Native American and Western Medical Ethics
with Kenneth "Bear Hawk" Cohen

The Path of the Native Healer
Witches in White Coats
The Random House Interview
Poems
Prophecies

THE PATH OF THE NATIVE HEALER
©2003 Kenneth "Bear Hawk" Cohen

It was an honor to be invited to the home of the Cherokee medicine man, Keetoowah, great grandson of Ned Christie, the renowned nineteenth century warrior who defended the rights of his people. Keetoowah was dressed in weathered overalls and a turban-like cloth cap with a spotted eagle feather propped up in the folds-- the traditional hat of the Cherokee. He looked far older than his sixty years.

I moved aside the piles of old magazines and a box of jewelry clasps and fasteners to make room to sit on the couch. Keetoowah sat across from me on a comfortable chair. He squinted slightly and said, matter-of-factly, "I hear you are interested in Indian medicine. Let's see if Indian medicine is interested in you." He placed a small quartz crystal in my palm and suggested that I hold it between my two hands and close my eyes. About twenty minutes later, Keetoowah asked me to open my eyes. "Well, what did you learn?" I told Keetoowah that I had felt something very peculiar. The crystal had entered my body, and its essence seemed to flow through me, as though carried by my blood. I felt that I had become the stone.

Keetoowah must have been satisfied with my answer because we spent the next few hours discussing our mutual interest in healing, continuing the conversation over lunch. I became a weekly guest in his home and quickly realized that I had found not only a great teacher but a new and very treasured friend. I received my Indian name, Bear Hawk, and my sacred ritual pipe from Keetoowah. For the next ten years, I became his principle apprentice and learned how to "doctor" people with my hands, my voice, and, most importantly, with prayer. Sometimes I find it hard to believe that more than twenty-five years have passed since that first meeting, and that my friend has been gone since 1987. In another decade I will be as old as Keetoowah was when I first met him. Time is strange, isn't it?

The Challenge of Healing

Native American healing is not an academic discipline that can be learned from books. Nor can it be grasped by participating in rituals, visiting power places, or following in the footsteps of other healers. The lessons are learned from nature, from the original elders: stone, water, earth, fire, air, animal, and plant. Their power enters into the soul through dreams and vision- seeking and during times of sacrifice and fasting. We fast from food, from water, from words and busy-mindedness. In some traditions, a seeker also fasts from light, meditating in a dark chamber or cave. Healing power comes as a grace to those who are humble enough to listen and courageous enough to express and act on their vision.

The Native American way is not for everyone. We each have our unique talents, gifts, and life purpose. Health is enhanced by discovering that gift and expressing it in a way that brings harmony and happiness to our communities and world. "You don't choose the medicine," said Keetoowah, "it chooses you." This is especially true of spirituality, the medicine path that leads people to the Divine. Don't pursue God like an object that you can grasp; rather live in a good way and you will receive what is needed. You may find that your medicine is Jewish, Christian, Celtic, Norse, or African. It is most likely the religion of your ancestors. However, it is also possible that your path is unique and not easily categorized. No spiritual gift or life purpose is better or worse than any other. In fact, each facet of the human spirit fits together like a puzzle-- like the continents that were once joined. After all, even science must now admit that people are more similar than different. There is greater genetic diversity between two lowland gorillas living in the same habitat than between an Alaskan Inuit, an Australian aborigine, and an Italian. If we have a single genetic ancestor, then perhaps we also share a common, though fragmented, spiritual teaching. A phrase from the original instructions is written in every soul.

The path of a Native American healer is not easy. An invitation must be extended by an elder or a spirit, and/or one may be compelled by a vision or deep intuition. And tests must be passed. The healer may find him or herself wounded and challenged as Spirit offers lessons in compassion and fortitude. I had to symbolically face North, the direction of Winter and death, during a seven year period of illness and personal hardship. I was lucky and passed through my "dark night of the soul" to stand in the East, the direction of Spring. Some people are not so fortunate; they face North and die. I am not trying to scare you away from Native American medicine if that is your calling. However, it is important to understand that although all paths are equal, they are not equally smooth or easy. I remember sitting with Keetoowah and a group of spiritual seekers one day. A young white man asked Keetoowah, "What do I need to do to become a medicine man?" Keetoowah scolded the man for his presumption, "I wouldn't wish that curse on anyone. And you can't do anything to become a medicine person!"

How to Learn About Native Culture

We do not have the right to trespass on Native American sacred sites or ceremonies any more than we may enter a person's home without permission. It is not that particular ethnicities are excluded because of the color of their skin. The problem is that many people have a romantic or stereotyped view of Native Americans, and thus pursue teachings for the wrong reasons. Rather than following an authentic inner voice, they believe that Native ways are adventurous, fun, and exotic and that it is their right to imitate and appropriate them.

Remember, also, that Native healing is only one aspect of Native culture. There are many respectful ways to learn about Native American culture, including:

• Reading. There are many excellent books about every facet of culture. See the resources at the end of this article for some that I especially recommend.
• Observing or participating in intertribal dance, music, and cultural gatherings known as pow-wows. When the master of ceremonies announces, "Intertribal. Everyone dance!" that includes you! The location and dates of pow-wows can be found in News from Indian Country and Native Peoples Magazine, listed in resources below.
• Enjoying the arts, culture, and history presented at Native American art shows, galleries, trading posts, and at museums such as the National Museum of the American Indian, the Gilcrease Museum, the Pequot Museum, the Heard Museum, the Iroquois Museum, and the many fine museums of individual Indian nations, often located on reservations.
• Listening to Native American music. Music is an important key to culture. You can find Native music in trading posts and most music and museum shops. Vendors at pow-wows have the largest selection.
• Offering financial support to organizations that defend the land and rights of Native peoples, such as the Native American Rights Fund (1506 Broadway, Boulder, CO 80302).
• Learning how to be a better protector and caretaker of your local environment through peaceful political activism (including voting) and ecologically responsible behavior that reduces consumption and waste.
• Exploring "primitive," that is, primal survival and living skills, such as building shelters, starting fires with a wooden drill, tracking, and recognizing and using local healing herbs.
• If an invitation is extended, observing or participating in Native American ceremonies. Many of these, such as the Sweat Lodge, are widely practiced and sometimes open to non-Native people as a way of building cross-cultural bridges. Learn the proper etiquette and protocol for the ceremony by asking more experienced participants or your host. Beware, however, of individuals who charge money for sacred ceremony. Educational seminars may require tuition; but according to Native tradition, it is immoral to equate healing or ceremony with a specific bundle of "frog skins" (green currency, or any other color of money).

