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mercredi 18 janvier 2012

A Day taking care of American Indians

While driving to work, just five minutes away from this Indian Village, I looked at the thermometer, -10 C, yes minus ten degrees, but wrapped up as I was I didnt feel the cold, felt the exhilaration of the wintry sun and the blue skies above. I am very lucky to be working with the same two people over all the years I have been coming to be with the Indians and we have such a good sense of friendship, unspoken depth.
We do our job as a team, not a hierarchical order system. You only have to keep in mind the welfare of the person who has come to see you seeking some medical advice and help, and you will not go wrong. It is not the arena to prove whether you are a good provider or not, those things should have been clear to you long before. 
so many things happen in the course of the day.. A nice conversation with my colleague stands out in which she was telling me about her family and how the characters are so different depending upon what branch of the religion they believed in .( she is a south dakotan of swedish ancestry). Money does create problem one way or another as Behavioural Economists have pointed out, in the USA in these 2000s, any more income than 60,000 usd per year does not increase your happiness. Money does not buy you happiness but absolute lack of it can cause misery. I told her briefly that lack of a liberal outlook on life does put restrictions in ones own life. As Simon Kuper had written elegantly in a recent column in FT, about Teenage Pregnancies in the USA, how the Americans have classified these behaviours as zones of disorder and restricted them, teenage sex, experimentation with drugs all prohibited or criminalized, so that normal experimentations of life becomes tragic experiences with great consequences. American society, he writes, tries to enforce good behaviour through the institutions of marriage, church and prison. it also manages to create an anxiety about these zones of disorders. It is nice to have such conversations in between patients who live in relative happiness in outposts of american civilization barely touched by them. There are reasons why Indians try to avoid American civilizations much more than it is necessary to survive: the more contact they have with American civilizations, the more suffering arrives at their doorstep. Friends come to watch sports events at your pay per view TV at home, all of a sudden there are fifteen of them, each with a beer in hand, so you are left with broken promises within yourself of wanting to help yourself remain healthy. One such patient arrived this morning. Counselling but the reality of the situation is stark. Give an alternative. Instead of telling dont drink beer and not enjoy the sports event, encourage him to go for a long walk. I can remember each of the consultations today but a couple stand out for their sheer uniqueness. An Observant Medical Practitioner is a natural Anthropologist!
32 year old, extremely independent extroverted young man with multiple medical problems, he needs to come into the hospital for one of the many of his "diseases",to  convince him about the seriousness of the situation I had to bring in history and culture, love of his family and my own relationship with other members of his family. The idea here is that we are not in professional relationships with our patients. We are friends of the patients and their families, we just happen to have some medical knowledge.
The other patient, 45 years of age, successfully combating one problem only to be told that there is yet another serious problem to be faced. Taking heed of the time my own sister in Miami had to face such dilemma, I spent considerable time with this patient, drawing in experiences from the world of Indians. Their sufferings are interpreted in context of the world they live in, nor the public world which they share with non indians. Bring them back to their normal world which they share with other Indians, it is so easy to counsel them philosophically because their lives are not robotic moments in a passing day but steeped in the tradition and cultue of their people, however assimilated they may appear on the outside. Faith and positive outlook, touching on Yoga Philosophy, giving her examples from her own culture. Nebraska farmers are cutting down trees so they can plant more corn (in just two years they have reduced the number of trees in their farms from 3.4 million to 750 00. Congratulations, takers of the fat of the land!) whereas this lady, ensconced as  she is in her world, would consider it a crime to cut down a tree, feels sad even for christmas trees !
You are not going through these sufferings alone,i assured her, we are with you and you can trust us. the freedom to trust another person, that freedom was taken away from them, in the three hundred years of contact with people with blond hair from another continent.
On the way out of the clinic, to the crispy evening air, the still blue skies of the Plains, i ran into an old friend whose mother had just recently died. How do you console a person who has lost her mother? UmPaTonGa the great UmonHon orator was at his best when he said eulogy for a visiting Lakota Chief. Express your feeling naturally and freely and not say things aimed at pleasing the other person. I briefly talked about the time i had known her mother, the postcards i used to send her. then suddenly without any warning a picture of her father who had been dead for a long time appeared in my minds eye. i told her, I see your father standing in dignity at the sidelines of the Pow Wow when he was judging something or another. I could see her eyes well up and my own throat choking. Before i could no longer speak, I said: All I can say is that I am glad to have known your mother and father... without looking back, I walked towards the door.
The night is upon me, a solitude of great magnitude which is welcome arrived. The temperature outside is minus 17 C but the warmth of the thoughts of my dear friends and lovers keep my hear in a perpetual sense of euphoria.. saudade ...