had, she showed me how to take an attitude of acceptance toward my own experience.
After talking for most of the session, she would put me on the table and feel my pulses then poke a few needles into me, or burn little piles of incense on my back. As she did she explained her diagnosis – too much damp heat, say – and she explained how her treatment was designed to address this problem, how addressing my qi at this particular point of this particular meridian was meant to help the imbalance of the energy in my body.
To be perfectly honest, I never noticed much physical effect from any of her treatments. But I keep going to her to this day. Because I love the way I feel about myself when I’m in her presence.
The acupuncturist also prescribed Chinese herbs for me, big brown pills that I was supposed to take on overly-complex schedules. I took them, even though once again I rarely felt much effect. But I appreciated the possibility that they might make a difference.
This is part of the appeal of alternative approaches to medicine. There’s a way in which not understanding how they work enhances our hope that they produce miraculous results. It’s irrational, I know. But it’s also sort of irresistible.
At any rate, the rational, empirical world of western medicine had had its shot at me. I needed to try something different.
So my mind was open when, in the summer of 2009, I found myself wandering through Seattle’s Chinatown. Mostly I liked hanging out there because I’d been trying to teach myself Mandarin. And even though I still knew very little Chinese, even though most people I met spoke Cantonese and most of the characters on the signs were written in a traditional style that I hadn’t studied, it was still thrilling to feel the possibility of understanding.
In fact, I love the sensation of almost-but-not-quite understanding. Being able to recognize two or three characters on a storefront sign made me feel the rich possibility of understanding all of them. Eavesdropping on conversations, I couldn’t have translated more than a few words. But I could hear where each word and phrase began and ended. I could divide that flow of sounds up into units that I knew were interpretable. Sensing the possibility that everything could make sense was thrilling.
I wandered into a pharmacy, looking at the assortment of dried herbs and mushrooms and sea creatures, the shelves of products whose meaning and purpose I couldn’t begin to discern.
At the back of the store there was a man sitting behind a desk. He wore a white lab coat and he was feeling someone’s pulses. A clerk approached me to ask if she could help me. On an impulse, I asked whether the doctor would be available to see me.
Of course, she said. Just wait your turn.
His hands were so strangely shaped. They were like soft claws, with the tip of each finger narrowing to a rounded point. He took my hand and placed a finger on my wrist, feeling my pulses as I described my symptoms as best I could through a translator. Very tired. Lost weight. How could I explain the muscle spasms? I tried my best.
He took his hand off my wrist and started writing, speaking as he did to the translator.
“You’re gonna feel better,” she said to me. “We make you a good prescription.”
She described what I was to do. She would give me bags of herbs. Every night after dinner I was to empty one bag into pan, cover it with cold water, then boil the liquid down for about an hour until there was a cup of liquid left. Drink that.
As she spoke, the staff of the pharmacy started assembling my prescription. They laid out seven paper plates on the counter, onto which they piled pieces of bark and seeds and dried mushrooms and objects I couldn’t recognize at all.
That night I prepared the herbs as I’d been instructed. The smell filled the house, an utterly distinctive, swampy, rotten, but still not entirely unpleasant sort of smell.
I strained the dark brown water through the pile of soaked herbs. My wife grabbed a camera and took pictures as I, in the words of my acupuncturist, gacked it down.
I continued to take the herbs all through that week. I seemed to feel a little bit better, so before leaving Seattle I went back to the pharmacy and the doctor read my pulses again, adjusted his prescription and sent me off with a month’s worth of herb-filled paper bags.
I administered them conscientiously for that entire month. And they really did seem to help. A little bit. But that was more than anything else had. In fact, it was the first time since this had all started that anyone had done anything for me that was designed to make me feel better. I had no idea how the herbs worked, but whatever the reason they were one of the few things through this whole ordeal that has helped at all.
But monthly trips from Missoula to Seattle were impractical. And while the herbs helped, they didn’t give me a diagnosis. They eased things, but they didn’t’ feel like the ultimate solution. The next time I’m in Seattle, I thought, Ill return to that pharmacy. But in the meantime I followed up with the few traditional medical appointments, while continuing to wonder even more about what it would mean for me to go forward without a diagnosis.
