The pain experience of traditional Crow Indian
by Norma Kay Krumwiede
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Nursing
Montana State University
© Copyright by Norma Kay Krumwiede (1996)
Abstract:
The purpose of this qualitative research study was to explore the pain experience of the traditional
Crow Indian people. An understanding of the Crow people's experience of pain is crucial in order to
provide quality nursing care to members of this population. As nurse researchers gain understanding of
these cultural gaps and report their findings, clinically based nurses will be better equipped to serve and
meet the unique needs of the traditional Crow Indian.
Ethnographic interviews were conducted with 15 traditional Crow Indians currently living on the
reservation in southeastern Montana. The informants identified themselves as traditional utilizing
Milligan's (1981) typology. Collection of data occurred through (a) spontaneous interviews, (b)
observations, (c) written stories, (d) historical landmarks, and (e) field notes. Spradley's (1979)
taxonomic analysis method was used to condense the large amount of data into a taxonomy of
concepts.
The taxonomy of Crow pain evolved into two indigenous categories of “Good Hurt” and “Bad Hurt”.
The Crow view “good hurt” as being embedded in natural life events and ceremonies, rituals and
healing.
The Crow experience "bad hurt” as emanating from two sources: loss and hardship. The Crow believe
that every person will experience both “good hurt” and “bad hurt” sometime during their lifetime. The
Crow gain knowledge, wisdom and status as they experience, live through, and learn from painful
events throughout their lifetime.
The research results can be used by health care professionals to better understand the Crow Indian
people. Greater understanding of the cultural dimensions of pain will help health care professionals
develop an effective approach to providing quality pain management to the Crow Indian population. THE PAIN EXPERIENCE OF TRADITIONAL
CROW INDIAN
by
Norma Kay Krumwiede
A th esis subm itted in p artial fulfillment
of th e requirem ents fo r th e degree
of
Master of N ursing
MONTANA STATE UNIVERSITY-BOZEMAN
Bozeman, Montana
May, 1996
© COPYRIGHT
by
Norma Kay Krumwiede
1996
All R ights R eserved
ii
APPROVAL
of a thesis subm itted by
Norma Kay Krumwiede
T his th esis has been read by each member of th e th esis committee and
has been found to be satisfacto ry reg ard in g content, English usag e,
form at, citations, bibliographic sty le, and consistency, and is read y for
submission to th e College of G raduate Studies.
D r. Helen Lee
Signature
Date
A pproved for th e Departm ent of N ursing
PLj). , Pa I. yj'ikt
D r. Kathleen Chafey
S ignature
Date
A pproved for th e College of G raduate Studies
D r. R obert Brown
Signature
Date
ffi
STATEMENT OF PERMISSION TO USE
In p resen tin g th is th esis in partial fulfillment of th e .requirem ents
fo r a m aster's d egree a t Montana S tate U niversity-B ozeman, I a g ree th a t
th e L ib rary shall make it available to borrow ers u n d e r ru le s of th e L ib rary .
If I have indicated my intention to copyright th is th esis by
including a copy rig h t notice page, copying is allowable only fo r scholarly
p u rp o se s, con sisten t with “fair u se” as p rescrib ed in th e U .S . C opyright
Law. R eq u ests fo r perm ission fo r extended quotation from or reproduction
of th is th esis in whole or in p a rts may be g ran te d only by th e copyright
ho ld er.
S ignature
Date
lI-
I H— £
iv
The th esis is dedicated to th e family and frien d s of C lara B ends.
The inspiration and motivation fo r m aster's stu d y and
investigation of th is m aster's th esis was initiated
when working for Clara B ends.
ACKNOWLEDGEMENTS
The continuous su p p o rt and encouragem ent from family, frie n d s,
and professional acquaintances w ere g reatly ap p reciated . The su p p o rt of
my family b ro u g h t hope and humor to an often in ten se p ro ce ss. T hanks to
my p a re n ts , Maralyn and Gary Krumwiede, to K urt and Kelly Krumwiede,
and to my grandm other, Elsa S u te r, for not allowing me to q u it and s ta r t
raisin g c h ick en s! A h e a rtfe lt th an k s is extended to th e 15 p articip an ts
in th e stu d y whose valued th o u g h ts, openness, and time no t only provided
a rich source of data, b u t also enriched my life.
The th esis committee members included D r. Helen Lee, D r. Jan
B u eh ler, and Wendy Blakely. I am gratefu l for your u n d e rsta n d in g ,
p atience, and m entorship. I also th an k D r. R obert Snider who remains
a stead y and accu rate reality check and offered exposure and in sig h t
to re s e a rc h . Your kindness and encouragem ent never fell on deaf e a rs.
Recognition is extended to Lucille Hill for dependable and excellent
secretarial help. Your u n d erstan d in g of time fram es and y o u r caring w ere
g reatly ap p reciated . I th an k Isaac and Mary Jane B irdinground fo r time
sp e n t a t Crow Fair and exposure to th e Crow way of life.
Finally, I w ant to th an k my close frie n d s, R obert H ector, A rt
Jacobson; Carol T en n y , Lori S h e rry , th e Wolfe and Meiers families for
p articip atin g in th e chaos and tran sitio n s. Your devoted frien d sh ip and
su p p o rt along th e way was greatly needed and ap p reciated .
vi
TABLE OF CONTENTS
Page
I.
INTRODUCTION...................................................................................................I
REVIEW OF LITERATURE
.......................................................................
IO oo
2.
I
CM CM CO O ' m
P urpose of Study
.................................................................................
Conceptual Framework .
P a i n ...........................
C u l t u r e ....................
Personal Experience
D e f in itio n s ..............
Pilot S t u d y ..............
Significance of S tudy .
10
The C r o w .................................................................................................. 10
The Crow of th e Buffalo Days ............................................................. 12
T ribal O r i g i n s ................................................................................. 12
Crow R ituals and Customs .......................................................... 16
The A rrival of S tran g ers in Crow T e rrito ry . .............................20
T he Crow of Modern D a y s ....................
23
3.
METHODOLOGY ...................................................................
26
Design of Study .........................................................................................26
Human S u b je c ts ............................................................................................ 26
Population . . . * ...................................................................
27
S a m p le ..................................................
28
Data Collection . . . . . . . ..................................................................... 29
Data Analysis
................. ................ ................................. ... . 32
Validity and R e lia b ility ..............................................
35
vii
TABLE OF CONTENTS — Continued
4.
ANALYSIS OF DATA
....................................................................................
37
Qualitative A n a l y s i s ........................................
37
F in d in g s ..........................................................................................................39
Good H urt ............................................................................................ 40
N atural Life E v e n t s .....................................................................40
C h ild b ir th ...............................................................................40
Death ......................................................................................41
H e a lin g ............................................................................................ 42
Traditional P r a c t i c e s ...........................................................42
Modern Medicine ..................................................................48
Bad H u r t ................................................................................................49
Loss ................................................................................................50
Mass A n n ih ila tio n ................................................................. 50
Death ....................
51
Former Way of L i f e ..............................................................52
F u tu re of C h i l d r e n ..............................................................56
H a r d s h ip .........................................................................................59
H istorical T ransitions ....................................................... 59
Social P r o b le m s .....................................................................62
Illness and D is e a s e ........................................
69
Summary of F in d in g s .................................................................................. 72
5.
DISCUSSION............................................... ... . . ......................................... 74
Summary of th e Study ...............................................................................74
Findings and Im p lic a tio n s ........................................................................ 75
B e n e f i t s ....................................................................................................
80
Limitations ...................................................................................................81
Recommendations fo r F u rth e r S t u d y ....................................................82
REFERENCES
................
APPENDICES . ' ................................................................................
A. R esearch Questions ..................................................................
B . Taxonomy of Crow Pain ................................................................
84
88
89
90
viii
LIST OF FIGURES
F igure
I.
Main S tudy Taxonomy of Crow Pain
Page
38
ix
ABSTRACT
The p u rp o se of th is qualitative resea rch stu d y was to explore th e pain
experience of th e traditional Crow Indian people. An u n d e rstan d in g of th e
Crow people's experience of pain is crucial in o rd er to provide quality
n u rsin g care to members of th is population. As n u rse re s e a rc h e rs gain
u n d e rstan d in g of th ese cultu ral gaps and re p o rt th e ir fin d in g s, clinically
based n u rse s will be b e tte r equipped to se rv e and meet th e unique needs of
th e trad itio nal Crow Indian.
E thnographic interview s w ere conducted with 15 traditional Crow
Indians c u rre n tly living on th e reserv atio n in so u th eastern Montana. The
inform ants identified them selves as traditional utilizing Milligan's (1981)
typology. Collection of d ata occurred th ro u g h (a) spontaneous interview s,
(b ) o b serv atio n s, (c) w ritten sto ries, (d ) historical landm arks, and (e)
field n o tes. Spradley's (1979) taxonomic analysis method was u sed to
condense th e larg e amount of data into a taxonomy of c o n cep ts.
The taxonomy of Crow pain evolved into two indigenous categories
of “Good H urt” and “Bad H u rt”. The Crow view “good h u r t” as being
embedded in n a tu ra l life events and cerem onies, ritu a ls an d h ealin g .
The Crow experience "bad h u rt” as emanating from two so u rc e s: loss
and h a rd s h ip . The Crow believe th a t ev ery person will experience both
“good h u r t” and “bad h u r t” sometime d u rin g th e ir lifetime. T he Crow gain
know ledge, wisdom and sta tu s as th ey experience, live th ro u g h , and learn
from painful ev en ts thro u g h o u t th e ir lifetime.
The rese a rc h re s u lts can be u sed by health care professionals to
b e tte r u n d e rsta n d th e Crow Indian people. G reater u n d e rstan d in g of th e
c u ltu ral dimensions of pain will help health care professionals develop
an effective approach to providing quality pain management to th e Crow
Indian population.
I
CHAPTER I
INTRODUCTION
N ursing re se a rc h e rs and p ractitio n ers recognize th e concept of c u ltu re
as a major variable th a t influences an individual’s rea ctio n , expression,
and definition of p a in . E arly childhood teachings form th e basis of th e
in d iv id u al's a ttitu d e s and reactions to pain. The individual lea rn s how to
e x p re ss p a in , re a c t to p a in , and seek relief for p a in .
An individual's pain experience is cu lturally based (V illarruel &
Ortiz de Montellano, 1992). H arding (1981) conveys th a t traditional beliefs
and behaviors continue to influence th e modern Crow people:
C u ltu re is viewed as a major variable in th e determ ination of health
and in th e utilization of health care serv ices. C ulture influences
th e development and maintenance of many health p ra c tic e s. The
p re s e n t Crow Indian c u ltu re consists of diverse c o n tra st between
trad itio nal and modern life sty les (p . I ) .
T h u s, to provide culturally congruent n u rsin g care to th e Crow people, it
is essential to f ir s t identify and u n d e rsta n d th e cu ltu ral background of th e
trad itio n al Crow people.
Purpose of Study
No stu d ies which re p o rt th e pain experience of Crow people were
located. Lack of c u ltu ral knowledge co n trib u tes to m isunderstandings
2
betw een Native Americans and non-N ative Americans. The specific
p u rp o se of th is qualitative resea rch stu d y was to d escribe and define th e
experience of pain fo r traditional Crow.
Conceptual Framework
Pain
McCaffery (1968) has sta te d , "Pain is w hatever th e experiencing
p erso n say s it i s , existing w henever th e experiencing person says it does”
(p . 95). Jean s and Melzack (1992) and th e members of th e International
Association fo r th e S tudy of Pain (1979) su p p o rt McCaffery’s definition th a t
pain is a personal and subjective experience. The pain experience consists
of physiological and psychological asp ects which a re influenced by c u ltu ral
teach in g s, cognitive variables, and psychological v ariab les. The focus of
th is stu d y is th e effect of cu ltu re on th e experience of pain.
Members of th e Crow T ribe a re a t g re a t risk of inadequate pain
assessm ent and pain management. As a whole, th e trib e has a cultu ral
trad itio n v astly d ifferen t from th e general p atien t population. Many
members of th e Crow T rib e, p articu larly elderly p e rso n s, speak only th e
trad itio n al Crow Language. C onsequently, th e Crow population fits th e
definition of a vulnerable ru ra l population (B u sh y , 1991).
3
C ulture
C u ltu re is a complicated linkage of values, beliefs, p rac tic es, laws,
tra d itio n s, custom s, a rtifa c ts , knowledge, language, and p a tte rn s of
behavior p assed down from generation to generation w ithin a cultural
group (B ranch & P axton, 1976; Hartog & H artog, 1983), T hrough th e
socialization p ro c e ss, th e cu ltu ral settin g shapes th e individual's th o u g h ts
and actions in relation to a pain sensation. The socialization process
teaches th e individual th e following about pain: (a) w hat is expected;
(b ) w hat is acceptable behavior; (c) which responses a re a p p ro p riate;
(d ) who should be told about th e pain sensation; and (e) which pain
sensations need immediate attention (A bu-saad & T e sle r, 1986) .
Watson (1979) believes th a t cu ltu re has a stro n g influence on th e
in d iv id u al's pain th resh o ld and th a t th e most noticeable difference between
c u ltu re s re la te to pain tolerance. The research Conducted by Zborowski
(1952, 1969) dem onstrates th a t individuals raised in d iffe re n t cultu ral
se ttin g s perceive and e x p re ss pain differen tly .
T he ex perience of pain is culturally specific. Perception of pain
is an individual process which depends on th e unique fac to rs of th a t
individual. T h u s, th e cultu ral beliefs of th e Crow T rib e g rea tly influences
th e pain experience of th e individual Crow person. The individual's
resp o n se to pain is based on personality, social/cultural influences and
4
personal experience. As n u rse s provide care, it is im portant to
u n d e rsta n d th e effect th a t cu ltu re has upon th e individual.
Personal Experience
Working as a R egistered N urse a t a regional medical c e n te r, I f ir s t
became aw are th a t th e behavior p a tte rn s of Native American and non-N ative
American p atien ts differ in re g a rd to p a in . The Native Americans I cared
fo r seldom verbalized pain and did not take as much medication fo r pain as
did non-N ative American p a tie n ts. Many Native Americans also req u e ste d
th a t trad itional “medicine men” be p re s e n t to a ssist with healing and
dealing with pain.
The second aw areness occurred while conducting re se a rc h on p atien ts
with low back pain fo r an orthopedic su rg eo n . One of th e resea rch
questions utilized d u rin g th e intake interview for a low back pain stu d y
w as, "If '0’ is no pain, and '100' is pain so bad you could live fo r only
a few m inutes, w hat num ber says how bad your pain usually is?” (S nider
Evaluation Tool, 1992, u n p u b lish ed ). The Native American p atien ts w ere
unable to answ er th is q u estio n . I t soon became clear th a t th e linear scale
of 0-100 proved to be an ineffective way to determ ine pain level for th e
N ative American population.
T hese experiences motivated me to attem pt to fill th e lack of cultu ral
information p ertaining to pain in hopes of providing im proved n u rsin g care
to p a tie n ts. I chose to stu d y th e Crow Native Americans of so u th eastern
5
Montana because of location and personal experiences while w orking with
Crow p atien ts and th e ir families.
Definitions
Milligan's (1981) Belief and Behavior Typology has been adapted for
th e stu d y . Milligan's typology consists of th re e categories: (a) Modern:
Developing th e new beliefs and behaviors which a re co n sisten t within th e
c u rre n t life sty le; (b ) T raditional: Maintaining th e belief and behaviors
th a t have p e rsiste d fo r generations; (c) T ransitional: Maintaining some of
th e beliefs and behaviors th a t have p e rsiste d for generations b u t also
developing some of th e new beliefs and behaviors th a t a re co n sisten t with
th e c u rre n t life sty le.
The following definitions by Wood (1993) have been provided to clarify
th e term inology in C hapter 2. T hese definitions include (a) B and: A small
group of Crows who lived and trav eled to g eth er; (b ) Clan: A group of
Crow fam ilies, th e members of which believed them selves to be v e ry closely
rela te d ; (c) R eservation: A tra c t of land se t aside by th e U .S . Government
fo r u se b y a specific group of Native Americans; and (d ) T rib e: A group of
people th a t sh a re a language, c u ltu re, and religious beliefs.
