[Music] good evening and welcome to doctors on call I'm Dr Mary Owen associate dean of Native American Health and director of the center for American Indian and minority Health at the University of Minnesota medical school I'm also a family physician for the Fondulac band of Lake Superior chipa I'm your host for our program tonight on indigenous Health the success of this program is very dependent on on you the viewer so please call in your questions or email them to ask pbsn north.org the telephone numbers can be found at the bottom of your screen our panelists this evening include Ricky defo Elder and pipe carrier in ojibway country roxand deil dean of indigenous and academic Affairs at Fondulac tribal and Community College and Arie Vel MD family physician at the manoyan clinic on the Fondulac ojibway reservation our medical students answering the phones tonight are Justin beeren from from prag Minnesota Ora Raymond from St Louis Minnesota St Louis Park Minnesota and Sophie Wang from Springfield Missouri and now on to tonight's program indigenous health so this is the second time we get to do this thank you all for being here um I'm glad that they that people wanted us to come back with this show so it's incredibly important we're talking about it more and more we're now teaching indigenous Health in our um medical school to um our students to all of our students but in particular uh there's particular interest by native students but also faculty now these days and and the general public I find so um roxan we'll start with you what when we say indigenous Health what do you what is that what do we mean in your mind and there are lots of different there's lots of different ways to think about this yeah health is such a a big topic too um it seems like it's all over the place right now excuse me I think it's for us it's more of a holistic it's not just a physical type of Health that we're concerned with it's mental Health spiritual health um there's the physical aspect of it but but that's only a part of it so it's this holistic kind of view of of what is healthy and Arie you've been trained in both Western medicine and you also practice our traditional ways or the traditional ways of the ojibway so how do you see it do you see it the same or is there anything you no um when I went to medical school two and a half decades ago um I assumed that was four years of so much information that it just gets all packed together and you come out like a hay bale on the end everything's exactly the same and um and I was pretty pleased to find out that's not true and then once I started on the Fondulac reservation uh getting to know Ricky and roxand and other um traditional people it really um brought out that part of me as a physician and um and and that's that's an important part you know maybe the biggest part of it practicing some traditional medicine as well is that what you mean or yeah practicing you know Traditions I don't do um traditional medicine as uh a practitioner but um but I certainly talk to patients about traditions and the importance of um ceremony and um and I do ceremonial things myself that are important to me do you talk to all patients about tradition or how do you find out if they're interested because not all not all patients are part of the yeah I ask and and some are some patients are so deeply hurt that um it almost invites that conversation and and some people don't have traditional beliefs and and um so then we we don't pursue that much further but some people do MH and um and and they really respond to having those conversations Pati MH I think uh the reason I ask you that is just as providers uh in general I think sometimes people are um reluctant to ask our community members what their beliefs are and and uh but I think it's really healthy to do so and ask what they follow traditions now you work in the clinic now or for the clinic as well Ricky providing some traditional medicine what does that look like do you get a call once a week a couple times a week or um it's much more than a couple times a week it's uh a couple times a day um sometimes it's a couple times an hour uh the need for health in America I think is is um at a is a real high right now um so I think that um for us to be in indigenous health I think we have to be centered in who we are the difference between um Native of American so-called and also indigenous there are differences there so I think that when we lump ourselves with the uh mainstream folks that we often times look at ourselves as the Bottom Rung constantly and that can be really heavy on us as a collective mindset so um I think the to Center ourselves in this Society is is a good starting point so part of your Healthcare then is reminding people of who they are and who they come from and our ways and the value of them yes because the the values of um America are different than the values of indigenous America um a Salient feature again of any society or any Community is who gets honored and in the values of the American culture the ones that are getting honored are the ones that are uh we certainly don't want our children to emulate their behavior avors um so there's a difference there in a value system um that brings about either Wellness or um some struggles so our values are completely um and the ones that we hold up as in in our society and our communities are those that serve the people and give of themsel and sacrifice and um so those are the ones that