The Scalpel and the Silver Bear

The above image is of the life cycle of the Pinon tree, this tree plays a part in the ecology of the Navajo people of the U.S. southwest. But like many things when it's cycle becomes imbalanced it has grave consequences. This supports the Navajo belief that one must walk in beauty, or be in harmony with all things.

The Book

     The Scalpel and the Silver Bear documents the journey of Dr. Lori Alvord. A woman who grows up on a reservation in New Mexico with one foot in the white man's world and the other in the traditional world of the Navajo. Lori is a 'Atni' meaning she is a "half breed" the daughter of a white woman and a Navajo man, Lori navigates the world from two perspectives simultaneously.

     In this book we follow her on her journey through college and university on the east coast, far away from her southwest roots, on to medical school. Lori struggles to reconcile the practices and ideals of western medicine with those of traditional Navajo systems, which see the human body not just as a body to be treated as a biological organism but as a whole being. 

The Navajo believe the key to health in walking in beauty, a person must be in harmony with all things and all people in order to attain and maintain good health.

     Once she returns to Gallup, New Mexico, Lori is faced with reconciling two pathways of medicine, as well as a language barrier. In western medicine we tend to pride ourselves on efficiency and a straightforward approach; for the Navajo the idea of having a person look you in the face, demand that you remove your clothing and then touch your body are all things that go against traditional culture. Lori also finds that new words must be formulated in Navajo for western biomedical words. These include: Azee'iitini na'atgizhii a hospital or literally, "the big space where medicine is given, or 'Ats'iis naatzid, cancer, literally "a body is rotting."

The Connection

     While much of this book has connections to what we have been reading over the past two weeks I would really like to focus in on the topic of condescension that Dr. Ceron brought up last week between those of biomedicine and traditional medical pathways. One passage in particular that I read in Nichter made me think of a connection to, “The Scalpel and the Silver Bear,” in Nichter chapter 2 there is mention of an “arboviral disease caused by ticks”. Many of the native South Indians wondered as to why only some communities were susceptible, they felt that those communities could not appease the local deities due to social upset following land reform and deforestation. This gave me pause, what if the deforestation had allowed for an increase in tick populations? This condescension by social scientists made me think about the case of the pinon trees and what was at, the time, termed “Navajo Plague” in the Alvord book.

Rainfall and the Pinon Trees

     In the spring of 1993 the medical center where Dr. Alvord works begins to see an outbreak of flu-like symptoms in otherwise healthy persons, followed quickly by respiratory and cardiac arrest. All medical professionals were baffled. During this time the CDC began to investigate, a bio medically trained Navajo doctor happened to ask a traditional, Navajo medicine man what he though of the illness. The medicine man replied that it was due to “excess rainfall, which had caused the pinon trees to bear too much fruit”( Alvord) This had caused the natural harmony of the world to become unbalanced.  It was this imbalance, according to the medicine man, that was causing the people to become sick.

     More people in Dr. Alvord’s community became sick and soon, although not as quickly as the medicine man,  the CDC came to the conclusion that it was the Hantavirus that was responsible for all the recent deaths. Furthermore, it was the rainfall that had caused the larger than usual pinon crop, that in turn caused the deer mouse population to increase, whose excrement had caused the outbreak of Hantavirus. The medicine man had been correct. (Alvord)

A Holistic Viewpoint

     I think the above illustrates how medical anthropologists and public and global health specialists must look at a community holistically, ecologically, and at the macro level as well as the micro level. It is not enough to assume biomedical, western thought processes are widely accepted and are therefore best practice, the world over.

     In applied anthropology collaboration with the community you are working with should be paramount. Consider, if this had been used in the case of the Hantavirus outbreak of 1993 in New Mexico, how much sooner might have the virus been halted, how many lives saved?

     The same views and tools of collaboration can be applied to the example from Nichter, what if the South Indian’s opinion had been taking into consideration, would that have changed the outcomes for certain groups who live in areas that have seen deforestation?

     These questions illustrate the ability of applied medical anthropology to help communities struggling to reconcile global health initiatives with day-to-day life.  

-Crystal

Sources:

     Alvord, Lori Arviso, and Elizabeth Cohen. 1999. The scalpel and the silver bear. New York: Bantam Books.

       Nichter, Mark. 2008. Global health: why cultural perceptions, social representations, and biopolitics matter. Tucson: University of Arizona Press.