Reverence for Rituals

Misspelling redefines spiritual care

By Norris Burkes
February 2020

In 2002, I was so thrilled to begin work as a chaplain for Sutter Medical Center in Sacramento that I failed to notice the typo on my ID badge.

It took more than a year, but a patient finally spotted the missing ‘r’ in “Spiritual.” She cupped a hand over her mouth and nose, and said, “I probably shouldn’t get any closer if you’re from the “SPIT-ual Care Department.”

After we shared a good laugh, I skedaddled downstairs to have human resources correct the badge. Little did I know that 12 years later, the identifier “Spit-ual Care” might be appropriate for my new position as a staff chaplain at St. Joseph’s Medical Center in Stockton.

One summer day I entered the room of a patient recovering from minor surgery. The man didn’t speak English, but his wife and granddaughter did. After introductions, I learned that the wife was also a shaman. Shamans are spiritual leaders and healers in the earth-based spirituality of southeast Asia. So with careful exploration, I asked what I might do to facilitate their faith traditions.

“My grandmother wants to conduct a Hmong ritual.”

“Can you say more?” I asked.

“The rite involves my grandmother putting water in her mouth and spewing it on my grandfather’s surgical site,” the granddaughter said with little emotion.
“Excuse me for a moment,” I said. “Let me ask the nurse how we can do that.”

I dismissed myself and ducked into the nurses’ break room to Google the request. My search told me that the patient’s wife was likely blaming “misplaced energy” for precipitating her husband’s illness. She needed the water to perform an “extraction” that would remove the displaced energy that had invaded his body.
I slid my phone back in my pocket and stopped at the nurses’ station for a consult.

“Can she spit water on the wound without risking an infection?” I asked the startled charge nurse.

She thought for a minute and replied, “Yes. The surgical site is stitched and closed. Just use bottled water.”

With that permission, I returned to the room and handed over the sterile water I’d picked up from the nurse. The patient’s wife opened the bottle, held it to her lips and sloshed the water around in her mouth. Then she tilted her head and—”Plah!”—she spat a mouthful on her husband.

I tried hard not to show skepticism by allowing my inner Baptist preacher to run amuck. I mean, what just happened? I saw no evil spirits come out of the man and there was no instant healing of the wound. I felt uneasy that this family was relying on such archaic beliefs amidst such modern medicine.

My discomfort reminded me of a story from the post-WWII occupation of Japan. An American serviceman was watching a Shinto worshiper distribute rice over his ancestor’s grave and asked, “When do you think your ancestor will eat the rice you left?”

The man replied, “About the same time that your ancestors smell the flowers you left.”

As simply as the shaman had begun, she concluded. I was thanked for intervening with nursing staff and given a dismissive nod. I returned to my office cubicle where I sat wondering what I would write in this patient’s chart. I wasn’t entirely sure what I’d accomplished.

However, as much as anything, good spiritual care had been merged into the Hippocratic Oath—“First, do no harm.” I had not ridiculed the woman or passed judgment on her request. I had not put up barriers or implied that she was inconveniencing the staff.

But more concretely, I noted an observable change in contentedness within the family. Reverence for their request had helped build a sacred, nonjudgmental space for worship. In the midst of medical uncertainty, the family rekindled and celebrated their own truths. The ritual helped them navigate the harsh maze of medicine and restored meaning to their world.

And that’s what I charted.

Norris Burkes can be reached at Follow us on Facebook, Twitter and Instagram: @insidesacramento. Burkes is available for public speaking at civic organizations, places of worship, veterans groups and more. For details and fees, visit


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