we hold up and uh unfortunately we're trying to nurture the younger generation to come and um give us a helping hand many are stepping up so that's a beautiful thing um we're grasping a lot of the things that are needed in in indigenous health and um particularly the language ceremonies and um the way of treating one another and things uh natural law and spiritual law so those things there are um but we we need more because the the unhealthy ways that were compelled to um go towards um from the social forces in America such as the uhu the media and such our youth are pushed towards those uh whole in those ones up with the um kind of um mischievous behaviors and things like that so uh we want to change that and and that's all built through relationships and so that's why we strive to have a welcoming uh genuine uh atmosphere to so that the folks show up thank you do you want to add something to that there's a direct correlation and research will back that up between the sense of self and and um identity belonging um all of this is is deeply connected to both our physical and our emotional health so when we think about the way in which this is all interconnected it's really important that we do understand who we are it's really important that we're we're feel we feel okay about who we are that we can stand out here and walk out here in the world and and feel as if we have a place it's when we don't that that then gets internalized and and then it it does things to our health I mean we're talking high blood pressure we're talking heart disease there are there are a number of things Eating Disorders there's a number of things that come about as a result of not being centered in who you are as a human being or as a cultural being and the reason that even comes up is that our ways and who we are were pushed asides that it could be replaced with non-native ways so that's why there's a struggle for some of our many of people in our community right right anything to add to this Arney well our ceremonies weren't even legal until 1978 and um so a lot of uh traditional um healing kind of went underground and happened in relative darkness and um when people come to see me sometimes they might be seeing a traditional provider and they would never volunteer that and they would certainly never volunteer it to somebody that's that's not native and um and and I do ask about that because I don't want somebody to have to choose between me and and um you know somebody that's that's helping them from a traditional standpoint you know I might not always be the best choice and I don't want them to have to choose you know they should be able to access both if they if they come to see me um they have a reason for that and um you know and and I we need to respond to that reason one of our uh audience members the people watching tonight want to know what types of traditional medicine do the panelists incorporate into their daily practice so they're asking more very I think it's hard for people to understand this so can you give an example of something that you incorporate into your daily practice or do you oh I do so when I get up in the morning it doesn't matter what day it is you know what I have if I got Hospital things to do um if um the first thing I do is I go out and I and I have a ceremony and I put I put tobacco out and um tobacco a sea it seems like why would a physician be doing anything with tobacco and it's a Sacrament it's a thing that we use for um you know when I put that out it it takes me a long time I include um people who have cancers people who need help people who are struggling um people who I know that you just got painted into the corners of life and and can't get out and um a little girl who's got seizures um somebody I just found out has cancer somebody's dad with cancer and um and when I do all those things in the morning I start out with gratitude and um and then and the whole day follows from there and and I start with enough gratitude that it lasts the whole day you roxan what do you incorporate into your oh gosh I'm like Arney there's not a morning well well that's not true there are some mornings where I'm so busy you know and then the physical world um kind of grabs me and I and I do bypass it's a very fast mman do my tobacco goes down he um but I but I like to pause with my tobacco I even remind my grandson ah being the K and he's got his tobacco hey as we as we just pause to give thanks for our day maybe we have to think about something specific um but it's about being grateful it's about remembering that um I'm just a I'm just a tiny little human being in the in the cosmos you know I'm just a tiny little speck I barely even am on the scale of being recognizable you know and and so it starts my day off and thinking that way it also helps me to slow down so that I'm not in such a hurry this world is this world is hard it makes us want to hurry and rush and you know so to slow down and connect mhm how about you Ricky for me I think it's uh quiet time I think is the most uh thing that's needed to Center ourselves in the day to get up early um to greet the sun uh natural law um to see the even before the sun comes up to be alert and ready so we have to think about our day ahead and I think because as the day gets going and the cars start moving to working to and fro I think that there's so much buzz in society that we feel a numbness to it we can't there's too much noise there's too much side stuff