Doctor Takes Lesson From Native Healers

The first woman Navajo surgeon once encountered a man whose intestine was pierced by a porcupine quill that he insisted was put there by an enemy’s curse, and a woman who was convinced that lightning had caused her cancer.

Dr. Lori Arviso Alvord has also seen a mysterious outbreak of a deadly flu-like epidemic that an Indian medicine man said was caused by too much rain. And she has learned that Navajo traditions can be better than Western practices for treating such unusual cases as well as more common illnesses.

Alvord, who grew up on a Navajo reservation near Gallup, N.M., said Western medicine often ignores a key tenet of Navajo beliefs-the idea that balance is the key to health. Just as too much rain can harm crops, too many negative thoughts can cause sickness.

When the mysterious flu-like illness swept through the reservation, a local medicine man blamed the outbreak on a surplus of nuts caused by the heavy rain. Experts at the U.S. Centers for Disease Control and Prevention were baffled by the epidemic, but they dismissed the nut theory at first.

Then they discovered that the medicine man had in fact found the root of the problem. Excess rain had nourished a bumper crop of nuts that in turn fed a rise in the mouse population. Those mice passed the disease along to humans.

Alvord, a graduate of the prestigious Stanford University medical school, said she learned more about caring for people while practicing surgery at the Indian Health Service in Gallup. Most of that hospital’s patients are Navajo, and medicine men are encouraged to hold healing ceremonies with songs and spiritual objects.

Alvord said Navajo patients do not respond well to the often brusque and impersonal attitude of many Western-trained doctors. Medicine men understand that and tend to use words instead of hands as the first tool to diagnose their patients.

“To [Navajo patients] it is not acceptable to walk into a room, quickly open someone’s shirt and listen to their heart with a stethoscope, or stick something in their mouth or ear,” she wrote in “The Scalpel and the Silver Bear,” a book about her life that was released this month.

The title comes from her clan, the bear, which prides itself on its courage and strength. Navajo legend tells of a woman who sought revenge against the people who had killed her husband and took on the form of a bear to give her the strength to defeat her enemy.

Alvord, who wears a bear charm around her neck, said she called on that same power when she was asked to dissect a cadaver in medical school. Navajo custom forbids contact with the dead, which are believed to possess evil spirits. When a person dies, Navajo believe the “good” part of the person leaves with the spirit and the “evil” stays with the body.

Alvord said medical schools are partly to blame for producing an emotionally cold medical community. Forcing students to work long hours and subjecting them to hazing by more experienced doctors may harden doctors to the pain and fear of patients, which can make treatment more difficult.

“Emphasis is placed on training doctors to be efficient, cut costs and be timely, making bedside manner an afterthought. But patients who feel taken care of and understood fare better. We doctors, like medicine men, are in the business of healing, and we must not lose sight of it,” she wrote.

The key is to train doctors to treat patients as if they were family members, she said. Hospitals can also make small changes, such as setting aside rooms where family members can spend the night close to ill relatives or adding windows to intensive care units.

“For many, many years ICUs had no windows,” she told Reuters by telephone. “Patients were in this room where they had no sense of night and day, no concept of what was going on outside, all kinds of crazy lines hooked up to them, all types of medication and no way to be oriented with the world.”

Alvord is now associate dean at Dartmouth Medical School and hopes to train a generation of doctors who understand how to treat patients as human beings rather than cases.

“Anyone who watches ‘ER’ is aware of the grueling way that residents are trained,” she said of the popular television series. “We’re looking at ways that students can receive a medical education where they don’t feel that they’re being harmed and changed in the process.”

At Dartmouth, Alvord has started a native healers lecture series where medicine men speak with students and a “talking circle” where students can openly discuss the tough issues they face, such as dealing with sickness and death.

“I hope [the next generation of doctors] make it a kinder, gentler system,” Alvord said. “I hope they make it somewhere where patients are not afraid to go to the hospital and where they know that people who they encounter will really, truly care for them and take care of them.”