By PATRICIA LEIGH BROWN


MERCED, California - 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 intravenous 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 role of traditional healers like Mr. Lee, inviting them to perform nine approved ceremonies in the hospital.

The policy and a novel training program to introduce shamans to Western medicine are part of a national movement to consider patients’ cultural values in medical treatment.

A 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, whether by adding Korean seaweed soup to the maternity ward menu at Good Samaritan Hospital in Los Angeles, or providing birthing doulas for Somali women in Minneapolis.

Since Hmong refugees began arriving in California and the Midwest 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, blood transfusions and other common procedures are taboo.

The result has been complications and delays in treatment exacerbated by “our inability to explain to patients how physicians make decisions and recommendations,” Ms. Mochel said.

Attitudes toward Western doctors have begun to loosen as young, assimilated Hmong- Americans assume more powerful roles in the family.

At the hospital in Merced, Dr. Lesley Xiong, 26, a resident physician, grew up as the granddaughter of two distinguished shamans. 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.”



Va Meng Lee, a Hmong shaman, treated Chang Teng Thao, who has diabetes. / JIM WILSON/THE NEW YORK TIMES