going on and andless we have a um something in place that we're centered ourselves and what we have our needs met um for ourselves our family uh and then the community uh I think then we have a we we can go along through the day in a good way and it's that little pause too see one thing that that is here but it it isn't being said directly is the fact that it's in the natural world that this is where our calm comes from it's in the natural world this is where we pause and put our tobacco out this is where we find that quiet it's in the natural world I'm so grateful for my yard I've got a I've got an amazing yard that I can step out into a I overlook Lake Superior I have an opportunity to pause and just look at her and talk to her you know so I mean it's in the natural world that we find this really strong feeling of equilibrium if you will you know that that all of a sudden just kind of being back on balance again yeah thank you for that there's this this question I'm going to direct to you Arie as um someone who travels back and forth between well you know both both forms of medicine but how do you treat severe diabetes in indigenous patients I'm going to start with you but I want to ask if you to have anything to add to it as well well certainly diabetes has hit us pretty hard and it's um it it's a metabolic problem and um blood sugars and don't want to get get myself in trouble here um I had a patient who would drink maple syrup right out of the refrigerator and um and and always thought that wouldn't raise his blood sugar but he wouldn't check his blood sugar and even though it's a you know it's a it's a better sugar it's a better carbohydrate it's a better everything you know there's still um there's still sugar in it and um and sometimes it it just takes a while people are skeptical and people are um a lot of people don't want to start with medicines you know so starting with diet and exercise and being outside and talking about nature and talking about you know going outside and going for a walk and um you know being outside and being present sometimes it just it it does take a while and um I don't know that I approach it necessarily from a tradition perspective that much it's hard to isn't it when it's not a traditional disease I mean we got this way he following non-traditional ways right the diet certainly isn't traditional that got us gets many of us to this this state where our pancreas is challenged and you know our body's challenged so it's hard would you add anything to that roxan I think that that's that's the biggest part of it is that it's not something that we can just use traditional medicines for because it is a metabolic thing I think there are some medicines out there that that might be able to work with it not anything that I'm familiar with I know I know some medicine people up in Canada that really are Adept at at those medicines those natural medicines um but I I lean a little bit towards you know Arie to is that you know there are some things that really um these are things that we need to treat from a medical place yeah anything different you Dad well I think there's a a two-pronged approach to that Western medicine and specifically traditional ways as you bring them together they compliment one another um for us as um indigenous peoples we want to return to the ways that were before the all these sicknesses came Zin bakap and the diabetes and things that Afflicted us um and that means to be the the wild animals but they're most of the um most of the of the mammals if you will on Earth are chickens and turkeys and um pigs and and the domesticated ones we're talking about the The Limited amounts of wild Meats um wild berries um wild rice um and things from the garden directly from our mother earth so it's a return to uh those those nutritious ways of living along with um um proper sleep um a proper exercise and so a holistic way of looking at things so that we can be even the people that we associate with because I think in um America there is design to get people addicted to whether it's sugar whether it's um whatever salt or whatever the scientists are then it's an addicted Society so there's profit in addiction there's profit in sickness there's profit in death so we're a profit Jen economy so it makes sense that's why we got to Center ourselves in that world and say what do I need to do to um navigate through that very uh sick Society Arnie uh someone's ready and says I'm a student hoping to go to medical school what can practitioners of Western medicine learn from traditional medicine I think they can learn a lot I think you know just listening to um Ricky and roxan talking about centering and and talking about being talking about gratitude and talking about looking at life from a different perspective and looking at we're a community and we're parts of a community and um and we're just when we go outside and an elder that uh has passed on Sat me down and made sure that he he wanted me to know that when I go outside I should look and listen to everything out there because everything's trying to tell me something and I do that so when I go out in the morning I do look and listen and I've been going out in the mornings for 60 plus years and Monday I saw Stars I mean it's the same stars but they were so bright and and I've seen in the mornings I've seen the tops of just the tops of the trees when this when the light is hitting them before the sunlight gets down to where I am