Sharing the Wisdom

Certain aspects of Native American culture can and must be shared if humanity is to survive. Native traditions can teach us how to live in harmony with the land and each other and to prevent the widely prophesied "Earth Changes." The foundation of Native American culture and healing is traditional values. When Seneca elder Twylah Nitsch was a young girl, her grandfather placed twelve stones on the ground in a circle and described how each symbolized a gift along the Pathway of Peace, a road to balanced living. I use a similar wheel to teach my students, derived primarily from Grandma Twylah, but also from the teachings of other elders. The gifts are:

1. Learning. Learn from all our relations, from mountain, plant, animal, human, from dreams, from elders and children, from stories and life experiences. Good learning creates connection and caring; poor learning is intellectual baggage.
2. Respect. Honor all forms of life; do not be careless in your thoughts, words, and actions. Respect yourself; low self-esteem insults Creator's precious gift of life.
3. Acceptance. We cannot grow unless we accept who we are and have the courage to face and learn from our weaknesses and shadows.
4. Spiritual Sight. Sight and insight are equally important. Spiritual sight means ridding the mind of mental screens, so that we perceive the world without preconception, stereotype, and prejudice.
5. Listening. The spiritual person is a good listener. Native American elders sometimes test prospective students by observing how comfortable they are with silence. The narcissistic person is always thinking and speaking and thus has nothing to express but his or her own opinions. There is no silent space in which to simply listen and experience.
6. Speaking. If we can hear the truth but are afraid to express and live it, even when it goes against the crowd, then we can never find inner peace. Walk your talk, and talk your walk.
7. Love. Keetoowah once said to me that he used to fight his enemies, but later decided he was going to love them to death! Love is for warriors, not whimps. Indian healers like to remind Christians that Jesus' love did not prevent him from throwing greedy merchants out of the temple. Actions that increase love are good; actions that decrease love are evil.
8. Service. Service is more than "helping." Some people help from a position of superiority and expect something in return. True service is selfless and without ulterior motive.
9. Relationship. Native American prayers frequently include the expression "All my relations." We are all related, like plants growing from the same soil. The action of any member of a community affects all members. We are accountable to each other and to all of nature. A feeling of connectedness is the source of responsible action.
10. Creativity. Nature never repeats herself. Although we are all related, we must each find our own path to Creator. An Innu elder once told me, "If you sing someone else's song, you are called a liar in my language." Creativity means allowing the mind to soar like the eagle. The eagle does not follow any one else's ruts and leaves no track in the sky.
11. Dynamic Spirituality. The spiritual person does not sit in a cave and wait for "enlightenment" before doing good in the world. A medicine person is in the front lines. A warrior like Geronimo would lead his warriors, not watch from the hill top. Spiritual warriors stand up for what they believe in and fight against injustice.
12. Gratitude. Gratitude is more than saying "thank you." We can express gratitude through music, song, prayer, dance, and art. When we are grateful to Creator for our gifts and blessings, we strengthen those blessings. If you receive a meaningful dream, thank Creator for the dream, and it is more likely to come true. If a deer crosses your path or an eagle flies overhead, thank these "creature teachers," as Twylah Nitsch calls them. Spiritual powers that appear in vision are more likely to hang around when they see concrete expressions of gratitude. They don't like to be taken for granted.

Closing Words

Like other spiritual paths, Native American tradition emphasizes ridding the mind of selfishness and egotism. "Ego means Edging God Out" -- ego blocks the voice of spirit. Even if you are not invited to a Sweat Lodge or Sacred Pipe Ceremony, you can still learn the wisdom of Native American healing. Have the courage to meet life face to face, nakedly, as in the Sweat Lodge. Become a hollow reed or pipe through which the Creator can send His/Her sacred breath and guidance.

Resources

Suggested Reading

Cohen, Kenneth. Honoring the Medicine: The Essential Guide to Native American Healing. NY: Ballantine Books, June, 2003.

Beck, Peggy V. and Anna L. Walters. The Sacred. Tsaile (Navajo Nation), AZ: Navajo Community College Press, 1977.

Four Worlds Development Project. The Sacred Tree. University of Lethbridge, Alberta, Canada, 1988.

Pow-wows Etc.

Information about Native American culture, issues, and events can be found in:

News from Indian Country
8558N County Road K
Hayward, WI 54843

Native Peoples Magazine
P.O. Box 18449
Anaheim, CA 92817-9913

WITCHES IN WHITE COATS:
NATIVE AMERICAN AND WESTERN MEDICAL ETHICS

©2003 Kenneth "Bear Hawk" Cohen

An early version of this essay appeared in
News From Indian Country XII:5, Mid-March 1998

I use the word witchcraft as a synonym for what Mexican Indians call brujeria, sorcery, meaning the abuse of spiritual power: attempting to disempower, coerce, harm, or control others or to influence events using means that are unethical or socially disapproved. (Readers should note, however, that in European culture, the term witchcraft may have a positive connotation, referring to ancient forms of pagan spirituality such as wicca. Practitioners of wicca, like Native Americans, recognize that Power is not inherently moral, but may be used ethically by an ethical practitioner.) Even without malicious intent, a Native community may label a person a witch if he or she repeatedly harms others. The key here is "repeatedly." All healers have failures, but one who continues to practice interventions that harm is probably under the spell of an evil power including perhaps his or her own ego.

At first glance, the power exercised by white-coated physicians has little relation to the subtle forces used by Native American healers. Yet, upon deeper inspection and reflection, we realize that both types of practitioners ultimately help the patient to heal him or herself. The surgeon's knife and the shaman's feather are mere tools towards this same end. The power of the shaman and the doctor are also equally subject to misuse. In fact, there may be more witchcraft practiced among white physicians than among Indian doctors.

