Let's Talk about Sex, BA-BY!

Bottom line: we can pretend like our youth are not exploring their sexuality, but the truth is that they are. The way I see it, we have two choices: 1. To pay attention to them by being supportive and answering questions. 2. To continue to let stereotypes about sexuality fester by letting youth feel ashamed about asking questions, leading to increasingly damaging consequences. I'm just sayin....

September 27, 2009 NYTIMES MAGAZINE PREVIEW

Coming Out in Middle School

By BENOIT DENIZET-LEWIS

Austin didn’t know what to wear to his first gay dance last spring. It was bad enough that the gangly 13-year-old from Sand Springs, Okla., had to go without his boyfriend at the time, a 14-year-old star athlete at another middle school, but there were also laundry issues. “I don’t have any clean clothes!” he complained to me by text message, his favored method of communication.

When I met up with him an hour later, he had weathered his wardrobe crisis (he was in jeans and a beige T-shirt with musical instruments on it) but was still a nervous wreck. “I’m kind of scared,” he confessed. “Who am I going to talk to? I wish my boyfriend could come.” But his boyfriend couldn’t find anyone to give him a ride nor, Austin explained, could his boyfriend ask his father for one. “His dad would give him up for adoption if he knew he was gay,” Austin told me. “I’m serious. He has the strictest, scariest dad ever. He has to date girls and act all tough so that people won’t suspect.”

Austin doesn’t have to play “the pretend game,” as he calls it, anymore. At his middle school, he has come out to his close friends, who have been supportive. A few of his female friends responded that they were bisexual. “Half the girls I know are bisexual,” he said. He hadn’t planned on coming out to his mom yet, but she found out a week before the dance. “I told my cousin, my cousin told this other girl, she told her mother, her mother told my mom and then my mom told me,” Austin explained. “The only person who really has a problem with it is my older sister, who keeps saying: ‘It’s just a phase! It’s just a phase!’ ”

Austin’s mom was on vacation in another state during my visit to Oklahoma, so a family friend drove him to the weekly youth dance at the Openarms Youth Project in Tulsa, which is housed in a white cement-block building next to a redbrick Baptist church on the east side of town. We arrived unfashionably on time, and Austin tried to park himself on a couch in a corner but was whisked away by Ben, a 16-year-old Openarms regular, who gave him an impromptu tour and introduced him to his mom, who works the concession area most weeks.

Openarms is practically overrun with supportive moms. While Austin and Ben were on the patio, a 14-year-old named Nick arrived with his mom. Nick came out to her when he was 12 but had yet to go on a date or even kiss a boy, which prompted his younger sister to opine that maybe he wasn’t actually gay. “She said, ‘Maybe you’re bisexual,’ ” Nick told me. “But I don’t have to have sex with a girl to know I’m not interested.”

Ninety minutes after we arrived, Openarms was packed with about 130 teenagers who had come from all corners of the state. Some danced to the Lady Gaga song “Poker Face,” others battled one another in pool or foosball and a handful of young couples held hands on the outdoor patio. In one corner, a short, perky eighth-grade girl kissed her ninth-grade girlfriend of one year. I asked them where they met. “In church,” they told me. Not far from them, a 14-year-old named Misti — who came out to classmates at her middle school when she was 12 and weathered anti-gay harassment and bullying, including having food thrown at her in the cafeteria — sat on a wooden bench and cuddled with a new girlfriend.

Austin had practically forgotten about his boyfriend. Instead, he was confessing to me — mostly by text message, though we were standing next to each other — his crush on Laddie, a 16-year-old who had just moved to Tulsa from a small town in Texas. Like Austin, Laddie was attending the dance for the first time, but he came off as much more comfortable in his skin and had a handful of admirers on the patio. Laddie told them that he came out in eighth grade and that the announcement sent shock waves through his Texas school.

“I definitely lost some friends,” he said, “but no one really made fun of me or called me names, probably because I was one of the most popular kids when I came out. I don’t think I would have come out if I wasn’t popular.”