and and how bright they are and um and one morning I saw just a drop of dew way up high in a leaf that was it was like a diamond I mean I've never seen anything that sparkly and that Prismatic and all the colors and um and you need to look for those things and they're there and um you know and you need to realize that we are just a part of that and that we have a connection with all those things but we have a connection to each other right and you know that we share our gifts and and that you know that we listen to Ricky and roxan and and people who um want to Center us back where we should be I'll never forget Ricky you telling uh the students and me one time in a class about um the wind blowing on us being a form of smudging and cleaning as well that was pretty powerful roxan someone wants to know what are some of the natural flowers of plants and do Physicians prescribe Pharmaceuticals on top of that is that okay and I'm not just answer what you feel like you're comfortable with yeah you know I think that I think that there is a way to blend but I think that um we have to always be careful of that too it's it's like at one point in time somebody had um swamp te muskog and um they drank like a gallon of it and then wondered why they got a bladder infection well duh do you take a whole bottle of aspirin and eat the whole bottle for a headache you know so I mean there's moderation to that but I think that our physicians um need to know what it is that you're using as well what what else do you do what what other medicines are you using are you working with a spiritual healer are you working with a traditional medicine so that you have a better idea of what mixes well with what how much of well how much are you getting of something right you know so I think they can I think they can work together and and we ask not for judgment but so that we know what other medications we're giving on top of it and how they'll run together right yeah anything else you want to add to that Arie or I absolutely think that um working together is the is the right way to do things it seems like it's being accepted more and more which is really nice good um we always get this question and it's a good one but uh Ricky how what would you say how can I support my local indigenous Community Support is to be in relationship because you got to be talking you've got to be not texting not emailing you got to be face to face you got to be in the same room and that's genuine relationships and things so um I think that's where the power is at in relationships um cuz then we can feel the pulse of the sickness the wellness um to share the burdens um also share the happiness so everything comes down to relationships um so and then the young ones sometimes don't know what to say or what to do and often times we don't either but the thing is to be there bring your spirit bring bring yourself and and things begin to happen and always the native will always have the tobacco that leads the way and um so those things are first and foremost roxan people look um I'll tell them that I'll remind people you have to be in relationship you have to build um relationships with our community and people still wonder how to do that you know they think okay do I go to Pawa what would you advise for people who still don't quite know how to get there gosh I there are so many places Bey on poos I mean you can come to the tribal college for an event go out to the folac band for events that they have there's Flyers all over the place every clinic in town has Flyers posted for events that are coming up go sit go watch go listen and then while you're there is it okay if I ask you about ask to ask yeah you know be be be willing to ask the questions those those relationships aren't going to develop just simply by sitting there you have to actually engage them yeah some humble curiosity and I think that that's one of my favorite tools ask to ask is it okay if I ask you about and then whatever it is because that way they can say no MH you agree anything El oh absolutely agree and learning language um Ricky teaches um language and I always have excuses for not making it to the to those language tables but those are um you know the just learning words and some phrases and you know listening to somebody that is teaching and goes off on a tangent a little bit and tells a story in the process that's the way we're supposed to learn that's the way we learned you know way back when and um and our and our ancestors were so they knew that there would come a time when when our language would be taken away when boarding schools would happen when um ceremonies would be illegal and they put our lessons right in the language itself and and if you learn to speak and even just learn some words you know there's there are things in there that that don't happen in English yeah beautifully said IG Wich yeah so inviting people in to have Community with us compassionate inquiry I love that yeah compassionate inquiry great I want to thank our panelist Rick Ricky defo roxan deil and Dr Arie vano and our medical student volunteers Justin baren Orin Raymond and Sophie Wang we'll be off next week due to Thanksgiving please join Dr Peter nen in two weeks for a program on men's health prostate bladder and kidney problems one his panelists will be Dr Nick Johnson Dr Benjamin Marsh and Dr John Wood thank you for watching and good night me know they be 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