Melvina McCabe, Navajo, MD, juggles many important responsibilities including caring for aging patients, teaching, doing research, directing a geriatric education center, and serving in national leadership roles.
As a geriatric physician, McCabe takes care of elders in the University of New Mexico Hospitals’ Senior Health Clinic. She also cares for elders who are in the hospital. McCabe says, “One of the joys of caring for our elders is the wonderful individuals whom I have the privilege of serving. Their life stories are intriguing, eye opening, emotional, and most of all educational. We health care providers gain so much when we get to know our patients as individuals, not simply as someone with diabetes or heart disease.
“The biggest challenge in serving geriatric patients is the wide spectrum of clinical presentations that can occur for a specific disorder. For example, an elder patient with acute coronary syndrome may not present with chest pain; the only symptom might be confusion. This is one of the many reasons I love working in geriatrics. It is like detective work and one must always be aware of the diagnostic possibilities.
“Another challenge for me specifically is making sure that I do not put my beliefs as a Navajo person on an elder who is non-Indian. For example, in the Navajo way we address this population as elders, which is a respectful connotation. I remember an interaction with a non-Indian in which I addressed the person as an elder. This person was very upset with me and stated that she was not an elder, but a senior citizen.”
As a professor in the Department of Family and Community Medicine at the University of New Mexico, McCabe teaches medical students, residents, and geriatric fellows. She says, “I serve as an attending [supervising teacher] in clinic and hospital settings. Learners see the patients, present to the attending, and we then go over the issues and management plans. Being a good educator is a challenge and probably one of the more important things that anyone in the academic setting does. I do not always attain the level of a good educator, but I strive for this, as I do with anything that I do.”
As a professor McCabe has engaged in research around such issues as Hantavirus, alcohol abuse, diabetes, and geriatric education.
Directing a Geriatric Education Center
For more than a decade McCabe has championed American Indian elders by serving as Director of the New Mexico Geriatric Education Center at the University of New Mexico (NMGEC). Under her guidance, the programs at the Center are designed to enhance the ability of physicians, nurses, pharmacists, social workers and other health care professionals to deliver geriatric and culturally-appropriate care.
“While we provide geriatric educational offerings to all health care providers, our focus is on health care providers serving American Indians,” says McCabe. “To assist us with this, we have a Council of Elders who serve the NMGEC in reviewing our curriculum, activities, and videos to assure that they contain appropriate cultural content. The Council is made up of 10 elders from the various tribes and pueblos in New Mexico.
McCabe not only directs but also teaches in the Center’s Summer Geriatric Institute, in the interdisciplinary geriatric certificate program and in periodic workshops that focus on such topics as dementia and depression.
The Center also supports a Senior Mentor Program for medical, physician assistant, and nursing students. Students are paired with elder mentors who are in good health and/or have learned to manage their chronic health problems. The goals of the program include dispelling myths and stereotypes surrounding the aging process, helping students learn more about seniors’ health concerns, and improving students’ communication skills.
As the 2009-2010 President of the Association of American Indian Physicians (AAIP), McCabe’s responsibilities included helping to prepare for the AAIP’s annual meeting and national health conference, which took place on the Santa Ana Indian Reservation near Albuquerque. From 2000 to 2001 McCabe also served as President of the AAIP. In 1999 and in 2003, in recognition of the many contributions McCabe had already made, the AAIP named her “Physician of the Year”.
McCabe is a grant reviewer for the Alzheimer's Association. She served as a member both of the Minority Affairs Consortium of the American Medical Association and the National Institutes of Health’s National Advisory Council on Minority Health and Health Disparities. She is also a member of the American Academy of Family Physicians.
In addition, McCabe was a Presidential appointee to the bipartisan advisory committee to the White House Conference on Aging 2006. Further, New Mexico’s Governor Bill Richardson chose her as a member of the Health Policy Committee.
In 2002 McCabe received the Stoklos Visiting Professorship Award for her promotion of integrated medicine (orthodox and Navajo) from the University of Arizona Health Sciences Center.
Even as a child, Melvina McCabe knew she would someday be a physician. Her role model was a Navajo elder, Christine Whipple, whom she later met when she married Whipple’s grandson. At the turn of the last century, Whipple left the Navajo reservation to train as a nurse. She worked in a hospital in Grand Rapids, Michigan from 1910 to 1919. When she returned home to the reservation, she worked as a nurse among the Navajo, serving as a midwife and physician's assistant, performing minor surgery and setting broken bones. “Grandma Whipple was a remarkable woman,” says McCabe. ”She never drove in her life, and yet she taught others to drive. Her ‘guiding light’ provided direction for many lives, not only within the family, but also within the community.
After completing her undergraduate work at the University of New Mexico (UNM) in 1980, McCabe began her own training for a life in medicine. She graduated from the medical school at the university in 1984 and then completed a family medicine residency and a geriatric fellowship at the UNM. “My career choice in geriatrics, I believe, had a lot to do with my culture,” reflects McCabe. “We are taught to respect and care for our elders. I saw geriatrics as an extension of this.
“I joined the faculty at the UNM School of Medicine in the Department of Family and Community Medicine in 1989. I thought long and hard about where I wanted to serve. I felt that I could best serve my people in academics where I would be able to help American Indian and Alaska Native students who want to pursue a career in medicine; teach about the importance of knowing other cultures and how culture might impact the delivery of care; and represent my Indian people and the elders at a national level. I hope that I have done this.”
Indeed, Dr. McCabe is doing a wonderful job of meeting her goals!