By: Carol Sullivan
Pahin Sinte: the words on the small sign along the highway signaled the turnoff for a powwow—a Native American gathering that encompasses pageantry, dancing, drumming, blessings, singing, and more. In the Lakota language, “Pahin Sinte” means “porcupine” and “quills of the porcupine.”
Rather than prickly suspicion, person-to-person encounters at the wellness booth felt more like kinship. In fact, osteopaths may share a surprising kinship with Lakotas when it comes to a holistic view of health. Second-year RVU medical students on the trip, who numbered ten, made these medical and cultural observations:
Conner Roggy noted that osteopathic medicine may complement Lakota beliefs in healing. “The Lakota people are very spiritual,” Conner said. “The more you could incorporate spirit into their health, the more engaged they became. They believe strongly that they are part of the world and that everything fits together for a reason. Because of this, the osteopathic principles that guide our profession are received [well] by the Lakota people. They loved being treated osteopathically and loved Osteopathic Manipulation Treatment (OMT). I think the more we incorporate osteopathy into our explanations of our treatment goals, the more receptive they people will be to what we want to do to help them.”
Conner also appreciated this unique opportunity to be with Lakotas: “They were open to approaching us and conversing with us. Considering the history of the people with the American government, I think that shows a lot of strength and integrity on their part.”
Alluding to Lakota history in opening ceremonies, the tribal chief had spoken of grief that is experienced when a relative goes to the spirit world. Grief often gathers between the shoulder blades, he said. Giving and eating sacred food gives comfort to the sufferer. The chief instructed that everyone there, including non-Lakotas, be offered sacred food. “Food is medicine,” he said. A few minutes later at the
RVU booth, Dr. George Ceremuga, DO, a preceptor from Rapid City, SD, was saying, “Food is medicine.”
Asking for OMT, not drugs, to relieve pain
Nick Chapman observed that in contrast to those who may regard OMT as “a fringe side of medicine,” one person asked if it was spirit-healing. “This seems to be the perfect population” for OMT, Nick said. “They were asking for OMT rather than seeking drugs to alleviate their pain.”
An encounter with a tall, traditional-looking Native American epitomized a blending of osteopathic and Lakota healing. Reese Beisser, A.J. Olson, and Dr. Cerumuga treated the man, who was still wearing headdress and ankle adornment for dancing. A big man in his late twenties, he complained of a rapid heart beat that occurred erratically, coming so suddenly and strongly when he was driving that he had to stop his car. At other times, his rapidly beating heart had awakened him around 4 am. Previously he had undergone an EKG that was read as normal.
As the man lay on the padded table under a portable canvas canopy supported by poles, Reese provided OMT, including pelvic rotation. Dr. Cerumuga talked about the value of yoga postures to release restrictions in chest movement.
In his back pocket, the man carried his wallet, as well as a concealed weapon. Habitually, he reached back for his wallet and favored one hip to accommodate the weapon perched on the other side. Such habits could shape posture, bone structure, and pelvic rotation, he was advised. The man was also advised to consult his physician about a heart monitor to measure his heartbeat over a longer period of time than an EKG measures. As he was leaving, the man said his whole body was working better. Discussing his case later, medical students talked with preceptor Dr. Phil Sullivan, MD, about the possibility of Supra Ventricular Tachycardia.
Another patient asked A.J. about OMT, and in turn she explained Lakota healing practices, such as blowing smoke into ears. Her blood sugar and cholesterol levels were checked. She gave a history of kidney cancer, which doctors had found when they operated in the wake of a ruptured appendix. The woman was fortunate, since renal carcinoma is diffificult to detect and is dubbed “a silent killer,” A.J. and a fellow medical student later noted.
One woman with depression received OMT from Reese. The woman’s husband had died, and she had no family. “OMT facilitates talking about mental health issues,” he observed. “Physical touch and the interpersonal component are important.”
Gabe Bensaad-Johnson treated a woman whose symptoms included hypertension, diabetes, tingling in her toes, glaucoma, and vision changes. Were these typical signs of aging, she asked. “We discussed how you can lessen the impact of diabetes which can also help with other symptoms, and that these symptoms are controllable. She was curious about what she could do for herself, and things she could do better, and we gave her some educational materials. She seemed heartened, very receptive.”
The experience reinforced Gabe’s conviction that “Anywhere, people may be receptive to taking charging of their own healthcare. Just because they haven’t learned how to do it in the past, doesn’t mean they aren’t interested in how to do it now.”
“Cool” healthy snacks, not sugary cola—and can you hear your breakfast?
Zoe Gordon found herself on her knees on the grass in front of the RVU booth surrounded by skipping, hopping, and transfixed youngsters with ribbons in their hair, jangling bells on their shoes, their brown eyes following her as she offered them bright green rubber bracelets and asked if they wanted to use her stethescope to listen to their hearts or their bellies. Zoe instructed one 5-year-old girl, “Here, place this part on your belly, and these parts in your ears. Can you hear what you had for breakfast?”
