Capítulo 4
The Healing Power of Song
In many cultures, song is medicine. More than just vibrations of air across throat membranes, songs come from mind, memory, community, and heart-that intersection where physiology, feeling, and spirit meet.
Despite modern medicine's impressive technologies, my tribe practices healing through song. When someone falls ill, a singer performs ceremonies called chantways-Beauty Way, Night Chant, Mountain Way-each addressing different ailments. I witnessed this power when a medicine man sang for Charlie Nez, my cancer patient who had undergone surgery, chemotherapy and radiation. As I watched, hope returned to Charlie's eyes-that essential will to live that all physicians know is crucial for healing. In that moment, I understood that both medicines were needed.
As the first Navajo woman surgeon, I live between two worlds. In one, I practice advanced Western medicine; in the other, people heal through songs, herbs, and sand paintings. My father was full-blooded Navajo, my mother bilagdana (white). My life feels like a rug I'm weaving, with one culture as warp and the other as weft, creating something meaningful from these contradictions.
Growing up on the reservation, doctors were always white men in my experience. Yet my mother encouraged me to read and dream beyond Crownpoint's boundaries. From early on, I understood my split identity - what Navajos call 'alni (a person who is half) or what Chinese call yuckso' (neither here nor there). Writing this book challenges Navajo values of humility and privacy, but I believe my story matters for Navajo girls seeking possibilities, for those interested in broader healing concepts, and for doctors whose practices feel incomplete.
Born in a military hospital in Tacoma, my father paid for my delivery with silver dollars - all the money he had. We returned to the reservation where I grew up with my sisters in poverty. My shindli (Navajo grandmother) shared stories of our clan and history, teaching us to embrace both American ways and Dine traditions. From her example, we learned pride in our heritage, but our eyes showed us Navajos as downtrodden. We inherited what's called "historical grief" - the burden of centuries of suffering that becomes your own as you learn your people's history.
After medical school, I returned to serve my tribe despite better opportunities elsewhere. I discovered that by respecting Navajo customs and speaking their language, I could bridge the gap between Western medicine and traditional beliefs. Remarkably, as I incorporated Navajo concepts of balance (hezho) into my practice, my patients' surgical outcomes improved.
Capítulo 5
Life Out of Balance
Returning to the Navajo reservation after my medical training proved unexpectedly challenging. Despite my medical accomplishments, I found myself caught between worlds, no longer fitting perfectly into my homeland as I'd imagined.
When introducing myself to Navajo patients as "Dr. Cupp, your surgeon," I'd extend my hand only to have it hang awkwardly in the air before receiving a delicate, pressureless handshake - nothing like the firm grip bilagdanas (white people) used. I'd explain my Navajo identity through my clans - "Tsi'naajinii and Ashijhi Dinee" - and mention my grandmother from White Horse Lake. Patients would acknowledge knowing my clans or grandmother, but then peer at me curiously, sometimes asking with doubt, "You are... Navajo?"
My heart would sink, realizing that in learning medicine, I had also "learned to be white." With my short pageboy haircut, white medical jacket, and stethoscope, I didn't look like a traditional Dine woman to my Dine patients. My medical knowledge had come at a high personal cost.
After negotiating with the Indian Health Service to work at Gallup Indian Medical Center rather than being sent to Oklahoma, I bought a small house on the edge of town at the base of the Hogback Mountains (Tse yik'aan). The home featured gray-blue carpeting, a fireplace, and a skylight. My grandmother Grace soon moved in with me, and from her window, she could see Churchrock, a sculptured finger of rock near where she was born ninety years earlier. Visible from nearby was Tsoodzil (Mount Taylor), the southern sacred mountain which, according to creation stories, was fastened to earth with a stone knife, covered with turquoise blankets, and decorated with dark mists and female rain, guarded by Big Snake. Living within view of this holy place was a blessing.
At GIMC, the intersection of cultures created unique medical situations. Doctors struggled to communicate with Navajo patients through translators, often missing crucial cultural context. My colleague Tim Simpson once removed a 2.5-centimeter porcupine quill from a patient's intestine - a man who believed he'd been "witched" by an enemy. Another patient told me both his father and brother had died from "choking" caused by skinwalkers - Navajo witches who featured prominently in the ghost stories of my childhood.
A pivotal moment in my understanding of Navajo medicine came during a difficult gallbladder operation on Evelyn Bitsui. The procedure was challenging - inflamed tissue, bleeding issues, and a struggling nurse trainee who couldn't find the right instruments. My fatigue and frustration turned to anger as I shouted at the nurse. Though we completed the surgery, Evelyn suffered a stroke the next day.