Pilot Study
As p a rt of an ethnographic stu d ies n u rsin g course a t Montana S tate
U niversity-B ozem an, an initial ethnographic stu d y of Crow Pain was
6
conducted d u rin g th e fall of 1992. The pu rp o se of th e stu d y was to explore
th e pain experience of Crow people.
The c u ltu ral group studied was th e Montana Crow Indians c u rre n tly
living on th e Crow Indian R eservation. Individual interview s were
conducted in th e towns of Lodge G rass, G arryow en, and Crow A gency.
My goal was to seek out and learn from th e "wise ones” and to become
aw are of th e ir p ersp ectiv e of th e pain experience. The "wise ones have
lived many y e a rs and have learned about th e many h u rts of life”
(p erso n al communication with key inform ant, October 1992).
The stu d y design consisted of ethnographic interview s and analysis
( S p rad ley , 1979). I became deeply involved in th e Crow cu ltu ral scene and
th is involvem ent enabled me to interview Crow people who had e x p e rt
knowledge. In th e unfam iliar cultural se ttin g , I became th e stu d e n t and
estab lish ed th e role of th e inform ant as an e x p e rt tea ch e r.
Collection of d ata occurred th ro u g h (a) spontaneous interview s, taped
when allowed; (b ) general observations; (c) w ritten sto rie s; (d ) historical
landm arks; and (e) field n otes. Examples of questions ask ed appear in
A ppendix A.
The resp o n se from a v e ry elderly key inform ant to th e question
“What is pain?” formed th e two main headings of th e Crow pain taxonomy.
The answ er was “Pain is good h u rt and bad h u rt” (personal communication,
7
O ctober 1992). The resu ltin g taxonomy of Crow pain evolved into two
c o n trastin g se ts - Good H urt and Bad H u rt (see A ppendix B ).
S p rad ley's (1979) taxonomic analysis method was u se d to condense th e
larg e amounts of information from interview s into a taxonomy of co n cep ts.
The taxonomic method searches for an in terv al framework of domains to lead
th e re se a rc h e r to identify contrasting s e ts . Each interview tra n s c rip t was
coded and p e rtin e n t information related to pain was e x tra c te d and placed
onto c a r d s . A c ard so rt method was th en u sed to break th e d ata into
categ o ries. As each category collected more c a rd s, a c u ltu ral theme
evolved. The taxonomy of Crow pain evolved from th e d ata collected.
I t was evident from th e initial ethnographic stu d y th a t th e prim ary
focus of th e follow up stu d y needed to be extended. Themes were
identified b u t complete saturation had not occu rred . F u rth e r refinem ent
of th e taxonomy was needed th ro u g h fu rth e r stu d y of (a) Crows'
ex p ressio n of pain, (b ) Crows' experience of acute a n d /o r chronic pain,
and (c) Crows' perceptions of acute a n d /o r chronic pain. D irections from
th is initial rese a rc h include (a) inquiring about th e “wise ones”,
(b ) “sending word” to th e key inform ant, and (c) allowing time for
interview s to evolve.
8
Significance of Study
According to L eininger (1978) th e holistic view of n u rsin g d irec ts th e
profession tow ard a tra n sc u ltu ra l approach. The n u rse m ust consider th e
c u ltu ral u n iqueness of th e p atien t when establishing a plan of c are.
N ursing m ust be sensitive to individual n e e d s. N urses m ust also be
knowledgeable about th e cu ltu res from which th e ir p atien ts o riginate.
A b ro ad er knowledge, appreciation, and u n d erstan d in g of d iv erse c u ltu res
will b rid g e th e communication difficulties between care g iv er and th e
c are rec eiv e r.
An u n d e rstan d in g of th e Crow people's experience of pain is crucial
in o rd e r to provide quality n u rsin g care to members of th is population.
As n u rse re se a rc h e rs gain u n d erstan d in g of cultu ral gaps and document
fin d in g s, clinically based n u rse s will be b e tte r equipped to se rv e and meet
th e u n ique needs of th e Crow people. N urses take p rid e in providing
holistic care; how ever, u n til th is c u ltu ral gap is filled, n u rse s lacking a
tr u e u n d e rstan d in g of Crow cu ltu re may be less effective a t caring fo r th e
Crow people.
T his stu d y provides a basic u n d erstan d in g of th e role of pain as a
major v ariable as it p e rta in s to th e Crow people. D escriptive d ata w ere
g a th e red about traditional beliefs and behaviors th a t affect th e experience
of p ain . T he rese a rc h re s u lts can be u sed by health care professionals to
9
b e tte r u n d e rsta n d th e Crow people. G reater u n d e rstan d in g of th e c u ltu ral
dimensions of pain will help health care professionals develop an effective
approach to providing quality pain management to th e Crow population.
10
CHAPTER 2
REVIEW OF LITERATURE
The Crow
In th e pilot stu d y , it became a p p aren t th a t th e pain and h ard sh ip th a t
Crow an cesto rs had experienced, th e modern Crow also consider th e ir pain
and h ard sh ip to th is day. T herefore, it was necessary to fully u n d e rsta n d
th e c u ltu re of th e Crow people from a historical p ersp ectiv e in o rd e r to
thoroughly resea rch th e meaning of pain to th e Crow people.
The lite ra tu re review is a sy n th esis of ethnographies by Rodney Frey
(1979, 1987) and R obert H . Lowie (1954, 1956, 1963, 1993). Additional
lite ra tu re about th e Crow from Algier (1993), Hoxie (1989), L indem an
(1932, 1957, 1962, 1972, 1974), Nabakaov (1967), Utley (1979) and Wagner
& Allen (1987) was also u sed to su p p o rt th e historical sy n th esis of e v en ts.
The Crow a re an indigenous trib e of N orth American Plains Indians.
The Crow a re essentially plainsmen who have lived in so u th eastern
Montana fo r generations. In lite ra tu re , th e Crow have been re fe rre d
to as “A bsarokee”, "Apsaalooke", “A psaruke”, and “Kite”. The
Apsaalooke name tra n sla te s to "the children of th e long-beaked b ird ”
( Lovzie, 1993, p . I ) .
11
The Indian c o u n try had a wealth of n atu ral reso u rces and th e
E uropeans w ere v e ry in te re ste d in th e reso u rces and m aterial items th a t
ex isted in th is c o u n try . When Europeans began to occupy th e Indian
c o u n try , problems developed as th ese v e ry d ifferen t c u ltu re s came
to g e th e r. The Europeans did not recognize nor u n d e rstan d th e im portance
of th e sp iritu a l, cu ltu ral, and intellectual riches which th e Native
Americans exhibited. The Europeans' religious b ig o try , c u ltu ral biases
and m aterialistic world view p rev en ted th e Europeans from u n d e rstan d in g
th e Native Americans.
The Native Americans were confused with th e various views of th e
dominant society. Francis Parkm an, a 19th c en tu ry h isto rian , sta te d
"Spanish civilization cru sh ed th e Indians; English civilization scorned and
neglected him; French civilization embraced and cherished him” ( Hoxie,
1989, p . 7 ). The p re s su re s of all th e colonial expansion forced th e Crow as
well as o th er Native American trib e s to move w estw ard. T he trib e had to
change from being a settled group to a nomadic people, who relied on
h u n tin g and followed game in o rd er to su p p o rt th e diet in stea d of raising
corn and sq u a sh . Native Americans actively and passively re siste d
annihilation and refu sed to relinquish th e unique id en tity of Native
American c u ltu re and be assim ilated into th e dominant society.
12
The Crow of th e Buffalo Days
T ribal O rigins
N ative American trib e s in North America sp e n t much of th e p a st 12,000
y e a rs h u n tin g antelope for meat, g athering edible seeds and b e rrie s,
planting an d raisin g squash and corn and being v e ry a ttu n ed to living in
harm ony with n a tu re . In th e y e ars following th e Ice Age, th e receding of
th e glaciers left abu n d an t game and p lant life. Native Americans trav eled
th e g re a t plains in small b an d s, hunting game and g ath erin g plan ts for
food. The trib e moved from place to place with th e seasons determ ined by
th e availability of th e food so u rc es.
O riginally, th e e n tire Crow T ribe lived to g eth er in small villages
of dome shaped dwellings made from wood, g rass and mud. Each lodge
housed sev eral families living in v e ry close q u a rte rs . As th e trib e became
more nomadic, it became necessary to sp lit into sm aller, more efficient
g ro u p s, called b a n d s. T hese small nomadic bands then liv ed , trav eled ,
and h u n ted independently thro u g h o u t th e a re a. The camps consisted of
tepees c o n stru cted from a wooden fram e covered with animal sk in s, well
su ited to th e lifestyle of such a nomadic people. The tepees could be
easily se t up and quickly taken down.
In th e w in ter, bands of Crow camped along th e u p p e r Missouri R iver
in th e valleys of th e Rocky Mountains. The topography of th e se regions
I
13
p ro tected th e Crow from cold w inters and th e heavy snow s. In th e sp rin g ,
th e bands would trav e l to areas w here rh u b a rb , stra w b e rrie s, and wild
tu rn ip s grew . L ater th e bands would search fo r chokecherry b u sh e s, plum
tre e s and o th er wild plants covered with rip e fru it. All y e a r long th e
Crow h u n ted in small p a rties for ra b b it, d e er, and elk. Each summer all
th e bands would u n ite for a g re a t buffalo h u n t. This was a special occasion
which allowed th e Crow to meet with families, v isit with frie n d s, exchange
sto rie s, and couples w ere m arried.
T he ideals of gen ero sity , b ra v e ry and loyalty c o n trib u ted to th e
stre n g th and ch arac ter of th e Crow people. The Crow's u tilitarian
philosophy to do what was b e st for th e e n tire group is th e essence of
Crow way of life.
A t th a t time, th e religious leaders controlled th e ceremonies and th e
eld ers made all th e political decisions. The elderly women owned and
farm ed th e garden plots th a t provided food. The early villagers w ere less
a ttra c te d to th e Plains te rrito ry th an to th e rich farm land on th e Missouri
R iv er. However, th e villagers soon came to know th e im portance of game in
th e g rasslan d s and began to h u n t th e buffalo for food an d fo r h ides.
The Crow T ribe made th e transition from farming to a h u n tin g and
g ath erin g trib e (Hoxie, 1989). The trib e tra d e d with th e F rench tra d e rs
and tra p p e rs , established tra d e netw orks, and communicated information to
th e dominant society. Techniques and skills w ere passed from th e dominant
14
society to th e Crow trib e . Some Crow learned new techniques of
a g ric u ltu re and sought fertile land and good sources of w ater in which to
estab lish communities. T rying to live harmoniously on th e same land was
one of th e major conflicts between th e dominant society and Native American
tr ib e s .
The Crow people w orked, trav eled , and developed a unique way of life,
one d istin c t from o th er g ro u p s, both Native American and non-N ative
American. The Crow m aintained all im portant in stitu tio n s in mobile form;
fo r example, in stru ctio n was not provided in school houses, b u t in tep ees.
The Crow did not find sp iritu ality in th e building as did th e dominant
people, b u t ra th e r in sacred places or in special objects th a t would be
c arried from camp to camp. The tru e meaning of life was not to be
discovered in a perm anent settlem ent with m aterialistic objects, b u t was
found in th e h e a rts and minds of th e Native American people.
An im portant dimension of Crow cu ltu re is th a t each trib a l member
belongs to a clan. Each clan is composed of a group of rela te d families,
th u s th e groups in th e Crow societies include many more people than th e
small nuclear families typical of th e dominant society. Clan members have a
v e ry special and close relationship with one an o th er. In fa c t, each clan is
so intim ately rela te d , th a t a man and woman from th e same clan cannot
m arry.
15
H istorically, th e clan system provided many role models fo r th e
c h ild re n . Members of th e same clan a ssiste d one another with special
religious ceremonies and hunting trip s , and sh ared p rid e in each o th e r's
good fo rtu n es in b a ttle . While members of th e dominant society place
emphasis on an individual's occupation or personal accomplishment, th e
Crow people value family tie s. The Crow a re bound to g eth er by a stro n g
kinship and by a uniform se t of cultural b eliefs.
To th is d ay, th e Crow observe a s tric t code of behavior based on
relationship to one a n o th er. The y o u n g sters a re expected to re sp e c t th e
eld ers within th e clan, known as clan uncles and clan a u n ts , who a re often
called m other or fa th e r. A dults would honor th ese relativ es by giving
special g ifts , a d d ressin g th ese relatives with special d ig n ity , and by
sh arin g meat from huntin g expeditions. Each Crow relationship calls for
d ifferen t behavior.
The Crow believe th a t certain relatives m ust be avoided; fo r in stan ce,
m arried men and women a re not perm itted to speak with p a re n ts-in -la w .
C hildren of men who belong to th e same clan a re called joking cousins.
T hese cousins a re expected to keep each oth er in line th ro u g h constant
rib b in g and joke playing. The Crow believe th is form of discipline is
much more effective than h a rsh punishm ents such as th e dominant society
in flicts. H istorically, th ese customs w ere all v ery im portant to th e Crow
society as cooperation among th e trib e 's people was essential fo r survival
16
as th e trib e trav eled from camp to camp. Even though th e family s tru c tu re
and th e customs a re v e ry confusing to o u tsid e rs, notable is th a t th ese
customs still have g re a t practical value to th e Crow.
Crow R ituals and Customs
H istorically, th e most prom inent societies were com prised of young men
who had gained honor in b attle and had acquired skills needed to defend
th e Crow homeland. Members within each w arrior society competed for
honor and g lory. The societies participated in public p arad es and took
g re a t p rid e in group su c ce sses, established unique custom s, and chose a
society lead er. To be a w arrior society lead er, a man had to do four
th in g s: lead a war p a rty , cap tu re an enemy h o rse, be th e f ir s t to touch
an enemy in b a ttle, and snatch an enem y's weapon. The w arrior who
achieved th ese g re a t feats was called “Eacheeitche1"', which meant
“big man”. The non-N ative Americans called th ese men ch iefs. The Crow
lead ers w ere given d ifferen t responsibilities. For example, th e elders of
th e clan se ttled family disputes and advised th e chief, holy men and women
perform ed th e cerem onies, and Medicine Men knew th e medicinal p ro p erties
of h e rb s and oth er means of curing illnesses.
A ceremony p racticed by th e male Crow is th e “vision q u e st” during
which a man trav eled alone to a remote a re a . The man p ray e d to th e
c re a to r asking for guidance through a sp iritu al vision. Upon successfully
seeing a vision, a sp irit would appear and offer in stru ctio n s or directions
17
on how to live. The sp irits often took th e form of an animal such as a b e ar
o r buffalo and th is animal would then become his gu ard ian . Sometimes th e
man would make an offering of his flesh to th e c reato r to e n su re th a t th e
vision q u e st would be successful.
A nother ritu a l im portant to th e Crow people was th e original
su n dance. This ceremony was usually held in th e summer and cen tered
aro u n d w arrio rs who w anted revenge for a frien d or a close relativ e who
died in b a ttle . The skin of th e pledger was pierced with lea th e r th o n g s.
As o th er p articip an ts danced, b eat drum s and san g , th e d ancer would fall
into a tra n c e d uring which a vision would ap p ea r, providing confidence to
be successful in avenging and punishing th e enemies for th e death of a
frien d o r relativ e.
Several days w ere sp e n t p rep arin g for th e sun dance. The ceremony
was usually assiste d by a holy man and an elder who became th e man’s
su n dance fa th e r. The men organized th e dan cers, sin g e rs, drummers and
fellow w a rrio rs, and helped build th e sun dance lodge. Sacred objects
w ere assem bled and placed in th e lodge. The organizers made special
costum es, g ath ered buffalo tongues to feed th e p a rtic ip a n ts, and p rep a red
th e p led g er for th e ordeal th roughout th e following d a y s. The organizers
also made a sun dance doll, believed to possess g reat sp iritu a l power.
