The Medicine Way

Volume 27, No. 4 - Summer 2016
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POLLINATION BY MICHAEL BEGAYBefore Europe’s imperial project in North America, virtually all Native nations had robust, well-established networks and protocols for training medicine people. These Indigenous healthcare models were rooted in the natural world and knowledge that had been passed down from generation to generation since time immemorial. Such is how Sanapia, one of the last of the Comanche eagle doctors, learned how to become a medicine woman.

Sanapia followed in a long line of puhakuts, or those recognized as individuals who had the preparation and power to heal. Her grandmother had trained her mother, and her mother went on to train her. But in the eagle doctor tradition, Sanapia had a review board of sorts, with her maternal uncle, maternal grandmother, and paternal grandfather all serving as instructors and advisors. In order to be recognized as a legitimate puhakut, Sanapia needed the approval of them all. Over the course of four years, they each taught her all they knew.

An integral part of her training was learning about the seemingly unending list of botanical medicines, where they could be found, and how to use them. They taught her that natsa’ksi is used for head colds, ekapokowa:pi for menstrual complaints, puitsasene for cataracts, kun natsu for toothaches and burns, bakuma for an upset stomach, sanawiha for eczema, oinatsu for asthma. Sanapia served as her mother and maternal uncle’s intern for a year, observing and helping them in their doctoring. She learned to diagnose and treat various ailments and diseases and had what were essentially seminars, or “long, long talks” with them about the Medicine Way.

Eagle doctors also had to abide by a strict code of ethics, a sort of Indigenous Hippocratic oath. The rules of conduct mandated that as a puhakut she lead a good and honorable life, always be accessible, never refuse treatment to anyone or any form of payment no matter how slight. She should never solicit her services, but rather wait for her patients to come to her. The puhakut had to be humble, and recognize that it was the sacred medicine at work and that she was only a caregiver. If an eagle doctor behaved in a disgraceful manner, she brought disgrace on both her practice and her medicine.

Sanapia’s training culminated in a final test of meditating and fasting in isolation for four days and nights. There, at the top of a hill, she prayed, cried, and talked to the spirits. Her mother warned her that during the night she may feel an evil presence, but that it was imperative she face her fears and stay true to her fast. During that dark time, she said that she felt the eagle speak to her and thereafter maintained, “I can feel the eagle working in me when I doctor and try hard to get somebody well.”

After the fourth night, Sanapia returned home to her mother’s embrace and a house full of well-wishers who gave her gifts of moccasins, blankets, food, and horses. A great feast followed to celebrate her accomplishment and recognize her as a practicing eagle doctor. For many years thereafter, Sanapia served her people through the most difficult of times, witnessing health issues multiply as the old ways faded and efforts to assimilate the Comanches grew.

What is needed today is a healthcare revolution in Indian Country—one that produces homegrown Native providers and Indigenous healthcare models that are created for and designed by tribal people.

Today, the health issues affecting Indian Country as a whole are greater than ever. There are unparalleled health disparities and the facts and figures reverberate like the beat of a drum: the highest rates of diabetes mellitus, chronic liver disease, unintentional injuries, suicide, and the list goes on. Most of us also recognize that those disparities are due in large part to economic inequalities and, of course, the long shadow of colonialism, which has resulted in great damage to traditional medicine ways and knowledge. And we are well aware that there is a dearth of trusted, reliable, influential, and potent Indigenous healthcare providers helping Indigenous people. All of these factors circulate in a vicious cycle. What is needed today to break that cycle is a healthcare revolution in Indian Country—a revolution that produces homegrown Native providers and Indigenous healthcare models that are created for and designed by tribal people and which can be passed down to subsequent generations.

This revolution has begun to take shape at tribal colleges and universities (TCUs). Read Dina Horwedel’s feature “Rx for Indian Country” and learn how TCUs in even the most remote corners of Indian Country are taking steps to reclaim tribal health. At Stone Child College, for example, the Rural Health Initiative gives students the opportunity to investigate historical trauma and to uncover how elders forged a path ahead despite the hardships they faced. The college is also partnering with fellow Montana TCU, Salish Kootenai College, to offer students healthcare provider training. And these TCUs are just two of over 20 across the nation that have developed culturally responsive healthcare curricula.

At Diné College, the public health program is rooted in Diné educational philosophy and incorporates the four directions model of Nitsáhákees (thinking), Nahat’á (planning), Iiná (implementing), and Siihasin (evaluating). In his feature article, “Connection and Community,” Mark Bauer explains how public health’s newest offering, the Summer Research Enhancement Program, gives students experience in public health research methods through a hands-on internship in their home communities, enabling them to employ the skills they’ve learned to improve their communities’ health. Bauer, who has taught at Diné College for over 30 years, says that the program stresses how fostering individual and community resilience is of the utmost importance.

Other tribal colleges have taken alternative approaches to tribal health and well-being. In “Four Legged Healers,” Jessica White Plume illuminates how Nueta Hidatsa Sahnish College’s Horse Nation Initiative employs equine assisted psychotherapy to heal the deep wounds of Native peoples from the Northern Plains. White Plume maintains that one of the casualties of colonization was the destruction of Native people’s historic connection to horses and the lifeway based around the animal. Students’ exit surveys indicate that the initiative is highly effective and tremendously popular.

While culturally responsive programs at TCUs are at the forefront of the healthcare revolution unfolding in Indian Country, part of the solution to many woes lies within. In “Very Good Medicine,” Cynthia Lindquist, chair of the American Indian Higher Education Consortium and president of Cankdeska Cikana Community College, discusses how humor and laughter ameliorate many of our problems. “Laughter rids us of tension, stress, anger, anxiety, grief, and depression,” Lindquist says. Her coauthor, nationally known comedian Mylo Redwater Smith, agrees, noting, “Indian humor is medicine. Like ‘chicken soup for the soul’ kind of medicine.”

As illustrated in this issue of Tribal College Journal, good medicine can take many forms. Just as Sanapia learned the Medicine Way generations ago, tribal colleges and universities today are developing Indigenous healthcare programs and models for generations to come.

Bradley Shreve, Ph.D., is the managing editor of Tribal College Journal.


Indian Health Service. (2015). Disparities. Retrieved from

Jones, D. (1972). Sanapia: Comanche Medicine Woman. New York: Holt, Rinehart and Winston.

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