Perspective
Lori Arviso Alvord, M.D.
Lori Arviso Alvord, M.D., is a new member of the National Advisory Council for Complementary and Alternative Medicine (NACCAM). She is associate dean for student affairs and multicultural affairs and assistant professor of surgery and psychiatry at Dartmouth Medical School, Hanover, New Hampshire. Dr. Alvord received her M.D. degree from Stanford University School of Medicine and did her postdoctoral training at Stanford University Hospital and the University of Colorado Health Sciences Center. Her publications include an autobiography, The Scalpel and the Silver Bear: The First Navajo Woman Surgeon Combines Western Medicine and Traditional Healing (Bantam, 1999).
After her medical training, when Dr. Alvord returned home to New Mexico to work in a Navajo community, she says, she discovered that "although I was a good surgeon, I was not always a good healer. I went back to the healers of my tribe to learn what a surgical residency could not teach me. From them I have heard a resounding message: Everything in life is connected. Learn to understand the bonds between humans, spirit, and nature. Realize that our illness and our healing alike come from maintaining strong and healthy relationships in every aspect of our lives."
Traditional Navajo healers (hataalii) use song, symbols (such as corn pollen, eagle feathers, masks of the Navajo gods, and sand paintings), and ceremony with their patients, and involve family and neighbors in the process. The psychological and spiritual comfort thus provided can prepare patients for surgery, childbirth, or chemotherapy, for example, and speed their recovery afterwards.
A Navajo sand painting. Among the Navajo and certain other tribes, sand paintings are created with colored sand by a traditional healer as part of a healing ceremony.
Courtesy Northwestern University Library, photo by E.S. Curtis
Tell us about your background and interest in complementary and alternative medicine (CAM).
Much of my background in CAM comes from being raised in the Navajo culture. The Navajo perspective, including on health and healing, is remarkably different from that of conventional Western culture. Our view, and that of many other tribes, is interested in the well-being of all things. We see humans as part of an embedded matrix that is much larger than we are and is made up of many things: mind, body, and spirit; relationships to other human beings, nonhuman beings (such as animals), and the natural world; and the air we breathe, food we eat, and water we drink.
There is also what some Western people call a "spiritual perspective"-a sense that all these are interconnected.
In the Navajo medicine system, we don't look at one organ and try to make it healthy; we look at how it interacts with the rest of the body, how the person is thinking, and how they are doing spiritually.
As one example, we can look at diabetes, which is quite common among Native people. In Western terms, diabetes is a disorder in the pancreas and blood sugar, of intolerance to glucose, etc. However, it can also be viewed as a people having come out of balance with their traditional way of living. It was important for Native people to be very active and strong in order to survive, to do things like hunt, grow plants, and haul water. Also, the traditional Native diet was one of whole foods such as whole grains, fruits, and nuts. They didn't have trans fats or highly processed foods and didn't use a lot of chemicals, sugars, or starches.
We are coming to better understand the effects of the mind on the body, which is often an element in CAM. I have studied the Navajo ceremonies, to interpret them in terms of their ability to provide mind-body interventions and other benefits to health. I also study how we can best deliver surgical care and prepare and sustain our patients by providing environments that are truly healing.
What environments can help people to heal better?
To start, there is the role (now better understood) that stress and anxiety play in our bodily processes. The more we can ease stress and anxiety, the better medical outcomes we can have. For example, in the surgical setting, people's blood pressure and heart rate can go wildly out of control if they are angry or stressed. It is difficult for patients to receive anesthesia if they are not in the "right place" in their minds and bodies.
Every part of a patient's experience matters and can affect outcomes. I believe that patients need to be able to trust in the people who are caring for them and feel that they are truly being cared for and respected. They need to have everything carefully explained (taking into account cultural differences and meanings) and have their concerns addressed at each stage. We should provide a place for them that is comfortable and gives them a sense that there many forces in the universe that can help them heal, such as music, artwork, animals, gardens, and calm places.
What are a few important things that most people could do to improve their health?
The things I discussed before—such as body, mind, environment, and relationships—all matter and require careful attention. I think that in our very busy society, we do not pay enough attention to the needs of our body, to nourish it correctly and give it proper exercise. So, we have an epidemic of obesity, starting in children.
With regard to our minds, we are not thoughtful enough about the things that will help our minds stay healthy. We are ever driven to be more productive, sometimes at the expense of our own sanity and well-being. We live in a faster and faster environment, with e-mail and so much else coming at us so quickly, and we are just supposed to keep up. This can make us unhappy. Unhappiness will present itself in the body somewhere along the way. For optimal well-being, we should nourish ourselves physically, mentally, and spiritually and pay careful attention to our relationships, especially to raising our children.
I am a strong proponent of meditation and of many Eastern philosophies, including Buddhism. Meditation has been extremely helpful in my own life. I also believe strongly in the work of psychiatrists and psychotherapists to help heal the wounds of the past, which I think are at the core of many illnesses. The better we integrate people who work with the mind and those who work with the body, so that they understand and work with each other, the faster we will come to an understanding of healing.
How do you see your role on NACCAM, and what do you hope to contribute?
I think one of the things that NACCAM does is to bring the perspectives of many people to the table. NCCAM's studies reflect that. I think I can offer a dimension both as a surgeon who researches surgical outcomes and as the only Native person on the Council. Many cultures, including those of the Native people, have traditions that reach way back. For example, Natives were the first to use vitamin C to treat scurvy and digitalis to help certain heart conditions. These cultures have wisdom that we are just beginning to think about carefully, understand, and research in the typical scientific way. It may or may not turn out to be the right model, but it's important to keep trying to understand the dimensions of that world.