T hese sun dance dolls w ere usually made to match w hatever was seen
18
d u rin g th e vision q u e st. The dolls w ere k e p t p rotected and th en passed
on from one generation to th e n ex t.
The young w arrior (p led g er) would emerge from his tepee and move
stoically and solemnly to th e sun dance lodge a t which time an elaborate
dance would begin. The pledger was continually encouraged by family,
frie n d s, sun dance fa th e r, and fellow w arriors to dance rhythm ically with
th e beating of th e drum s. Most of th e dancers stopped from time to time,
b u t th e p ledger continued to dance. The pledger was nev er allowed to
r e s t, and needed to dance continuously. An eagle bone w histle was blown
in time with th e drum b e a ts. The sun dance fa th e r's doll was suspended
before th e pledger th ro u g h o u t th e dan cin g . The pledger would sta re a t
th e doll u n til falling into a deep tra n c e . I t was in th is tran c e-lik e
sta te th a t th e pledger would receive a vision.
The Crow had specific task s which w ere linked to women's work an d to
men's w ork. The girls w ere in stru c te d on how to b u tch e r buffalo, how to
p ro cess th e buffalo h ides, and how to make tools. The g irls learned how
to sew le a th e r into moccasins, tep ees, and clothing. Women w ere also th e
g u ard ian s of th e h u sb a n d 's shields and w ere in charge of most of th e
d ay -to -d a y activities within th e Crow camp. The boys w ere ta u g h t how to
scout fo r enemies and to tra c k game and w ere encouraged to do th is a t a
v e ry early age. The boys w ere th en p rep a red to defend th e camp, go on
enemy ra id s , and provide food for th e clan. However, th e re was no s tric t
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division of lab o r. If a woman showed specific skills in a m an's ta s k , th e
woman was allowed to proceed with it. If a man showed in te re s t in women's
w ork, it was acceptable to engage in th a t w ork. It was im portant th a t each
individual do w hatever p articu lar skill or activity th a t th e person was well
su ited to do.
The Crow's traditional form of governm ent was well su ited fo r th e
custom ary way of life and maintained th e cohesiveness of families and
communities. Leforge was able to observe how th is historical political
system o perated th ro u g h th e trib e ( Hoxie, 1989). Leforge rep o rte d th a t
th e Crow "had among them selves law and o rd e r, more effectively p rev alen t
th an among any community of white people I have known. T heir laws w ere
few, b u t th ey w ere well enforced” (Hoxie, 1989, p . 42).
One asp ect of Crow trib a l life most difficult for people to appreciate was
th e religious life. Larocque (Hoxie, 1989) in te rp re te d th e Crow's beliefs as
good and bad sp irits and th e suprem e m aster of life. Larocque considered
th e Crow a v e ry deeply religious people, despite th e fac t th a t th e Crow did
not have any perm anent ch u rch es. Sunday was not th e only day th a t one
ob serv ed religion. The Crow believed th a t th e trib e was blessed by th e
c re ato r of th e e a rth , and th a t th e creato r was never fa r aw ay. Crow
religious beliefs w ere a p a rt of th e Crow individual each and ev ery day,
w hereas non-N ative American people b u ilt monuments fo r religion and
re se rv e d Sunday as a day to be religious. As sta te d e a rlie r, th e Crow
20
re g a rd e d th e ir homeland as proof of th e c re a to r's p resen ce. Because th e
c re ato r was n e arb y , th e Grow people believed th a t th e c re ato r could be
contacted th ro u g h special ceremonies such as th e vision q u e st and th e
su n dance.
While special ceremonies w ere im portant religious ritu a ls to th e trib e ,
th e time taken for th ese ritu a ls to occur was minimal compared to th e time
sp e n t in ev eryday religious life. Grow religion and visions w ere sought on
a co n sisten t b asis. The Crow c arried “medicines” which ran g e d widely in
size and pow er. The objects could be v e ry small articles such as a tooth
of an animal or a ro ck , or v e ry larg e bundles th a t held a v a rie ty of sacred
objects fo r an individual. Some of th ese items had been "told” to th e Crow
man d u rin g a vision q u e st. These items w ere th o u g h t to have special
pow er, req u ire d special care, and w ere c arried with th e trib e from camp
to camp.
The im portance of th is discussion is to u n d e rstan d how o u tsid ers
believed th e Grow lived a v e ry fre e and u n stru c tu re d way of life, y e t
o u tsid ers failed to appreciate th e v e ry deep sense of group responsibility
th a t th e Crow people felt and dem onstrated.
T he A rrival of S tra n g ers in Crow T e rrito ry
S tra n g e rs e n tered Crow te rrito ry fo r several reaso n s. Some fu r
tra d e rs came seeking tra d e with th e Native Americans while some came ju s t
fo r th e sen se of a d v e n tu re . S ettlers th en followed th e f u r tra d e rs ,
21
trav elin g w estw ard in covered wagons seeking a new way of life. T hese
stra n g e rs introduced th e Native Americans to new custom s, new ideas, and
basically changed th e Native Americans' way of life fo re v e r. The fu r tra d e
b u sin ess seemed to be v e ry good for th e Native A m ericans, b u t
u n fo rtu n ately , th e non-N ative Americans not only in troduced foreign goods
b u t also foreign diseases such as smallpox and m easles. T hese diseases
sp re ad quickly among th e Crow and w ere usually worse d u rin g th e w inter
when bands sh a red v e ry close q u a rte rs . However, th e Crow quickly
learn ed to a d ap t and also how to contain an outbreak of smallpox or an
o u tb reak of m easles. When an individual became infected in th e g ro u p , th e
Crow would sp lit off into v e ry small groups and sc attere d in d ifferen t
d irectio n s. In th is way th ese v e ry small groups were able to isolate
them selves from th e v ir u s .
In 1887, th e N orthern Cheyenne T ribe honored Sword B earer for
b ra v e ry shown d uring a sun dance cerem ony. Sword B earer was given
in creased a u th o rity and th e su p p o rt of th e Crow people. L ater on th a t
summer, Sword B earer led a successful raid and upon re tu rn in g , as was
th e custom , celebrated victory by ru n n in g through th e camp, yelling and
firin g rifles into th e a ir. The celebration got c arried away and la ter
Army troops attem pted to a rr e s t Sword B e are r. When Sword B earer would
not subm it th e soldiers opened fire , killing Sword B earer and eight o th er
Crow w a rrio rs.
22
With th e death of Sword B earer vanished th e Crow's la s t hope fo r
re tu rn in g to th e old way of life. A fter th is la st act of b ra v e ry ,
Washington officials became v e ry s tric t and w anted to divide th e Crow
Indian reserv atio n into individually owned p lots, or allotm ents. The
dominant society th o u g h t th a t th is would allow so much land fo r each
N ative American to farm in o rd er to su p p o rt th e family. However, most
Native American people were re lu c ta n t to drastically a lte r th e family
lifesty le, and lacked th e necessary knowledge to farm successfully. With
th e land broken into allotm ents, th e Crow people who w ere no t proficient a t
farm ing w ere able to sell portions of land to th e s e ttle rs , which explains
how th ey came to live and a re c u rre n tly farm ing within th e boundaries of
th e Crow reserv a tio n .
T h ere a re many documented accounts of th e difficulties Crow people
faced in adapting to reserv atio n life. Many Crow could not accept th e
rea lity of being re s tric te d to such a small te rrito ry as th e re s e rv a tio n .
T h ere w ere a few Crow who did take th e governm ent seriously and
attem pted to learn how to farm like th e s e ttle rs . Some Crow trie d to
position th e trib e in a politically advantageous stance so th a t no additional
homelands would be lo st to th e governm ent.
Chief Plenty Coups was born in th e summer of 1848 and became a chief
of th e Crow T ribe a t a v e ry young age. According to Linderman (1962),
Plenty Coups was known fo r his im pressive speech and commanding
23
p resen ce. His youth was an advantage in envisioning th e fu tu re of th e
Crow trib e in a rapidly changing environm ent. Plenty Coups was able to
maintain dignity and a stro n g sense of p rid e , which gained th e re sp e c t of
th e officials in W ashington. Plenty Coups was v ery effective in effo rts to
p ro te c t th e Crow people’s way of life. He encouraged th e Crow to join th e
United S tates Army as soldiers and as scouts and by so doing, th e Crow
w ere su b seq u en tly scorned by oth er trib e s . Plenty Coups s tre sse d th e
im portance of education and believed th a t th e Crow's fu tu re power would be
d irectly linked with knowledge. The la st of th e traditional Crow Chiefs,
Plenty Coups died in 1932 a t age 84.
The Crow of Modern Days
In 1934 th e Grow people took charge of th e ir own trib a l a ffa irs.
By 1935, th e trib e had developed a General Council which still governs
th e reserv atio n today and works to improve th e Crow sta n d a rd of liv in g .
The Council has trie d to increase th e trib e 's independence by improving
th e Crow economy. The council encouraged farm ing and ran c h in g , b u t
in to d ay 's w orld, th e Crow people find it difficult to be successful in
a g ric u ltu re . P a rt of th is is due to th e local non-N ative American controlled
b an k s which a re re lu c ta n t to lend fu n d s to th e Native American people.
T h u s, th e Native American people lack money to buy c attle , tools, seed,
tra c to rs and equipm ent.
24
T h ere a re few jobs available on th e reserv a tio n . Even though th e
T rib e has trie d to solve th is by sta rtin g program s and b u sin esses on th e
re s e rv a tio n , th e re s u lts have been u nsuccessful. Crow people find it
difficult to compete with non-N ative American businessm en. Most of th e
reserv atio n income comes from Crow w orkers hired by th e trib a l
governm ent fo r enforcing laws, managing program s to im prove th e trib e 's
health c a re , education, and housing. T here a re other prim ary sources of
seasonal jobs off th e reserv atio n as cowboys, farm hands, and a t th e coal
companies, resu ltin g in a high level of unemployment d u rin g w inter
m onths. A ccording to Hoxie (1989) th e unemployment ra te escalated to
g re a te r th an 50%.
R eservation schools have not effectively dealt with Crow children.
Many Crow children drop out of school, although th e num ber of college
g rad u ates has increased over th e y e a rs. L ittle Big Horn Community
College was established on th e reserv atio n in 1980 to enable Crow
stu d e n ts to gain education to b e tte r compete for jobs ( Hoxie, 1989).
The Crow people a re try in g to establish a g re a te r sen se of u n ity by
banding to g eth er to collectively fig h t political b a ttle s . T he Crow people
continue to work h a rd to defend individuals and homes from o u tsid ers.
T he b a ttleg ro u n d has changed from Plains skirm ishes to courtroom s. The
Crow people have adapted and learned v e ry well how to work within th e
dominant society's system . These successes have helped to keep th e Crow
25
sp irit stro n g and will continue to help th e Crow people th riv e in th e y e a rs
to come.
The review of lite ra tu re provided a historical account and p ersp ectiv e
th a t a re im perative to th e basic u n d erstan d in g of th e Crow people. The
lite ra tu re provided in sig h t into th e pain experience of th e traditional Crow
which helped form ulate th e questions utilized for th e d ata collection.
26
CHAPTER 3
METHODOLOGY
This ch ap ter describes th e research methods utilized to stu d y th e
experience of pain by traditional Crow p erso n s. Design of stu d y , human
su b je cts, population, sample, data collection, data a n aly sis, validity and
reliability a re described in th is c h ap ter.
Design of Study
The p u rp o se of th is resea rch stu d y was to describe th e experience
of pain fo r traditional Crow people, utilizing th e ethnographic approach.
Spradley (1979) describes ethnography as “th e work of describing a
c u ltu re ” ( p . 3 ). The essential p ersp ectiv e of th e ethnographic approach is
to u n d e rsta n d another way of life from th e point of view of th e indigenous
members.
Human Subjects
Montana S tate U niversity-B ozeman, College of N u rsin g 's Human
Subjects Review was completed during th e summer of 1994. T he consent
form was rea d to each inform ant. I answ ered all questions related to
inform ed consent and th e research stu d y . I emphasized th a t participation
Tl
was s tric tly v o lu n tary , confidentiality of th e ir id en tity would be
m aintained, and th e inform ant could stop th e interview or w ithdraw from
th e stu d y a t any time. Each inform ant signed th e consent and perm ission
to tap e th e interview was verified. No inform ants w ithdrew th e ir
interview s from th is stu d y .
Population
One of M ontana's many Plains Native American trib e s , th e Grow T ribe
is located on a reserv atio n in sou th eastern Montana. The Crow villages
include Crow A gency, Wyola, S t. X avier, P ry o r, G arryow en, F ort Smith,
and Lodge G rass. The population of th e Crow R eservation is 6,366
according to th e U .S . Departm ent of Commerce (1990) and th e size of th e
reserv atio n is listed as 1,554,253.87 a c re s. However, th e re is c u rre n t
disagreem ent over th e accuracy of surveying done on th e 107th Meridian.
If th e land is re tu rn e d to th e Crow, th is would increase th e c u rre n t size of
th e rese rv a tio n . The Crow people tak e g re a t p rid e in th e fac t th a t 79% of
th e Crow population speaks th e native language (B ry an , 1985).
All categories of Milligan's (1981) cultu ral typology can be identified in
Crow people. The "traditional” category consists of p racticing Crow
people. The traditional Crow hold fa s t to th e old w ays. T he typology of
“tran sitio n al” consists of th e Crow who a re positioned on th e continuum
betw een “m odern” and “traditional”. The Crow categorized in th e
28
tran sitio n al group consist of those who blend both th e old and new beliefs
and b eh av iors. The "modern" Crow a re viewed as th e fu rth e s t removed
from th e old life w ays.
Sample
The purposive sampling technique allowed me to locate key inform ants
who w ere c u ltu ral e x p e rts. The inform ants w ere indigenous Crow persons
who p o ssessed c u ltu ral knowledge. Two c rite ria were developed to identify
potential inform ants. F irst, th e eligible p articip an t self identified as
“trad itio n al” Crow according to Milligan's (1981) cultu ral orientation
schem e. Secondly, th e p articip an t was a t least 50 y e ars of ag e. Keeping
in mind th e need fo r enculturation, c u rre n t involvem ent, an d adequate time
fo r th e inform ant to p articip ate, th e inform ants were th en approached.
The initial access to a Crow inform ant was initiated by calling a
n u rsin g home located in H ardin, Montana. I asked th e d irec to r of n u rsin g
if th e re w ere any Crow re s id e n ts . The d irector then approached th e
initial inform ant and inq u ired if it would be all rig h t for me to come
and speak with th e re sid e n t. I trav eled to Hardin and spoke with th e
re sid e n t, who th en identified another possible inform ant who lived in
Lodge G rass, Montana.
I trav eled to Lodge G rass to locate th is potential inform ant.
The directions were sketch y and no house num bers w ere visible on th e
29
governm ent housing. A fter several unsuccessful attem pts, I located th e
second inform ant. This inform ant also identified several o th er Crow people
who would be able to a s s is t me with th is project.
As I drove th ro u g h Lodge G rass, I noticed five older men obviously
engaged in social conversation while leaning on th e hood of an old tru c k .
I pulled o v er, introduced m yself, and explained my p u rp o se . The men
w ere in trig u ed with my in te re s t to learn more about th e experience of
pain in th e Crow population. AU of th e men p articipated as inform ants.
One of th e men took me to v isit C u ste r's B attlefield, which has now been
renam ed L ittle B ighorn B attlefield.
The sample continued to snowball u ntil a total of fifteen Crow
individuals w ere interview ed. Nine male and six female inform ants
p articip ated in th is stu d y . The p articip an ts ran g ed from 50 to 101 y e a rs of
ag e. All p articip a n ts lived on th e Crow Indian R eservation arid identified
them selves as traditional Crow. The difficult task was to stop
th e momentum of th e snowbaU when I had obtained enough inform ants from
whom to collect data.
