The Trail of Tears

     It's been about a week since I completed my locum tenens assignment for the Chickasaw Nation and Indian Health Services (IHS) in Southern Oklahoma. Looking back, I keep thinking about what a privilege it was to participate in a special part of American history. If I didn't go into medicine, I probably would've become a history teacher. I was tempted to try to double major in biology and history but it wasn't  feasible and stuck with the former. But in all levels of my education, I really enjoyed learning about the world, past present and future. But sadly, our education system is deeply deficient in teaching about native american history. It is one of the darkest aspects of this nation's history that I never fully appreciated. But now, many years removed from college, armed with years of life and medical experience,  I was able to once again learn and appreciate some history.
   Briefly, in the 1830's the U.S. Federal government forcibly relocated several Native American tribes who lived east of the Mississippi river. Amongst this group of tribes were the Chickasaw who lived a healthy and peaceful agrarian life in the Mississippi river valley. The journey west towards an undeveloped, less hospitable land (modern day Oklahoma) was wrought with danger, starvation and death. There was also the tremendous psychological toll of a people forcibly removed from their ancestral home. This journey by the Chickasaw and many other tribes was referred to as "The Trail of Tears."
    Fast forward almost 200 years, these tribes are slowly recovering from this painful past. In my recent work as a primary care provider, I personally saw the sequelae of the Trail of Tears manifest as a myriad of modern healthcare problems. At it's root is poverty. Once forcibly relocated, the tribes immediately went from a self sustaining agrarian society to a broken, poor and dependent community with little to their name except undeveloped Oklahoma land. Without the ability to subsist off the land, the federal government tried to fulfill their obligations by providing cheap unhealthy food rations and not much else. Generations later, these native american tribes became a people struggling with obesity, diabetes, dyslipidemia and all their terrible manifestations that I personally took care of on a daily basis. In addition to the metabolic diseases, mental illness, violence  and alcoholism took a foothold in these disrupted communities and have wreaked havoc for generations. Furthermore, it wasn't only until the 1950's that the Indian Health Services was established to help provide access to healthcare for the Native americans and their specific health needs.
     Many years later since the establishment of the IHS, I found myself working in a beautiful office building in Southern Oklahoma, emblazoned with the insignia of the Chickasaw nation. The building was new, a symbol of a society's recovery and hope to treat many of the ailments rooted so deeply in the darkness of native American history. And in that building, were hundreds of people (many of whom were native Chickasaws) working tirelessly to take care of their own people (and members of other Indian tribes). Although as a locum tenens physician  I played a minuscule role in this renaissance, I felt quite proud to have been a part of a history that will one day read much brighter and hopeful than the descriptions of the Trail of Tears.

The Chickasaw Nation

The Chickasaw Nation Wikipedia
Trail of Tears Wikipedia

Indian Health Service