Family Circle
A mother turns to a Lakota Sioux healer to help pull her daughter from the brink of death

By Heather Stringer
September 25, 2003


JoEllen Koerner, Ph.D., RN, FAAN, felt her heart beating wildly as she watched her daughter pace in circles like a caged animal. Kristi Welch, 30, had endured months of knife-stabbing pain from kidney stones and stents, and was accelerating toward her breaking point.

Then, Welch asked her mother a dreaded question: "If this does not change in two days, will you help me die?"

For the veteran nurse, the question revealed just how thoroughly Western medicine had failed her daughter. At that moment, Welch didn't need another procedure, pill or visit to the emergency room. In desperation, the two women turned to the aid of an American Indian healer named Wanigi Waci, a Lakota Sioux who offered Welch new options for medical aid-options that ultimately helped her walk away from the brink of death.

The experience propelled Koerner toward a new mission in her nursing career: working to introduce the American Indian model of medicine to more patients, doctors and nurses. She is one of several nurses nationwide pioneering programs that incorporate indigenous holistic health into the Western medical system. These nurses suggest that American Indian practices derive healing power from spiritual and familial connections that Western medicine often fails to tap into.

But even with Koerner's strong convictions about the power of indigenous healing, the path to integrating these considerably different models has proved to be far from simple.

"There is an arrogance in Western society that we have the only way to heal," said Koerner, who lives in South Dakota. "I think Western medicine diagnoses a disease and treats the symptoms, but not the root causes. The root causes can be the emotional component of something. I really believe now that sickness is a manifestation of something deeper."

System failure

Welch's medical problems started escalating severely during her second pregnancy. She developed gestational diabetes, pre-eclampsia, endocrine system complications and then kidney stones. The doctors she visited continually misdiagnosed the problems and were even rude at times. One kidney specialist said she could not possibly have kidney stones at age 30 with no family history of the disease.

She finally had emergency kidney surgery and the surgeon found that she had five stones. Doctors inserted stents to help the stones pass, but the stents caused wrenching pain.

Koerner's voice halted as she described the terror she felt when her daughter's pain was so severe she went into shock-her body was drenched in sweat, her face was white and lips blue as her hands flailed in the air.

Even with the stents, the stones were not passing. Helpless and frantic, Koerner took her daughter to an American Indian healing ceremony, where people from the tribe prayed for her. There, something supernatural happened for Welch.

"I'm a very analytical person, but now I'm a strong believer in our ability to interact with beings we really can't see," Welch said. "When they called my name during the prayer ceremony, I definitely felt actual thumping on my back even though no one was touching me. It felt like a gruff tapping."

The American Indian medicine man also told her that the largest stone probably would not come out on its own. He turned out to be right. She would later need surgery to remove it.

Wanigi Waci also gave Welch a chilling-yet empowering-explanation of her severe illness. He pointed out that Welch and her mother came from a Mennonite culture that was oppressive to women, and he believed it was no accident that she had five kidney stones-one for each generation of women who had nearly died during childbirth. He believed Welch's illness was an opportunity to heal the generations of emotional and physical sickness in the family.

"It gave me clarity to know that we really are all interconnected, and my decisions and thoughts become my children's whether I like it or not," Welch said. "The choices I make along the way make it harder or less hard for my children. I really do believe that."

Spiritual analysis

This clarity gave Welch the strength to overcome the excruciating pain, and her remaining stones finally began to pass. Welch has been free of pain for more than three years, and she and her mother are working on a project that aims to introduce American Indian holistic health to diabetes treatment. The Health and Human Services project, which is based in South Dakota, tracks the effect of spiritual and familial connection on blood sugar levels.

In the Western medical approach to diabetes, exercise and food intake are the most important factors linked to blood sugar levels, Koerner said. In the new project, American Indians with diabetes are starting to track how glucose levels are affected by other decisions, such as attending ceremonies, festivals or reunions that nurture a connection to family. The participants in the project also are asked to track blood sugar levels after spiritual events, such as naming or grieving ceremonies or prayer ceremonies.