Data Collection
Each potential inform ant was informed of th e stu d y , ask ed to identify
c u ltu ral orientation (Milligan, 1981) and ag e. If th e two c rite ria w ere met,
30
an informed consent was obtained from th e inform ant. The interview was
th en conducted.
The se m i-stru ctu red interview was developed to elicit resp o n ses from
trad itio n al Crow about th e concept of pain. T hree ty p es of questions w ere
utilized to collect th e d a ta. The f irs t ty p e was descriptive questions.
D escriptive questions elicited data about term s, p ersp ec tiv e s, and
situ atio n s. Examples of questions asked include: "Could you d escribe a
painful situation?” “Could you describe th e pain of su rg e ry ? ” “Could you
tell me w hat you do a t a sun dance?” The second ty p e was s tru c tu ra l
q u estio n s, which elicited data about th e relationships and “how 's” of th e
term s identified from th e d escriptive q u estio n s. Examples of questions
ask ed include: “What a re all th e d ifferen t kinds of 'good h u r t'? ” “Can
you sh a re any o th er ty p e of 'good h u r t’?” I found it im portant to rep e at
th e s tru c tu ra l questions in o rd er to elicit multiple answ ers. The final
ty p e was th a t of c o n tra st questions. The c o n tra st questions elicited d ata
about th e differences in term s. Examples of c o n tra st questions asked
include: “What is th e difference between 'good h u rt' and 'b ad h u rt'? ”
“What d istinguishes death as a good or a bad h u rt? ”
The interview s w ere conducted on th e Crow Indian R eservation d u rin g
th e late summer and early fall months of 1994. The inform ants p articip ated
in individual a n d /o r group interview s. The interview s ran g e d from one
to six h o u rs in len g th , and gradually increased as th e d ata collection
31
p ro g re sse d . I learned th a t th e time sp e n t in initiatin g , developing,
and maintaining th e research er/in fo rm an t relationship was im portant to
th e Crow p e rso n . The Crow inform ants also ta u g h t me th e im portance of
patience while waiting fo r answ ers to questions and th e need to take a
more p assive approach d uring th e interview process.
Data began to reoccur by th e second interview . Term s, relatio n sh ip s,
and th e sim ilarities and differences became v e ry a p p aren t d u rin g th e six th
interview . Interview s continued to p ro g re ss to w hat Lincoln & Cuba (1985)
have defined as th e point of redundancy when only rep eated sto ries,
is s u e s , and themes w ere being communicated.
Interview s w ere audio taped with th e perm ission of th e inform ant.
No names w ere associated with th e ta p e s. Each human su b ject was assigned
a le tte r of th e alphabet. Initial interview s were labeled as A - I , B - I , C - I ,
e tc . S ubsequent interview s with th e same inform ant w ere labeled A -2,
B -2, C-2, and so f o r th . A professional ty p is t with 35 y e a rs experience
in w orking with confidential information tra n sc rib e d th e audio ta p e s .
When th e tran scrip tio n was completed, th e audio tapes w ere e ra se d .
Field notes containing d irect quotes, id eas, summaries, general
o b serv atio n s, and in sig h ts were taken d u rin g th e interview . The field
notes w ere fu rth e r expanded following th e conclusion of th e interview .
I would d riv e a sh o rt distance from th e home of th e inform ant and stop to
rec o rd my reflections of th e interview .
32
Data collection also occurred while participating in recreational,
holiday, and special e v en ts. W ritten data from inform ants w ere also made
available to me.
Data Analysis
The f ir s t step in th e data analysis was to develop a method for
controlling and organizing th e data. I decided to use a c ard system to
control th e larg e amount of d ata, and then developed a coding method
which consisted of colored dots and symbols which identified th e specific
interview . Additional dots w ere then added as th e su rfa ce , domain and
taxonomic analyses evolved. In o rd er to keep th e information gained from
in terv iew s, field n o tes, and ideas se p ara te and organized, I c u t e x ce rp ts
from th e tra n sc rib e d interview s and placed them on c a rd s. I th en review ed
my field notes and made notations of th e im portant data and in s ig h ts .
Finally, I utilized colored card s to identified linkages, categ o ries,
an d taxonomic b o x es.
A c ard s o rt method was used to sep arate th e data into categ o ries.
As each category b uilt up more c a rd s, a cultu ral category or theme
evolved. The development of th e card s took a large amount of time and
e n e rg y , b u t la te r allowed me to easily manipulate and re a rra n g e th e groups
of inform ation. I filed th e card s into groups u ntil th e final stag es of
development of th e taxonomy. D uring th e final analysis I designated an
33
e n tire wall in my home to display th e m ultitude of card s and attached
n otations. The ability to visually display th e card s allowed th e identified
themes to telescope into la rg e r g ro u p s. The la rg e r groups w ere then
a rra n g e d b y related categories, u ntil th e final grouping of categories
was condensed into a taxonomy of concepts. The card s o rt method was
extrem ely useful in th is p ro c e ss.
Data analysis began a fte r th e completion of th e f ir s t interview .
Each interview was analyzed independently and then compared with
previous in terv iew s. Once th e data of th e interview and field notes
w ere placed on card s and coded, th e in -d ep th analysis could begin.
A fter reading th e response to a question, I would place th e response
into one of th re e categ o ries. The f ir s t category would be a definite yes
(it does fit, su p p o rt, and fu rth e r develop th e c a te g o ry ). T he second
category would be a definite no (it does not fit, su p p o rt, or develop th e
c a te g o ry ). The th ird category was u n c ertain ty (it seems to be im portant,
b u t will have to be clarified during a su b seq u en t in te rv ie w ). The raw d ata
w ere organized, condensed, and placed into specific gro u p s th ro u g h th e
p h ases of su rfa ce , domain, and taxonomic an aly sis.
The f ir s t p h ase, su rface analysis, was perform ed on each of the
tra n sc rib e d interview s and accompanying se t of field n o te s. A su rface
analysis identified c u ltu ral term s and provided in sig h t into th e pain
experience of th e traditional Crow. The indigenous term s of "good hurt"
34
and "bad h u r t” were identified during th e su rface analysis. Questions
related to th e variables identified d uring th e surface analysis w ere
g en erated and utilized with th e n ex t interview .
The second phase was domain an aly sis. The groups of “cover term s”
and "included term s” as described by Spradley (1979), w ere reanalyzed,
re a rra n g e d and re -g ro u p e d into them es. The semantic relationships of
th e them es, linkages, and boundaries of th e themes evolved d u rin g th e
domain an aly sis. Additional questions w ere generated and asked of th e
inform ants, which fu rth e r clarified th e themes and validated how th e
theme was defined. T hrough careful domain analysis, th e potential
gro u p s of themes w ere identified fo r th e taxonomic a n aly sis.
The final phase was taxonomic analysis. The discovery of
c u ltu ral meaning was solidified during th e taxonomic analysis ph ase.
T he relationships among th e themes w ere grouped by sim ilarities
and d ifferen ces. The similar groups were matched with o th er similar
dimensions resu ltin g in th e identification of categories. T he categories
w ere designed to be inclusive of domains th a t fit tig h tly to g e th e r.
From th ese categories, I th en c o n stru cted a prelim inary taxonomy. The
relatio n sh ips of th e categories located in th is taxonomy w ere then
analyzed an d matched as a whole. The utilization of s tru c tu ra l questions
was extrem ely im portant during th is phase of analysis. The outcome of
35
th e taxonomic analysis resu lte d in th e final taxonomy shown in F igure I ,
th e pain experience as described by traditional Grow.
Validity and Reliability
In qualitative re s e a rc h , validity re fe rs to obtaining knowledge and
u n d e rstan d in g all th e facto rs and dimensions related to a phenomenon being
stu d ied . Leininger (1985) defined th e im portance of validity in qualitative
rese a rc h as "qualitative validity is concerned with confirm ing th e tru th
o r u n d e rstan d in g s associated with phenomena" ( p . 68). Validity was
determ ined by meeting th e goal of knowing and u n d e rstan d in g th e concept
u n d e r stu d y —th e experience of pain by traditional Crow people.
In relation to qualitative re se a rc h , Leininger (1985) sta te d
Reliability focuses on identifying and documenting re c u rre n t,
a cc u ra te, and consisten t or in consistent fe a tu re s , as p a tte rn s ,
them es, values, world view s, experiences, and o th er phenomena
confirmed in similar or d ifferen t contexts (p . 69).
S tern (1985) fu rth e r clarified th a t reliability is b e st su b sta n tia ted by
th e p a rtic ip a n ts. The p articip an ts se rv e as “th e most reliable judges
of th e ir rea lity ” (p . 151). The data fo r th is stu d y is reliable based on
th e assum ption th a t th e inform ants met th e inclusion c rite ria and were
reliable e x p e rts .
P atto n 's (1990) triangulation process was utilized to enhance in te g rity
of th e re s e a rc h . The f ir s t triangulation was th a t of so u rces. The same
interview questions were asked of more th an one inform ant and th e
36
questions th a t elicited data were k ep t while other questions w ere eliminated
or changed. The second form of triangulation was th a t of m ethods.
Individual and group interview s w ere conducted, field stu d y notes w ere
reco rd ed following each interview session, and th e findings w ere p resen te d
to th e 1994 convention of th e Montana Gerontology Society. The data w ere
validated b y th e Crow p articip an ts attending th e gerontology conference
p resen ta tio n . The d ata w ere positively validated d uring th e follow-up
in terv iew s. The Crow particip an ts listened and shared how th e data
impacted them . The th ird form of triangulation was th a t of analysis.
Multiple an aly sts reviewed findings, including th e th esis committee,
one Crow inform ant and one non-Crow . Utilizing P atto n 's process
of trian g u latio n , th e d ata w ere co rrected .
37
CHAPTER 4
ANALYSIS OF DATA
The p u rp o se of th e qualitative stu d y was to explore and d escribe how
trad itio n al Crow people experience th e phenomenon of pain. Meaningful
in sig h t is enhanced by knowledge of Crow h isto ry and c u ltu re , while a lack
of th is knowledge con trib u tes to m isunderstanding. U nfortunately th e re is
often a significant Native American/ non-N ative American c u ltu ral gap.
Qualitative Analysis
A qualitative analysis was ap p ro p riate to provide a method to gen erate
and g round concepts. The raw data w ere organized, red u c ed , and placed
into specific g ro u p s. T hese groups th en formed th e taxonomy as shown in
F igure I , which categorize th e pain described by traditional Crow people.
The main taxonomic analytical method was developed by Spradley (1979).
A su rface analysis identified cultu ral themes and provided in sig h ts into
th e pain experience of th e traditional Crow. T hrough careful domain
an aly sis, I identified th e taxonomic boxes or domains of knowledge.
38
Concept
Categories
Dim ensions
Natural
Life
Events
GOOD
HURT
Themes
Components
Childbirth
Death
Traditional
Practices
Healing
Indigenous Healers
Rituals/Ceremonies
Modem Medicine
Surgery
Medical Interventions
Mass Annihilation
P
Untimely Deaths
Death
Loss
A
Separation
Nature
Former Way
of Life
I
Tradition
Economic
BAD
Future
N
Assimilation
Ot
Children
Bicultural Adaptation
HURT
Historical
Transitions
Government-Reservation
Days
Missionary Days
Boarding School Days
Hardship
Discrimination
Social Problems
Alcohol and Drags
Deprivations
V
Illness and
Disease
Physical Pain
Emotional Pain
Figure I. Taxonomy of pain as described by traditional Crow.
39
Findings
The concept of pain experienced by Crow people evolved into th e
categories of "Good H u rt” and "Bad H u rt.” T hese indigenous term s were
articu lated by th e key inform ant who was th e oldest of all th e inform ants.
T hese two d istin ct categories then serv ed as th e corn ersto n e of th e analytic
p ro ce ss. I th en review ed th e interview s in which pain was discu ssed ,
id entifying common themes and consistency of statem ents. The main them es
w ere su b seq u en tly linked and placed in relation to th e two categories of
good and bad h u rt.
The Crow view “Good H urt” as being embedded in N atural Life E vents
and Healing. The Crow experience of “Bad H urt” emanates from two
prim ary so u rces: Loss and H ardship. The f ir s t source of Bad H u rt, which
evolved into th e dimension of Loss, includes th e four themes of Mass
A nnihilation, D eath, Former Way of Life and F u tu re of C hildren. The
second source of Bad H urt evolved into th e dimension of H ard sh ip , and is
associated with th e four themes of Historical T ran sitio n s, Laws and
R egulations, Social Problems and Illness and Disease. T he following
p a ra g ra p h s reveal how th e traditional Crow view th e experience of pain.
A discussion of Good H u rt is followed by th e discussion of Bad H u rt.
40
Good H u rt
The most significant and in trig u in g category is th a t of Good H u rt.
Crow inform ants experience good h u rt with th e philosophy th a t pain is good
if th e pain se rv e s a pu rp o se and will lead to a favorable outcome.
The them es developed into th e dimensions of N atural Life E vents and
H ealing. C hildbirth and Death a re th e themes which comprise th e N atural
Life E vents dimension of Good H u rt. The second dimension of Good H u rt is
th a t of Healing which includes th e two themes of T raditional P ractices and
Modern Medicine.
N atural Life E v en ts. N atural Life E vents is th e f ir s t dimension of th e
Good H u rt category and includes th e themes of C hildbirth and D eath.
Crow view child b irth and death simply as n a tu ra l events th a t occur in one's
lifetim e. The Crow a re able to d isre g ard th e pain, focusing only on th e
end re s u lt.
C h ild b ir th .
The f ir s t theme of th e dimension N atural Life E vents is th a t
of C h ild b irth . Crow view childbirth as having two a s p e c ts , th e f ir s t of
“being b o rn ” and th e second of “giving b i r th .” One inform ant talked
ab o u t a p e rso n 's own b irth as being th e f ir s t and th e b e st good h u rt
experienced in one's lifetime even though one cannot remember th e ev en t,
s ta tin g , "It m ust be w onderful to come out of th e mother and s ta r t your
own life as an independent p e rs o n .”
41
The Crow consider th e pain experienced during ch ild b irth as a
good h u r t. As two m others explained, "you g et rew arded" an d “you g et a
precious g ift a fte r th e pain." The pain of childbirth is also considered a
good h u r t because children b rin g wealth to th e family. The Crow m easure
wealth in th e num ber of children in a family, ra th e r th an in th e possession
of m aterial item s. One inform ant believed th a t Crow women experience more
difficulty in childbirth saying: "we have a h a rd time having babies. We a re
all small hipped and a re b uilt like th e buffalo - broad shouldered, narrow
h ip p ed , with long skinny le g s .” Crow women accept th is fa c t and willingly
e n d u re th e pain.
D e a th .
The second theme of th e dimension N atural Life E vents is D eath.
Death is a u n iv ersal experience and some Crow inform ants believe th a t
death is good. One inform ant exclaimed, “Death! Now th e re 's a
good h u r t! ” However, o th er inform ants consider death to be a b a d h u r t.
W hether death is considered good or bad seems to depend on th e situ atio n ,
th e exp erience, and w hether death is good for a p a rtic u la r p e rso n . The
Crow viewed th e experience of pain as bad if th e pain did not se rv e a
p u rp o se o r was associated with emotional pain. Death as a good h u rt is
d iscu ssed in th is section, and death as a bad h u rt will be discussed la te r.
The Crow believe th a t both life and death serv e a p u rp o se . All key
inform ants e x p ressed th e th o u g h t, “death is n a tu ra l. I t is p a rt of life .”
E very life is considered sacred - th e life of each tre e , animal or b ird , or
42
th e life of a Human. One inform ant explained, “death is good if you u se up
more reso u rces than you re tu rn or you become a b o th e r.” A nother ad d ed ,
"If th e p e rso n 's time has come - if th ey a re elderly. I n e v er feel bad about
a death except fo r some young person whose time h a s n 't come.” Death is
considered good if th e person is su ffering from diabetes or cancer and is
consequently experiencing in ten se pain. The Crow feel th a t it is good to
end th e p e rso n 's su fferin g and th a t death is good when one is no longer
able to enjoy life. The Crow have a p ersp ectiv e th a t death is a n a tu ra l
process based on stro n g sp iritu al tie s. As clearly articu lated by an elderly
Crow man, “We do not fe a r d eath , b u t embrace and experience i t . ” The
Crow an ticipate crossing over to th e “oth er side camp” w ithout fe a r, as it
is believed th a t th e sp irit continues and deceased loved ones a re w aiting.