Despite extensive testing, we found no medical explanation for her stroke. But instinctively, my Navajo side understood. The disharmony in the operating room - my anger, the nurse's defensiveness, the patient's fear - had created perfect conditions for complications. Even under anesthesia, patients sense the energy around them.
This experience taught me to integrate Navajo healing concepts into my Western practice. In Navajo tradition, illness comes from imbalance or disharmony in any area of life. I began creating a more harmonious healing environment by speaking Navajo phrases to patients, touching them respectfully and only when necessary, and viewing them as extended family members.
Capítulo 6
Rez Dogs and Crow Dreams
During morning rounds in the ICU, I reviewed patients with fellow physicians - each case revealing alcohol's devastating impact on our community. Ray Slim with cirrhosis and hepatitis from weekend binge drinking; Robert Thompson with severe bleeding ulcers; Betty Redhouse with knife wounds from domestic violence; and Henry Antonio who attempted suicide in jail. Gallup had about fifty bars for fifty thousand people, with over ten thousand DUI arrests annually. The epidemic touched every aspect of Navajo life - creating the highest rates of fetal alcohol syndrome in the country and becoming what some called a "lubricant of domination."
My father's story personified this tribal tragedy. Robert Cupp was an extraordinary man who could communicate with animals - especially rez dogs and crows - and taught us traditional Navajo ways of moving silently through nature and respecting the animal world. But he carried deep wounds from being punished for speaking Navajo as a child and being taught his culture was inferior. Despite being a straight-A student who attended prestigious schools and studied pre-med, he abandoned his dreams, married my blonde, blue-eyed mother, and turned to alcohol to escape his grief. His binges would leave us searching bars, police stations, and even morgues. In 1993, he died when his car rolled four times near mile marker 47 on Interstate 40.
Like my patients whose lives were scarred by alcoholism, my father's story revealed how generations taught to feel shame about our culture lost the very traditional beliefs that could have kept them strong.
Capítulo 7
Ceremony Medicine
In Navajo, there is no word for cancer. When explaining this illness to patients, I struggled to convey its meaning, using phrases like 'ats'tis naatdzid ("a sore that does not heal") or natzee ("something that rots"). My patient Carolyn Yazzie, a college-educated Navajo professional who introduced herself by her clans (Biih Din'e'e and To'dhdni), faced cultural isolation after her breast cancer diagnosis. Her family and coworkers avoided her food and touch, fearing contagion. Many Navajos believe cancer results from evil actions or can be transmitted like other "white man's illnesses."
I recommended surgery but suggested she could also see a medicine man, recognizing that traditional healing ceremonies provide crucial spiritual preparation for healing. Though Carolyn didn't return, I attended a Yeibechei ceremony for another young woman - the final night of a nine-day Night Chant held in winter "when the snakes are sleeping." Standing among five enormous pinon fires, I watched Talking God and other yei dancers approach the patient, who sprinkled them with corn pollen. The hypnotic chants, woodsmoke, rattles and drums created a powerful healing environment absent in Western medicine, reminding me of my tribal identity and the ceremonies of my childhood.
For Navajos, wholeness and holiness are the same - everything is interconnected. Many traditional Navajos oppose surgery (na'agizh or "to cut open") as it disturbs the harmony of the whole. Navajo patients typically request their removed organs back, believing witches could use discarded body parts to cause harm.
The best surgeons don't just operate on organs but on whole people with lives, families, and beliefs. Surgery itself can be a spiritual experience - when done correctly, movements are fluid and the team works in perfect concert. I learned to accommodate Navajo patients' requests for ceremonies before surgery, noting they resulted in calmer patients with lower heart rates and blood pressure. Medicine men worked through channels Western medicine didn't yet understand.
Capítulo 8
The Spirit Horse's Bridle
Despite strict orders for bedrest due to my pregnancy-induced hypertension, I made a decision that might have seemed foolish to my Western medical colleagues - I drove three and a half hours to Tuba City to see a Navajo medicine man. Something deep within told me this journey was necessary for both me and my unborn son, whom we'd decided to name Kodiak (Kodi for short) after the great Alaskan bear.
The drive took me through pine forests and into stark canyonlands, with Grandma's parting words - "Don't hit any bumps" - echoing in my mind as I navigated the rough highway. By noon, sweltering in hundred-degree heat, I questioned my own sanity as I caught my enormous reflection in a gas station refrigerator case.