Like Koerner, Lanette Perkins, RN, is a nurse vying for more American Indian practices in the hospital setting. Perkins, whose father was Crow, Chippewa and Cherokee, works as an American Indian patient advocate at Deaconess Billings Clinic in Montana.

She's witnessed the power of smudging, a cleansing ceremony, and she recently completed the hospital's first official smudging policy.

During one of these ceremonies, members of a patient's tribe typically burn cedar, sage or sweet grass in a patient's room and pray to give the patient spiritual cleansing. Now, when a patient requests a smudging ceremony at the hospital, the staff can read the policy to find out who to call to have it approved and how to handle patients on a ventilator.

Perkins' next goal is to create an amputation policy because many American Indian patients suffer from diabetes, a disease that can increase a patient's chances of losing a limb. The hospital's usual policy is to incinerate amputated limbs, but tribes in Perkins' area believe that when a person dies, the entire body should be with the deceased in the world after death.

Perkins would like to develop a policy that will allow patients to take their limbs home.

"To me, it will be an exciting challenge that will hopefully help hospital staff be respectful to certain tribes," Perkins said. "A lot of times when I worked as a nurse before, Native American patients had such a negative experience and thought Caucasians just didn't understand.

"One of the biggest things I enjoy is being able to help the patients and their families feel like they are valued."

Perkins also has worked with hospital staff to help them accept that American Indian patients may have more than the usual number of visitors. She's accustomed to finding space for 60 to 80 people from a tribe who may come to visit a patient.

It's all relative

The importance of family connection also is an American Indian value that John Lowe, Ph.D., RN, has capitalized on in his treatment of teens who suffer from substance abuse. Lowe, a Cherokee and an assistant professor at Florida Atlantic University, has developed an intervention project that uses Cherokee values to help American Indian teens recover from addiction to alcohol and drugs.

Lowe believes the American value of individualism can sometimes conflict with the Cherokee value of an individual's deep connection to others. In his program, he encourages teens to respect their heritage.

"I explain that if you harm yourself, you are harming everyone you are connected to," Lowe said. "When one person or one thing is not able to make their contribution, then the circle is not whole and there is an incompleteness."

About 150 high school students from Oklahoma have participated in the program, and a year after completing the program, the students are reporting a marked decrease in substance abuse.

Although Lowe, Perkins and Koerner are forging ahead in their efforts to capture American Indian methods of healing, the road has been bumpy.

"Some days, it's a real challenge," Perkins admitted. "Unfortunately, we still have some people living back in the 1890s. We all can be prejudiced in different ways and sometimes staff members don't take time to meet some of the American Indian patients that come through here."

Koerner worked with hospital administrators in South Dakota on a plan that would fund a new ceremony room in the hospital, but the project lost priority during a reorganization, and Koerner was deeply disappointed when the project never took off.

Phil Authier, MPH, RN, also tried to advocate for a specific smudging room in a South Dakota hospital, but he hit barriers when hospital administrators discovered the room could be used only for smudging. The tradition for the American Indians who wanted the room was to use a particular space solely for smudging, but Authier's hospital could not commit to this.

The hospital did accommodate the American Indian value of family by loosening the rules for visiting hours and working to find places for the many relatives to stay while visiting.

Even though some of the traditions may seem foreign to Westerners, nurses such as Koerner can vouch for the healing power behind these traditions. She believes that nurses can reap the benefits of American Indian philosophies by learning how to help patients understand their illnesses.

"Nursing's primary work is to help people make meaning out of illness," Koerner said. "The key in what I experienced with the Native Americans was that they absolutely believe there are no accidents. Everything has a purpose to help us become aware. That's really what nursing is about."

For Koerner, who was both a mother and nurse for her daughter, finding that purpose was the difference between life and death for Welch.

Contact Heather Stringer at heather_stringer@sbcglobal.net