To each child, Zoe offered cucumbers and carrot sticks, adding patter about “cool” healthy snacks.” She held a 16-ounce transparent coke bottle containing 48 grams of granulated white sugar. Zoe captioned her prop, “That’s how much sugar you’re drinking when you have a coke—eek!”
Amanda Andersen was another Pied Piper around children at the powwow. “The kids run over to us, and they don’t notice skin color [or see us as outsiders]. They can be a bridge to the parents.”
Amanda would like to work with Zoe and other RVU students when they return to Porcupine next May for a wellness event at the school. Classroom talks and show-and-tell about stethoscopes and other instruments in a doctor bag might engage young persons. How to pursue opportunities to become a doctor, a nurse, PA, or MA would be explained. Amanda has worked as a volunteer in Gypsum, Colorado, in a camp for kids who are “really sick.” She observed that doctors at the camp “loved to see kids in a normal setting, not a crisis.” In other educational settings, Zoe has seen middle schoolers thrill to hands-on experiences such as donning gloves and holding a sheep’s heart, or listening to their own hearts.
Near the RVU booth, Annie Szmanda showed two ll-year-old girls her rubber percussion hammer, as well as how and why reflexes work. A former gymnast, she taught the two girls how to extend the spine, and she braced them as they moved from standing into deeper backbending. In turn, they taught her about the significance of certain Lakota dances and face paint. Annie also learned how to write a few letters of the Lakota alphabet.
Michal Klepadlo, president of the school’s chapter of SAACOFP (the national student association of colleges of osteopathic medicine), noted that he was struck by “the push toward reigniting the local heritage through language. The first patients we saw were a man from Guadalajara and his spouse, a Native American woman. When I asked him if they speak Spanish, he told me that his children were learning Lakota. I found this amazing, because language plays a major role in who we are as people and how we identify ourselves. [On the first RVU trip to the reservation] I was very impressed by the efforts of the primary schools in the region to strengthen the heritage by teaching the Lakota language.”
Sarah Pederson saw a woman in her early 20s who had multiple complaints—in fact, a review of systems indicated low blood pressure, hypothyroidism, and a recent diagnosis of ADHD. Sarah advised her about hypothyroidism and related weight changes, the significance of ADHD, and signs to heed related to low blood pressure. Although Sarah noticed scars on the woman’s wrist from cutting, this wasn’t discussed because the patient had to leave early.
Sara also saw a child with a nose bleed, and Dr. Sullivan showed her how to treat it, noting that 90 percent of nose bleeds can be stopped by pinching the anterior portion of the nose distal to the nasal bones.
Sarah helped her fellow medical students administer a survey that she and two other RVU students, Austen Anderson and Krysta Sutyak, had designed at the behest of Dr. Camille Bentley, DO, Global Medical Track and Medical Outreach Professor of Primary Care. The survey asks how RVU can best supplement ongoing healing services, notably Indian Health Services and Native American healers. Anonymity and privacy are important to the validity of the survey, Sarah noted, because of questions such as use of alcohol, which is illegal to possess or consume on the reservation.
Results from the 20 completed surveys will be used to design the RVU second Health and Wellness Fair on May 3-5, 2019, at Porcupine School.
Theodore Schultz, a mechanical engineer, worked as a volunteer at the RVU booth. Recently he had moved from Germany to live with his spouse, medical student Sarah Pederson. Theo appreciated the many cultural exchanges that he witnessed among RVU students and Lakotas. It was a rare opportunity to “enter into an experience where it is not important to know what’s going to happen next,” Theo said. Instead, it becomes a chance to watch and to “reflect on what you see.
Playful kids act as bridges to parents.
During the powwow boys, girls, men, and women danced and paraded in ceremonies. Some removed their headdress, bells, and feathers before they visited the medical tent. Receiving medical screening and OMT, they looked so ordinary that Zoe could whimsically “picture a bunch of dudes sitting in a circle, sharing a beer together.” But when these same persons were dancing, “It is captivating, immaculate, magical.”
One 5-year-old girl “adopted us all,” Zoe said. During a break, the girl sat on the grass with Zoe, asked to hold her cell phone, and fended off her 6-year-old brother as he swooped toward her. The boy turned into a mischievous brother who wrestled his sister for the cell, which Zoe managed to retrieve as she drew the young girl back into her lap. Yet a few hours earlier his rhythmic dancing had mesmerized her.
Dr. Bentley praised the RVU students for their medical work and presence as volunteers: “You were all engaged. You showed good faith, and got to see your first powwow.”
Postscript: Naming ceremonies for newborns were also part of the ceremonies. Each newborn was welcomed into the Lakota community, and greeted by “all the relatives.”
The chief told a legendary story to explain how a child receives her/his name. The wind carries the name of the newborn, and a man on horseback leans into the wind and listens. When he hears the name, he announces it, and then rides back to tell the ancestors. One day the rider will return bringing with him another horse. The one whose name had been declared at birth will mount the other horse to return to the spirit world to join the ancestors. Between birth and death, one is expected to live up to the name, what it implies, what it means.
These RVU medical students are becoming Doctors of Osteopathy. As they earn that name, they are learning to live up to the tenets of their professional name, and to draw on and contribute to its wisdom .