Dangerous Procedures and Dismal Prognoses

Recipients of western medical intervention often suffer more from the treatment than the disease. Iatrogenic disease-- diseases caused by incorrect, excessive, or unnecessary medical interventions--are epidemic in Western medicine. These include psychological or physical side-effects from medication such as depression, digestive problems, liver disease, or kidney failure; "complications" after surgery or invasive diagnostic procedures, including the prevalence of blood clots, heart attacks, and strokes after orthopedic surgery; rejection of transplanted organs or artificial body parts; weakened immunity after antibiotics, chemotherapy, and steroids; and the mutation of microbes into drug resistant strains because of excessive or incorrect medication. In the United States each year there are more than 100,000 deaths from hospital-originated infections. According to the Journal of the American Medical Association, drug reactions account for up to 140,000 deaths annually, more than 10,000 from anesthesia administration alone. The JAMA article states that adverse drug reactions cost an estimated $136 billion per year, "higher than the total cost of cardiovascular care or diabetes care in the United States." (Classen, David C., M.D., M.S., Stanley L. Pestotnik, M.S., R.Ph., et al. "Adverse Drug Events in Hospitalized Patients: Excess Length of Stay, Extra Costs, and Attributable Mortality," Journal of the American Medical Association 277:4, January 22, 1997, p. 301). Negligence is also rampant-- in New York State hospitals, approximately 30,000 cases of negligent or dangerous care per year. We might be apt to excuse these figures as an unavoidable by-product of increasing patient-to-doctor ratios and the impersonal nature of technomedicine: doctors often seem more interested in test results than in the patient. I and my Native colleagues tend to view these statistics as proof of the prevalence of "bad medicine" in both senses of the phrase.

Sometimes diseases can be traced to grim prognoses that act like hexes. Unkind words instill in the patient a sense of uncertainty, dread, and vulnerability to further suggestive influence, including the influence of his or her own thoughts. A doctor who tells his patient, "The condition is terminal" or "You may die of a heart attack any minute" may create a self-fulfilling prophecy. In The Lost Art of Healing, cardiologist Bernard Lown recounts the story of a patient who was recovering from a heart attack. He suddenly took a turn for the worse. His pulse was racing, and he had signs of cardiac congestion. Dr. Lown traced the likely source of his reversal to the morbid fear the patient experienced when he overheard residents and physicians indicate on various occasions that he had "coronary thrombosis, myocardial infarction, and an acute ischemic episode." When he asked the nurse about his condition, she said, "You'd better not ask." He knew that he had had a heart attack, but what about these other conditions? How could he possibly survive? You can imagine his relief to learn that all of these disease labels were various terms for the same condition! Imagine if he had been told, instead, "You have a beautiful heart, and it is mending."

Expectant trust can be a force for helping or harming. If the patient believes in the power and authority of the doctor, then words of hope and support can encourage healing. Conversely, if the doctor's words, tone of voice, or use of images (including disease labels) communicate discouragement, despair, or condescension, the patient may feel compelled to oblige the doctor's expectation. Patients whose privacy and sense of integrity are invaded by highly personal questions and the probing of body parts are especially vulnerable and susceptible to such effects. It seems odd to me that it is nevertheless considered ethical for the physician to avoid ordinary physical touch. An orthopedic surgeon will saw through the patient's femur, but dare not administer a healing hug.

The saying, "The operation was a success, but the patient died," is a sad commentary on modern medical practice. How many doctors are willing to admit, "This disease may or may not kill you. The same can be said of my treatment." Unfortunately, futile, unnecessary, or dangerous interventions are sometimes more a result of fear of malpractice than prudent care. "Better safe than sueable" betrays the escalating lack of trust between patients and their providers, fueled by the astronomical costs of health care and health and malpractice insurance, a litigious society, and human greed.

Unnecessary and heroic procedures are also a direct result of the West's compartmentalized view of the body-- it becomes more important to save a disconnected body part than to preserve quality of life and soul. As Lawrence J. Schneiderman, M.D. and Nancy S. Jecker, Ph.D. remind us in their insightful work, Wrong Medicine: Doctors, Patients, and Futile Treatment, "Keeping a heart beating or lungs breathing does not accomplish medicine's goals when a person will never again regain consciousness, or never leave the intensive care unit, or never be free from intense and unremitting pain.." (p. 129) The subject of medical care, they tell us, should be "the suffering person, not the biological organism or failing body part."

By contrast, Native American medicine is generally helpful and empowering to the patient. The patient receives a treatment designed to improve quality of life and enhance relationships with the community and the Creator. The patient is encouraged to maintain the healing benefits and prevent future recurrence by taking greater responsibility for his or her own physical, psychological, and spiritual health. The Indian doctor does not fix the patient, but rather facilitates help and guidance from the realm of Spirit. Therapeutic interventions, including herbal medicine, very rarely have harmful side-effects. People die routinely from western medicine; I doubt if many die from indigenous medicine. Native treatments are non-invasive and respectful of the privacy and dignity of the individual. The goal is healing, making whole, rather than curing. Curing is, of course, the most desirable outcome, but Native healers realize that this is ultimately in the hands of the Great Spirit.

Hospitals Are For Sick People

Native healers create a sacred, supportive, and healing atmosphere to affect the patient at both conscious and unconscious levels. Their office or operating room is the tipi, hogan, wikiup, kiva, longhouse, or other sanctified place, filled with a community of praying people and ceremonial helpers. No one would think of breaking the reverent silence with any words or actions that do not contribute to or augment the healing energies.

Compare this with the surgeon who knocks out the patient to both humanely anesthetize the pain and ensure the patient's unawareness and inability to protest the loud music, lewd jokes, and disrespectful behavior that sometimes accompany surgery. Physicians place patients in institutions filled with sick people who confirm the patients' fears and insecurity. Positive expectations are quickly dashed in the grim, almost morbid setting of the hospital. Contrast this with the Indian doctor who surrounds the patient with an empowering milieu of healthy, concerned people and symbols of well-being. Sick people have a greater need than healthy people to be surrounded by healthy people and healing environments. Native healers realize that a healing place encourages hopefulness and a positive state of mind, factors that are essential for healing.

