Lori Arviso Alvord
Dr.
Lori Arviso Alvord was the first Navajo woman to
become a surgeon. Currently she is Associate Dean of
Students and Multicultural Affairs at Dartmouth
Medical School. She is an assistant professor both in
the departments of surgery and psychiatry.
The Scapel and the Silver Bear
For many years, Dr. Lori Alvord knew that she had to tell
two stories. The first story is about how a girl from a
remote Navajo community was able to travel across cultural,
class and educational borders and become a surgeon in a
medical world whose doors have been closed to minority
people for most of its existence. The second story is about
how ancient tribal ways and philosophies can help a
floundering medical system find its way back to its
original mission: healing.
In
The Scalpel and the Silver Bear, Alvord and
Elizabeth Cohen Van Pelt beautifully intertwine these two
stores. The themes are so universal and timely that the
book is well on its way to becoming a best-seller. Both
Native and non-Native readers are finding inspiration in
Alvord's journey.
Alvord grew up in a family that had little money, power, or
influence. Although her parents did not have college
degrees, they encouraged her and her two sisters to get an
education. Alvord made good grades in high school. She
allowed herself to believe that she might some day hold a
college degree, but her college plans were modest. She
writes, "I resisted any larger dreams, for fear they could
not come true."
A Navajo student attending Princeton University told her
about Princeton University and Dartmouth College. At that
time Princeton had only five Indian students, but Dartmouth
had 50, so Alvord applied to Dartmouth. At age 16, she was
accepted into Dartmouth's freshmen class. She was one of
only six in her high school class of 58 students who went
on to college. She was the first graduate of her school to
become an Ivy League student.
Fitting
In
Despite the relatively large number of Indian students at
Dartmouth, Alvord experienced culture shock: "I thought
people talked too much, laughed too loud, asked too many
personal questions, and had no respect for privacy. They
seemed overly competitive and put a higher value on
material wealth than I was used to."
At Darmouth she honored and cherished her tribal
membership. She realized that tribes provide connectedness,
a blueprint for how to live, a feeling of inclusion in
something larger. In the years that followed she would even
come to understand that tribal membership is central to
mental, spiritual, and physical health. She realized that
community and tribe not only reduce the alienation people
feel but in doing so stave off illness.
During college Alvord missed traditional clothing,
ceremonies, and her favorite foods. However, she and the
other Native American students created a group that
nurtured and supported each other. As she thought about the
sororities and fraternities on campus, she wondered if the
non-Indian students were trying to claim or create tribes.
Walking a Lonely Path
Alvord graduated from Dartmouth with a major in the social
sciences. However, her fascination with the human body led
her to a research assistant position with a medical
researcher. One day her boss asked her if she ever thought
about going to medical school. Alvord didn’t think that she
had what it took, but after much reflection and hard work,
she successfully completed some science courses and then
applied and was accepted into the prestigious Stanford
Medical School.
In her medical school class of 86 students, Alvord was one
of only three American Indians. Once again she was lonely
and found it difficult to be competitive and to draw
attention to herself. She was accused of being remote and
disinterested. Yet it was hard for her to behave any other
way. Silence is a normal part of Navajo communication;
words are used sparingly and weighed carefully. It took her
a long time to be comfortable with the non-Navajo style of
learning.
During medical school Alvord had to deal with Navajo
taboos. Dissecting a cadaver during the anatomy course
meant breaking the taboo against touching the dead.
Examining and operating on patients, required breaking the
taboo against touching another person, especially a person
one does not know. Asking patients sensitive and probing
questions required breaking the taboo against asking
personal questions.
Alvord knew that she wanted to be a surgeon and that she
wanted to help her people. This meant not only continually
going up against these taboos but also facing other
obstacles. At that time only about 4% of practicing
surgeons were women. Further, there were only a few
American Indian surgeons in the world, none of whom were
women.
Understanding Bonds
In dealing with these formidable obstacles, Alvord had the
help of Ron Lujan, a full-blooded Indian who guided her
through periodic rotations at Acoma-Canyoncito-Laguna
Hospital near the Navajo reservation. He became her mentor,
friend, and later, her colleague. With his guidance, she
was accepted into the very competitive surgical residency
program at Stanford.
After facing a serious personal illness and completing her
residency program, Alvord joined the Indian Health Service
and worked at the Gallup Indian Medical Center, 50 miles
from her hometown. She thought that she could easily fit
back into the Navajo community, but she discovered that
because of the ways in which her education had changed her,
returning was as difficult as leaving. “Although I was a
good surgeon, I was not always a good healer," she admits.
"I went back to the healers of my tribe to learn what a
surgical residency could not teach me. From them I heard a
resounding message: Everything in life is connected. Learn
to understand the bonds between humans, spirit, and
nature.”