“When I first realized I was gay,” Austin interjected, “I just assumed I would hide it and be miserable for the rest of my life. But then I said, ‘O.K., wait, I don’t want to hide this and be miserable my whole life.’ ”

I asked him how old he was when he made that decision.

“Eleven,” he said.

To read the rest of the article: http://www.nytimes.com/2009/09/27/magazine/27out-t.html?_r=2&pagewanted=print

Cultural Sensitivity

This is a great article from Sunday's NYTimes on the importance of cross-cultural sensitivity in hospitals. It's an easy an obvious transfer to other American institutions, yet one that we still refuse to acknowledge.

I also highly recommend the book mentioned in the article, which I read before starting Clinical Pastoral Education a few summers ago. It's an incredibly poignant example of the issues the article raises.

September 20, 2009

A Doctor for Disease, a Shaman for the Soul

By PATRICIA LEIGH BROWN MERCED, Calif. — The patient in Room 328 had diabetes and hypertension. But when Va Meng Lee, a Hmong shaman, began the healing process by looping a coiled thread around the patient’s wrist, Mr. Lee’s chief concern was summoning the ailing man’s runaway soul.

“Doctors are good at disease,” Mr. Lee said as he encircled the patient, Chang Teng Thao, a widower from Laos, in an invisible “protective shield” traced in the air with his finger. “The soul is the shaman’s responsibility.”At Mercy Medical Center in Merced, where roughly four patients a day are Hmong from northern Laos, healing includes more than IV drips, syringes and blood glucose monitors. Because many Hmong rely on their spiritual beliefs to get them through illnesses, the hospital’s new Hmong shaman policy, the country’s first, formally recognizes the cultural role of traditional healers like Mr. Lee, inviting them to perform nine approved ceremonies in the hospital, including “soul calling” and chanting in a soft voice.

The policy and a novel training program to introduce shamans to the principles of Western medicine are part of a national movement to consider patients’ cultural beliefs and values when deciding their medical treatment. The approach is being adopted by dozens of medical institutions and clinics across the country that cater to immigrant, refugee and ethnic-minority populations.

Certified shamans, with their embroidered jackets and official badges, have the same unrestricted access to patients given to clergy members.

Shamans do not take insurance or other payment, although they have been known to accept a live chicken.

A recent survey of 60 hospitals in the United States by the Joint Commission, the country’s largest hospital accrediting group, found that the hospitals were increasingly embracing cultural beliefs, driven sometimes by marketing, whether by adding calcium- and iron-rich Korean seaweed soup to the maternity ward menu at Good Samaritan Hospital in Los Angeles, on the edge of Koreatown, or providing birthing doulas for Somali women in Minneapolis.

In Merced, about 120 miles southeast of San Francisco, the Mercy hospital shaman program was designed to strengthen the trust between doctors and the Hmong community — a form of healing in the broadest sense. It tries to redress years of misunderstanding between the medical establishment and the Hmong, whose lives in the mountains of Laos were irreparably altered by the Vietnam War. Hmong soldiers, Mr. Lee among them, were recruited by the C.I.A. in the 1960s to fight the covert war against Communist insurgents in Laos and afterward, to avoid retribution, were forced to flee to the refugee camps, with most resettling in California’s Central Valley and in the Midwest.

During a seven-week training program at Mercy Medical Center, 89 shamans learned elements of Western-style medicine, including germ theory. They visited operating rooms and peered through microscopes for the first time. Looking at heart cells, one shaman, an elderly woman, asked the pathologist to show her a “happy heart.”

Designed to defuse the Hmong fear of Western medicine, the program has “built trust both ways,” said Dr. John Paik-Tesch, director of the Merced Family Medicine Residency Program, which trains resident physicians at Mercy Medical Center.

Since the refugees began arriving 30 years ago, health professionals like Marilyn Mochel, a registered nurse who helped create the hospital’s policy on shamans, have wrestled with how best to resolve immigrants’ health needs given the Hmong belief system, in which surgery, anesthesia, blood transfusions and other common procedures are taboo.

