As a teenager, Elena Avila joined her high school’s nursing club and idolized those who wore the cape and the white cap. But after earning her BSN degree from the University of Texas and embarking on a career as a psychiatric nurse, she realized she’d left behind something very valuable from her past.
Avila first felt the need to reach back into her Chicana cultural heritage during her first assignment on a psychiatric ward. There she encountered schizophrenic patients who were very intelligent yet couldn’t survive outside the ward. The young nurse also realized that treatments offered to the mentally ill were limited and often ineffective.
“I felt so much compassion and confusion when I saw how the mentally ill were treated,” Avila recalls. “I didn’t see a lot of them getting well and it was painful to watch what their families when through. It was very sad.”
It was this dissatisfaction with the mental health care system that started Elena Avila, RN, MSN, Curandera, on a journey that began in 1974 and continues today. Her quest is to rediscover and practice the ancient art of curanderismo, the traditional folk medicine that has been handed down through generations of Mexican caregivers. The healing practices used by curanderos (male practitioners) and curanderas (their female counterparts) were developed out of a blending of Aztec, Spanish, Native American and African medicines.
The daughter of Mexican-born parents, Avila grew up in the barrios of El Paso, Texas, where her mother turned to curanderas in the neighborhood when the family needed medical care. The family’s reliance on curanderismo, which uses holistic treatments like herbs and massage, was prompted by both tradition and economic need.
“We were very poor and there were different women in the neighborhood who were curanderas,” Avila explains. “Some of them knew about herbs and some of them knew about setting bones. If you sprained your ankle, you would go to see that person. [People from] my culture had learned to survive by experimenting and relying on people in the community who knew about the body.”
But for many children of Mexican immigrants, assimilation into American culture was also an important part of survival. Wanting to blend into the melting pot of America, this new generation of Mexican Americans often left behind its old language and customs--including curanderismo.
“We lost so much because we felt the modern world had more to offer,” Avila says. The 30 years she has spent resurrecting the forgotten art of curanderismo have resulted in a successful private practice, a full schedule of speaking engagements and an acclaimed book.
When Avila first began her research into curanderismo in 1974, she had mixed feelings about the practice. Even though visiting curanderas was a familiar part of her childhood, the practice was not without controversy in the Chicano community.
“People were superstitious [about curanderismo], even in the community,” she explains. “It was seen as being old-fashioned. And some people felt that only a priest should be called to do certain cures. A curandera who did those could be viewed as a witch.”
Avila still carried some of those superstitions with her when she decided to journey across the border and learn more about curanderismo. “It was not an easy task for me to start studying the medicine, because I grew up with all those superstitions,” she remembers. “I believe I justified it to myself at the time by considering it research. But when I [went to Mexico and] began to apprentice with curanderas, I was amazed at what was there. In Mexico, there are still a lot of curanderas who set up and sell their medicines. I started hanging around and asking them questions.”
As a nurse, Avila still had some reservations about the curanderas. But she found the folk healers pleased to share their knowledge with a Western health care provider. “They were very open and very respectful to people in the medical profession,” she says.
This cooperation, it turns out, is a key principle of curanderismo. Avila stresses that a good curandera will be part of the team. Instead of discouraging a patient from seeking Western treatments, a curandera incorporates those and will freely refer patients to physicians and consult with the doctor.
As the young nurse discovered other principles, she found that curanderismo as it is actually practiced--both in Texas and in Mexico--was quite different from the way it was portrayed in studies she had read on the subject. “So much of what I read about it was silly and naïve,” she says. “When I actually studied it with a curandera and she explained it, there was a stark difference.”
Avila now believes that many of these early researchers failed to consider cultural traditions and differences when writing about folk medicine. A writer, for example, might interview a curandera who talked about a soul being lost but was speaking metaphorically. Researchers would not pick up the metaphor and the final report would tell of folk healers chasing souls.
In Avila’s private practice, the area of “lost souls” is a specialization. While curanderas do have gifts or natural abilities to treat certain ailments, specialties are viewed differently than in Western medicine. As a clinical psychiatric nurse specialist, Avila concentrates on matters of the mind. As a curandera, though, she treats mental illness without the mind/body dichotomy common in Western thinking. Body, mind and spirit all fall under her care.
Using this integrative approach to healing, Avila helps patients rebuild their inner self, or their soul. “So much of that [inner spirit] is lost through abuse, through traumatic events,” she says. “We have to nurture and develop it.
“I want to honor my culture and honor Western medicine and all the gifts it has offered,” she adds. “So I treat a person, not a diagnosis.”
