When Two Cultures CollideBy Richard P. Holm, MD
As I was researching the history of Native American health care, I took note of the various terms used early on by indigenous people to describe European immigrants. Initially, the references had to do with skin color. Several tribes labeled Europeans as “white skinned,” or “yellow-hided.” Some tribes still use the term “umsewah,” meaning “bleached wood.” Other tribes described Europeans as “hairy mouthed,” “hair faces” and “dog faces,” referencing facial hair on European men. Ears were also important in naming. One tribe characterized the immigrants as “ears sticking out” because they did not have long hair covering their ears as did Native Americans. Some say that the ear label referred to that tribe’s word-meaning for donkey or mule. As time went on, Native Americans began to describe Europeans based not only on how they looked, but on how they behaved. A Lakota word for Europeans is “wasichu,” which means, “taker of the fat, or a greedy individual.” Recognizing the transgression over the last two centuries, I can’t blame the Lakota for choosing the label, “wasichu.” These Native American words reflect the impact of two cultural world’s colliding and reveal a disharmony resulting from the loss of access to traditional hunting and farming lands, the loss of family and language as children were shipped to boarding schools, the loss of self-respect with isolation on the reservation and much more. The result of all this has been decades of health disparities. For example, American Indians are 50 percent more likely than white people, to have a substance abuse disorder, 60 percent more likely to commit suicide, twice as likely to smoke cigarettes or to die of childbirth, three times more likely to die from diabetes and five times more likely to die of tuberculosis. But change is coming. Revered Oglala Lakota medicine man, Black Elk, prophesized that with the seventh generation following the tragic Wounded Knee massacre of 1890, Native American people would begin to recover from the historical trauma experienced since the collision of these cultures in the mid-19th century. From 1890 to 2020, that’s one hundred and thirty years. Divide that by seven and, right now, you have 19-year-olds who constitute that seventh generation. It’s time for those of us with ears sticking out and those without, people of all skin colors and cultures, to create an environment that allows all people to come out of poverty and help make positive changes in Native American health care. Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central. Stress and Anxiety Affect Us All By Richard P. Holm, MD
Standing in front of a group of De Smet Parent Teacher Association® (PTA®) members, I was to play a trumpet solo. My teacher thought I was prepared, but unfortunately, I was not. My fears brought my heart up into my throat, I became short of breath, my heart pounded and, indeed, I stumbled and had to start over again. Although my failings were likely amusing to some in the audience, they were certainly not indicating any musical skills. It was a devastating experience for me. During our lifetimes, all of us experience physical and psychological ailments. People will admit to physical trouble but don’t like to admit to psychological problems, and most of us are reluctant to ask for help. Many of these feelings increase adrenaline levels which, in turn, cause fast heart rate, shaking, shortness of breath, dizziness, diarrhea, urinary frequency, sleeplessness, headache, sweating and generalized discomfort. Sometimes these feelings of anxiety are normal, and sometimes not. A reasonable level of anxiety can keep us driven to hunt for food, fix something, discover another frontier and improve what we can improve. Without stressors and the anxiety that follows, some experts believe we would become lazy, stop dealing with troubles and civilization would end. On the other hand, when feelings of anxiety expand out of proportion to the trouble we are facing, or come on easily and frequently, anxiety can sometimes interfere with a normal functioning life. Too much anxiety can be harmful to an individual. We are all thrown off-balance by one kind of psychological challenge or another as we struggle through the typical encounters of daily living. Who hasn’t experienced periods of anxious moodiness that follow the reduced sunlight of winter, or anxiety following the loss of a job or facing the demands of a new job? How does anyone handle a severe illness in a child or a spouse? Who can deal with divorce without anger, disappointment and, you guessed it, anxiety? Life is often very difficult; every individual will confront stressors in different ways and sometimes we just need help. Bottom line: Each of us must deal with our own physical and mental illnesses throughout our lifetime, sometimes minor, like forgetting a trumpet solo, sometimes major, like a prolonged sense of anguish after a death in the family. When our ability to live a normal life is being interrupted by anxiety, it’s time to see the doctor. Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central. Your Guide for Prevention and WellnessBy Deb Johnston, M.D.