First Do No Harm

Doctors are taught the admirable rule, primum non nocere "first do no harm". This saying dates from a time before the advent of technomedicine. It refers to far more than denying a patient the appropriate technological intervention. Harm can be inflicted by attitude, tone of voice, and body language. Perhaps western doctors can learn something from one of the rules of Indian medicine, "First, do good." Focus on health rather than pathology, on a patient's strengths rather than his or her weaknesses. Inspire the confidence to overcome challenges.

Ironically, the rule of "do no harm" is not a requirement of medical school education. The long, grueling hours of work and study and the rigid hierarchy of the hospital disempower the sincere student. It is no surprise that doctors feel most comfortable with patients who are "compliant." The doctor's fragile or shattered ego is compensated by a false projection of power and confidence, backed up by a society for whom the doctor is a priest in service of the god Science. A patient who wishes to take responsibility for his or her own health pushes the doctor dangerously close to his own shadow.

Technical Jargon

Technical jargon and dismissive or condescending replies to questions further disempower the patient because it creates an impression that only the physician understands or is capable of healing the patient. Yet, isn't it obvious that no matter what help the patient receives from external sources, it is ultimately the patient who must heal him or herself? Sadly, some physicians attempt to disempower the patient in order to hide from personal feelings of inadequacy. Human beings reinforce delusions of superiority by making others look inferior.

Rather than using difficult medical terminology, a far better model for physician-patient communication would be medical humor. Humor is a powerful way of coping with, managing, and surviving personal suffering, and doctors should model it for their patients. Why not make Therapeutic Humor a required course in medical school? Doctors would not graduate residency without demonstrating clinical humor competency. If a patient has lost her hair after chemotherapy, why not suggest that she is having "a no hair day"? Perhaps an obese man visiting your office with his spouse would feel less embarrassed about his problem if you asked the couple to reveal their "combined average weight." Instead of putting herself above the patient, the physician could put herself at a lower level. "You may lose some brain cells in the operation, but being over age 50, I have already lost most of mine!"
Humor, including self-deprecating humor, is common in Native American healing. Humor is empowering for the patient. It creates empathy between the patient and healer. The healer never laughs at the patient, but should be willing to laugh with him.

The Price of Healing

Western medicine is a profit making business. Patients' options are limited by their ability to pay or by their insurance companies' willingness to cover expenses that they deem necessary. Quality medical care of both the living and dying is often a matter of what the patient can afford. Let me share with you two anecdotes that highlight the dismal and immoral nature of a medical system driven by economics.

A surgeon was about to perform an emergency bypass operation on a twenty year old patient that had been brought in by ambulance. As he looked over the patient's medical records, he exclaimed, "Wait a second. She has no insurance! Who is going to pay me?" The assistant surgeon looked at his colleague with disgust and said, "Put it on my master card."

A few years ago I was wading in a pool on a hot summer afternoon. A distinguished looking man in his sixties struck up a conversation. When he asked me what I did for a living, I replied with what I thought was a politically correct statement, "I teach alternative medicine, specializing in indigenous healing systems." This was evidently tantamount to making a declaration of war. The man informed me that he was a medical school professor who also sat on advisory panels for various medical societies and government organizations. He said, "If you people have your way, in ten years we will be treating cancer by sticking a lettuce leaf on the patient's big toe." After several other equally misinformed statements, I proceeded to calmly cite experimental and peer- reviewed journal evidence for alternative medicine's efficacy. I also reminded him of his own profession's reliance on placebo and untested procedures.

After my half-hour long sermon, the man, whom I had previously mistaken for a gentleman, rejoined, "I must admit that I cannot refute this kind of evidence. It makes sense. I see that you are well-educated and well-informed, and I believe you. However, I also believe that people like you should be shot." "That's not a very Christian thing to say," I said in amazement, not sure if he was being maliciously contrary, dangerously threatening, or just ornery-- the latter being a characteristic I sometimes admire. He continued, "I mean it, you should be shot. You are threatening the wonderful salaries we doctors make." This statement was made with utmost seriousness. I felt like countering with some inane statement about the importance of the patient, but realized that it is useless to argue with someone who has different or perhaps no values. Instead, I said with a profundity equal to his own, "It seems that we have very different points of view." I waded over to a different section of the pool. When I saw him in the changing room, he stated again, as though calmly citing a fact of life to his medical students, "You really should be shot!" Not wishing to tempt fate, I made no reply.

According to Native tradition, healing is a grace from God that may or may not occur in spite of all our best efforts. It is given as a gift; patients also pay the healer with gifts. The healer never charges a set fee for his/her help. A high fee would tax the limited resources of a patient during the time when he is most in need of help. Money and healing gifts should flow to the patient, not from him.

Native witches, by contrast, work for a high or inflexible fee. They are tempted to enter their craft because of a desire to demonstrate power over others by wantonly harming, or because of envy, greed, and a desire for wealth. The prohibition against fee setting is so strong among some Native people, that a person attempting to heal may be accused of witchcraft if he tries to take economic advantage of the patient. Witches, like some unscrupulous doctors, prefer to victimize the most wealthy. According to Clyde Kluckhohn's classic Navaho Witchcraft, after a witch inflicts disease, the witch's partner offers a costly cure; the two split the fee.

Colonial Control

One of the strategies used by witches to exert power and control over others is by fostering dependency. Although "bad medicine" may sometimes be practiced without the victim's knowledge or belief, it is much more effective if the victim is made fearful of the witch's curse or presumed power, and thus vulnerable to suggestion.

The goal of an ethical healer should be to make his or her own work obsolete. This does not seem to be the goal of western medicine; it encourages relationships in which patients become emotionally and financially dependent on the information and technology of expert doctors. Since many of the interventions are themselves causes of disease that require technological cures, the patient soon feels trapped in a system from which there seems to be no escape. Ultimately, the patient becomes dependent on institutions that profit from biotechnology: government, industry, banks, and educational institutions.