Alvord was reminded of the concept of Walking in Beauty,
which means caring for your mind, body, and spirit and
having the right relationships with your family, your
community, the animal world, the environment, the planet
and the universe. People, she decided, want and need
medicine that connects rather than isolates.
Alvord discovered that patients who went through sings and
ceremonies prior to surgery were calmer and had better
outcomes. "I needed the patients' spirits to assist me in
surgery, and their minds should be relaxed and in a state
of trust before they went to the operating room," she says.
"They should be prepared to let me enter the sacred
chambers of their bodies."
In time, Alvord learned, “The scalpel is my tool, as are
all the newer technologies of laparoscopy, but my Silver
Bear, my Navajo beliefs and culture are what guide me.”
Alvord learned that she could draw both on western and
traditional medicine, not only when caring for her patients
but also when caring for herself.
Breaking
Through
Initially Alvord was not drawn to academic medicine because
so many of the academics that she met were competitive and
not fun to be around. Unexpectedly, she was invited to
apply for the position of Associate Dean of Student Affairs
at Dartmouth Medical School. After going through a very
competitive process, Alvord was offered the job.
Alvord knew it would be very difficult to leave her people
and the beauty of the southwest. Then she considered the
benefits: “For Navajo people, I would be breaking another
glass ceiling, which might make it easier for others to
follow a medical path in the future.” Alvord could also
influence prospective physicians and teach Native ways of
thinking about the healing process. In addition, the
Dartmouth community was welcoming, and the faculty and
students were open to her ideas.
Envisioning a Better Future
Now as Associate Dean at Dartmouth, Alvord supervises
admissions and four other programs. In a telephone
interview, she challenged the conventional approach of
selecting medical students largely on the basis of their
prior academic performance. "This approach can result in
the admission to medical school of competitive, even
cut-throat students," she said. "If we want our future
physicians to be empathic and altruistic, this approach is
upside down. Other cultures, such as Native cultures,
select healers who have demonstrated an ability to think
and live like a healer, people who are role models and
communicate well with others."
Most of Alvord’s patients in rural New Hampshire are not
American Indian. However, she still uses Native approaches
without labeling them as such. She listens carefully to
patients, builds trust, and encourages patients to be
active participants in their healing. Before surgery,
Alvord works to ensure that patients are well-informed,
relaxed, and in balance in their life and their world.
When Alvord teaches these approaches to her students, some
students wonder how they can do this when they and most
physicians are being forced to see more and more patients
per hour. Alvord replies: “I do not know the answer. But
what works for me, whether I have 5 or 55 minutes, is to
give myself completely to my patient for that time. I
listen to them and let them know that my attention is
completely focused on them and that this is their time. It
isn’t the entire answer, but it helps.”
What is Alvord's advice to Native people who want to go
into the health professions? "Do it for the right reasons.
One valid reason is the desire to want to heal. Another is
the desire to be in a profession that helps make the world
a better place. Healing is not necessarily physical
healing. Healing is not limited to people. Some people try
to help heal the environment. Healing is a way of bringing
more beauty, harmony, and balance into the world."
Contemporary hospital and clinic buildings with square
walls, harsh lighting, and cold chrome are not Alvord’s
idea of good places for people to heal. “I would love to
see Native leaders in health care begin to design models of
health care that include our culture, our way of thinking,
our spirituality, our ways of interacting,” she says.
"Medicine men should be involved. The physical structure
should reflect “the ways that we see beauty, the art that
we create. Perhaps it would have adobe walls and natural
smells such as roasted green chili and fresh corn. It would
be light- filled and warm, with generous and comfortable
seating for relatives. There would be porches and gardens.
In addition to state-of-the-art operating rooms and
equipment, there would be a ceremonial space, for use by
any who felt the need for it.”
"Even the grounds on which the hospitals and clinics are
built should honor the relationship that we have to the
earth and to animals. For example the grounds might be
farmland with horses and sheep." In short, Alvord, who
walks competently in both the traditional world and the
high-tech world, says, “We need to reclaim our healing.”
The
Scalpel and the Silver Bear. Lori Arviso
Alvord and Elizabeth Cohen Van Pelt. New York: Bantam
Books, 1999.
The
article above was originally published in the Spring 2000
issue of
Winds of Change. (The cover
artist is Dan V. Lomahaftwea, Hopi. For more information
contact Lomahaftewa Fine Art, Joyce
Wetzel, artist representative, Jozel Inc., 3 Aster Way,
Santa Fe, New Mexico 87505, (505) 984-0729.
)
Contact ,
e-mail:
jozelinc@aol.com