I never intended for my first blog post to be negative or sarcastic – but I did know I wanted it to be honest. And so, the best I can hope for this time around is to find some positivity through this immodestly frank vent session. Today, I humbly confess the struggles I’ve had while living on the Rez, and how surprised I am at myself for struggling so soon.
Now that the luster of moving to a Reservation has worn off, and the sexiness of doing raw, underserved medicine is no longer novel, Todd and I are beginning to understand why life is so difficult for our patients. In four short months, we’ve had many a lesson on convenience – or should I say – inconvenience. Lessons that relentlessly and inarguably reveal that health is a luxury. But I will save the verbose detailing of just how social inequities lead to health disparities on Navajo Nation for another time.
Let’s start by painting the picture of Christmas Day, 2021. It is the first time in four years my husband and I are off together for the holiday. We wake mid-morning to snuggles from two furry and affectionate dogs – Daisy and Tabitha. The cool hallway tiles suggest it’s colder than usual outside, but the sun still shines brilliantly through the sheer curtains overlying the frontroom window. In our PJs and sleep hair, we let the dogs out, wave to the neighbor (an ED doc), and then walk to the kitchen to fill the dog bowls. Only there, I am met by the surprising and undeniable smell of propane gas. Fortunately, we were able to have someone investigate the next day and the leak was found and repaired within a matter of minutes. Problem solved. Except nothing is that easy on the Rez. One problem here invariably begets at least one other problem.
You see, following the leak, our propane tank was down to 10% capacity. Normally, we are supposed to order a replacement when the tank is 30% full for no other reason than it takes that long to deliver propane on the Reservation. I hop on my phone to order a replacement. But the internet is out – not because of a sandstorm or rain shower like usual, but just because it is the middle of nowhere Arizona and the internet can go out whenever it damn well pleases. The next day, we place our order. While awaiting the replacement delivery, we turn down the heat and start whipping up crockpot meals to avoid using the oven. But our efforts weren’t enough. We ran out of propane a week later, and spent the next ten days wearing snow pants inside, sleeping in double layers, and cooking in the microwave. Amidst other daily inconveniences like the nearest vet being 90 minutes away, a grocery store that is frequently out of items like yogurt, cheese, and fruit, while also having infuriatingly long lines, and us being outside the service area for any major appliance repair, I started to wonder if I was really cut out for life here. Even more unnerving was that I began to sincerely question how the hell I’d ever endure what I thought for so long was my dream job – a position with Medecins Sans Frontieres as a pediatric intensivist in a Lebanese refugee camp.
But just as I have learned to live with the conveniences of being White in middle to upper class neighborhoods, I am confident I can learn to live without them. Our short stint without heat or internet was just a taste of what most of our patients endure regularly. You see, it’s not uncommon for many people here to still heat their homes with wooden stoves – with wood they find and chop themselves. Not long before Christmas, I met a teenage boy in clinic after he sustained a shoulder injury. He presented to clinic alone as his parents traveled for work and he had been caring for himself while they were away. He was happy with the care plan I came up with… Except… Except then, he bravely and honestly asked, “Who will chop my wood?”
I pursed my lips hard and exhaled loudly through my nose. I can’t write a prescription for a wood chopper. And lordy, if I went over to chop the wood for him, we’d probably both freeze before I made any substantial progress. In a moment, I not only recognized how fragile stability is here, but was also humbled at my relative inferiority to the size of problems my patients and coworkers face.
Undoubtedly, I am already indebted to my patients. Though painful at times, I am thankful for how graciously but unapologetically they illuminate my flaws and shortcomings. I value beyond words their patience with me as I try to help them while also navigating a health care system and culture vastly different from anything I have ever experienced. I stand in awe at their quiet resilience and appreciate how it forces me to continuously reevaluate my perspective. It’s because of my patients that I can see all I still have. What I have here is community as it should be – colleagues who let us use their washing machine when ours breaks, neighbors who offer their spare bedrooms when our heat is out, and mere acquaintances who take in our dogs when an unexpected medical problem meant an overnight stay at a hospital in Phoenix. And so, while I may not have a regular supply of Feta cheese, here on the Rez I have people who help carry my struggles. I have warm clothes to layer, money to buy an extra space heater, and friends who let me use their last two cans of coconut milk because the grocery store is out. Best of all, I have a loving husband with whom I can laugh at these moments and share in the growing pains. And all of that my friends, is enough for me.
Enough For Me 