H ealing. The second dimension of th e category Good H u rt is Healing.
T he Healing dimension developed into th e themes of T raditional P ractices
and Modern Medicine.
T r a d itio n a l p r a c ti c e s .
The f ir s t theme of Healing is th a t of T raditional
P ractices. T raditional practices a re stro n g ly linked to a n ce stral teachings
of trad itio n al medicine p rio r to reserv atio n d ay s. T raditional practices
such as R ituals/ Ceremonies have evolved b u t still remain an in h e re n t p a rt
of th e Crow c u ltu re . The f ir s t component of traditional Healing is th a t of
Indigenous H ealers. Indigenous Healers consist of “medicine men” and
43
Clan A unts/U ncles. Medicine men a re essential to th e traditional healing
p ractices of th e Crow.
The Crow medicine men receive knowledge of traditional methods of
alleviating pain from visions and th ro u g h oral communication with m entors.
Some traditional ways to tre a t pain include “special roots . . . white
mud . . . a d rin k of tea to alleviate p a in .” AU Crow inform ants su p p o rt .
th e belief in traditional w ays. Also, it should be explained th a t to th e
traditional Crow, “medicine” can mean not only th e medicinal p ro p erties of
h e rb s and o th er rem edies, b u t also describe medicine as a source of pow er.
For example, “A m agnificent eagle appeared and communicated with th is
man. The eagle then became his medicine [power] th ro u g h o u t his lifetim e.”
Pain is an accepted and in teg ral p a rt of ritu a ls and cerem onies.
An example of a painful ritu a l utilized by medicine men is th a t of th e
vision q u e st. D uring vision q u e st ceremonies a person would trav e l to a
rem ote high altitu d e area to seek a vision to provide direction and
guidance. Medicine men seek visions for guidance and to gain fu rth e r
knowledge of medicine. One inform ant described a typical vision q u est:
Medicine men would trav el to a high point and stay by them selves
fo r th re e to fo u r days w ithout w ater and food. T hey would build
an oval rock form ation, lay th e ir buffalo robe down and sleep
th e re . They would g et up and go to th e rim to p ra y and m editate.
When young Crow men a re seeking a vision - th is g uardian angel
would guide and communicate with them throughout th e ir liv es, and
th en th ey a re read y to seek a medicine. Even in th ese d a y s, many
Crow go to a sacred place to m editate and p ra y , and leave offerings
of sag e. They do a lot of praying using tobacco. T hey b rin g sage
44
and sm udge them selves, because th e smoke c arries our p ra y e rs to
th e Almighty.
The Crow believe th a t th e Medicine Man has th e power to c u re people
su fferin g from physical, m ental, or sp iritu al pain. One inform ant talked
about a Native American diagnosed with liv er cancer. The Medicine Man,
u sin g medicine and eagle w histles, was able to drain off th e poison from th e
liv e r and heal th a t person even though th e process was v e ry painful. This
example of Crow people willingly accepting and enduring th e pain of
trad itio n al medicine is typical, stre n g th e n ed by stro n g c u ltu ral beliefs.
The second ty p e of Indigenous Healer is th a t of th e Clan A unts/U ncles.
The clan a u n ts and uncles hold powerful “m edicine.” One inform ant talks
about th e “medicine of th e little people.” The inform ant's clan uncle
utilized th e “little people” to adm inister h ealing. The clan uncle would
place th e little people in th e homes of th e Crow person to p ro te c t th e
individuals living th e re from harm .
The second component of traditional p ractices is th a t of R ituals/
Cerem onies. The ritu a ls and ceremonies discussed by th e inform ants
consisted of th e sun dance, sw eats, and peyote m eetings. T he sun dance
will be d iscussed f ir s t, followed with a discussion of sw eats
and peyote m eetings.
H istorically th e sun dance was utilized to m easure th e individual's
ability to overcome pain and su ffe rin g . T his rite of p assage established
45
th e individual's ability to be a lead er. All th e inform ants sh a red th e
view th a t “th e pain people experience in th e ritu als is a good p a in .”
Government re stric tio n s p rohibit Crow people from p racticing th e p u re
form of th e sun dance. The sun dancers would pierce th e ir skin with
thongs anchored to th e c en ter pole and then pull back while dancing u ntil
th e thongs to re th ro u g h th e flesh. One inform ant re la te d , “When I was a
kid those men would b a re them selves from th e waist u p . T hey had larg e
sc a rs on th e ir c h e sts. Some would place th e thong in th e ir back and had
sc a rs th e r e .” T hrough sacrifice and endurance of pain, th e dancers
dem onstrated courage and th e ability to w ithstand any pain th a t will be
experienced th ro u g h o u t life. Today, th e dancers inflict su fferin g upon
them selves by withholding w ater and food d uring th e e n tire sun dance, and
a re allowed a v e ry minimum amount of sleep . The exertion and denial of
su sten an ce to th e sun d a n cer's body causes physical pain and a mental
tran c e-lik e sta te which facilitates a vision experience. The Crow feel th a t
d u rin g ritu a ls > sincere sacrifice leads to favorable outcomes such as vision,
medicines and th e acquisition of knowledge. I t is in te re stin g to note th a t
th e original sun dance excluded women, b u t it is c u rre n tly acceptable for
women to p articip ate and experience th e pain and sacrifice of th e
su n dance. D eprivation of food and w ater induces pain and su ffering and
is d escrib ed by a sun dancer:
46
You d o n 't appreciate w ater u ntil you've been in th e sun dance.
You remember ev ery time you d id n 't finish a glass of w ater and
pou red half out! Water is basic to all life and w ithout it,
you have nothing.
One of th e more common ritu als is participation in th e sw eat lodge,
often re fe rre d to as th e small lodge. Most traditional Crow have
c o n stru cted a personal sw eat lodge w here “heated rocks a re placed in a
p it and w ater is sprin k led on them , creating a lot of steam . T hey ru b
them selves with sage and th is combined with th e steam cleanses th e ir
b o d y .” I t is commonly believed th a t re g u la r u se of th e sw eat lodge will
heal most ailm ents. One inform ant related th e experience of being in a
sw eat lodge:
The sw eat lodge causes in ten se b u rn in g , and to go th ro u g h th e
process of th a t in ten se b u rn in g is so im portant because it cleanses
y o u r mind, it cleanses your s p irit, cleanses your sp iritu a l body.
I t tak es all y o u r ailments away so th a t you d o n 't have th a t inside
y o u r body anym ore. B ut a t th e same time it's v e ry painful fo r th e
p a rtic ip a n ts.
The extrem e h eat, as described by p a rticip a n ts, makes flesh feel like i t is
On fire . The hot humid a ir nearly suffocates th e p a rtic ip a n t, making th e
verbalization of p ra y e rs a painful experience.
Peyote meetings a re th e final example of R ituals/C erem onies. Peyote is
a hallucinogenic substance th a t some traditional Crow u se d u rin g special
cerem onies, religious g ath e rin g s, and for treatm ent of p ain . Only members
of th e N ative American church a re able to legally possess peyote. Peyote
m eetings a t th e Native American church la s t for many h o u rs and would be
47
intolerable if not fo r th e u se of peyote. One Native American church
member relates “Peyote makes you real numb when we sit in th e ch u rch for
h o u rs on end and helps with visions. Sometimes we s it in one spot
cro ss-leg g ed fo r 12-16 hours and peyote helps keep u s fre e from p a in .”
A nother key inform ant told about a peyote meeting held fo r th e
inform ant's m other. The mother remained in sev ere pain following su rg e ry
fo r can cer. Members of th e family a rra n g e d a “peyote m eeting” and th e
meeting was recalled by th e inform ant:
One of h e r uncles was a Medicine Man and he doctored h e r and told
h e r it was in h e r stom ach. The Medicine Man held a bone w histle to
h e r stomach and from th a t w histle came out black w ater which filled
up about five to seven big coffee c a n s, of w hatever it w as. I t was
throw n away and she w ent into rem ission for five or six y e a rs
before she had to go in for another operation.
Many Crow actively p articip ate in th e sun dance, sw eats, and th e
N ative American C hurch. The Crow also u n d e rstan d when Crow members
choose not to p articip a te , and have th e unique acceptance of th e wide
variation of practicing historical healing with contem porary healing. Crow
families will sometimes invite resp ected indigenous healers to v isit
hospitalized family members. The healers (traditional an d contem porary)
blend reso u rces to a ssist with healing. Some individual Crow incorporate
both trad itional p ractices with modern medicine b u t in tern ally stru g g le
th ro u g h th e tran sitio n s of melding both healing m ethods.
48
M o d e r n M e d ic in e .
The second theme of Healing is th a t of Modern
Medicine. Suffering from a brain tum or, an inform ant sta te d , “I would tr y
to sta y alive, believing th a t my mind would control my body. I would do
ev ery th in g in th e world possible to heal myself inside - like any ty p e
of treatm en t [traditional or modern] to sta y alive."
S u rg e ry is th e f ir s t component of th e Modern Medicine them e. One
inform ant d iscussed painful experiences with su rg e ry :
I'v e had a few su rg e rie s and th ey w ere all for som ething. I had
successful lung cancer su rg e ry th a t d id n 't bother me, as you've
got 3 -4-5, 10 days of pain maybe. I lost th e u se of my hand from a
pinched n e rv e and I had a doctor operate and he gave me back th e
u se of my h and. It was one of th e b e st things I e v er did . Had my
elbow o perated on and then p ro sta te s u rg e ry , b u t th ey w ere all to
achieve an end. I n ev er looked a t s u rg e ry as being something real
detrim ental and th e pain d id n 't la st long - it goes away.
All key inform ants believe th a t if th e pain serv es a p u rp o se and th e end
re s u lt will be b e tte r, then th e pain is viewed as a good h u r t. One
inform ant explained, “Pain a fte r s u rg e ry would be a good h u r t, it se rv es a
p u rp o se - to c u re you." A nother inform ant su ffering from bone cancer
openly d iscussed th e anticipation of undergoing a painful injection of
A stronium , a new chem otherapeutic a g en t. Astronium is in fu se d , seeks ou t
and d e stro y s cancer cells, b u t causes in ten se pain th ro u g h o u t th e body.
S u rp risin g ly , th e inform ant sta te d , "I'm looking forw ard to th e injection
and to experiencing w hat it will do to me. And th e pain is a p a rt of it."
One a re a of dissention was th a t of th e utilization of pain m edications.
The old traditional view is th a t you m ust experience th e pain and le t th e
49
pain become a p a rt of you, b u t th is is balanced with th e modern view th a t
"if th e pain g e ts more th an I can handle, all I have to do is call th e doctor
and I'll have something imm ediately.”
Medical In terv en tio n s is th e second component u n d e r Modern Medicine.
Even though th e younger Crow a re viewed as more willing to utilize pain
medication, th e traditional Crow choose not to utilize pain medication.
“T h ere a re pain medications now so th a t a person d o esn 't have to s u f f e r .”
One v e ry traditional elder sta te d , "In th e old days we w ere ta u g h t to deal
with p ain . Now, young people d o n 't deal with pain. They tak e pills and
tre a tm e n ts .” One inform ant sh ared th a t, “The only problem is th e
medicine can raise hell with you mentally - p u t you in a fo g . ” The
inform ant f u rth e r clarified th e utilization of medication by justify in g its u se
(
as follows, "when th a t time comes and y o u 're ju s t waiting fo r death
anyw ay, y o u 'd probably relish th e fog ju s t to g et rid of th e p a in .” On th e
o th er end of th e continuum , one inform ant related a personal observation
of h e r s is te r's d eath , “She ju s t decided to die a t home and d id n 't lin g e r.
She accepted h e r death and did not w ant any treatm ent fo r p a in .”
Bad H u rt
The second major category of pain is th a t of Bad H u rt. This category
developed into two dimensions - th a t of Loss and H ard sh ip . The f ir s t
dimension of Bad H u rt is th a t of Loss, which consists of fo u r them es:
50
Mass A nnihilation, D eath, Former Way of Life, and F u tu re of C hildren.
The second dimension of Bad H urt is H ardship consisting of fo u r them es:
H istorical T ran sitio n s, Laws and R egulations, Social Problems, and Illness
an d D isease.
All key inform ants su p p o rt th e belief th a t emotional pain is always
considered a bad h u r t. The Crow believe th a t one cannot shield oneself
from emotional pain, b u t one m ust simply experience it. I t is fe lt th a t th e
Crow p erso n m ust learn from th e experience, and then rid them selves of it.
L oss. The f ir s t dimension of th e category Bad H u rt is th a t of Loss,
which consisted of four them es: Mass A nnihilation, D eath, Former Way of
Life, and F u tu re of C hildren. Loss is considered an in h e re n t p a rt of daily
life. The pain encom passes all losses, not only in th e p re s e n t b u t historical
ev en ts and fu tu re ev en ts y e t to occur.
M a s s a n n ih ila tio n .
The f ir s t theme of Loss is th a t of Mass A nnihilation.
T he Crow f ir s t experienced mass annihilation with th e introduction of
European diseases, The most notable was th e smallpox epidemic which took
a g re a t toll on th e Native American population, causing n e a r extinction of
th e Crow people. This historical event causes g rea t emotional pain to th e
Crow inform ants in recalling th e loss of so many an cesto rs and th e scarc ity
of valued trib a l e ld e rs. The effect of th e smallpox epidemic was told by a
trib a l h isto rian :
51
On th e rese rv a tio n , you will see v e ry few old people. You have to
go back historically from th e time th e Crow met Lewis and Clark
back in 1805. Until th a t time th e re was not much in te rac tio n . In
ab o u t 1830, th e diseases sta rte d coming in . Once a y e a r all th e
fo u r bands of th e trib e would meet for a rendezvous. In 1847, th e
e n tire trib e congregated rig h t w here th e Metra is! [Metra P ark
C enter-B illings, M ontana]. At 12,000, it was th e la rg e st th e trib e
has e v er been. They formed a g re a t big camp a re a . One of th e
trad in g p a rtie s had gone to F ort Union by North Dakota w here one
Crow picked up th e smallpox b u g . The guy was already sick with
smallpox when th ey got back to camp and th e v iru s sp re ad like
w ildfire. Within a space of seven d ay s, we w ent from 12,000 people
to only 3,800. I t practically annihilated us! The trib e trie d to
slowly build back and by 1876 d uring th e C uster campaign th e trib e
num bered about 6,000. A fter th e trib e moved on to th e
rese rv a tio n , th ey only num bered 1,104. I mean, we almost died
off! D uring World War I, th e re w ere less than 1,500, d u rin g
World War II, we num bered less th an 2,500, and today th e re 's
almost 9,000. Somehow we su rv iv ed and have come up to w hat we
a re to d ay . The Crow lost many of th e ir wise people an d with th ese
c u ltu ral e x p e rts w ent much knowledge of ritu a ls , medicine and
s e c re ts , and also th e ability to maintain trib a l ro les. T h a t's
why th e re a re v e ry few older people, with th e av erag e Crow man a t
age 45 and th e average Crow woman about 60. Our median age is
ab o u t 20 and y o u rs is about 28.
D e a th .
The second theme of th e Loss dimension is th a t of D eath. Death
as a bad h u r t consists of two components, th a t of Untimely Deaths
and Separation.
T he untim ely death of any Crow person is considered a “w aste”,
as each individual is considered a valuable reso u rce to th e trib e .
T he Crow T ribe continues to su ffe r th e loss of members as explained,
“T h ere a re many deaths of young people from car w recks, huntin g
accid en ts, and I suppose some from ab u se. E very week th e y lose another
young p e rso n . Many a re killed in car w recks because of alcohol.” This
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b rin g s not only emotional pain to family members, b u t also desp air to
th e e n tire trib e .
