A fascinating path

By Dr. Arthur Vall-Spinosa

Friday, May 13, 2016

Culture, family, and friends in a remote corner of the world

Dr. Vall stood outside Albquerque's Best Western Motel on Central Avenue on August 11, 1965, his first day of work for the Indian Health Service.

I experienced two very different cultures as chief of internal medicine at the Tuba City Indian Hospital.

In a long career, it was my favorite job.

The hospital is in the northwest corner of the Navajo Reservation, but we also served a nearby Hopi Indian village. The Navajo live in small, isolated family camps and tend flocks of sheep whose wool is used in the tribe’s famous weavings. The Hopi live in villages and farm small plots of land in the surrounding countryside. Many Hopi men are silversmiths.

Tuba City had eight physicians — several became my lifelong friends — working in a 75-bed hospital with some outlying clinics. We lived next to the hospital so were able to spend lots of time with our families. Most of us had children while we were there.

We shared call, which meant that even as an internist I delivered 200 babies, covered the emergency room, assisted at surgery, treated kids, and was able to develop public health projects.

Dr. Taylor McKenzie, shown here with his wife, Betty, was the first Navajo physician. He later served as vice chairman of the Navajo Nation.
By a wonderful chance, our surgeon was Dr. Taylor McKenzie, the first Navajo physician. He later served as vice chairman of the Navajo Nation. Dr. McKenzie was an extremely accomplished surgeon and helped us gain insight into the Navajo culture. Many of the supporting staff were Navajo or Hopi, so we were truly immersed in a diverse community.

In the 1960s the major illnesses on the reservation were lung diseases and trauma. We saw very little heart disease, diabetes, and cancer. There were many unusual illnesses. For example, the pituitary glands of several women had infarcted due to massive blood loss at childbirth. The pituitary gland sends messages to other endocrine glands, so the condition manifested in unexpected ways. We saw it so often that it generated a scholarly paper in an obstetrics journal.

Other medical issues included hemophilia, snake bites, gall stones, and schizophrenia. Gall stone patients often came in with “hickies” on their abdomens because a Hopi medicine man failed to remove the stones by a technique known as sucking. We often consulted tribal medicine men and added their ceremonies to our treatment plans.

Occasionally, when I was unsure of a diagnosis or treatment, I flew to Albuquerque in a small plane with the patient for a consultation with a specialist.

The experience of working in Tuba City, away from a larger medical community and forced to make my own treatment decisions without advice from others, matured me as a physician and cemented my decision to become a pulmonary specialist.

It set me on a fascinating path.