What a doctor learns after a life’s work

A pediatrician reflects on his work in Navajo Nation.

 

In this remarkable memoir, Brian Volck reflects on his career as a pediatrician, including stints at inner-city hospitals in the Midwest, several volunteer missions to Honduras and years on the Navajo Reservation. Through his practice, Volck has gained considerable wisdom, though he’s too humble to call it that.

Attending Others is less a compendium of lessons learned than a gorgeous meditation on the things that cannot be fully understood, such as the mysteries of the human condition. Volck focuses on how vulnerable we become through our bodies and our bonds with those we love, especially in the ties between parents and their children. His experiences with his own and other people’s children serve to perpetually reinforce what he calls “the first lesson of parenthood”: “You’re not in control.”

Dr. Dena Wilson assesses a patient at Indian Health Services in Phoenix, Arizona. There are only about 100 Native American physicians in Arizona. As a white physician, the author of Attending Others had to learn about Navajo culture to be an effective doctor in the community.
Megan Bridgeman/Cronkite News

The memoir’s structure is indicative of its overall humility. After an opening scene at a Navajo wedding, Volck goes into the stories of two young patients who died while under his care: Brian in Cleveland, and Alice in Tuba City, Arizona. As he mulls over what he and the other medical professionals did when these children were brought into the emergency room, he shows us how a cure can elude even the most highly trained and conscientious healers.

“I don’t think about Brian as much as I once did,” Volck writes. “There are months now when I think I’ve forgotten him, but he’s never really gone. I carry his death like a pocket charm, laying it on the dresser at night with my wallet and keys. And if I ever do forget Brian, I remember Alice.” Alice is a 2-year-old whose father brings her to the E.R. during the Navajo Nation Western Agency Fair. Alice’s father wants to drive her to a hospital in New Mexico, six hours away, thinking the care there will be better. But Volck dissuades the family from moving her, noting that he was “careful to avoid warnings about ‘what could happen if you don’t do as I say,’ which to traditional Navajo can sound as though the doctor wishes them harm.”

Alice’s pneumonia symptoms intensify, and eventually she dies. Volck will never know if she would have made it safely to the other hospital, and if the doctors there would have detected something he didn’t. But despite his setbacks, Volck’s hard-won knowledge of Navajo culture eventually helps him become a better doctor to their community.

Volck writes, “Like many Anglo medical professionals, I learned from Navajo or Hopi babysitters the prime directive of Native hospitality: always bring something.” Volck learns to be patient with Navajo social customs when he introduces a translator, instead of rushing the conversation toward the questions he wants answered. No matter how much he discovers about Navajo culture, though, Volck respects that he can never fully understand it or consider himself a part of it. “When I lived on the Navajo reservation, I knew no matter how long I stayed, I would always be a visitor from somewhere else. I also saw up close how sad and parasitic wannabes are, how protestations of oceanic tolerance never change who you are and where you come from. When I’m asked what I learned from my years on the reservation, I usually say, ‘That I’m not Indian; not even in a past life.’ ”

When Volck and his family decide to leave Arizona, people at the hospital ask why. “When I answered, ‘Because our kids need to see their grandparents more than once or twice a year,’ our Navajo and Hopi friends would almost invariably lean closer, touch my shoulder with feathery lightness, and grin, sometimes adding, ‘Looks like we actually taught you something.’ ”

Volck returns periodically for stints with the Indian Health Service whenever they need a doctor to fill in. Over the years, he notices changes — fewer young people learn to speak Navajo, for example, and “facilities had improved, staff expanded, and serious acute illnesses gave way to chronic conditions like childhood obesity and Type II diabetes.”

Volck illustrates the endless problems facing children in poverty — from malnutrition to accidents — yet he never loses sight of the grace that each encounter offers him. As he writes about one young patient: “Pay attention; here is a most special person.”

Volck’s writing is luminous, vigorous and sensory, inviting the reader into the scene. The love he has for his patients is clear, as is his irritation with bureaucracy and the more tedious aspects of his job. Attending Others is about the practice of medicine, but in a larger sense it’s about being a human being, trying to navigate relationships and a career despite one’s particular flaws, and occasionally finding moments of connection and beauty that make all the frustrations worthwhile.

Attending Others: A Doctor’s Education in Bodies and Words
By Brian Volck
222 pages, softcover: $25
Cascade Books, 2016.

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