Among Native American populations, there are further ethical issues. Western physicians undermine Indian cultural values and self-esteem if they portray themselves as representing the only official or legitimate healing system. I have spoken to Indian Health Service physicians who, in spite of long tenures among Indian Nations, were completely unaware of Indian methods of healing or counseling and never attempted to consult with the traditional health-care providers. (Sometimes the doctors are disillusioned by the degree of social and psychological problems that they witness-- contrasting sharply with previously held, unrealistic stereotypes. Yet it is as unfair to judge Indian healing by the patients in an IHS clinic as it would be for an Indian doctor to judge white people based solely on experiences working in an inner city drug rehab center.) How many needless suicides, abuses, or diseases could have been prevented by consulting with a wise clan-mother or traditional healer? Although I recognize and commend the fine collaboration that is occurring between allopathic and Native medicine (e.g. the work of the Four Worlds Development Project and the Swinomish Tribal Mental Health Project), it is still far too infrequent.

WESTERN AND NATIVE AMERICAN MEDICAL ETHICS

adapted from Kenneth Cohen's Honoring the Medicine: The Essential Guide to Native American Healing (New York: Ballantine Books, 2003)

Healing The Healers

Is there a cure for western medical witchcraft? The cure consists of three principles that are easy to name but, unfortunately, because of the inertia of both people and institutions, will be challenging to put into practice. First, self-healing is the foundation for healing others. Doctors need to cultivate inner acceptance by facing personal shadows-- places of insecurity, avoidance, and fear. Medical school education should incorporate self-empowering practices such as meditation, relaxation techniques, nature-awareness, and humor. Secondly, physicians need to learn how to empower patients by teaching preventive medicine and health education, by practicing lifestyle counseling, and by conscious and skillful use of placebo effect (trust and positive expectation). Thirdly, medicine needs to be run as a charity rather than as a business. I honestly believe that doctors, being in a profession of service, should accept salaries on par with or lower than the people they are treating.

And we can add another principle for non-Indian physicians who treat Indian people: make your interactions as culturally congruent as possible by learning the languages and customs of the people and community you are treating and by seeking the guidance of the elders. Remember the cardinal rules of Indian country: respect, humility, gratitude, and generosity.

I am certainly not denying the miraculous, life-saving power of allopathic medicine. I recommend western medicine as necessary and primary therapy for acute conditions that can be traced to specific causal agents such as bacterial infections, drug reactions, concussion, hemorrhage, broken bones, biologic depression, appendicitis, and emergency room trauma. Even in these circumstances, Native American medicine can act as a support and complementary therapy before, during, and after treatment.

Today most Indian people would rather go to a doctor than an herbalist for bacterial pneumonia. A patient with severe chest pain would be ill advised to substitute hawthorn berries for a nitroglycerine pill recommended by his cardiologist. It is unfair, however, to judge a profession only by its most dramatic successes. According to Native American tradition, the more powerful a medicine, the greater the responsibility because the greater the potential for harm. Power and the wisdom that encourages proper use of power must be kept in balance. The ethical concerns of Native American healing offer a fresh cultural perspective and, like an elder teaching a child, may have much to teach its younger sister, Western Medicine.

THE RANDOM HOUSE INTERVIEW WITH
KENNETH "BEAR HAWK" COHEN

• What is Native American Healing?

By "Native American" I mean the indigenous people of North America, as defined by Native American nations. Only these sovereign nations have the right to define tribal identity. And I use the term "healing" to distinguish it from curing. Curing is the domain of licensed health-care providers, such as physicians. It means applying a therapy with the purpose of eradicating disease. Curing can be measured and replicated. Healing, on the other hand, means to make whole and holy, to establish a greater connection between self and nature, self and community. It focuses on qualitative change more than quantitative, on spiritual well-being more than cure. Of course curing disease is a desirable outcome or side effect, but it is not the primary purpose. In fact, only the Great Spirit knows the ultimate purpose or outcome of a Native healing ceremony. Native American healing is part of Native spirituality. It goes way beyond science and medicine.

The very idea is absurd and I would even say insulting. Neither licensing boards nor government agencies, whether state or federal, should interfere with Native American spiritual practices and religious freedom. You can't test or expect uniform answers from healers who are given unique instructions by the Great Spirit! Also, each of the more than 500 tribes in North America have their own culture, language, and healing traditions.

In my view, the term "medicine man" is an honorific, a title conferred by a Native elder or community because of a person's healing knowledge, wisdom, courage, and selfless attitude. It is not proper for a person to call him or herself a medicine person.

No one knows the age or origin of Native American healing. It has been practiced in North America for at least 40,000 years, and possibly for much longer. Anthropologists are now forced to admit that they seriously underestimated the antiquity of the occupation of North America. Some tribes' oral traditions describe volcanoes that have been extinct for one million years. How do you explain that?

• I can't

Well, here's my version of the Bering Straits legend. Native Americans started in North America. They traveled from North America across the Bering Straits many years ago, when North America and the Russian Far East were connected by a land bridge. They didn't like what they found there, so they came back. And that's why you find evidence of cultural diffusion going both directions.

Honestly, I think the Bering Straits nonsense was created by Europeans to prove that, since Native peoples were not originally in North America, the colonizers had as much right to the land as they. With this kind of logic, it is more correct to say that both Europe and North America belong to Africa. After all, geneticists are certain that homo sapiens originated there.

• You call your book Honoring the Medicine? Does this title have a special meaning?

Yes, the medicine is that which inspires a sense of the sacred. It is a power in people and in nature. It is the breath of the Great Spirit. The purpose of my book and the dedication of my life is to honor the medicine. Honoring the medicine is also a principle in Native American healing practice. Healers teach their patients to discover and honor their unique medicine-- their life purpose. Honor the medicine by living it, by having the courage to express it and use it for the good of others. To honor the medicine is to live a satisfying life.

• What, from a Native American viewpoint, are the primary causes of disease?