Wandering Spirit
Then one day last Fall, a dear friend who knew about what was going on with me approached me with an unusual offer. She had a friend, a Hmong woman, whose mother was a traditional healer. My story had come up and a proposal arose: would I like my friend’s friend to ask her mother whether she might be willing to treat me?
I nearly broke into tears at this offer of help from a complete stranger, this lovely moment of what I can only call grace. I didn’t know much about the Hmong people. I was aware that there was a sizeable Hmong community in Missoula, that they were refugees from the portion of the Vietnam War that had spilled over into Laos. I knew it was a brutal history that involved armed conflict, years of displacement in refugee camps, then a process of resettling halfway around the globe. I’d briefly had one Hmong client, years earlier, a sullen teenager who was the only client I’ve ever had who literally fell asleep during a session. While I was trying to find a way to work with him I’d read The Spirit Catches You and You Fall Down, a powerful book about the struggles that Hmong people in America have in their interactions with the western medical system. Now I was starting to look at that story from the other side. What would it mean for me as a white man to try to open myself to traditional Hmong healing practices?
The healer was a compact, quietly intense woman. She spoke very little English. She worked at an Asian restaurant. When her daughter told her about me, her mother responded that she knew there was someone out there who needed her help, but she hadn’t been able to learn who it was. Now she knew. She was grateful to have found me.
You know mom, her daughter had said, you don’t need to do this. You’ve never treated someone who’s not Hmong before.
But her mother said that I was the person she was meant to help.
It was a powerful thing, to suddenly feel accepted and valued by this person I didn’t know, from a culture I only poorly understood. I started trying to understand more. I read what books I could find, including a beautiful memoir by Kao Kalia Yang called The Latehomecomer, which tells the story of her family’s passage from Laos to Thailand to America. I read a little about the Hmong language, with its seven tones, and tried to teach myself a few phrases.
I spoke to the healer’s daughter, who explained to me some of the Hmong spiritual beliefs. She told me how the Hmong believe people have more than one spirit or soul. And these souls can wander. And wandering spirits can cause physical illness. Sometimes they wander so far off that they can’t find their way back home. Sometimes they leave a person because something has frightened them away, some trauma that makes them afraid to return. The healers work is to call back your wandering spirit, and to help keep the spirits that haven’t wandered from getting lost.
Again, I was almost in tears listening to this. I wasn’t certain how it all might apply to my health, but emotionally it resonated deeply with my experience. A part of me was lost. I needed help getting it back.
The healer worked with her husband, who assisted her and also acted as translator. He asked me to come to their home to meet with them.
With their granddaughter in the room watching SpongeBob on television, we talked. I did the best I could to explain what I was going through. After awhile, the healer handed me three sticks of incense and asked me to blow on each of them. She was very interested in whether I had had any recent, sudden frights. I couldn’t think of anything like that (I had of course often been fearful over the past year and a half, but that fear was anything but sudden). I tried to convey to her a sense of the past trauma that I’ve experienced in my life, the times in which I had been frightened in the ways she was talking about. She went downstairs. Her husband explained that she was doing a ceremony to help her know what I needed. As we waited, we talked. About the family’s history, about his daughters and their husbands, their jobs. About ordinary things.
“You’re going to be okay,” he said to me, more than once. “Don’t worry, you’re going to be fine.”
When she returned, his wife told me that my spirit had wandered and that I needed a healer.
It had been explained to me before that this was a formal procedure through which we would begin this process. I knew that my role at this point was to ask her, formally. if she would be my healer.
She agreed. Her husband then got a roll of string and a pair of scissors. He cut several lengths and he tied them around my wrists, explaining the nature of the knots he was tying. This, I understood, was meant to prevent my remaining spirits from wandering further, to tie them to me.
They explained that because my frights had been a long time ago, my spirit might have wandered very far. It might be a little hard to bring it back.