The result has been a high incidence of ruptured appendixes, complications from diabetes, and end-stage cancers, with fears of medical intervention and delays in treatment exacerbated by “our inability to explain to patients how physicians make decisions and recommendations,” Ms. Mochel said.

The consequences of miscommunication between a Hmong family and the hospital in Merced was the subject of the book “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and The Collision of Two Cultures” by Anne Fadiman (Farrar, Straus and Giroux, 1997). The book follows a young girl’s treatment for epilepsy and the hospital’s failure to recognize the family’s deep-seated cultural beliefs. The fallout from the case and the book prompted much soul-searching at the hospital and helped lead to its shaman policy.

The Hmong believe that souls, like errant children, are capable of wandering off or being captured by malevolent spirits, causing illness. Mr. Lee’s ceremony for the diabetic man was a spiritual inoculation, meant to protect his soul from being kidnapped by his late wife and thus extending his “life visa.”

Such ceremonies, which last 10 minutes to 15 minutes and must be cleared with a patient’s roommates, are tame versions of elaborate rituals that abound in Merced, especially on weekends, when suburban living rooms and garages are transformed into sacred spaces and crowded by over a hundred friends and family members. Shamans like Ma Vue, a 4-foot, 70-something dynamo with a tight bun, go into trances for hours, negotiating with spirits in return for sacrificed animals — a pig, for instance, was laid out recently on camouflage fabric on a living room floor.

Certain elements of Hmong healing ceremonies, like the use of gongs, finger bells and other boisterous spiritual accelerators, require the hospital’s permission. Janice Wilkerson, the hospital’s “integration” director, said it was also unlikely that the hospital would allow ceremonies involving animals, like one in which evil spirits are transferred onto a live rooster that struts across a patient’s chest.

“The infection control nurse would have a few problems with that,” Ms. Wilkerson said.

A turning point in the skepticism of staff members occurred a decade ago, when a major Hmong clan leader was hospitalized here with a gangrenous bowel. Dr. Jim McDiarmid, a clinical psychologist and director of the residency program, said that in deference hundreds of well-wishers, a shaman was allowed to perform rituals, including placing a long sword at the door to ward off evil spirits. The man miraculously recovered. “That made a big impression, especially on the residents,” Dr. McDiarmid said.

Social support and beliefs affect a patient’s ability to rebound from illness, Dr. McDiarmid added, pointing out that over half of the people who respond toantidepressants do so because of the placebo effect.

One of the goals of the new policy, Ms. Mochel said, is to speed up medical intervention by having a healing ceremony coincide with a hospital stay, rather than waiting days for a patient to confer with family and clan leaders after a ceremony at home.

Attitudes toward Western doctors have begun to loosen as young, assimilated Hmong-Americans assume more powerful roles in the family. Dr. Kathie Culhane-Pera, the associate medical director of the West Side Community Health Center in St. Paul, home to the country’s largest concentration of Hmong, said she worked informally with shamans, obtaining permission from the hospital to turn off the smoke alarms for incense, for example. Signs of the growing movement in cross-cultural health care can be found on the Navajo reservation in northern Arizona, where the federal Indian Health Service has three medicine men on staff and recently instituted a training program similar to Mercy’s.

At White Memorial Medical Center in Los Angeles, Dr. Hector Flores, the chairman of the family medicine department, refers patients to, traditional Hispanic healers, curanderos, on a case-by-case basis. The facility also trains community members as “promotores de salud,” or health promoters. Dr. Flores called it a “low-tech approach in which the physician is not the end-all, but part of a collaborative team geared toward prevention.”

At the hospital in Merced, Dr. Lesley Xiong, 26, a resident physician, grew up as the granddaughter of two distinguished shamans. Though she chose to become a doctor, she said there was ample room for both approaches. “If I were sick, I would want a shaman to be there,” Dr. Xiong said. “But I’d go to the hospital.”

http://www.nytimes.com/2009/09/20/us/20shaman.html?_r=1&sq=hmong&st=cse&scp=2&pagewanted=print

Score

This e-mail made my day. One of my former students overheard her mom talking to her sister on the phone this summer, "Your sister is really into Jesus recently. I don't get it."

