MULTICULTURAL MEDICINE : Hospitals are going beyond cursory measures to understand the needs of patients. Some schedule Cesareans on propitious dates for Asian women. : Others offer ethnic food or allow families to perform rituals.

The morning after Suwen Shen’s son was born, a Garfield Medical Center nurse swaddled her baby in a red-and-green blanket--avoiding white, the traditional Chinese funeral color.

The nurse also brought a breakfast tray with a man tou roll, rice porridge and warmed soybean milk, knowing that in Chinese culture, cold fluids are taboo for new mothers and sick people.

Shen, a 31-year-old Taiwanese native, blissfully turned her thoughts away from nagging superstitions and toward her newborn, who, she hinted on the mid-January day after his birth, already has the makings of a doctor.

“It made me feel like home,” said Shen, a south Orange County resident who came to the Monterey Park hospital primarily because of its multicultural environment. “It made me feel like they care and respect our culture.” As the San Gabriel Valley’s demographics change, Garfield Medical Center and a few other hospitals are extending themselves beyond the basics of providing translators, multiethnic staffs and trilingual signs and forms, actions that cost tens of thousands of dollars. These efforts--no matter how expensive--are not always enough in a fiercely competitive health-care market, in which hospitals are offering more culturally based extras than ever before. In ethnically diverse areas such as Monterey Park and Alhambra, hospitals are boning up on the folklore and traditions of their multicultural communities, sometimes even bending the rules for the sake of a patient’s or family’s peace of mind.

“There is a major trend in the hospital community toward the increasing recognition of ethnic and racial diversity,” said David Langness, a vice president of the Hospital Council of Southern California trade group. “I see hospitals beginning to go beyond the standard signs in different languages and staff people who can translate etc., into a deeper recognition of the cultural differences in certain populations and ways to treat them.”

The push for cultural awareness is part business, part goodwill, said Langness.

“What we’re seeing in Los Angeles and Southern California is the first world metropolis,” he said. “Hospitals have to respond to that . . . if they don’t, they’ll lose patients. It’s not a matter of being politically correct. It’s a matter of responding to your patients’ needs.”

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Asian culture is particularly rich with ancient superstitions associated with milestones, such as birth and death--beliefs that hospitals such as Garfield, where Asians account for 55% of the patients, cannot afford to ignore.

Other hospitals with relatively large minority populations include Alhambra Hospital, where Asian, white and Latino patients are seen in roughly equal numbers; and San Gabriel Valley Medical Center, where patients are 55% white, 26% Latino, 16% Asian and 3% other groups.

By contrast, at Huntington Memorial Hospital in Pasadena--the Valley’s largest--only 7% of the patients are Asian and 22% are Latino, according to 1992 statistics, the latest available. Consequently, Huntington and other hospitals with fewer minority patients have made relatively few changes to accommodate ethnic populations.

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The nod to multiculturalism in medicine is sometimes as simple as adding a pair of chopsticks to a hospital tray or as thoughtful as offering gift-shop wrapping paper in the Chinese lucky color of red, the way Alhambra Hospital does.

Or as savvy as providing mahjong sets for Asian recreational therapy patients, the way Garfield does.

Or as community-minded as celebrating the Chinese New Year on Feb. 10 with gifts for newborns, the way San Gabriel Valley Medical Center in San Gabriel will do.

On a deeper level, hospital staffs are learning about and accommodating the traditional rituals that some families and patients swear by. At several local hospitals, for instance, expectant Chinese mothers who need Cesarean sections ask their doctor to deliver at an auspicious time and day, as selected by a fortuneteller.

Garfield nurses say they will wrap the nutrient-rich placenta in a plastic bag for Vietnamese mothers who take it home to eat or for Filipino mothers who bury the placenta with books in the belief that the ritual will make the baby smart.

And at Alhambra Hospital, administrator Elaine Reavis remembers the time last November when a Chinese Buddhist family asked that a loved one’s body stay in the hospital room for eight hours after death so the soul would have a chance to depart while a monk chanted the proper prayers. The hospital agreed to bend its rules.

Tied to the respect for tradition is a recognition of the mind’s power to heal, said Pitzer College sociology Professor Jose Calderon. For instance, Calderon said, when he was sick as a boy, his mother put potatoes on his head as a way to draw the fever out, an old Mexican folk remedy that he says is medically harmless but psychologically healing if a patient believes that such a “cure” works.

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“That’s the real significance of all this--to really build up the living force of the patient, the desire to keep themselves alive,” said Calderon, chairman of the Alhambra School District’s Human Relations Advisory Committee on ethnic diversity.

“It may be something the medical world says this doesn’t work, but it would be very disrespectful to tell someone that it doesn’t work,” he said. “We have to be able to integrate what our beliefs are in terms of our traditions and contemporary medicine.”

Doctors who ignore other cultures can risk more than offending people, said Dr. Jeffrey Tsai, a Chinese American urologist and chief of staff at Alhambra Hospital. For example, some Vietnamese and Chinese patients put heated porcelain bottles filled with alcohol against their skin, in an attempt to suck out the sickness. The hot pressure leaves marks that look like bruises, he said, leading some doctors to mistakenly suspect domestic or child abuse.

Even doctors who are sensitive to patients’ needs have limits, said Dr. Thomas Tam, chairman of the obstetrics department at Garfield. For instance, physicians will not approve Cesarean sections for mothers who don’t need them, he said. But Tam, who is Chinese American, will go along with mothers who require Cesareans and want to deliver at a predetermined lucky time, even if he has to work on a holiday or at 2 a.m.

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“If it doesn’t hinder the general good practice of medicine, I will comply to make her happier for psychological reasons,” Tam said. “I will run the extra mile, beyond the call of duty, to make her happier in her cultural needs.”