“But you shouldn’t worry. You’re going to be okay.”
Over the next week, I went to their house several mornings. She cut up some ginger and massaged it into my arm. Then she took my jacket and went into the kitchen. I could hear her chanting as she shook my coat above the heat of the stove. “Shaking out the things that are scaring you,” her husband explained.
After several of these treatments we waited a few weeks to see how I would respond. I didn’t know quite what to expect. I was scared about what was happening to my body and I was hopeful that what she was doing for me might help. But I had no frame of reference with which to make sense of how it might help. All I knew to do was to hold myself open to it. I concentrated on opening my heart to this help as much as I possibly could. I tried to hold myself in a receptive, grateful state of mind.
So it upset me that I didn’t start to feel better. As a patient, I want to report to my healer – whether it’s a Western physician or an Asian shaman – that the treatment is working. I know that it’s irrational to think of myself as a “bad” patient if I don’t respond to someone’s treatment. I also know that in order to be treated well you have to report on your experience as accurately and truthfully as possible.
So when I spoke to the healer’s husband I simply stated the truth. I explained to him that while I was still hopeful, I wasn’t actually feeling any different.
“Don’t worry,” he said. “This thing we do takes time. It’s not like you take a Tylenol and your headache goes away.”
He said that because my spirit had wandered so long ago, it was having a hard time finding its way back. He said that he and his wife wanted to do a ceremony for me, at my house. He told me that for the ceremony I would need to get hold of two young chickens to be sacrificed, one male, one female.
Ceremony
Recently in Missoula it’s become a popular practice to keep chickens, even within the city. We have several friends who are raising chickens, so I started calling around to figure out how I might get hold of a few of my own. As it turned out, it wasn’t that hard to find a male. Roosters don’t lay eggs and because of their noise they’re banned within city limits. I was able to find a colleague who keeps chickens, someone who wasn’t upset by the idea of them being sacrificed in a healing ritual, and who just happened to have two young males that she could sell me. It would be helpful to her, she said, if I could take both of them off her hands.
I bought the second one as well, to give to my healer as a gift.
Finding a female was harder. But eventually I found a young woman just outside town who raised and sold chickens and who wasn’t put off by the reason I needed to buy one from her. The ceremony could proceed.
On the afternoon of the ceremony, my wife was out of town and I was taking care of our two sons on my own. They’d come with me to get the female chicken and I’d explained to them as best I could what was going to happen during the ceremony. They’re going to sacrifice the chickens, I said. But you don’t have to be around for that if you don’t want to.
They opted to keep their distance.
In truth, I knew very little about what was going to happen. I certainly had no idea how one went about sacrificing a chicken. I anticipated that it would involve me in some way. That I would have to say or do things, or at least stand there while things were done to me.
But it didn’t actually involve me, not directly. I needed to be there, of course. But it was done on my behalf. I was not an active participant.
When the healer arrived, her husband quickly oriented himself to our kitchen. He had brought a large pot which he filled with water then put on the stove to boil. He asked me to find a medium-sized stone from our yard. Then he took out a packet of glittery red paper and some scissors and he started cutting a human figurine out from the paper.
“It’s you,” he said brightly. “It represent you.”
It’s difficult to remember the precise order in which everything happened. That’s largely because they went about their spiritual business in such a subtle way. I had been expecting something intimidating, serious rituals during which I could easily do something embarrassingly inappropriate. But it wasn’t like that at all. The spiritual work was woven seamlessly into an ordinary conversation. As the healer crouched in the corner, chanting and repeatedly tossing a pair of water buffalo horns, her husband asked me about my family, talked with me about hunting and cooking and gardening. It was the same sort of conversation I could have been having with anyone in Missoula at that moment.
After making a series of preparations, the healer’s husband asked me if I had something that he could use to dig a hole with. Then he asked me to locate a spot in our yard that wouldn’t ever be disturbed. I picked a far corner where he dug a small hole. As his wife chanted, he lit a match to the paper figurine. Then they placed the stone I’d selected in the hole along with the ashes and quickly covered it with the stone I’d found for him.