Separation is th e second component of th e theme of D eath. The
emotional pain associated with death is always considered a bad h u rt
because of th e loss of a relationship, “To be w ithout relativ es is to
be p o o r.” T his loss is most acutely felt with th e death of a “Wise One”,
as much tre a su re d knowledge, wisdom, and especially traditional reso u rc e ,
is lo st as well.
F o r m e r w a y o f life .
The th ird theme of th e Loss dimension is th a t of
Former Way of Life, which th e Crow consider a bad h u r t. With th e
occupation of th e Native American c o u n try by th e E uropeans, th e Native
American people initially accommodated them . However, th e Crow people
had an abundance of rich n atu ral re so u rce s, and many E uropeans realized
th e economic value of th ese n atu ral reso u rc e s. The Crow viewed trib a l
reso u rces not as a possession to be bought or sold, b u t r a th e r an in teg ral
p a rt of each Crow p erso n ’s being. A v e ry fundam ental belief is th a t “land
is alive and it is th e source of all life .”
N ature is th e f ir s t component of th e Former Way of Life them e. One of
th e most valued asp ects of th e Crow's form er way of life was th a t of living
harm oniously with n a tu re . The loss of a fre e and independent life sty le,
th e essence of traditional Crow life d uring th e days of th e buffalo, still
53
causes continuing anguish and is freq u en tly re fe rre d to when discussing
bad h u r t. The essence of being a Crow was explained by a trib a l histo rian :
Being a Crow person meant th ey a re a p a rt of th e land and not
se p ara te from it and th a t th e land was th e source of all life.
As you moved from place to place, you needed to move with th e
lan d , not ju s t over th e land. It is a t th is point th a t th e Crow
people recognize wisdom, because you became wise when you knew
when and how to work with th e land.
Crow people communicated with n a tu re , resp ected n atu ral item s, and
p ro tected th e environm ent.
The Crow w ere v e ry attu n ed to th e seasons and could trav e l around in
total freedom . A male inform ant related :
W arriors and h u n te rs would trav el over th e Crazies and th e
B eartooth mountains fo r food, for visions, for guidance. They
w ere v e ry physically active - th ey had a lot of fre s h a ir - and
w ere a v e ry nomadic people.
Those days w ere gone fo rev er a fte r th e Crow w ere confined to
re s e rv a tio n s.
. The Crow people experienced th e heart-w renching loss of trib a l space
an d te r r ito r y . Crow land was taken by th e United S tates Government
th ro u g h tre a tie s and th en sold to th e s e ttle rs through th e allotment
p ro cess, b y which th e lands w ere broken into p arcels. Lands not
apportioned to th e Native American people w ere made available for p u rch ase
b y th e s e ttle rs . The b a ttle over land rig h ts still rag es to th is day.
As one inform ant rep o rte d with obvious fru stra tio n :
54
In fa c t, we ju s t went th ro u g h it again. A fter th e Cheyenne
re tu rn e d to Montana from Oklahoma th e governm ent had no place to
p u t them . A Crow chief named Crazy Head agreed to give them
th a t are a by A shland, B usby, Lame D eer. He moved over and th e
C heyenne took th a t. A governm ent su rv ey o r was se n t to define
th e b o u n d ary , known as 107th Meridian. He came out d ru n k , made
a m istake a mile wide and 120 miles long, so all th a t land we lost for
all those y e a rs. We also lost a g re a t deal of land when th ey initially
se t up th e reserv atio n system .
A nother significant loss to th e Crow people was th a t of th e buffalo, th e
main stap le of Crow life, which provided sh e lte r and a source of meat. The
Crow still favor th e buffalo meat and have continued to fig h t fo r th e rig h t
to h u n t th e buffalo as Crow traditions a re freq u en tly celebrated with a
fe a st of buffalo meat. The Crow w orry about th e possibility of losing th is
r ig h t and it is felt th a t "the governm ent came in and took e v ery th in g away
a fte r th e loss of th e b u ffalo .” The Crow w ere forced to change th e ir diet
from low cholesterol buffalo meat to th a t of beef. One inform ant discussed
th e impact th a t th e changing diet had on th e Crow:
The buffalo w ere gone and Indian people w ere sta rv in g . The
commodities th a t w ere b ro u g h t to them w ere su g a r, coffee, flour
and la rd . The meat consisted of beef and bacon which is v e ry high
in cholesterol. T heir diet was not u sed to th ese foods and th e ir
bodies w ere unable to ad ju st v e ry well to th a t.
The Crow became increasingly dependent on th e commodities as
th e ir main source of food. The governm ent viewed th e Crow people as
"sub-hum an” and c o rru p t ag en ts would sell off th e commodities for th e ir
personal gain, leaving many Crow to die of starv atio n . A Crow historian
sh a red th e following view reg ard in g th e impact of th e loss of th e buffalo:
55
D uring th e buffalo days, th e roles fo r both men and women w ere
v e ry d istin c t. Men w ere w arriors and h u n te rs . W arriors p ro tected
th e trib e and h u n te rs provided food fo r th e people. The female
role was to be n u rtu re r and care fo r o th e rs. When th e buffalo
w ere killed and we were placed on th e reserv atio n , th e roles
became confused.
The loss of roles led to a spiraling decrease in self re sp e c t and d ignity.
No new roles evolved fo r th e Crow men. This painful loss of dignity and
re sp e c t a re closely linked to th e loss of Crow tra d itio n .
The second component of th e Former Way of Life theme is th a t of Loss
of T rad itio n. The dominant society w anted th e Crow people to abandon
trad itio n al ways and assim ilate. The governm ent attem pted to assimilate
th e Crow th ro u g h mass annihilation; how ever, when killing all th e Crow
was u n su ccessfu l, th e governm ent began to establish oppressive laws
and reg u latio n s.
The governm ent prohibited th e Crow from practicing traditional ritu a ls
and cerem onies, th reaten in g severe penalties and im prisonm ent.
If c au g h t, th e Crow faced losing th e fam ily's allotment of food, th e
possibility of to rtu re , p erh ap s even d eath . D uring th is period of time,
th e governm ent basically controlled ev ery facet of th e Crow's existence.
As a re s u lt of th is oppression, th e Crow became increasingly dependent on
th e governm ent for meeting all needs fo r existence. Some Crow felt totally
pow erless, because by try in g to su stain th e Crow cu ltu ral h eritag e ,
losing needed governm ent su p p o rt was a big ris k . Being re s tric te d from
p racticin g traditional ritu a ls and ceremonies reduced th e u nique id en tity
56
of th e Crow and diminished individual se lf-re sp e c t. T hus began th e
vicious cycle of increasing dependence upon th e governm ent. One
inform ant rem embers asking about th e traditional ways and th e p a re n ts'
firm re sista n c e , saying "no, you c a n 't do th a t. The governm ent will c u t
you o ff.” Often causing in tern al family conflict, how ever, g ra n d p a re n ts
would continue to teach traditional cerem onies, ritu a ls, an d healing
p rac tic es. The d esire to hold on to traditional w ays, while resp ectin g
family adm onitions, and still realizing th e need to ad ap t to th e dominant
society causes continual emotional turm oil. The Crow people continue to be
reg u lated b y a complex system of F ederal, sta te and trib a l regulations
which often cause confusion and continue to su p p re ss th e Crow people.
The la s t component of th e Former Way of Life theme consists of
economic lo sses. The Crow considered them selves w ealthy in term s of
n a tu ra l reso u rces and rich h eritag e . With th e a rriv a l of tr a d e r s , th e Crow
became a stro n g economic force and w ere able to develop valuable tra d e
ro u tes betw een th e G reat Plains and N orthw est te rrito ry trib e s . As time
p ro g re sse d , th e Crow became more and more o p p ressed , forced onto
reserv a tio n s to live in p o v erty .
F u tu r e o f c h ild r e n .
The final theme of th e Loss dimension is th a t of
th e F u tu re of C hildren. Until th e ad v en t of th e reserv atio n d a y s, th e Crow
n e v er had to w orry about th e fu tu re of th e children, how ever, one of th e
57
g re a te s t and p erh ap s most profound losses to Crow people o ccurred with
th e assimilation of th e Crow children into th e dominant society.
The f ir s t component u n d e r th e theme F u tu re of Children is th a t of
Assim ilation. While assimilation was accepted in th e b eg in n in g , th e
d an g er of losing th e traditional Crow c u ltu re soon became a p p a re n t.
Today older Crow people a re fru s tra te d with th e lack of re s p e c t shown by
y o u n g er members. One inform ant is w orried about th is tre n d , saying,
"Young people do not listen to th e old ones as th ey did when I was y o u n g .
T hey know nothing about our old customs and if th ey wish to le a rn , th e re
is nobody now to teach them .”
B icultural A daptation is th e final component of F u tu re of Children
them e. With th e loss of so many elderly Crow people and many of th e Crow
tra d itio n s, th e Crow a re tru ly a t a b icultural cro ssro ad . Crow people a re
facing a stru g g le about values which leads to g rea t emotional pain. This is
associated with choosing th e rig h t direction - w hether to totally abandon
traditional roots and assim ilate into th e dominant society, or to hold fa s t
to trad itio n al cu ltu re and beliefs, enduring th e emotional pain th a t comes
with th is social isolation. Many traditional Crow believe th a t blending and
compromising traditional values is not possible and th a t one m ust choose to
trav e l one direction or th e o th er. One key inform ant, when asked about
th e fu tu re of ch ild ren , hypothesized th a t “if th e White people ju s t wait,
assimilation will tru ly happen unless th e Crow choose to tak e a d ifferen t
58
road and go back to th e ir basic traditional ro o ts, back to being with th e
b u ffalo .” A nd, th e inform ant said ", . . all th e White people would
d isap p ear. T hat ju s t a in 't gonna h a p p e n .” Even with th e full realization
th a t Crow can n ev er re tu rn to th e buffalo days, one inform ant sta te d th a t
th e young people have a difficult choice:
The traditional roots ad h ere to those s tric t philosophies, values,
and teaching those th in g s th a t come th ro u g h in th e old traditional
ways - th e sto ry tellin g , those themes and philosophies, and build
th e ir fu tu re world around those. T here is a fo rk in th e road th a t
th ey need to tak e - eith er left or rig h t - th ey eith er need to totally
go to th e White world and th e White ways or not.
T his inform ant believes th a t if th e trib e does nothing, th a t within th e
n e x t fo u r generations th e re will be no tru e Native American people le ft,
th a t all N ative Americans will be absorbed into th e “White world” and into
th e “White ways”. Several Crow inform ants believe
The Crow need to improve them selves, not ju st pick up th e ir
governm ent checks. They need to work h a rd a t th e ir education,
g e t more people in th e academic w orld, g et people in positions
w here th ey can change th e system . Once th ey 'v e broken into th e
White system , to not ju s t be satisfied and stay a t one level th ey need to continue to move up th ro u g h th e ran k s and keep
improving them selves even if it g ets h a rd e r and tak es more
e n e rg y . Each h ig h er level broken into by Indian people will
make i t easier for th e n ex t generation to move up to th a t level
and p ro g re ss even h ig h er.
Many Crow dream of a fu tu re w here th e traditional ways can be passed on
and p racticed and w here each child can learn what is “inside him self.”
Some Crow dream fo r th e romantic days of th e buffalo. O ther Crow hope
fo r in d u s try , education, and facilities within th e boundaries of th e
59
re s e rv a tio n . All key inform ants w ant to see a decreased u se of alcohol
and d ru g s , im proved health sta tu s fo r all Crow, and education (traditional
and formal) for th e young people. I t is believed th a t in an ideal
environm ent fre e from all forms of discrim ination, all children could
reap th e benefits from both c u ltu re s.
H ard sh ip . The second dimension of th e category Bad H u rt is
H ardship, which contains th re e them es: Historical T ran sitio n s, Social
Problem s, and Illness and Disease. The h ard sh ip s faced by th e Crow
people a re an unending source of emotional p a in .
H is t o r i c a l tr a n s itio n s .
The f ir s t theme of H ardship is th a t of
H istorical T ran sitio n s. T here a re major differences in how th e dominant
society and Crow people experience pain. W hatever experiences th e
an cesto rs have gone th ro u g h become a p a rt of each traditional Crow
p e rso n . Crow pain is nev er forgotten and is communicated in oral trad itio n
and rem ains a p a rt of th e traditional Crow person into th e p re s e n t day.
T he dominant society seem to sep arate them selves from a n ce stral h e ritag e ,
b u t th e Crow people continue to c a rry th e emotional pain of an ce sto rs.
Crow a re a v e ry p ro u d people and traditionally pass sto rie s, inform ation,
and th is sh ared pain down from generation to generation. Even though
Caucasians learn about h isto ry , an inform ant observed “th a t White people
se p a ra te them selves from historical e v e n ts, b u t th e Indian people adopt
60
th e ir h isto ry unto them selves and th a t h isto ry then becomes p a rt of th e
Crow p e rs o n .”
The most significant historical source of emotional pain fo r th e Crow
people emanated from th e B attle of th e L ittle B ighorn, and was explained,
"Crows scouted fo r th e White man and were considered tra ito rs to other
tr ib e s .” Then another inform ant reinforced th is view, ad d in g , "Crows led
C u ster and some scalped Sioux and N orthern Cheyenne who w ere fighting
C u ste r. Lots of tales a re c arried down generation to generation and th a t’s
how th e h a rd feelings and animosity have grown and developed over th e
y e a r s .” How ironic fo r th e governm ent to subsequently place th e Crow and
N o rth ern C heyenne to g eth er on reserv atio n s which sh a re a common b o rd e r.
G overnm ent-R eservation Days is th e f ir s t component u n d e r H istorical
T ran sitio n s. Those days when cultural practices w ere all b u t
ex tin g u ish ed , still b rin g painful memories:
D uring th e reserv atio n days th e governm ent prohibited th e Indians
from practicing th e ir religion and outlawed th e sun dance. The
governm ent completely stopped th e sun dances in th e 1870's and
d id n 't le t them s ta r t up again u n til 50-60 y ears la te r.
They [Crow] lost it, b u t th ey a re getting it back now.
One inform ant summed a feeling of loss by sta tin g , “P rid e, d ignity and
re sp e c t . . . we lo st a lot of th a t when we w ere p u t on re s e rv a tio n s .”
Missionary Days is th e second component u n d er H istorical T ran sitio n s.
B eginning in th e late 1800's, during th e m issionary d ay s, th e Crow people
w ere re g a rd e d as uncivilized h e a th e n s. Missionaries believed it th e ir d u ty
61
to "civilize" and "elevate” th e Crow people to th e sta n d a rd of th e dominant
society. Painful childhood memories of one inform ant:
T h ere’s th e psychological pain th a t is associated with religion.
The P ro te sta n t p a sto rs, Catholic p rie s ts , and nuns sh ared a
philosophy th a t by imposing s tric t ru les and shaming th e Indian
children th ey could rid them of th e ir 'diseased' Indian ways and
make them tru ly White children.
The final component of Historical T ransitions is th a t of B oarding
School D ays. In th e early 1900's th e governm ent launched plans fo r mass
indoctrination of Native American children through th e development of
boarding schools. The children w ere exposed to basic educational
p rin cip les and C hristian teachings. The governm ent paid bounty h u n te rs
$5.00 fo r each Native American child delivered to th e boarding schools for
assim ilation. O ften, th e children w ere forcibly taken from th e ir homes.
Upon a rriv a l, th e children su ffered th e humiliation and traum a of
having th e long black h a ir c u t s h o rt, familiar clothing replaced with
school-issued a ttire , and “even th e ir names were changed . . . to make
them A m erican.” Children were given such names as Adams, W ashington,
and Je fferso n . The lack of Native American h isto ry ta u g h t a t th e boarding
school caused emotional pain. The Crow children w ere ta u g h t th e dominant
c u ltu re p ersp ectiv e of h isto ry , th a t indigenous people a re ig n o ran t and
it was bad to be an Native American. One inform ant recalls:
We w ere ta u g h t nothing about Indian h isto ry . Nothing about who
o r w hat WE w ere. AU th e personal re sp e c t and p rid e th a t we
had was about [holding index fin g er and thumb one inch a p art]
th a t b ig .