HAHAH! WIN for Jesus :)

A Lesson in Trust

This is a beautiful reflection from a good family friend that ran in the Washington Post recently. She has quite a lesson to share.

A September Lesson to Trust the Universe

Washington Post, Monday, August 31, 2009

With September upon us, something beautiful to greet the month.

My garden never looks better than it does in September. Maybe it's the tilt of the earth creating longer shadows and shorter days that gives it new depth and contrast -- matured colors becoming deeper and stronger. Maybe it's the months of exhausting growth that relaxes into a mellow peacefulness -- the garden now content with butterflies hop-scotching around its flowers.

In my garden, persistent perennials, aromatic herbs and eager annuals grow in a village of colored diversity -- their blossoms bursting throughout the summer in scattered sequence, like fireflies in the dark. Until now, I believed the beauty of the September garden was a result of my persistent summer nurturing: carefully arranging roots with space to grow and putting stakes in the ground to support wobbly stems.

All summer I care for my plants the way the owner of our local garden center tends to stray kittens -- feeding, sheltering and helping them to find just the right home to grow. If a petunia looks peaked, I dig it up and try it next to the basil. If the sage is too soggy, it gets moved next to the sun-loving daisies. More often than not, my transplanted patients sigh, and, for a short time, slump with limp leaves. For the most part, they are able to establish roots again and flourish; those that can't will wither and retreat to the soil to sprout again another day.

Sometimes, when the garden is just the right blend of textures, hues and heights, I pull out the shovel and disrupt the peace. Spreading the joy is what I tell myself as I dig up a couple of contented cone flowers and move them to another spot. I can sense their impatience -- much like my children who used to roll their eyes in protest when I fussed over them too much. Roots cling tightly to the earth as I yank and pull, falling backward from the force of their stubbornness. These are the plants that simply develop new roots, get on with life and thrive.

There is a whole universe in my garden. Things are born and die. There's conflict: Vines that want to hug the daisies to death, squirrels that want to eat the blossoms off the begonias, blue jays that push the sparrows out of the way at the feeder. But, most of all, there is harmony and interdependence -- bees work dutifully among the blooms to pollinate the flowers; worms tunnel below ground supplying aeration and nutrients; tomatoes bear fruit for sustenance. And now, for the first time, I've figured out why my garden looks the best in September. It's because I've stopped fretting over it by then. While I'm off looking for golden mums and orange pumpkins, my garden is allowed to "just be." It's alone with itself -- autumn activity bustles elsewhere. It inhales a collective breath of gratitude and releases it toward the heavens. And now, in the September of my own life, through the crisp clarity of autumn and the faith of a flower, I've come to know the universe will also take care of me, if I just let myself be.

-- Jane Donaldson, Alexandria

Sunset/rise

I've always been fascinated by the earth's rotation. As the sun is setting on my edge of the world, it's undoubtedly rising on the other side. It's something that affects everyday life, yet I don't give it a moment's thought as the sun rises and sets each day. Lately, this image has been helpful for me as I'm adjusting to life in a new place with lots of new things and new people - new, new, not old, new! Coincidentally I got 3 calls from "old" friends today that reminded me of how to find beauty in the new. While relying on the comforting experience of the past, I can rest easy knowing new things bring forth possibilities for fresh joys. Tonight I'm grateful for their wise and kind voices that reminded me that with each new sunrise comes great reason to celebrate! Friends to "run to" are a priceless gift.

I Run To You

I run from hate

I run from prejudice

I run from pessimists

But I run too late

I run my life

Or is it running me

Run from my past

I run too fast

Or too slow it seems

When lies become the truth

That's when I run to you

This world keeps spinning faster

Into a new disaster so I run to you

I run to you baby

And when it all starts coming undone

Baby you're the only one I run to

I run to you

We run on fumes

Your life and mine

Like the sands of time

Slippin' right on through

And our love's the only truth

That's why I run to you

This world keeps spinning faster

Into a new disaster so I run to you

I run to you baby

And when it all starts coming undone

Baby you're the only one I run to

I run to you

-Lady Antebellum