When I was visiting Navajo reserve in Arizona last year, I was fascinated by how similar the Navajo and ethnic Chinese custom are similar. ( For those who don’t know, I am a village heart doctor in Brooklyn Chinatown.) When you introduce yourself in the Navajo reserve, you tell people your name and which clan you are from. This is similar to Chinese: they often tell me which village in China they are from and asked me which village I am from.
Navajos believe in Hózhó, or “Walking in Beauty”: “The word embodies the idea of striving for balance and harmony together with beauty and order. Every aspect of Navajo life, whether secular or spiritual in nature, is connected to hózhó. As humans we straddle the border between health and sickness, good and evil, happiness and sadness. According to the Navajo worldview, the purpose of life is to achieve balance, in a continual cycle of gaining and retaining harmony. Through this exhibition, we will explore one aspect of Navajo creativity that exemplifies hózhó their basketry. When hózhó has been lost, a ceremony is held to restore balance. Baskets are a necessary part of ceremonies that re-establish hózhó. They are the material expressions of the essence of the Navajo worldview. In order for weavers to make baskets that are beautiful, they themselves must “walk in beauty” or live in hózhó.”
Navajo reserve is plagued by many diseases such as alcoholism and diabetes, as well as suicide. The Navajo explanation is that they have lost their ancient way and lost the balance between the land and the people. Diabetes, gun violence, and alcoholism are the result when people lost this balance.
There was a mysterious outbreak of febrile illness in Navajo reverse in the 1990s: young patients would die rapidly from a flu like illness. CDC was initially stumped. As described by Dr. Lori Arviso’s book “The Scapel and the Silver Bear”, the medicine man observed that the reason was because of the recent rainfall has caused a larger than usual piñon crop, resulting in lack of balance in nature. The medicine man said that sand painting with a mouse has been used as the traditional therapy for this rapidly fatal disease. The medicine man told CDC to “look to the mouse”. So CDC started looking at rodent population and realized that the higher than usual crop of piñon resulted in higher rodent population, leading to outbreak of rodent hantavirus.
There is a movement in the Navajo community to return to “Walking in Beauty”, in order to rid it from the epidemics of modern diseases.
In contrast, Italian immigration to US left their homeland and migrated to a strange land. Despite such trauma, they remain united as close family. Roseto was one of the tightest knit Pennsylvania small town where many settle. The story of the town of Rosetto is fascinating. This town was almost 100% Italian has the lowest cardiac mortality compared with many small towns.
From Wikipedia:
The Roseto effect was first noticed in 1961 when the local Roseto doctor encountered Dr. Stewart Wolf, then head of Medicine of the University of Oklahoma, and they discussed, over a couple of beers, the unusually low rate of myocardial infarction in Roseto compared with other locations.Many studies followed, including a 50-year study comparing nearby Bangor and Nazareth. As the original authors had predicted, as the Bangor cohort shed their Italian social structure and became more Americanized in the years following the initial study, heart disease rose.
From 1954 to 1961, Roseto had nearly no heart attacks for the elsewhere high-risk group of men 55 to 64, and men over 65 enjoyed a death rate of 1% while the national average was 2%. Widowers outnumbered widows, too.
These statistics were at odds with a number of other factors observed in the community. They smoked unfiltered stogies, drank wine “with seeming abandon” in lieu of milk and soft drinks, skipped the Mediterranean diet in favor of meatballs and sausages fried in lard with hard and soft cheeses. The men worked in the slate quarries where they contracted illnesses from gases and dust. Roseto also had no crime, and very few applications for public assistance.
This is in spite of their bad diets. Researchers have looked into why they have unexpectedly low mortality despite high conventional risk factors in the 1969s. The answer is that these Italuans am have very tight knit family and tat this strong family bondage helped lower overall mortality.
As I become more familiar with the Chinese American community, I become much more aware of the importance of tightly knit community as a protection against cardiac disorder. When I treat one patient, I become aware that this patient belongs to the whole village. I found that if I take advantage of this dynamics and social force, my patients are more likely to stay well. Firstly, they are more likely to follow the lifestyle advice. Secondly, ,any new immigrants come to me with cardiac problems that have psychosocial origin. They have stopped “Walking in Beauty”, having lost touch of their homeland and the familiarity of their ancestral home, and moved to this land called America. My role as a healer is to reconnect them to this new community and make them realize that they are not alone in the new land. We all belong to the same village, just like the Italian immigrants in Roseto Pennsylvania.
When I used to see the Upper East Side rich people, I realize many of these people are unhappy. Many of them are isolated in their own world. They may be rich and powerful, but the are not happy like my villager patients. My community may not be rich, but the people in my community are tightly knit. Therefore, despite the wealth gap, my Chinese patients live longer than the rich Upper East Side people. I routinely see patients who are 90 year old and above, who are healthy and happy. One guy even ran on my treadmill and I got bored watching him because he just kept going. Another 99 year old walked into my room and he looked like a 70 year old man.
My secret to seeing my patients stay healthy even after 90 year old: treat them like a family member in the same village, focus on health not sickness, emphasize lifestyle while minimizing unnecessary medications and procedures, personal responsibility in health, and above all, encourage development of strong community bond.