Because your spirit has been wandering for so long, they explained, it has given up hope of returning and it has started on the process of reincarnation. The hole was to help guide my spirit back. The figurine took the place of my spirit, so that it could return to me instead of continuing on the path toward reincarnation.
Prognosis
I’m not sentimental about animals. My grandfather was a sheep rancher and as a child we raised steers for beef. I’ve never slaughtered an animal myself, but as a teenager I shot ducks and rabbits and it didn’t upset me.
Sacrificing an animal felt different though. Not in a bad way. Just different. Killing an animal for meat has an explicit logic to it, which, perhaps paradoxically, allows you to keep an emotional distance on the event. To me, it’s like pulling a carrot out of the ground.
But when you sacrifice an animal you have to make yourself so much more aware of what’s happening. It’s so much more…intimate.
And when you sacrifice an animal in your own kitchen there is no coherent way to distance yourself from the experience. You just have to face it.
So while I’m not inclined to romanticize or over-value the experience of animals, I did expect this act to hold a certain weight. I expected a ceremony that was emotionally intense, something which froze the moment.
In fact, just as everything else had, the sacrifice took place calmly and casually, in between conversation about everyday things. The healer and her husband took the female chicken, the smaller one. He held it’s body while she slit its throat over our kitchen’s garbage can. The chicken struggled for a minute or so before dying. The healer finished draining out the blood then took the body and started plucking out the feathers. Her husband then asked me to hold the larger male chicken while he cut its throat. I held it as it struggled then grew still. The blood drained slowly into our garbage can.
They plucked both chickens then placed the bodies in the pot of boiling water. We continued talking together until they agreed that chickens had been in the pot long enough. Talking between themselves in Hmong, they examined the chickens’ bodies for signs. They first looked at the feet, at the particular alignment of the three talons. Then they pulled out the chickens’ tongues. Attached to the hard tongues were pieces of cartilage that tapered off into a thin point. 
They studied these objects for a long time.
Then they explained to me that all the signs were good. The purpose of the chickens, I came to understand, was prognostic. They provided information about how the rest of the ceremony had gone. The particular angle of the talons, the particular shape of the cartilage, all pointed to a positive outcome. The ceremony had gone well. My spirit would return.
“Don’t worry,” they told me one more time. “You’re going to feel better.”
A diagnosis
Years earlier, when my father was in a coma in the ICU after suffering a devastating head injury, I’d watched as several elders from the Mormon church sat by his bedside and said a special prayer for him. They took out a small jar of oil, said an anointing prayer over it, then rubbed it into my father’s unfeeling scalp. I’d had nothing to do with the Mormon church for years and I had absolutely no personal belief that this ritual would have any effect. Still, I was grateful for it. I could feel what it meant to everyone else in the room, the hope that it represented.
From an early age I understood that while the religious culture I came from pretends to be guided by a rational system, it is in fact infused with mystery and superstitious beliefs. When that system had control over my life, I resisted it by insistently asking unanswerable questions. Now that I am out from under its sway, I can appreciate the power that those beliefs have to bring people together, to comfort them and even to help them heal. From the outside, I no longer have to struggle against it. And this allows me to open myself to mystery in other ways. Just as I can accept the prayers of Christian friends and family, I can also accept a healing ceremony from a Hmong shaman.
I’m certain that I haven’t done justice in my description of this ceremony. I’ve been an outsider participating in a culturally foreign practice. I can only describe my experience of the encounter and express my great gratitude for it.
In the end, whether this woman was going to cure me or not (and I understand that the jury may be out on this question for a long, long time), she gave me something that no one else up to this point had been able to give me: a diagnosis.
You are sick because your spirit has wandered.
And she knew how to treat me: she called my spirit back.
It was not a diagnosis that I would have anticipated. But it felt deeply right.
I may not be feeling any better. But I’d received an extraordinary gift.
[In part six of this series I will pause to review the story so far and to take stock.]
