Caring for Individuals, Families and the
For 11 years, family practitioner, Dr. Adrienne Laverdure, Turtle Mountain Band of Chippewa Indians, has been caring for individuals, families, and the community at the Peter Christensen Health Center (PCHC) in Lac du Flambeau, Wisconsin. The health center is located on the Lac du Flambeau Indian Reservation, home of the Lac du Flambeau Band of Lake Superior Chippewa Indians.
“Every day I feel like I’m helping somebody,” says Laverdure. “You can actually see outcomes. People think of you as someone they can trust, not only with physical health concerns but also with mental health issues, such as depression and anxiety. You’re the first one they come to see when they need something.”
“Every day is different, Laverdure continues. “That’s why I like family practice.” Laverdure’s patients range from pregnant women and newborn babies to Elders. She might first examine a man with diabetes and then talk with him and his wife about modifying the family’s diet. Next she might examine a baby and talk with the mother about the baby’s care. Since the practice includes urgent care, Laverdure might next have to care for a patient who doesn’t have a scheduled appointment but needs to be seen immediately because he is suffering with severe chest pain. “I never know who is going to walk in the door,” she says.
Like most family practitioners, Laverdure works with a team of providers. In her case, her colleagues include a second family practitioner, a nurse practitioner, a physician assistant, and a third family practitioner who joins the team two days a week and helps with phone calls from patients and their families when the clinic is closed.
Speaking of the PCHC team, Laverdure says, “We’re close and take care of each other. We spend time together outside the clinic. We’re family-oriented. We work it out so we can see our kids perform in a play or we can be home with a sick child.”
Despite the many demands of a busy practice, Laverdure asserts, “My work doesn’t seem like a job. On my day off, I miss it.”
Before coming to the clinic each day, Laverdure stops at the hospital in Woodruff (about 12 miles away from her clinic). Here she examines newborn babies that she has recently delivered as well as their mothers. She also visits and cares for any of her patients who are in the hospital, including patients in the intensive care unit. Then she goes to the clinic.
Laverdure particularly enjoys taking care of families and multiple generations. “For problems, such as diabetes, we work hard to get the family involved. We make appointments with our families, and we have developed family-oriented services, such cooking classes. We also test for diabetes and high cholesterol in children, and we keep an eye on our patients’ body mass index.”
Laverdure and her colleagues make special efforts to care for Elders. “We do home visits. We send out community health workers, who, among other things, help our Elders maintain their daily schedule of medicine. The Lac du Flambeau Tribe also has several support programs for its Elders, including our food program.”
One of Laverdure’s proudest accomplishments to date is the creation of a new, larger clinic that will be open soon. A home for Elders will be next to the clinic so that Laverdure and her colleagues will be able to visit the Elders on a regular basis.
Like many family doctors, Laverdure and her colleagues care for patients in the context of their community. She is proud that PCHC is community-based and that they do outreach not only for Elders but also for the rest of the community. This includes health fairs as well as programs that take place at worksites.
Laverdure thinks it’s important to work closely with the tribal council on health initiatives. She says that the tribe, which has assumed responsibility for the administration and operation of health services and programs, supports PCHC health providers and their efforts to work towards preventing, reducing, and eliminating serious health issues, such as diabetes. Laverdure and her colleagues also collaborate with the tribal council and the tribal departments in programs that help individuals prevent illness and maintain good health.
Laverdure enjoys mentoring and supervising physician assistant students, nursing students and medical students who come to the clinic for supervised clinical experiences. She is providing valuable experiences for the much needed workforce of tomorrow.
“I always knew that I wanted to be a doctor, even when I was small,” says Laverdure. However, I never thought I could go to medical school.” Laverdure says she feels lucky that she got into the University of North Dakota (UND) and into their Indians into Medicine (INMED) program. “But living on a reservation all my life, I was shy and scared. I wanted to go home. I called my mother and asked her to come get me. Thank God she didn’t.”
While Laverdure was at UND, family physician, Dr Lois Steele, Fort Peck Assiniboine, was the director of INMED. Laverdure describes Steele as a strong advocate for Native students and Native health care. “Once you got into INMED, it was hard to get out,” Laverdure says with a laugh. “Our counselors, like Deb Wilson, my main counselor, really supported us. They kept us on the right tasks.” Laverdure and the other Native students “hung out in groups” and supported each other.
Laverdure was accepted into the medical school at UND with an IHS scholarship. In her sophomore year, though, she faced major challenges. Like many American Indian students she had difficulty taking standardized tests, including an important national board examination. During this same period she was delighted when she gave birth to her son, Ken, but the pressure of being both a medical student and a mother was enormous.
