The new health clinic on the Chumash reservation here is state of the art, and Dr. Julio Torres and the nurses do what clinicians do everywhere. They give little kids shots. They prescribe medication. They urge patients to get more exercise. And they wrestle with problems small and large.
But just around the corner, there's a different world. Adelina Alva-Padilla is the spiritual leader of the Santa Ynez Band of Chumash Indians. She is a healer too.
She treats all kinds of ailments, but with burning sage and secret herbs, feathers of a red-tailed hawk, chants and songs. Some nights, she takes the ailing to her sweat lodge.
All this is in the tradition of Native American healing practices dating back thousands of years. The partnership between the mainstream doctor and the spiritual healer is a blend of old and new. And of mutual respect. Torres and Alva-Padilla see themselves as a team.
"Dr. Torres really respects the Native American approach and Adelina's method of spiritual healing," said Frances Snyder, a tribal spokeswoman. And Alva-Padilla "tells her patients to do what the doctors tell them. And she goes to the clinic herself when she needs to."
The tribe's new clinic, opened in December across from the new Chumash tribal hall, was built for about $4 million with profits from the tribe's casino. The gambling hall expanded in recent years, making it a source of increasing revenue and controversy for the tribe.
The 10,000-square-foot clinic is open to Native Americans and everyone else in the Santa Barbara County's surrounding Santa Ynez Valley.
Torres, 67, was born in Los Angeles and graduated from UC Irvine Medical School. He spent most of his career taking care of the poor. He practiced in Compton for 15 years, then in the South Bay. Seven years ago, he became the Chumash medical director.
The spiritual healing practiced not far from his door hasn't really changed his medical views, Torres said, as he performed a routine exam on a non-tribal patient. Strong spirituality has always been a plus in dealing with sickness. And also part of his own life, he said.
"My views have changed only in that I'm aware there is an additional dimension," Torres said. "I spent most of my life treating the poor. I like to think I had a good spiritual component before I came here."
For serious trauma or disease, such as the lung cancer patient who had visited just a day earlier, Torres' orders are strictly modern medicine -- a CT scan, biopsy and referral to a hospital.
A case of depression, however, might allow more room for creative cooperation with Alva-Padilla, his spiritual counterpart.
Torres probably would prescribe medication. The medicine woman said she would offer counseling, or perhaps take the patient to the sweat lodge, staying as long as necessary and keeping the patient talking. The sweat lodge is like the womb of the mother, Alva-Padilla said.
Bronchitis or high blood pressure might again bring a trip to the sweat lodge, with steam from heated stones and the smell of eucalyptus leaves.
No matter what the problem, she always supports modern medical techniques, said Alva-Padilla, also 67.
"I always tell a patient everything their doctor does will help them," she said. "We always work together when that is the appropriate action."
The U.S. medical establishment has taken a cautious stance on the value of native spiritual healing.
One report on alternative medicine by the American Cancer Society in 2000 declared: "There is no scientific evidence that Native American healing can cure cancer or any other disease. However, the communal support provided by this approach to health care can have some worthwhile physical, emotional and spiritual benefits."
The society's report, however, described one clinical trial in which 116 people with ailments including diabetes, asthma and cancer were treated with traditional Native American healing. Five years later, 50 of the participants said they were cured of their diseases, and 41 others said they felt better. The report called for further research.
Alva-Padilla ministers to about 1,500 people a year, and never turns anybody away, even if they aren't among the 157 members of the Santa Ynez tribe, she said.
She has traveled widely as a practitioner of traditional Native American medicine. Today, she is a consultant to the Santa Barbara Museum of Natural History, as well as a tribal elder. She is also the mother of seven, grandmother of 37 and great-grandmother of 19.
Alva-Padilla's house is just up the street and around the corner from the tribe's new clinic. A dozen wind chimes greet visitors with a soothing melody. Everything inside is a gift, except for the couch. The spiritual healer said she takes no money, so people give her presents instead.
Indian baskets and rugs and the pictures of old warrior chiefs fill her home. All around are magical icons from many cultures -- elves on the porch, a glass with Mickey Mouse in his sorcerer's hat.
In the backyard, a Buddhist shrine and a Catholic shrine stand not far from a ceremonial fire ring. The tree-branch frame of the sweat lodge stands ready.
"This is my house," Alva-Padilla said, without pretense. "And this is your house."
She took a long and trying route to her present place.
Her mother gave her away at age 6, she said. She spent years drinking, and she lived for 15 years in Watts. But she believes a divine creator predetermined that she would come home to the reservation as a healer.
There's one key difference between Torres and Alva-Padilla when it comes to healing, she said. Antibiotics and other medicines don't require faith to work, she said. But her medicine is all about faith.
"Some people come who don't believe," she said. "They think it's some kind of show.
"But if you don't have total belief, it won't work," Alva-Padilla said. "You have to have complete faith. You don't monkey around with the Creator."