People become sick because they do not follow the Creator's instructions. They bend to the conditioning influences and pressures of educational and religious institutions. They fill their lives with things and their minds with noise rather than silence. They forget how to listen to the deepest voice, a voice that is both inside and outside. I would say that this is the primary cause of disease.

Yet Native people, like modern physicians, recognize that there are many causes of disease. It is never simple. According to Native teachings, there may be physical reasons for disease, such as exposure to viruses or bacteria; emotional factors like depression or anxiety; and spiritual factors such as living without gratitude, breaking taboos, or vulnerability to negative or even evil forces.

• How do Native healers treat disease?

There is no universal method. It depends on the culture of the healer and his or her training, sensitivity, vision, and connection to spirit. However, if we look at Native cultures generally, we can say that certain methods are extremely common-- and these are explored in detail in my book. For example, all healers pray; most sing and use sacred instruments such as the drum. And many Native healers practice, counseling, ritual, massage or laying on of hands, and herbal medicine. And, by the way, most healers use therapeutic humor. I've learned most of my jokes from Indian people.

• Have Native healing methods changed over time, or are the methods today the same as those practiced in the past?

Some methods have remained relatively unchanged, but many have evolved because of innovations and visions of influential healers and because of cultural exchange between healers from various tribes. Also, Native healers do not live in a vacuum. They are part of both the modern world and the ancient world. Today, it is not uncommon for a healer to pray over a prescription drug to increase its efficacy or to refer a patient to a physician to treat the medical side of a problem.

• Have you performed any miracle cures?

Well they may seem like miracles because the Great Spirit is beyond our knowledge. For example, after one brief ceremony, a man with advanced multiple sclerosis was able to walk normally. A Vietnam vet overcame many years of post traumatic stress disorder after a ceremony in which he asked forgiveness of one of his victims. A drug addict stopped using drugs and got off the streets after an exorcistic ritual. I recount some of these stories in my book, but please remember that I did not perform the cures. The Great Spirit is the doctor. I just helped to make a connection with His/Her miraculous power.

• What do you charge for a consultation or a ceremony?

Nothing.

• Nothing?

Yes. Now, I can only speak for myself. I am not saying that other healers shouldn't charge for their services. But as I have been taught by my elders and instructed by Spirit, it is wrong to charge money for a traditional healing. When a person is sick we should not take advantage of him or her. A doctor should be generous and thus must be willing to be the poorest of the poor. I have never charged a fee for Native American medicine. Yet, this does not mean that healing is free. Some sacrifice, some offering must be made by the patient. Perhaps a pilgrimage or a fast, perhaps a donation to a Native charity-- something to demonstrate dedication, resolve, and good will. The patient may also need to pay travel expenses for a healer and his or her helpers and host a feast. In the old days, a patient might give horses and blankets; today a patient might offer personal gifts as well as money. But I personally feel that it is wrong to set a fixed fee for traditional healing.

• Does Native American medicine include practices that people can do for their own healing?

Of course. For example the Lakota holy man, Fools Crow would doctor himself by sitting in the sunlight and using his hands to energetically remove unneeded or toxic forces. But the most important self-healing practices are 1. learning how to maintain inner silence and 2. spending as much time as possible in the wilderness. Herbal medicine and diet are also important components of a Native American self-healing program. I am a proponent of natural foods; we should eat fresh, seasonal, local, and organic. And stay away from the three whites: sugar, salt, and white flour.

• What about "bad medicine" or sorcery. Do you believe that it really exists?

The human mind has the power to influence its own physiology in a positive or negative way. We also have the power to influence others. The greater the power, the greater the responsibility to use it correctly. I know people who have been the victims of curses. It is real, and curses work whether the victim believes in them or not. I tell several stores of curses and cures in my book.

• Are there any dangers? For example, do Native American therapies produce side effects?

Before I answer this question, let's look at the record of western medicine. More than 200,000 people die each year in hospitals because of unforeseen effects of medication. Many people also die from surgical complications. And if we look at subjective reactions to western medicine, it is even more grim. Patients generally feel worse after seeing a physician. Taking penicillin or having blood drawn or one's anatomy probed is not fun.
By contrast, Native American medicine is generally safe and free of unpleasant side-effects. Of course there are some commonsense precautions, such as not advising an anorexic to fast and not feasting a diabetic on donuts. Significantly, patients generally feel better after visiting a Native healer than they did before seeing him or her.

• Is Native American healing used as a stand-alone therapy? What do Native people think of Western medicine?

No person or culture has a monopoly on healing wisdom or technique. Is Western medicine a stand alone therapy? Or does the patient need the loving support of his or her family to truly overcome disease? Does the patient require counseling or lifestyle changes? Perhaps the patient must take herbs or yogurt to heal his intestines after a course of antibiotics. What therapy on earth is a stand alone therapy? Native American philosophy is pragmatic. If it works, use it. Native medicine men do not hesitate to personally visit doctors for bacterial infections, trauma, diabetes management, and many other conditions. They go to the optometrist and the dentist, just like you and me.

• What illnesses can Native American healing cure? Is there scientific evidence?

I have personally facilitated healings from cancer, arthritis, chronic pain, encephalitis, migraine, Crohn's Disease, fibromyalgia, diabetes, chronic fatigue, asthma, multiple sclerosis, bipolar disorder, schizophrenia, and other conditions. Not all aspects of Native healing are subject to measurement. For example, we can measure distinct changes in brainwaves, blood chemistry, and skin conductivity in both the healer and patient, but we cannot measure the Great Spirit or his power directly. We can determine the biochemically active agent in a healing herb, but cannot measure how the prayers of the healer empower that herb.

Some of the best healing research was conducted at the Menninger Institute during the 1980s and early 1990s. Compared to untrained people, exceptional healers were able to produce unusual electrical currents on the skin and electric fields around their bodies. The results were published in peer-reviewed scientific journals.

• How many healers were tested?

Nine.

• You were one of those healers, weren't you?

Yes.

The Personal Side

• Your last book was about qigong, Chinese healing therapies, and you are well known as master of qigong. I understand that you even speak the Chinese language. Is qigong related to Native American healing, and how do you manage to teach or write about these two different subjects?