Primary care doctors do a lot of different things. We diagnose illnesses from the trivial, to the catastrophic. We treat maladies both chronic and acute. We confront, and we console. Of course, these are common roles in medicine, filled by many different providers. One role the primary care physician is more uniquely suited to fill, however, and one of my personal favorites, is that of guide. I’m talking specifically about the art of prevention, of maintaining wellness over the long term, and reducing the risk of diseases that might make it harder to do what you need to do, what you want to do, what you love to do. Prevention is truly underutilized. We’re a lot better at looking for a problem, and a pill or a procedure to fix it, than we are at fixing what might lead to a problem in the first place. In fairness, human beings are inclined to wait for the crisis to hit before we believe it is really and truly ahead. Changing habits is hard and eating takeout pizza while watching must-see TV is a lot less work than hitting the gym and making a salad. On the other hand, some parts of prevention are easy. It’s easy to get a flu shot, or a shingles shot. It’s easy to get a mammogram, or a colonoscopy. It’s easy to get blood drawn, and get checked for diabetes or hepatitis C. Of course, it’s only easy to do these things if you are aware of the benefits of doing so. This is the value of the annual checkup. From birth, to your last birthday, wellness visits have an important role. For infants and children, we monitor growth and development. For adults, we screen for diseases, and give advice on reducing risk factors that might lead to disease. Even the oldest of our old can benefit from simple tests for things such as hearing and memory. At every age, we think about safety: is that infant sleeping on her back? Is that teen wearing his seatbelt? Is that adult drinking and driving? Is that elderly person at risk for falls? Has that patient received their flu shot? Under the Affordable Care Act, most insurance programs cover prevention visits with no copay. This even includes Medicare. Everyone can benefit from these opportunities to focus on staying well, rather than treating problems. Prevention is an important part of being a primary care doctor, and an important reason to HAVE a primary care doctor. So, take your preventative action today, make a call and set up an appointment, just for that checkup. Deb Johnston, M.D. is a contributing Prairie Doc® author who has practiced family medicine for more than 20 years. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central. Sunscreen…Don’t Leave Home Without ItBy Kelly Evans-Hullinger, M.D.
It’s the dead of winter, and who among us isn’t craving the feeling of warm sunshine on our skin? I, for one, am dreaming of summer days spent outdoors, not a care in the world, basking in that delicious ultraviolet light. But alas, I must be my own physician buzzkill (maybe in this case, sun-kill), and remind myself that there is more to those rays than the pure delight I am romanticizing. The truth is, there is technically no “safe” amount of UV exposure when it comes to our skin and the risk of skin cancer. One in five of us will have a skin cancer diagnosed in our lifetimes, and while many types of skin cancer are not life-threatening, some are. Melanoma, in particular, is a skin cancer with great potential to metastasize and ultimately take lives. Like other skin cancers, ultraviolet exposure is a major risk factor for melanoma. I can recall one summer day when I was 13, I fell asleep on a July day watching a cousin’s baseball game. My fair-skinned back was exposed to the sun, unprotected, leaving me horrendously sunburned in the days that followed. I will never forget those next few days, one of which I spent carrying my golf bag on a hot, humid tournament day, my back covered in blisters. The thought of it now is enough to make me cringe. And let’s not forget it doesn’t have to be a hot summer day to incur skin damage. Many of us have been surprised with a sunburn sustained while skiing or ice fishing – sun is sun, whether the temperature is hot or cold – and even on a cloudy day those UV rays make it down to Earth. And don’t get me (or your friendly dermatologist) started on the risks posed by tanning beds. Protecting one’s skin from the sun is something we can all do to stay healthier. There are a variety of ways to do this: Avoiding sun entirely or staying in the shade, wearing protective clothing like long sleeves, pants, and a wide brimmed hat, physical sunscreen like zinc oxide, or chemical sunscreen – the experts recommend at least SPF 30 applied every 2 hours. I still love summer. I love being outside for hours, sweating in the sun. But these days you’ll find me with SPF 50 applied before I leave the house and carried along at all times for reapplication. Kelly Evans-Hullinger, M.D. is a contributing Prairie Doc® columnist who has practiced internal medicine for the past four years in Brookings, S.D. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central. |
Archives
February 2025
Categories |