My time in Whiteriver has finally come to an end, and I have learned so much from this experience that I will bring with me.
My last couple of weeks I spent working in a variety of clinics ranging from Family Medicine to high-risk OB/prenatal care, from Pediatrics to Internal Medicine. I truly saw the full spectrum from a 3 day-old newborn infant to an 80 year-old man with metastatic cancer. I learned how to manage rheumatoid arthritis and ankylosing spondylitis (yes, it does exist!) where there is no Rheumatologist and care for an open fracture of the distal finger where the nearest Orthopedic surgeon is 2 hospital transfers away. I witnessed the devastating effects of substance use rooted in personal and historical trauma and the hope and joy that accompanies one's faith in something larger than oneself. In all of these things, I re-discovered the beauty of medicine and caring for others- I was reminded of why I chose to become a physician in the first place.
Yesterday I had the opportunity to work in Cibecue, a rural town of ~2,000 people on the White Mountain Apache Indian Reservation. Cibecue is over an hour drive from Whiteriver, so I joined the group of workers in a large van that carpools daily from Whiteriver to Cibecue. The area just saw a large snowstorm, so the drive was exceptionally beautiful- scattered with frosted trees and bushes, snow-capped mesas and alpine mountains, snow-powdered red rock, and wild horses roaming around. When I arrived at the Cibecue clinic it reminded me of the free stand-alone clinics that I've worked at both on the Navajo Nation in Arizona and in rural areas of Central and South America. Most of the people living in Cibecue do not have any means of transportation, so having a clinic there with doctors who can provide full-spectrum care is necessary.
The patient encounters I had that day comprised everyday Family Medicine issues, but most unique was getting to know the patients beyond their medical conditions. I met one man who was a bull-riding judge who had been hired to judge at many national competitions. He is known for his handmade belt buckles, especially in Canada where most of his buyers are. He talked to me for 20 minutes about his experience and reiterated to me one important lesson he learned in his work- to never sacrifice one's integrity for something or someone. I also encountered a woman who, like me, graduated from the University of Arizona- a fellow Wildcat as we say. She has a doctorate degree in Education and works at the local school in Cibecue. She acknowledged that she isn't using her degree as one would expect, but she is passionate about educating the children of her ancestors and that's what is important to her. She always knew she wanted to return to where she grew up. And then there was another man who works at the Apache Sunrise ski resort who after I had said I was visiting from Colorado told me he had worked at the Eldora ski resort in Colorado for more than 10 years! We talked about our mutual interest in skiing and our love of the mountains.
"Patria es humanidad," or in English, "the only nation is humanity." This is a phrase that is written in Mountains Beyond Mountains, a book I am reading that follows the life of Paul Farmer and his international work in Haiti. Call it coincidental, but I think this phrase stood out to me after all of these patients I met yesterday. Despite all of the cultural and language differences that could separate us, the physical borders and mountains that could divide us, and even the doctor-patient gradient that could further distance us, I was reminded of what we share in common: our humanity. I have learned that many of the challenges that have come with providing care to people different from myself rise from the failure to recognize this common humanity. There will always be inevitable barriers when caring for people different from myself, things that can't necessarily change like language, culture and tradition, history. But when recognizing one's humanity is at the forefront of that interpersonal encounter, I firmly believe that these barriers are made easier to overcome. This is what the Apache Indians have taught me.
When I was writing my first blog post, I asked myself why I came to Whiteriver to do an elective rotation, and I didn't really know the answer at that time. I could easily come up with a list of self-serving reasons: to improve my medical knowledge and experience providing rural and full-spectrum healthcare or to scope out potential options for my future career. I remember when I initially came to Whiteriver I assumed that maybe I wouldn't be well-perceived by the Apache Indians after dropping in for one month only to leave and move on to different things. And though this still might be true, I was surprised by how many patients and staff appreciated my coming to Whiteriver. They explained that they need people who understand their experience and care about improving the health and well-being of a people who have been forgotten for too long. The only way to know their experience is to learn from them and see that experience for oneself. It's the first step. I still don't know if this is where or whom I'm called to serve. I have had the privilege to get a small glimpse into the lives and experience of the Apache people, and for that I am grateful. I hope that I have also shared some of that experience with you so that they, and their story, won't continue to be forgotten.
No comments:
Post a Comment