Today was an emotional day. First we had rounds and there were more Indians with cancer here trying to survive. I was thinking about yesterday and the young guy who died unexpectedly in the endoscopy lab- he had an internal bleed and no matter how much blood they fed into his body it never made it past the bleed in his stomach. Apparently his family was waiting outside when it happened and the surgeon told them all while they were standing in the hospital courtyard. I heard that the family�s wails were heard throughout the building. He was only thirty. He was native too. It was very sad to hear this, both from the practitioner side (the surgeon was completely upset because he couldn�t save the guy) and from the Indian side. So then we have all these guys and they are sick with cancer and I know they won�t get the treatment they deserve. I guess I am partly mad at the system that doesn�t pay nurses to care and I am partly mad at the racism that allows them not to care.

So then today Miss America came to Montana. We had the opportunity to show her around the hospital and she went into a few patient rooms to visit with them. She was short on time so we only could see one oncology patient on the adult floor. We took her into the room of a native guy about the same age as my father. He had cancer a few years ago and survived to have it come out of remission this spring. He had to have part of his intestines removed and is now having trouble recovering from that surgery. He�s been miserable and he knows that his chances for survival are poor. We met him yesterday and he was completely flat and not interested in engaging. So we took a gamble and introduced him to Miss America. She got him talking and he was really excited and I watched from the doorway thinking that this could be my dad or my grandpa or one of my uncles. Or even my brother. It made me really sad. I�ve never really treated very ill natives before so I never had this identification problem like I have now. I really identify heavily with these patients- it�s a strange longing I have for them. I wish there was some system where we could have respectful and culturally appropriate care while still obtaining the highest possible standard of care available. I wish we could take the knowledge and experience from one of the big teaching hospitals and stick it right in the middle of Indian country, and then have all native nurses and medicine men roaming the halls.

But instead we have to conform to the dominant forces. And we have to manage our illness with the same people who think we�re beneath them socially.

I just talked to my dad on the phone. After seeing that patient this afternoon I just wanted to check in with him. He�s doing well. Ever since he saw his own father die of colon cancer he�s been extra vigilant about his health. I still worry about him. I worry about him because that man in that bed could have been him.

I cried all the way home today. I cried for the Native American breast cancer survivor I met who was diagnosed while she was in prison. I cried for the man with colon cancer who had lost all his hair, because we are only supposed to cut our hair when we are grieving. Instead he and I grieved because he lost his hair. I cried and cried. It didn�t help me feel any better.