In Tuba City, I met Thomas Hataathlii, whose name itself means "medicine man." Far from the weathered elder I'd expected, Thomas was a young, athletic man with a modern sensibility who balanced his role as an IHS mental health counselor with his traditional calling as a healer. We connected immediately through the Navajo custom of establishing clan relationships - discovering we were related through the Ashijhi Dinee clan.
Thomas shared how his path as a medicine man began at age four when his grandfather instructed him to run toward the dawn each morning. Shortly after, he had a profound encounter with a spirit horse after disturbing an old bridle in a sacred place. "You touched the spirit world," his grandfather had told him, marking him as a holy person.
Though his mother had warned him that speaking too much English would change his ability to perform ceremonies, Thomas had managed to balance both worlds - becoming one of the youngest Navajo medicine men while also receiving formal education. He had mastered the Blessing Way ceremony with its more than three hundred songs, learning them through direct transmission rather than recordings.
In Thomas's modern trailer home, he transformed into a medicine man by tying a blue sash around his head. He instructed me to kneel on a Pendleton blanket while holding his grandfather's medicine bundle of eagle feathers. During the ceremony, Thomas sang prayers in Navajo, guiding me to pull the bundle toward my heart four times while chanting "It is beautiful all around me." He sprinkled corn pollen over specific points on my body and had me turn around once outside before concluding. Despite the scorching heat, I felt peaceful driving home, passing through a thunderstorm and seeing a rainbow touch down near the highway-a sign that everything would be alright for Kodi, Jon, and me.
Capítulo 9
Walking in Beauty
After my grandmother Grace passed away at about ninety-one years old, I received an unexpected job offer from Dartmouth Medical School to become associate dean of student affairs. I hadn't been looking to leave Gallup, where I loved my practice and patients, but this opportunity came through Gordon Russell, a Dartmouth alumnus and advocate for the Native American Program.
During interviews at Dartmouth, I shared my evolving philosophy about combining Navajo healing concepts with Western medicine-explaining "Hozho nahasdlii" (Walking in Beauty) as living in harmony with oneself, community, and environment. I contrasted Western medicine's compartmentalized approach with the Navajo healer's holistic view that examines a person's entire life context, recognizing that imbalance in relationships, community, or with nature can manifest as physical illness.
I explained how imbalance extends beyond individuals to communities and nations. When communities lose balance, problems like gang violence, elder neglect, and drug abuse emerge. Traditional Native societies value elders for their wisdom and care for children communally. At the national level, nations living in disharmony lead to war. Humans must also maintain balance with the natural world - Native peoples have always respected animals as having spirits, protecting species for millennia, while Western society's carelessness threatens extinction for many species. In the Navajo worldview, sun, water, forests and creatures have spirit and life, considered family as "Mother Earth, Father Sky," and animals as siblings. This reverence protected our planet for thousands of years, though it now faces grave jeopardy.
I described my vision of the perfect hospital to my Dartmouth interviewers. It would be physically beautiful with adobe walls, natural smells like roasted green chili, light-filled spaces, round windows, porches and gardens. Beyond state-of-the-art equipment, it would include ceremonial spaces and staff who speak patients' languages. Everyone from receptionists to surgeons would be committed to patients' comfort and healing. Illness would be viewed holistically - not as a single organ problem but as an imbalance in any part of a patient's world: body, mind, spirit, relationships, community, or environment. I was pleased to discover Dartmouth-Hitchcock Medical Center embodied many of these ideals - surrounded by forest, flooded with natural light, without hospital smells or intercom pages, creating a healing environment where nature was invited close to encourage healing.
Returning to Dartmouth as faculty after visiting at sixteen when I felt invisible was profound. The campus was now more diverse and welcoming to Native Americans and women. Though my new responsibilities seemed overwhelming - overseeing student affairs, minority affairs, financial aid and more - I was excited to teach medical students to respect the privilege of placing hands inside another human being, to gain patient trust, and to understand healing principles I'd learned from my tribe's ancient beliefs.
When a student asked if Navajo concepts had relevance for non-Indian peoples, I confidently answered "Absolutely." Like the story of Hosteen Owl and Hosteen Bat bringing medicine to the Fire People, I felt I was helping share Navajo healing ideas with the world. As we left New Mexico, passing Mount Taylor in the rearview mirror, I thought of my daughter's placenta buried on its peak and whispered, "I am taking you with me, if only in my heart."