62
T he fe a r and traum a of being to rn away from familiar family su rro u n d in g s
h a u n t many Crow to th is d ay, as poignantly e x p re ssed , “T h ere is no
g re a te r pain th an to be o rp h an e d .” Children w ere re s tric te d from having
any contact with th e ir fam ilies. Remembering boarding school d a y s, one
inform ant recalled a painful memory, “I was not allowed to speak my
language. I t was a w ritten ru le . . . 'you will not speak any th in g oth er
th an E n g lish !'” The inform ant's mother had also atten d ed a boarding
school and when caught speaking th e Native American language was
sev erely p u n ish ed . The inform ant said “my mother and h e r s is te r had to
sta n d in th e hallway. The nuns drew a circle on th e wall and th ey had to
sta n d with th e ir noses in th e circle all n ig h t until th e n e x t m orning. ” The
traum atic experience of being uprooted as a young child, forced to comply
with s tr ic t ru les u n d e r th re a t of sev ere punishm ent, combined with th e
humiliation of being considered somewhat 'sub-hum an' still affects some
Crow individuals to th is day.
S o c ia l p r o b le m s .
The second theme of th e H ardship dimension is th a t of
Social Problem s, and Discrimination comprises th e f ir s t component of Social
Problem s. The pain of discrim ination was f ir s t experienced in th e failure
of th e E uropeans to recognize and value th e im portance of th e spiritual
trad itio n s and intellectual riches of th e Crow people. T his lack of
u n d e rstan d in g began th e f ir s t stag e of discrim ination a g ain st th e
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Crow people. One inform ant was adam ant when discussing th e re su lts
of discrim ination:
If people feel lost dig n ity , th ey do w ithdraw . T hey t r y to hide
and sta y on th e reserv a tio n . Then once th ey come ou t, th ey have
to face discrim ination ev ery day and because of th e ir p rid e ,
d ig n ity , and re sp e c t - it's tough. You walk into a sto re and
tr y to apply fo r c re d it, or a job. 'Uh u h , y o u 're an In d ian '.
A nother inform ant told of f ir s t encountering a non-N ative American person
a t a v e ry young age, being coaxed into an alley by th e offer of a candy b a r
and su b seq u en tly b eat u p . Memories of a bloody nose, th re a ts , and told in
v e ry g rap h ic words th a t Native American people were not supposed to come
to town and to sta y on th e reserv atio n .
The media promotes discrim ination and lack of u n d e rstan d in g of th e
tr u e essence of Native American c u ltu re , not ju s t th e Crow people. One
example was adam antly e x p re ssed , “Well, ju s t look a t th e movies and books
th a t have been published. This wrong information is why even today some
White people th in k Native Americans still live in tep ees. T h at’s because th e
books say s o .” The bad h u r t comes from constantly facing not only th e
m anufactured image of th e historical Native American b u t also racial and
c u ltu ral intolerance of th e contem porary Native American.
T his a ttitu d e is m anifested in th e medical community as described
b y a key inform ant who works in th e health care field. T he inform ant
said , "I have rea d my medical reco rd th a t sta te s 'obese Indian fem ale'.
Immediately th ey assum e th a t I am overw eight, have tu b erc u lo sis, th a t
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I am u n ed u cated , even though I am an R .N . T hat really makes me a n g ry .”
The stereotypical image of th e “dumb Indian" was also discussed as it
affects any b usiness dealings. An inform ant who holds a responsible
position fo r a sta te agency sta te d , "Business people th in k 'th is dumb
itin e ra n t ig n o ran t Indian - I can cheat him .' Well, I can g u aran tee you,
most Indians a re p re tty sh arp and when you show th a t a ttitu d e tow ards
them , you ju s t cre ate a lot of h a rd fe e lin g s.” Facing th is prejudice on a
daily basis continues to be a source of unrelenting emotional p a in .
Several inform ants rela te personal examples of discrim ination when
seeking medical treatm ent a t clinics and hospitals. Even though firm
appointm ents have been made, Crow re p o rt being routinely pushed back
while o th er people a re taken care of f ir s t. F u rth e r, many Crow believe
th a t Native Americans receive a lower sta n d a rd of medical care th an nonN ative A m ericans. Painful discrim ination is also experienced when seeking
h o using. One inform ant ex p ressed hesitancy to ask fo r an apartm ent,
having been tu rn e d away so many tim es. A nother form of discrim ination is
fe lt in sev eral o th er se ttin g s, such as re s ta u ra n ts and departm ent sto re s.
One inform ant described a common example of discrim ination:
C lerks p ass u s by and serv e oth er people fir s t. We go th ro u g h
i t ev ery day . . . when you g et y o u r d riv e r's license, apply for
in su ra n ce , apply for a job - everyw here. And even when I was
older and had a child, th e city w ouldn't let an Indian w rite a
check. I t makes you tough. I t's ju s t p a rt of being an Indian,
I g u e ss.
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Discrimination affects all lay ers of Crow life, even perm eating places of
en tertain m ent, as one inform ant shared
I play bingo once in awhile and one day I won two $100 jackpots.
I o v erh eard someone say 'who won all th a t money? . . . oh, some
old In d ian , th ey always win' and I replied 'it's because w e're
so lu c k y '. They d id n 't know w hat to sa y . B ut you see, th a t
d ero g atory 'some old Indian' really u p se t me. We pay our money
fo r o u r bingo c a rd s. Why sh o u ld n 't we also have th e rig h t to win?”
The inform ants feel th a t th e Crow people can n ev er escape th e pain of
prejudice and discrim ination. One inform ant ex p ressed a dismal outlook by
say in g , “White people a re opinionated before they ev er g e t a chance to talk
to y o u .” The stereotypical image of th e 'lazy, drunken Indian' seems to
be p erv asiv e in th e job m arket as well. As described by one inform ant,
"I am tre a te d d ifferen t because I'm an Indian. When I tell them I am
looking fo r a job, th ey look a t me like I have th re e heads. I t's th e tr u th .
Indians face it ev ery d a y .” The inform ants then discussed feelings of
discrim ination in th e work place and one said:
Sometimes it's h a rd a t work when people a re prejudiced. B ut th a t's
th e situation when Indians work in th e non-Indian secto r - we a re
tre a te d differently because of th e color of our skin an d because we
talk an o th er language.
Several of th e inform ants shared th e feeling of having to do b e tte r
th an th e ir non-N ative American co-w orkers. Some exam ples: "We have to
speak plain and a rticu late”, ". . . b e more productive and know twice as
much as fellow employees”, feeling “talked around” in professional
m eetings, and being freq u en tly passed over for job prom otions. Not only
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do Crow applicants experience discrim ination in h irin g , b u t also experience
re v e rse discrim ination with th e unspoken a ttitu d e of co-w orkers th a t
"the only reason you’r e in th is position is because you a re an In d ia n .”
Facing discrim ination in th e work place creates daily ten sio n , which
p re v e n ts Crow w orkers from gaining personal satisfaction and a sense
of well being.
T he Crow people have a wide ran g e of views with re g a rd to
discrim ination, from d e sp air, to resignation, to optimism. With te a rs , one
inform ant sh a re d , “It really h u rts th a t because I am an American Indian,
I am any d ifferen t from anyone e ls e .” A nother stated “I'v e seen some real
ra n k discrim ination ag ain st Indians, b u t th e re is discrim ination in all walks
of life."
One inform ant e x p ressed an optimistic view:
I th in k th in g s a re getting b e tte r all th e time* I do. More
people a re becoming educated and know th a t discrim ination is
w rong. It'll n ev er be completely eradicated - you'll always
have some. B ut it is getting b e tte r.
T he su rp risin g issu e about discrim ination is th a t not only does th e
dominant society discrim inate against th e Crow, th e Crow also discrim inate
among them selves, "I grew up in th e governm ent sq u are and people u sed to
th in k we w ere h o tty to tty because we lived th e re . My m other worked for
th e B ureau of Indian A ffairs. We w ere s e p a ra te .” The emotional pain
experienced by Crow a t th e hands of oth er Crow is th e most d istressin g
discrim ination of all.
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Alcohol and D rugs is th e second component of Social Problems. The
h ard sh ip associated with alcohol and d ru g abuse is always considered a
bad h u r t. Not u n til th e a rriv al of tra d e rs and se ttle rs did Native
Americans f ir s t experience alcohol, which was widely u sed as a commodity
in buying and trad in g Native American goods. Unknown before th a t time,
th e introduction of alcohol b ro u g h t an e n tirely new dimension to th e Crow
way of life. As one inform ant sta te d , “Alcohol has been and still is v e ry ,
v e ry bad fo r th e Crow people. I t's too bad th ey feel th a t th e y have to
drown th e ir sorrow with alcohol. B ut th ey d o .” With th e loss of
independence and valued roles of w arrior and p ro v id er, Crow men tu rn e d
to alcohol fo r solace.
T he Crow continue to have a problem with d ru g s and alcohol on
and off th e re serv a tio n . A key inform ant sta te d , “Alcohol is a bad h u r t,
it really i s . ” Some male inform ants talked about th e “Lysol d rin k e rs ,”
a small faction of th e population hopelessly addicted to an in g red ien t
in aerosol Lysol sp ra y . Lysol cans a re p u n c tu re d , draining th e fluid
in sid e, which is then mixed with w ater and in g ested . Lysol d rin k e rs
have in creased in num ber and th e T ribe is try in g to control th e problem.
The final component of Social Problems is th a t of D eprivations.
The p o v erty which began when th e Crow w ere forced onto reserv atio n
continues today. The inform ants believe th a t Crow people have become
desensitized to th e p o v erty conditions on th e reserv a tio n , explaining,
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"It is v e ry desolate and many people a re d e stitu te out on th e re s e rv a tio n .”
With no a ltern a tiv e , one inform ant said, “I had to leave th e reserv atio n or
s ta rv e . No w ork, no money, no fo o d .” Severe pov erty is readily a p p a re n t
on th e re serv a tio n , evidenced by abandoned c a rs, tra s h , broken windows,
th in d o g s, abandoned b usiness establishm ents, and b arb ed w ire around th e
school fo r protection from vandals.
One inform ant commented on th e scarcity of jobs, say in g , "On th e
rese rv a tio n , 75% unemployment is considered normal. D uring th e summer,
it d ro p s to roughly 30-45%. You have to remember th a t fo r th e non-Indian,
8-10% unemployment ra te is considered h ig h .” D uring th e w inter m onths,
“A lot of gu ys have to go on unemployment or general assistan ce . . .
an y th in g th ey can ju s t to g e t through th e w inter. Then summer comes and
th ey s ta r t taking seasonal employment - w hatever th ey can g e t.” A Crow
p erso n is considered lucky to be employed.
A nother problem is th e notable lack of meaningful activities for
youth on th e re se rv a tio n . An inform ant emphasized th a t “th e re is an awful
lot of empty tim e.” The children do not have enough activities to keep
occupied. As a re s u lt, “Children mentally sta rv e on th e re serv a tio n .
No pool, no bowling alley, no YMCA, nothing to keep them b u sy so th ey
d rin k and u se d ru g s."
One inform ant rationalized th a t because Native American people feel so
hopeless and have such a sense of despair th a t sometimes Crow lose re s p e c t
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fo r n a tu re and pollute. For example, a fte r th e annual Crow F air, a w eeklong trib a l g a th e rin g , th e re is a lot of g arbage strew n around th e a re a .
Bad h u r t always ex ists when a Crow person is d isre sp ec tfu l. One Crow
inform ant said “th ey lose re sp e c t and th e ir p rid e is sucked aw ay .”
U nbroken, th is cycle continues u n til “th ey come to a point w here th ey
d isre sp ec t them selves - th ey d isre sp ec t th e ir elders - th ey d isre sp ec t
Mother E a rth . ” The final issu e is th a t of fru stra tio n as voiced by one
Native American who said “it is a well known fact th a t th e Crow own th e
most lan d , b u t y e t we a re th e poorest trib e . . . som ething's w rong!”
I lln e s s a n d d is e a s e .
The final theme of th e H ardship dimension is Illness
and D isease. P rior to th e in trusio n of non-N ative Americans and th e
su b seq u e n t introduction of diseases and foreign food commodities, th e
Crow w ere an extrem ely healthy people. A n atu ral d iet, combined with an
active and nomadic lifestyle, k ep t th e Crow people in excellent physical
h ealth . Life was simple and s tru c tu re d , with clearly defined roles,
resp o n sib ilities and ru les to maintain a harmonious social community.
The end re s u lt of many causes of emotional pain has m anifested itself
in tangible and m easurable physical pain because of facto rs such as
u n h ealth y d iet changes, lifesty les, p o v e rty , and alcoholism. One of th e
most p rev a len t diseases among th e Crow people is th a t of diabetes.
According to one inform ant, “now eig h ty -fiv e p ercen t of th e Indians have
d ia b e te s.” One explanation could be th e relatively re c e n t introduction of
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refin ed su g a r into th e Crow diet left th e Crow people highly susceptible to
th e diabetic disease p ro cess. The sudden and w idespread u se of su g a r
began when it was initially included in th e food allotment d u rin g early
reserv atio n days.
The f ir s t component of Illness and Disease is th a t of Physical Pain.
A nother re s u lt of losing traditional lifestyle and food source is m anifested
in a high incidence of gallbladder disease. As noted by one inform ant,
"It's not u n usual to see someone with gallstones a t th e age of 14. Also
th e re is a high incidence of kidney sto n e s .” With th e loss of th e traditional
d iet, came increased consumption of fa t. Many Crow lament th e loss of a
relatively low cholesterol and chemical fre e food source th a t has been
replaced by a high fa t, su g a r and p re serv a tiv e laden d iet.
The Crow people a re experiencing an increased num ber of those
su fferin g from cancer. The dram atic change in diet is th o u g h t to be
a co n trib u tin g facto r in th e high incidence of gastro in testin al can cers.
One inform ant sta te d "cancer destro y s you. Mentally, physically,
emotionally and financially. I t d estro y s you financially more than
an y th in g else, I su p p o se .” One inform ant described th e physical pain
c u rre n tly being experienced, by saying:
A tumor d estroyed th e n erv e sheath in my fee t. The n e rv e s a re
ju s t b a re and raw , so my fee t ju s t tingle and scream all th e time.
Sometimes th ey g et v e ry painful - peripheral . . . pins and
needles and pain.
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An inform ant explained th a t th e concept of pain was relatively new
to th e Crow. The closest Crow word is "ache.” Also difficult fo r Crow
people to g rasp is th a t th e term 'pain' can be m easured on a scale for
in te n sity . When an Native American person is asked to explain th e
in te n sity of pain, a specific answ er is difficult to elicit on th e 0-10 scale.
One inform ant su g g ested th a t instead of th e linear line m ethod, perhaps
one needs to develop more of a circu lar way of communicating th a t pain. In
essen ce, one needs to u n d e rstan d th e literal world of th e Crow. An
example was offered:
You can ask them if th ey 'v e had a broken arm or a broken leg does it feel like that? Does it feel like when you fell off
y o u r horse? Or when th e horse kicked you? Or when th e horse
step p ed on you? Does it feel like when you stu b b ed y o u r toe?
When you have a toothache? And you will then g et a much
clearer p ic tu re .
Emotional Pain is th e final component u n d e r th e Illness and Disease
them e. All th e key inform ants believe th a t physical pain can be tolerated
and th a t one can learn to overcome th e painful experience; how ever, th e
emotional resp o n se to pain is more difficult to overcome. A key inform ant
offered th e following explanation:
To me, pain would be not physical from an in ju ry , b u t would be
like pain inside - an emotional sc ar th a t might develop a fte r
something has happened, like a d eath . T h at's how I would define
pain in my own term s. I have a lot of tolerance fo r physical pain,
b u t I d o n 't like pain inside . . . th e pain of rejection, m istru st,
and being ridiculed. For in stan ce, words th a t might come from
an o th er person th a t would cause pain inside of me. I d o n 't mind
pain from su rg e ry or from an in ju ry - I can to lerate th a t. B ut
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I would ra th e r have th a t ty p e of pain th an th e oth er ty p e of pain
th a t I ju s t describ ed .
