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A Navajo doctor tends to the spirit and body

Yale Medicine Magazine, 2009 - Autumn


Patricia Nez Henderson integrates a concept of balance and harmony into her thinking about medicine.

When Patricia Nez Henderson, M.P.H. ’94, M.D. ’00, was a child in rural Arizona, her grandfather would come to her house early in the morning and splash water on her and her siblings. “Get up! Get up! Go run and meet the rising sun,” he told them in Navajo. “If you sleep too much, you’re going to be left behind, and the morning gods are ready to bless you.” The children would jump out of bed and run toward the glow in the east.

From growing up in a Navajo-speaking community without electricity or running water to completing medical school as Yale’s first female American Indian graduate, Nez Henderson’s was a remarkable journey. Her interest in medicine began early, influenced by her grandfather—a medicine man—and other traditional healers in her family. Most of her relatives worked as shepherds, and she recalls listening to lambs’ hearts with a stethoscope her mother had bought her. “I’d come home smelling like manure,” she said. “My mother says that’s when she first realized I’d go into medicine.”

Nez Henderson earned her M.P.H. at the School of Public Health in 1994 after earning a degree in biochemistry at the University of Arizona. Then it was on to medical school.

It was there that culture shock took hold. Having grown up among healers who took patients’ spiritual as well as physical health into account, Nez Henderson felt miserable at an allopathic school. “My heart was dissected from my head,” she said. “I felt it immediately upon getting into med school, and there were no other Native students there, so it was hard to explain to students or even my professors what I was going through.” One day a faculty member made a thoughtless comment about her imperfect command of English. It devastated her. At that moment, she said, she understood why so many American Indian students leave school. “All I saw was a room full of men in white jackets, predominantly white, and I just began to cry, [thinking] ‘I don’t belong here.’ ”

Shortly afterward, Peterson Zah, a former president of the Navajo Nation, came to speak at Yale. Before his speech, Nez Henderson met with him privately and told him what had happened. Later, as he addressed the crowd, he turned directly to her and spoke words of encouragement in Navajo, whereupon she decided to stay at Yale.

After earning her M.D., along with an award in her name given to recognize a graduate committed to improving health among American Indians, Nez Henderson went to Colorado. Her sense that allopathic medicine is in-sufficient—as well as the frustration among physicians she had witnessed during clinical rotations at underfunded Indian Health Service sites—had convinced her to pursue public health research. She joined the faculty of the University of Colorado Health Sciences Center’s Native Elder Research Center for a two-year program that trains Native health professionals for research careers. Funded by grants from the National Institutes of Health, the Centers for Disease Control and Prevention, and the Robert Wood Johnson Foundation, she began to study tobacco control and prevention among American Indians, an interest that continues today.

Tobacco has long been sacred to Native communities, but its abuse leads to disproportionately severe health consequences for them. Nez Henderson studies American Indians’ reactions to nicotine, which may have genetic underpinnings. She has also designed Web-based interventions and smoking cessation classes that incorporate tribal practices like prayers, visits to sweat lodges, and fasting, and that emphasize the sacredness of life. “Navajo tribes use a word, hozho, which means ‘in balance’ or ‘it’s beautiful.’ There’s that harmony,” she said. “Anything that impacts hozho and makes it go out of balance, we know that’s toxic, like cigarettes. … It’s a more holistic approach. Instead of just telling a person to do these things that are backed by evidence, you combine it with things that are spiritual.”

Nez Henderson lives in South Dakota with her husband Jeffrey A. Henderson, M.P.H., M.D., an internist who is Lakota Sioux, and their daughter, Zahlanii, 7, and son, Mato, 5. They head the Black Hills Center for American Indian Health in Rapid City. In addition to her research, Nez Henderson works with tribal leaders to effect tobacco policy changes within the Indian nations. “With sovereignty comes responsibility,” she said. “A lot of tribes are looking at ways to bring economic development into their communities, but if they put health first, all that they’re looking for will come next.

“I work all the way from prevention to cessation to policy,” she said. “I absolutely love what I do.”

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