There are two major similarities between qigong and Native American healing. First, both qigong and Native American medicine are ancient and indigenous healing systems. Second, people who pay close attention to their bodies and to nature discover similar things. Thus, both cultures recognize the existence of subtle, invisible life currents, connected with the breath. And they independently created similar methods of balancing these life currents with acupuncture and massage. The Native American and Chinese healing systems are complementary. There are, however, some important differences.

I feel that Native American healing is more truly holistic. It examines not only the energetic components of disease-- the specialty of qigong and acupuncture-- but also the emotional, mental, spiritual, and environmental. It also places a strong emphasis on the intuition, visions, and dreams of the healer.

Why should it be difficult to write about or teach both Chinese and Native American traditions? If I told you that I was teaching French and Tibetan, you would say I was "talented." If I had graduate degrees in psychology and theology and taught courses in both, you would not assume discord-- provided that I didn't speak French while teaching Tibetan or confuse the psychology of Freud with theology of Hassidism! I teach and write about two different but related subjects. As an educator I keep them distinct. I see no need to fit myself into a box. Specialization is a European, colonial concept.

• How do Native people feel about you writing about Native American medicine?

Elders have encouraged me to share what I know. A Cree medicine man did a ceremony over the title page of my book. The spirits blessed it and told me to publish. I had the same positive reaction from the many elders I visited or asked to review my work. They know that I am aware of traditional protocol--there are many things that I will not write about or allow to be recorded. Some teachings must be earned or only given at certain times.

• How did you become interested in Native American medicine?

The medicine chose me. It is not a matter of interest or choice. I do what I have to do. To live any other way is to be disrespectful to the powers. If you are asking about the particular circumstances that clarified my life path-- that is easier to answer. When I was in my twenties I went on a pilgrimage, a search for life purpose that led me to a very special place-- a lake at the top of the continental divide, the home of Thunderbird, spirit of the West. Here I was given direction and purpose.

• How does a person become a medicine man or woman?

Some people are born with the gift; it is in their blood and family line. Some receive it ceremonially, in a kind of initiation or transmission. But, to me, the most important way to become a medicine person is through personal training and sacrifice.

• How were you trained?

I have been initiated into various Native American medicine societies. Elders have also transmitted the power of sacred stones and plants into my body and spirit. And, my formal adoption by a Cree elder was certainly a kind of initiation. I carry songs and teachings from my adoptive family. But, as I said above, the most powerful way to become a healer is through personal training. I have apprenticed with elders, participated in ceremonies, fasted, and prayed for a vision of my life purpose.

• Are there any teachers that had a particularly strong influence on your life, and could you tell us something about them?

I tell stories about my teachers in a lengthy chapter at the back of my book. One of my most influential mentors was the Cherokee healer Keetoowah, who gave me my Indian name "Bear Hawk" and first taught me doctoring. He was a powerful and kind person and full of humor. He once told me that he'd done everything in his life except scalp a white man. He used to be quite a warrior, but in his old age, he said, "I've decided to love my enemies to death!"

• Any closing words or advice?

Very few people are called by spirit to become medicine people, and even fewer survive the tests and tribulations of this path. But everyone can benefit by learning the values and ancient wisdom of Native peoples. My book emphasizes these values and teachings. My ultimate goal in writing Honoring the Medicine was to inspire people to live with greater honor and to respect themselves, each other, and the earth.

POEMS BY KENNETH COHEN

MASKWA (Bear)
for Joseph
©1989 Kenneth Cohen

From a great distance you are coming
Great White Bear, from the silence, from
the stillness, from the solitude of the North.
From a great distance, with slow ambling gait
Shifting side to side, stepping drum beat
Feet upon our earth mother,
walking with respect
walking with prayer.
From a great distance you are coming
Bringing new life, bringing spring medicine.
You will heal our wounds with your touch.
You appear! bringing blessings down from
Kitche Manitou--The Great Spirit-- to All Relations
You are a Sacred Pipe
Your smoke, your breath touches Creation.

From a great distance you are coming,
Great White Bear,
Yet you are always close by!

A WINTER PRAYER
© 2003 Kenneth Cohen, from Honoring the Medicine: The Essential Guide to Native American Healing (NY: Ballantine Books)

I am grateful to you Snowy Owl
Take me from the West, where the sun sets,
Where my mind sinks into its depths,
To your home in the North,
Cold northern winds that test and strengthen.
And on to the East, place of new light.
May I have the courage to make this journey
To face my tests with dignity and grace,
To see through my places of darkness
And release what is old and unneeded.

Snowy Owl, you are beautiful!
Fly by me with still, silent wings,
I know that you bring, not death,
But spiritual rebirth--
May I be renewed, as a child,
From moment to moment.
Winter is, after all, only a point
On the Great Circle of Life.
And whether it be difficult or easy
I know that it is good.

SPIRIT DANCE
© 2003 Kenneth Cohen, from Honoring the Medicine: The Essential Guide to Native American Healing (NY: Ballantine Books)

For the sake of the future and unborn generations
To provide a spirit trail for them to follow
The old man dances.
In a candle lit cedar planked room
Wooden benches along the walls
Filled with the community of prayer helpers.
The old man dances.
He is beyond age.
He breathes calmly as his feet stomp
to the strong drum beat.
His eyes are penetrating, already looking
through this reality to the next.
The old man dances.
Though dressed in poor work clothes,
I see him in what he has earned--
Red and black flowing cape, with shell-button totems:
They are dancing with him.
The old man dances
To honor the Creator's gift.
He knows that a gift not honored
a gift not given
Is quickly lost.

IN THE NAME
© 1991 Kenneth Cohen
Swinomish Nation., Winter Season

Warrior Jesus would be proud of the People
Finally honoring his teachings.
Fighting greed and selfishness
with Giveaways,
Fighting lies and abuse
with songs of gratitude,
Fighting apathy and uncaring
with prayer and community.