Happily, thanks to the significant support from INMED and her family, Laverdure was able to move forward. After taking an intense program in test taking, she passed the national examination. Meanwhile her family stepped in and helped with the care of Ken. “At one time my sisters and I lived in the same low-income building complex in the same hallway. Also, when I moved on to the campus, it helped to have my younger brother living with me for a while.”
During her third and fourth year of medical school, when Laverdure and her classmates spent blocks of time learning and working in the various specialties, such as internal medicine, pediatrics, and surgery, she found that she loved everything. Delivering babies was one of her most enjoyable activities so she considered going in to obstetrics and gynecology until she realized that, from her perspective, specializing would prevent her from working with a tribal community as a whole. As she looks back, she knows that choosing family medicine was the right decision for her.
Finding the Right Place to Practice
Laverdure feels that her residency at the family medicine residency program in Fargo, North Dakota helped equip her for her current work. “We dealt with poorer populations. We took care of refugees from all over the world. We had migrant farmers from Mexico. We could work at the local Native American clinic. We had good instructors and four hospitals. We were exposed to things that most residents never see.”
In the last year of her residency program, Laverdure gave birth to her daughter, Veronica, After her residency Laverdure had been planning to return to Turtle Mountain with her children and practice there. However she learned about Lac du Flambeau where there was more need for a physician than in her own community. What ended up cinching the deal? “In the first phase of the search process,” she says, “I was interviewed by a group of Elders who helped me realize that Lac du Flambeau was the right place for me to practice. I immediately liked the community and the people. I’m glad I decided to practice in Lac du Flambeau and call it my home.”
Another Doctor in the Family
Laverdure was the first member of her family to become a health professional. She’s not alone though because her son, Kenneth Lee Bernard, is currently in his third year at Harvard Medical School. “Due to my passion and love for working with American Indian people, Ken has also chosen to work for the Indian Health Service. He has also committed himself to getting an MBA degree at Harvard to support his work in administering tribal health services.”
Laverdure continues, “I knew what I wanted to do when I was young. My son wasn’t sure what he wanted to do. When he started talking about medicine, I said, ‘Really, are you sure?’ He suffered a lot when I was going through my training. We laugh now, but back then we ate a lot of Ramen noodles and hamburger.”
Laverdure is proud of her son and her daughter, Veronica, who plans to be a pastry chef. “We need a pastry chef because lots of things in our family revolve around eating,” says Laverdure with a smile.
Dr. Laverdure with her children (Ken and Veronica) when Ken received his bachelor's degree
Laverdure is also proud of her nephew, Kyle, who she regards as a son. He lived with Laverdure and family while he was in sixth and seventh grade and is now a graduate student in clinical psychology and plans to specialize in helping Native youth.
Gratitude to Her Family
“Our passion for life and learning comes from my family,” says Laverdure. “With the help of my grandmother, my mother raised seven children and served as a judge on the reservation for many years. My sisters, two with doctorates and one with a paralegal degree, encouraged me to pursue my goals and to keep family as a priority. My three brothers (one is an architect, one a Tribal judge, and one a parole officer) have supported me as an American Indian woman in a tough field. Without family, commitment, and goals, it would have been difficult to succeed. As a family we hold these core values dearly. We support Ken and the other children in the same way. Their success will impact many generations of American Indian people.”
Dr. Laverdure reports that five members of her next generation plan to be health professionals.
"My son, Ken, will graduate from Harvard Medical School May, 2011. He has not yet decided what kind of residency he wants to do.
“My nephew, Kyle Hill, is in the doctoral program in clinical psychology at the University of North Dakota. This summer Annabell Hill, his wife, will start nursing school at the University of North Dakota.
“My niece, Dara McDougall, also plans to go into medicine. She was accepted into the undergraduate programs at Harvard, Brown and Dartmouth. She will visit the campuses later this month as part of deciding which school to attend.
“My daughter, Veronica, has decided to go into family practice, instead of becoming a pastry chef.
“I am president elect of the medical staff at Howard Young Medical Center. With health reform now a reality, I hope that I can again focus on reform in Indian Health, including improving preventive care. The health care provided by tribes is not of equal quality. We are trying to develop a consulting-type service among different tribal health care facilities, so all tribes can provide high-quality care. We need to communicate and share knowledge.”
The article above was originally published in the Spring 2009 issue of Winds of Change. The cover artist is Joe Maktima, Laguna Pueblo/Hopi. This piece entitled "Chanting Wind" and the rest of his work is rooted in the culture of his pueblo ancestry. For more information visit the artist's website: joemaktima.com or email him at: firstname.lastname@example.org.