Even Asian residents with longtime roots in the United States sometimes find it hard to shake the old ways, said Marina Tse, co-chair of the Multi-Cultural Community Assn. of the San Gabriel Valley.

“I grew up listening to it, exposed to it, and people gave me examples of it (working),” said Tse, a Monterey Park resident who has a master’s degree in special education from USC. “You forget about logical thinking. Somehow my heart’s afraid a little bit (of not following tradition).”

In Chinese culture, superstitions are passed through the generations over thousands of years, with the same fervor that prompts ailing Americans to turn to chicken soup, said Tse, who has advised local hospitals on such traditions.

Among the common clashes with Chinese tradition: hospital beds that don’t face south, believed to be the only lucky direction; decor in blue and white, which are traditional funeral colors; assigning patients to a room No. 4, a number that sounds like the Chinese word for death; and prescriptions written in red, an ink color chosen when a writer wants to signify the end of something, such as a relationship.

Most patients do not demand such changes, hospital administrators said. But they are grateful for small favors--the little touches that make them feel that a hospital respects their roots.

On a recent morning at Alhambra Hospital, 77-year-old patient T.P. Wu was recovering from injuries resulting from a bad fall. The Taiwanese native clad in pajamas sat on his bed, circling his meal choices from the Chinese-language menu. A stack of Chinese newspapers was on his bed, delivered by hospital staff. On his night stand was a thermos of hot water, brought by nurses who knew that he would want to avoid cold liquids.

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Later that day, Wu had the option of watching a Chinese language documentary on the in-house cable system. When he is discharged, he’ll pass by original Chinese calligraphy scrolls in the admitting room.

“If someone respects us and understands what we want, it helps us recuperate,” said his grateful wife, Li Ming Lu, through a hospital-provided translator.

The respect also gets business.

Last spring, after a Chinese Eastern Airlines flight from Shanghai crashed in Alaska, 20 of 160 injured passengers made their way to Alhambra Hospital, said Iris Lai, the hospital’s director of marketing. A group of recuperating passengers had asked to be transferred to Los Angeles, their original flight destination, where they heard about Alhambra Hospital’s staff and services from local doctors.

Lai and the hospital’s Chinese chef, Benny Chung, visited each patient’s bedside, asking for meal requests. Chung then whipped up individual requests for broccoli beef, sweet and sour pork and pickled vegetables in the hospital’s kitchen, which is equipped with a special Chinese range, wok and rice cooker. The crash victims left Alhambra with only one complaint-- the hospital had served no shrimp dishes.

Hospital staffs are also learning about the psyche of patients who come from countries in which the Western practice of medicine is often bewildering.

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Methodist Hospital of Southern California in Arcadia has presented ethnic awareness seminars to avoid misunderstandings, said Marcia Jackson, an administrator for the parent company. Staff members have learned, for instance, that some Asian patients avoid eye contact, a sign of respect in their culture, Jackson said.

In Asian cultures, doctors are often looked upon as gods, and patients tend to be blindly obedient, said Wendy Chan, the Chinese American director of marketing at Garfield Medical Center.

“They just follow, like the Holy Bible,” Chan said. In staff training, nurses are instructed to press Asian patients for questions and make sure they understand the doctor’s instructions, she said.

Patients come to Garfield from as far away as San Diego for multicultural services that include ultrasound cards in English, Spanish or Chinese labeled, “Baby’s First Picture” and trilingual classes on breast self-examination, cardiopulmonary resuscitation and prostate cancer, among others.

“The one complaint that I have is they’re so popular here,” said Richard Eng, whose pregnant wife could not get a spot in the hospital’s Chinese-language Lamaze classes.

Eng, 30, a resident of North Hills in the San Fernando Valley, said the 40-minute drive to the hospital is worth it because the Chinese nurses and doctors there understand the needs of his Hong Kong-born wife.

“It’s not just hiring bilingual nurses and putting up a few signs,” said Eng, an engineer. “Cultures are very different. There are a lot of little things that not everyone knows. It’s a big commitment (to learn).”

Asian traditions are among the most complex; hospital administrators say it is usually easier to meet the needs of other ethnic groups.

Latino patients, for instance, tend to have long visits from members of their extended family. Consequently, San Gabriel Valley Medical Center designed extra-large maternity rooms for its new obstetrics unit, which opened in June, 1993, said Virginia Gladwin, administrative director of obstetric services.

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At Queen of the Valley Hospital in West Covina, nurses have allowed Hindu families to sprinkle rose petals around a loved one’s dead body and a family from the Middle East to pour honey on the head of a newborn baby as a blessing, said Vivian Branchick, vice president of patient care services.

Still, some health-care providers are refusing to acknowledge even the basics of multiculturalism, said Calderon, the Pitzer College professor. Last year, he said, his Spanish-speaking grandmother died in a Monterey Park convalescent home that had “English Only” signs posted for its workers. Calderon was the only one who was able to feed his grandmother, though he did this by trickery. He would ask questions like, “Com o se llama?” (“what’s your name”) and would spoon in the food when she opened her mouth to answer--something she would not do with English speakers.

“It showed a real insensitivity,” he said of the convalescent home’s English-only policy. “Those kinds of things still exist.”

Patient Populations

The following is an ethnic breakdown of patients in selected local hospitals, according to the latest available statistics:

Alhambra Hospital, Alhambra White 36% Asian 31% Latino 30% Other 3%

Garfield Medical Center, Monterey Park White 11% Asian 55% Latino 32% Other 2%

Huntington Memorial Hospital, Pasadena White 56% Asian 7% Black 13% Latino 22% Other 2%

Methodist Hospital of Southern California White 75% Asian 8% Black 5% Latino 12%

San Gabriel Valley Medical Center, San Gabriel White 55% Asian 16% Latino 26% Other 3%