"I am the Way"--this is our trail
through the woods, brushed by the cedar trees;
this is our path through the wilderness--
the black unknown.
"I am the Truth"--this is our vows,
our commitment and dedication,
our love for the Creator.
"I am the Light"--this is the Red Road,
the blood of Mother Earth, smoke we send out
for seven generations.

Warrior Jesus
Dances the round dance with the People.
His kingdom is already on Earth
For those who have eyes to see it.

SHAMAN'S CRY
© 2003 Kenneth Cohen, from Honoring the Medicine: The Essential Guide to Native American Healing (NY: Ballantine Books)

The cry is an obsidian blade
That pierces this reality.
It cuts open a window
Into the dream time.

My suffering is unavoidable;
I must release the pain of separation--
of speaking instead of singing.
I must release the pain of culture and language;
I must release even my self.
I cry, and the Creator pities me.

I have shed my human form
I have entered the Bear Robe
I look at you but cannot see you
Unless you have prayed yourself into existence.

TAWODI (Hawk)
for Hawk Littlejohn
© 2003 Kenneth Cohen, from Honoring the Medicine: The Essential Guide to Native American Healing (NY: Ballantine Books)

Long Person, I come to pray with you
Where life begins at the edge of earth and water
You have been flowing since before I was born;
You will sing long after I am gone.
Hear now my voice and stretch it back
And onwards so it moves, like you, beyond time.

Wado! I am thankful for this old friend returned
Brother Tawodi, who stood with me on similar banks
In our Beloved Mountains, long ago,
We were brothers, not only in spirit.

Our friendship is sacred.
These words are True.
Gahlgwogi! (Seven)!

A NEW SONGLINE
An Honoring/Eulogy Poem for Tom Laughing Bear Heidlebaugh (Lenape)
Offered at the Honoring Ceremony, Suquamish Nation
©1997 Kenneth Cohen

You may be unpublished,
But your work is more widely read than my own,
Your pages will never weather or age--
They are "timeless classics."

In the Dreaming, ancient spirits sung the land
Into sacred story and history, heard and rechanted
Today by their descendants on Walk-about.
Very few in any generation have the power, wisdom, or love
To add a new songline, to be walked and read
By the future generations.

The first notes were sung to you
On the knee of great-grandfather Yellow Lark.
Later, you found your own rhythm and melody
Your breath became the flute, your song: the wind.
You chanted to the deserts, jungles, mountains, and ocean
--Kenya, Ethiopia, Mexico, Nicaragua, Turtle Island.
Laughing Bear danced with brothers and sisters
Among the Diné, Quileute, Makah, with Goat and Salmon People.

Your work is widely read, my poet-friend,
And your songs, unlike my own, never need translation.

PROPHECIES

WHERE EAGLES NEST
© 2003 Kenneth Cohen, from Honoring the Medicine: The Essential Guide to Native American Healing (NY: Ballantine Books)

Native American healing wisdom may be needed for the survival of Indians and non-Indians alike. Its emphasis on respect, justice, and frugality with generosity is sound ecology. We need to learn these lessons if we are to prevent the widely prophesied political and economic conflicts or catastrophes and "earth changes": cataclysmic natural events that may occur as part of the Earth's attempts to rebalance the scales that Western civilization has upset. The elders say that the time is right to share sacred teachings. On August 20, 1994 a rare white buffalo calf was born on a farm in Wisconsin. Native medicine people recognized the calf as a symbol of the rebirth of the sacred in a world that has long suffered for its lack.

The urgency of sharing these teachings was confirmed for me during a Sacred Pipe Ceremony that I conducted at the turn of the millennium. The Pipe Ceremony is a way of communing with the forces of life, all of which are symbolically placed in the tobacco, ignited by the fire of transformation, and sent prayerfully up to Creator with one's breath. At the end of the Pipe Ceremony, I had a vision in which I saw, with the eye of spirit, layers of shimmering clouds hovering overhead. Eagles were flying slowly, almost meditatively, in the highest clouds. They transmitted a message to my mind, "In the Old Days, our spirits lived in and around the people. But today, people are polluting and destroying our home; few see or respect us physically or spiritually. Our spirits have withdrawn upwards. We no longer dwell naturally among you but must be enticed down through ceremony and personal sacrifice."

The Eagle Spirit grants people the ability to dream and to see life from a higher, wider, and more balanced perspective. How sad that at a time when we need Eagle's inspiration the most, the Eagle is farthest away. We have made the world inhospitable to the Eagle, and like a traumatized person, his spirit has dissociated to an inaccessible realm. We can bring the Eagle back by caring for the Earth, by making the Earth a beautiful place where the Eagle will wish to nest and raise her young, and by prioritizing sacred knowledge, especially the wisdom that comes in dreams and visions, over material wealth.

from SPIRITUAL PERSPECTIVES ON WAR AND PEACE
©Kenneth Cohen
Alberta Native News 20:4, April 13, 2003

In 2001 I had a dream and a vision that I realize, in retrospect, predicted the 9/11 attacks and the continuing crisis. Early that summer I had a disturbing dream several nights in a row. There was a volcano in New York City. Thick clouds of black smoke were pouring from the volcano. I saw hundreds of people trapped in a subway underneath the volcano, unable to exit because explosions had destroyed the stairs to the street level. When I saw the horrid pictures of the collapsing towers and learned about the people who had been burned and crushed in the subway under the World Trade Center, I realized the accuracy of my dream.

In October of 2001, I took my sacred pipe into the mountains to pray for guidance and a message. I heard the voice of the Earth: "The wars will not cease until human beings learn the lesson of simplicity. Two-leggeds are removing the bones of their ancestors, the plant people whose ancient bodies are coal, oil, and gas ["fossil fuels" created when carbon in vegetation is compressed underground for millions of years]. These bones are sacred. When you mine coal, oil, or gas, you rob the graves of your ancestors.

"When you stand on the ground, you stand on your plant elders. They support you, and their energy is the source of feeling centered, rooted, and in touch with nature. As two leggeds pull up their own roots, they become incapable of making wise decisions, whether in the Middle East, the United States, or elsewhere. If they hoard resources or continue to disrespectfully excavate, burn, and consume my body, conflict will continue or get worse."