The Scalpel and the Silver Bear: The First Navajo Woman Surgeon Combines Western Medicine and Traditional Healing

Great book and the deliver time was extremely fast. This was a good book in good condition.

Wow! What a book! What a great book! Complete new appreciation for medicine, New Mexico, Arizona, surgeons, and our native-Americans! Wow!

Lori Arviso Alvord walks in two worlds. Raised on the Navajo reservation in New Mexico -- "the rez" -- she is the daughter of a Navajo man and a white woman. Carrying this dichotomy into her education and career, she went from the reservation high school to Dartmouth College, then found her path to Stanford University School of Medicine and a surgical residency in New Mexico.

As the first Navajo woman surgeon, she learned to integrate the science-based world of medicine and the spirit-based Native American culture. The importance of the singing cures, native healing practices, and other spiritual traditions was brought home to her when she observed her patients' outcomes. Surgical skill was often not enough when delivered without respect for the language, culture and spirituality of the Navajo patients.

The main focus of this memoir is Dr. Alvord's path to acceptance of the first Navajo principles: balance, harmony and wholeness, known as "Walking in Beauty." Along the way we learn a great deal about Native American history and culture, sensitively presented.

Dr. Alvord speaks of the cultural bases for Native American alcoholism and the prevalence of gang culture, monumental threats to the health and well-being of her people. The healing of these ills will never be achieved in the operating room alone, and many patients' stories illustrate this lesson effectively.

The outcome of Dr. Alvord's journey is signaled from the beginning, as is often the case with a memoir. While this may dilute the dramatic tension of her story, we're rewarded with a thoughtful and inspiring look at one woman's life and work, in all its contexts. I recommend this book to readers young and old who have an interest in the cultural aspects of medical care.

Linda Bulger, 2008

Daughter of a full-blooded Navajo father and white mother, Lori Arviso Alvord grew up on a New Mexico reservation in a family that took pride in its native heritage, but followed few of the traditional ways. She attended Navajo schools but never learned the language; she knew her clan relationships and enjoyed the security of tribal connections but seldom attended ceremonies or understood the depth of meaning in the Navajo concept "Walk In Beauty."

Such a person might expect to shed the remnants of tribal culture on leaving the reservation to become a high-powered surgeon, a career that by its very nature flies in the face of Navajo precepts like privacy and self-effacement.

Indeed, throughout her memoir, co-authored by Elizabeth Cohen Van Pelt, Alvord seems to straddle two worlds separated by an uncomfortable gulf. She first looked upon the deepness of that gulf at Dartmouth.

"For a girl who had never been far from Crownpoint, New Mexico, the green felt incredibly juicy, lush, beautiful and threatening." Unable to see the horizon, she felt claustrophobic. But the culture shock was worse. "I thought people talked too much, laughed too loud, asked too many personal questions, and had no respect for privacy." Navajos do not put themselves forward and cooperation is valued over competition. Not a good prescription for success at an Ivy League school.

At Dartmouth she began to feel her tribal identity more strongly and wonder if a kinaalda ceremony (a celebration of womanhood) would have helped empower her in such alien surroundings. But not until after medical school at Stanford, where she was forced to break numerous taboos (Navajo never touch the dead, for instance) and joined a profession where it is essential to ask prying, intimate questions and invade another's personal space at will, did Alvord really begin to explore the philosophical grounding of Navajo culture.

Becoming a surgeon at the Gallup Indian Medical Center, close to the reservation, Alvord notices that her patients do better when they are calm and relaxed, that harmony - even in the operating room when the patient is unconscious - is important for recovery.

She grows more interested in the Navajo philosophy that "everything in life is connected and influences everything else." To "Walk in Beauty" a person strives to live in balance, symmetry and harmony with everything and everyone else.

While this is an ancient precept, held in common with many other cultures and enjoying something of a renaissance in American medicine today, Alvord comes up with a particularly striking example. One of her surgery patients, a young woman, was the first to die of a strange illness that swept through the Navajo nation, killing 11.

A doctor working for the Centers for Disease Control, Ben Muneta, visited a medicine man, a hataalii, who told him "the illness was caused by an excess of rainfall, which had caused the pinon trees to bear too much fruit." There was "a significant deviation from the natural harmony of the world."

The medicine man showed a sand painting of a mouse and said that twice before in years of excess rainfall a similar disease had struck. " `Look to the mouse,' " he said. Weeks later the CDC determined that the Hantavirus was contracted from the droppings of infected deer mice. The deer mouse population had surged due to an excess of pinon nuts. "It was the rain."

Alvord's tone is quiet, reserved. It does not seem easy for her to describe the alcoholism of her charming father or the difficulties and generosity of her (married at 16) mother. Though she takes us to a nightlong ceremony for the sick and celebrates the strength her patients draw from medicine-man visits, she never explains why it takes her so long to visit a hitaalii during her own pregnancy. Or why she never approaches a medicine man to discuss cross-cultural treatments despite her growing conviction of the efficacy of the "whole body" approach.

While most of the book concentrates on her work and her struggle to reconcile cultures, she provides a wide, sad look at reservation life, beset by poverty and "white mans'" diseases. The long grief of history resides in the alcoholism and the self-loathing of so many - a balance that can never be put right.

At last Alvord leaves. Seeing it as the next natural step in her own "life trail", she returns to Dartmouth as a surgeon and a dean of minority and student affairs. At Dartmouth, she hopes, she can teach the Navajo "Walk In Beauty" principles to new doctors as well as working within the established system to bring better care to her own people.

I am full-blooded Navajo, I was taught to believe in my traditonal ways and it disappoints me that she has talked about very scared ceremonies.