Curanderismo’s belief that “heart heals heart” forms the basis of Avila’s practice and, indeed, her life. Each appointment with a patient begins with a conversation using Avila’s listening skills. As she’s listening and prodding, she’s noting medical clues. While she may use a traditional ritual in an effort to treat an illness, the principles of Western medicine never leave her mind. Indeed, while she practices ancient traditions, she’s often performing Western-style nursing assessments.
“If I am doing a massage and I notice a growth, then I know the importance of referring that person to a medical doctor,” she says. “Sometimes my patients have to take their medicine and I do encourage that. But I also have other [natural remedies] that work.”
Avila still encounters superstitious patients occasionally--and those superstitions aren’t centered just on curanderismo. On the other side of the cultural equation, some patients are suspicious of Western medicine. For example, sometimes the family of a patient diagnosed with schizophrenia or another mental illness doesn’t believe the diagnosis and instead believes their loved one has been cursed. “In these cases, I begin with education about mental illness,” Avila says.
Anyone spending a few minutes with Elena Avila will understand clearly that she is a very spiritual person. Although she refers to herself as a Chicana, her heritage is Mestiza, a combination of Native American (Mayan) and Spanish ancestry. Her beliefs, which draw on both Native American and Christian values, are a central part of her health care practice and she welcomes today’s renewed interest in spirituality among Western practitioners. Physicians and nurses often attend her workshops on fusing spirituality with modern medicine.
When incorporating prayer or other aspects of religion and spirituality into health care, practitioners must understand that the patient’s beliefs take precedence over their own, Avila stresses. For example, if a patient in her private practice is Catholic, a rosary might be included as part of the treatment process.
“As practitioners, it’s important that we learn to respect all spiritual beliefs,” she maintains. “[Before I begin to treat patients], I explain my beliefs and show the tools that I use, and I ask the patients if they are comfortable with that.
“Sometimes, as a nurse, you have to recognize that it’s not about you. It’s about the patient,” Avila continues. “Maybe the patient doesn’t want prayer. So many practitioners are discovering these concepts now and I think that’s good. But you have to realize what the needs of your patients are.”
Avila encourages other minority nurses to look back at their cultural heritage, whatever that may be, and embrace traditional healing methods that are still valid. “Start the path with an open heart and open mind,” she advises. “Don’t go into it blindly. Be willing to see [which traditional practices are] no longer valuable.”
Avila warns that not all folk medicine traditions should be brought into the modern American health care system. Importing herbs from other countries, for example, can be dangerous, because there are often no safeguards to guarantee their content and quality. She also cautions nurses to be wary of folk practices that contradict their formal nursing training. The two should instead complement each other.
“Use your own intuition to determine what feels right and what doesn’t feel right,” she recommends. “[When I did my research on curanderismo], I did see some [traditional practices] that were harmful, but it took my own discernment to determine what is still valuable for my patients.”
Much like her immersion into the world of curanderismo, Avila’s nursing career has also been a journey of self-discovery. Her dream of becoming a nurse was delayed by marriage at age 16 and the arrival of the first of her four children at 17. When her children were old enough, she went to work as a receptionist in a medical office, where the office nurse encouraged her to enter nursing school.
After earning her BSN degree in 1976, Avila obtained her master’s from the University of Texas in 1981, specializing in mental health with a minor in nursing administration. She held a number of administrative positions at health care facilities--including nurse manager of psychiatry, director of maternal/child nursing and director of a rape crisis center--before starting her private practice.
An accomplished poet, Avila began writing about her experience with curanderismo early in her journey. As her writings grew, she felt a responsibility to add to the literature published about these ancient healing practices passed down through generations of Mexican culture. Woman Who Glows in the Dark: A Curandera Reveals Traditional Aztec Secrets of Physical and Spiritual Health was the result. Published in 1999 by Tarcher/Putnam, Woman Who Glows in the Dark is, according to her publisher, the only title ever published that reveals the secrets of curanderismo from an authentic practitioner’s point of view.
Avila’s book seeks to not only expand the health care profession’s interest in curanderismo but also to correct some of the misinformed research studies she had read earlier in her career. “Most curanderas don’t write and their medicine is passed on orally,” she explains. “The book was another way I could share and teach.”
Her efforts to share curanderismo have taken her to Cuba, Spain, Germany and all across the United States. They have also brought her awards and national media coverage. But even with all of her accomplishments, speaking engagements and responsibilities, Avila still maintains her practice in Albuquerque, New Mexico. Healing is for her a reason for being.
“I don’t know what would have happened to me if I had not incorporated this into my life,” she says. “I feel like I was born to practice curanderismo and to be a nurse. One of the most beautiful things about rediscovering this medicine was discovering my own roots. To go back and be proud of who I am and proud of my people has been incredible.”
To learn more about Elena Avila, RN, MSN, Curandera, visit her Web site, www.elena-curandera.com.