public health rotation

On Being a Non-Native

Dear Tumblr,

I am surrounded by beauty.  Each day I am greeted by the sun rising over the mountains on my morning walk to work.  Weekend hikes take me to awe-inspiring views.  This is sharply contrasted by the people I am here to serve.  People who are marginalized and forgotten about by most of society.  People who have welcomed me into their lives.

I elected to spend a month working for the Indian Health Service because, quite frankly, I am ignorant about Native Americans.  I come from a white, middle class background and my exposure to cultures not my own is lacking.  Though many of my peers are seeking to do audition rotations or overseas trips for 4th year, I wanted to broaden my experiences here in my own country.  So my girlfriend and I packed up the car and drove to our assigned Native American reservation.

The health problems here are dramatic.  Crime and violence reach rates seen in downtown L.A.  Patients are brought to the Emergency Department with BACs of 0.80 and walk out with BACs of 0.40 (for the record you are considered driving impaired when your BAC is 0.08).  Some areas of the reservation seem more like 3rd world countries in regards to poverty and living condition.  The impact of western culture is ever present in the sky-high diabetes rates.  

But the people are kind and noble.  They are more than the statistics presented about their population.  They are intelligent, yet quiet.  After just a few weeks I am finding myself comfortable in their presence, and more adept at making them comfortable in mine.  My introduction now includes a brief joke; my interview is less direct than what I might use with anglo people in my own community. 

The hospital we work for is small enough that providers literally work in all departments.  Board certified pediatricians see adults; internists see pregnant patients.  Hospital Wi-Fi is non-existent, and sometimes the internet is so slow we use paper charts.  It is a magical community where doctors practice the type of medicine I dreamt about before med school.  My heart feels a longing to stay in this simpler place forever. 

But this cannot last.  Before long I have to return to the hustle and bustle of an academic medical center.  My hospital has its own magic, thought it has lost its luster from the hours and hours I have spent inside its walls.  Perhaps it will seem a bit shinier when I return; or perhaps I will shine a bit brighter from this experience.  And maybe I will return one day, to this mountain hospital.  But for now I have to begin preparing for my next big training adventure.  

T-minus 6 months until I officially become an MD.      

Hopefully I will have time to write more about my experiences in the coming days.

Always yours,

The Disagreeable Doctor