T raditional clients a re often afraid to seek treatm ent from modern medicine
fo r emotional pain. Crow people "feel real guarded - th ey a re afraid of
being h u r t . ” Inform ants w ere unable to identify how Grow people dealt
with emotional pain in th e p a st. While many modern Crow do seek medical
treatm en t, some individuals still experience fea r and apprehension.
One inform ant appeared fru s tra te d and a n g ry saying, “You g e t nothing
from doctors as th ey have no answ er for emotional problem s. I t's not
p a rt of w hat th ey e v er le a rn .” An inform ant stated th a t:
Your sp iritu al being needs taken care of, as well as y o u r physical
b ein g . T h ere 's no doubt about it. It seems like in th e White
medical w orld, th ey sep arate th e sp iritu al from th e p hysical, b u t in
th e Indian population, you cannot se p ara te th e sp iritu a l p a rt from
th e Indian person . . . th a t is th e core of who th ey are! When a
doctor comes to th a t Indian person to tre a t them , many times th ey
ju s t w ant to tre a t th e medical p a rt of th a t person and th ey deny th e
sp iritu a l p a rt, and th en th e Medicine Man comes because th e family
has certain sp iritu al beliefs, and th e y 're not included in th e
complete health care of th a t p e rso n .
Those providing health care need to u n d e rstan d th e difficulty th a t Crows
experience in communicating physical and emotional pain.
Summary of Findings
Pain is accepted as a u niversal experience and each Crow person will
experience pain as a p a rt of life. The Crow believe th a t all people
will experience both good h u rt and bad h u r t sometime d u rin g a lifetime;
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th e re su ltin g pain is generally reg a rd ed as something which helps
one gain knowledge and wisdom. One inform ant explained, "Wise ones
have lived many y e ars and have learned about th e many h u rts of life .”
One reason older Crow people a re held in such high esteem is th a t
th e eld ers have experienced, lived th ro u g h , and learned from painful
ex p erien ces. The Crow elders a re those to whom some young people tu rn
fo r guidance, su p p o rt, and u n d erstan d in g of how to deal with personal
painful experiences.
Crow people experience and accept pain as a n a tu ra l p ro cess of life.
The Crow people consider pain to consist of two d istin ct ty p e s described
as Physical Pain and Emotional Pain. All key inform ants su p p o rt th e belief
th a t physical pain can be to lerated , b u t th e emotional pain is th e h a rd e st
to b e a r. As one Crow inform ant sta te d , "pain is an emotion and th erefo re
one can control your em otions.”
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CHAPTER 5
DISCUSSION
This c h ap ter p re se n ts a summary of th e stu d y , discussion of th e
fin d in g s, b en efits, lim itations, and implications of th e stu d y .
Recommendations a re offered for fu rth e r stu d y .
Summary of th e Study
This qualitative stu d y of th e experience of pain by traditional
Crow people has provided meaningful in sig h t and enhanced th e knowledge
of Crow h isto ry and c u ltu re . The focus of th e resea rch p ro ject was
to provide c u ltu ral knowledge to non-N ative American n u r s e s . In th is
stu d y , ethnographic interview s w ere conducted with 15 traditional Crow.
S pradley's (1979) method was utilized to conduct interview s and analyze
d a ta . A taxonomy was generated from th e d ata, expanded th ro u g h
follow-up in terv iew s, and verified by some inform ants.
The stu d y provides a basic u n d erstan d in g of th e role of pain as a major
variable as it p e rta in s to th e Crow people. D escriptive d ata w ere g ath ered
about trad itional beliefs and behaviors th a t affect th e experience of pain.
G reater u n d erstan d in g of th e cultu ral dimensions of pain will help health
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care professionals develop an effective approach to providing quality pain
management to th e Crow population.
Findings and Implications
The findings from th e data revealed th a t cu ltu re is a variable th a t
affects th e traditional Crow's experience of pain. Several im portant themes
em erged from th is stu d y : n atu ral p ro cess, group pain, expression of pain,
family sh ared pain, assessm ent, and th e blending of modern and traditional
medicine.
The Crow client believes pain is a n a tu ra l p ro cess. H istorically, th e
eld er Crow gained re sp e c t and wisdom because th ey had lived and
experienced many “h u rts ” thro u g h o u t th e ir long life. The d ata collected
su p p o rt th a t “good h u rt” and “bad h u rt” m ust be experienced as a n atu ral
p ro ce ss. T he Crow person does not fe a r th e pain, b u t simply must
experience th e pain. V illarruel and Ortiz de Montellano’s (1992) resea rch
on Mesoamericans su p p o rt th e concept of pain as a n a tu ra l p ro cess.
Mesoamericans m aintained th a t "pain was an accepted, a n ticip ated , and
n ecessary p a rt of human life” ( p . 26). The traditional Crow people hold
fa s t to th is value.
Crow people consider pain to have both physical and emotional
elem ents. The physical pain is easily accepted and e n d u re d , b u t th e
emotional pain is h a rd e r to b e a r. The Crow believe th a t emotional pain is
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considered a bad h u r t. One cannot shield oneself from emotional pain b u t
m ust simply experience it.
T raditional beliefs, values, and behaviors m ust be recognized. N urses
m ust be aw are of th e y e ars of d is tru s t and abuse inflicted by th e dominant
society onto th e Crow people. The pain is experienced as an e n tire group
of people, not unlike th e Jews and th e Holocaust and th e ethnic cleansing in
Bosnia. N urses need to u n d e rstan d th a t h istoric pain continues to impact
trad itio n al Crow people to th is day. The most notable historical events a re
th e B attle of th e L ittle Big Horn, th e small pox epidemic, th e m issionary,
governm ent and reserv atio n days.
The findings of th is stu d y su p p o rt th a t Crow people have experienced
many pains th ro u g h o u t th e transitional y e a rs, th e most notable being th e
loss of Crow lands and tran sitio n from a fre e and independent life sty le to
th e re p re ssiv e existence on th e Crow reserv a tio n . The findings identify
th a t th e loss of role and duties by th e Crow is still fe lt. For example, th e
trad itio n al male roles of w arrior and h u n te r have not been replaced.
The Crow continue to transition and evolve. The emotional pain
continues to be experienced as th e Crow a re caught betw een two se ts of
values - th e values of th e old ways and th e values associated with th e new
w ays. T hese co n trastin g values a re th e cause of most emotional pain.
The second theme from V illarruel and Ortiz de Montellano's (1992)
rese a rc h was "The ability to en d u re pain and suffering stoically was
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valued” (p . 28). Some traditional Grow consider pain as an emotion,
and th ere fo re th e Grow person is able to control th ese emotions. The
trad itio n al Crow inform ants believe th e younger people a re soft and
have not been ta u g h t th e same values associated with not ex p ressin g pain.
E nduring and experiencing th e emotional and physical pain has been an
in te g ral p a rt of th e traditional Crow u p b rin g in g .
C hildren of both th e dominant society and Crow people learn about
pain from examples se t by oth er family members, b u t th e lessons learned
a re much d ifferen t. The dominant society child learns how to avoid and
alleviate pain. The Crow child learn s how to experience, sh a re , and leave
th e pain , becoming stro n g e r through th e p ro cess.
N urses need to know and u n d e rstan d th e im portance of family to th e
Crow people, as it is an essential element to th e traditional Crow p erso n .
The Crow g reatly value th e im portance of extended family. The findings of
th is rese a rc h stu d y su p p o rt Prim eaux's (1977b) theme th a t to th e Native
American, tr u e p o v erty is to be w ithout family.
Primeaux (1977b) identified th e theme of sharing in th e Native
Am ericans. Primeaux re p o rts th a t in time of illness, th e family members
sh a re th e su fferin g of th e client. The findings of th is re se a rc h su p p o rt
Prim eaux's them e.
The Crow client does not en d u re pain alone as is th e case of th e
dominant society. The Crow people believe in an element of “sh ared pain”
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and it is crucial th a t n u rse s u n d e rstan d th e im portance of la rg e num bers
of family members w anting to be n ear th e Crow client. The fa mily members
of th e Crow client a re able to sh are th e experience of pain and need to be
accommodated and not chastised for th e ir beliefs. Hospitals and agencies
also need to u n d e rsta n d th is and allow o th er Crow to v isit, sta y , and sh a re
th e c lien t's pain.
T raditional beliefs, p ractices, and behaviors m ust be recognized,
resp e c te d , and considered in o rd er fo r n u rsin g to provide optimum care to
cu ltu rally d iv erse clien ts. N urses caring for clients outside th e ir cultu ral
group need an aw areness of th e health beliefs and c u ltu ral practices in
o rd e r to in te rp re t and effectively a d d re ss th e pain of th e client. The
n u rse m ust not over-generalize th e values of one client to th e values of
all Crow clients and m ust re sp e c t th e individual's c u ltu ral beliefs and
p ra c tic e s.
The Crow person believes one m ust learn from and gain knowledge from
th e pain experience. T h u s, for n u rse s to lessen or shield th e client from
a painful experience would be detrim ental to th e traditional Crow client.
The Crow's ability and willingness to e n d u re pain is foreign to dominant
society n u rse s' way of th in k in g . The Crow client may not ask for
m edications, and p erh ap s even refu se to tak e medications to relieve th e
physical pain being experienced.
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The d ata reveal th e im portance of including a c u ltu ral assessm ent
in th e n u rsin g health h isto ry . The ethnic identification of Caucasian/
White, Native American, Afro-Am erican, A sian-Am erican, or
Hispanic/M exican American is not sufficient. The health h isto ry needs
to include a basic cu ltu ral assessm ent as well. W hether n u rse s utilize
Jacobson & Booton's (1991) simple question of “How Indian a re You?”
(p . 356), Milligan’s (1981) more categorical definition of trad itio n al,
tran sitio n al, or m odern, or Bloch's (1983) e th n ic/c u ltu ral assessm ent
guide, th e n u rse m ust asse ss th e cu ltu ral involvement of th e client.
The findings of th is stu d y indicate th e need to develop a culturally
specific pain assessm ent tool. The traditional Crow people do not th in k in
a lin ear fashion, b u t th in k more in a circu lar p a tte rn . When n u rse s ask th e
client to ra te th e se v erity of pain on a 0-10 point scale, th e traditional
Crow client is not able to provide th e n u rse with an answ er.
The fin dings of th is stu d y show th e im portance of th e n u rs e to describ e
painful e v e n ts, th erap ies or treatm ents in such a way to include th e
p u rp o se and possible outcome of th e painful ev en t. The pain is end u red
more easily if th e traditional Crow person knows and u n d e rsta n d s th e
p u rp o se fo r th e pain involved.
The ultim ate goal fo r n u rse s is to provide culturally con g ru en t
n u rsin g c a re . As n u rse s provide d irect physical and psychosocial care
to individuals, families, and g ro u p s, th e c u ltu ral orientation of th e
80
client m ust be a sse ssed . N urses will need to a d d re ss th e client and
continue to learn about th e diverse client populations se rv e d . The quality
of care provided to clients of diverse cultu ral backgrounds will continue
to improve as th e n u rse obtains a clear u n d erstan d in g of th e clien t's
cu ltu ral orientation.
The final finding of th is research is consistent with H enderson &
Prim eaux's (1981) statem ent th a t Native Americans utilize both modern
medicine and traditional Native American p ractices. The traditional Crow
also access both ty p es of medicine, and th is is im portant information for
n u rsin g to em brace. T here is a need fo r th e n u rse to re s p e c t and
in co rp o rate th e traditional practices into th e client's plan of c are.
Prim eaux (1977a) sta te s th a t to th e Native American, “Medicine and religion
a re inseparable" (p . 55). The traditional Crow I interview ed explain th a t
medicine and sp iritu ality a re interw oven. No referen ce to religion was e v er
made.
B enefits
Two of th e inform ants did experience immediate benefits from th e
rese a rc h stu d y . One p articip an t experienced closure of personal issues
when sh arin g h e r sto ry . A nother p articip an t gained th e in n e r s tre n g th
and motivation needed to particip ate in th e Crow sun dance cerem ony.
81
U ndertaking a research project th a t is tra n sc u ltu ra l in n a tu re has
re su lte d in a journey fa r from th e o rd in ary . The acquisition of knowledge
from th e Crow cu ltu re is in itself a valued asp ect of qualitative re se a rc h .
The personal benefit arisin g from th e stu d y was th e deeper u n d erstan d in g
and appreciation of th e unique Crow c u ltu re.
Limitations
In th is stu d y , th e sample was purposefully taken from one segm ent
of a community. Only those Crow who self-identified them selves as
trad itio n al Crow w ere interview ed. A nother sample of n o n -traditional Crow
might reveal d ifferen t re s u lts . T herefore, th e findings of th is stu d y a re
not generally applicable to other Native American trib e s nor to
n o n -trad itio nal Crow.
B ecause I am not a Native American, I can nev er experience th e reality
of pain from th e p ersp ectiv e of a Native American. Because of th is fa c t, it
may have been possible th a t an im portant connection, m isinterpretation of
d a ta , o r o p po rtu n ity to obtain additional e x p e rt data may have been
overlooked d u rin g th e resea rch p ro c e ss.
82
Recommendations for F u rth e r Study
F u rth e r n u rsin g resea rch is needed relating to th e c u ltu ral needs,
issu e s, and health care of Native Am ericans. Several specific a reas a re in
need of fu r th e r investigation:
1.
O ther Native American trib e s or cultu ral groups need to be
stu d ied to identify th e ir experience of pain. Studies need to branch
out into th e expanded issu e of pain assessm ent, tolerance, expression,
and p ercep tion.
2.
The effects of historical pain m ust also be explored within
Milligan's (1981) o th er cultu ral su b -g ro u p s of th e Crow people. O ther
Native American trib e s or cultural groups may be similarly affected by
historical pain.
3.
The concepts and taxonomy which emerged from th is stu d y
needs to be v erified , expanded, modified or re fu te d . In addition,
th e relationship of th ese concepts demands fu rth e r in v estig atio n .
4.
C ulturally sensitive tools need to be developed which ad d re ss
th e physiological param eters (in te n sity and q u a lity ), behavioral param eters
(c u ltu ral teachings and response to p a in ), and cognitive param eters
(h isto ry , experiences, and meaning) of pain assessm ent.
83
The c u ltu ral re s e a rc h e r's im perative and ultim ate goal is to complete
c u ltu rally con g ru en t stu d ies. The knowledge gen erated from culturally
co n g ru en t resea rch stu d ies can be utilized to develop and deliver a h ig h er
quality of care to specific cultural populations th e n u rse is se rv in g .
84
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88
APPENDICES
89
APPENDIX A
RESEARCH QUESTIONS
0
What is y o u r definition of pain?
6
Could you tell me about th e pain Crow people experience?
0
Could you tell me about th e pain your ancestors experienced?
0
Could you tell me about th e pain you have experienced?
°
Could you tell me about th e pain y o u r children and g randchildren will
experience in th e fu tu re?
o
Do Crow people experience pain?
°
A re th e re d ifferen t kinds of pain?
0
Could you tell me an example of th ese d ifferen t kinds of pain?
90
APPENDIX B
TAXONOMY OF CROW PAIN
CHILDBIRTH
H A R D WORK
GOOD
HURT
R U N N IN G / EXERCISE
SURG ERY
SU N DANCE
D EA TH
TRADITION
TRIBAL RESPECT
ELDERS, CHIEFS, W ISE ONES
LOSS
PRIDE
DIGNITY
RESPECT
BAD
SPACE
Physical
STARVATION
HURT
M ental
Separation
DISCRIM INATION
Future
HARD-
Physical Pain
SHIPS
ILLNESS
Emotional Pain
Drugs
SOCIAL
A lcohol
Economic
M O N T A N A S T A T B U N IV E R S IT Y L IB R A R IE S
a I Z b 2 1 U 2 3 8 2 3 4 fc>