Two weeks later Mr. Whitecloud was again late for his appointment.
So were most of my clients-except the ones sent from the prison; they
were always on time. Gradually I realized that time and schedules had a
different meaning for the Pima than they did for me; it was more fluid
for them. A 2 o'clock appointment would never stand in the way of some
friendly conversation with a grandmother or nephew; to behave otherwise
would be insulting. I began to see that my own preoccupation with time
might be less sane than the Pimas' relaxed attitude. Here I was, asking
them to show up at precisely 2 p.m., discuss intensely personal issues
for no more than 50 minutes and then come back in two weeks. From the
Pimas' perspective my behavior must have seemed more than a little crazy.
What kind of person would so jealously dole out time the way I
did?
Given my caseload, however, I had no choice but to continue my
rigid ways. I saw five or six patients each day-about 30 every week. And
most of them were destitute.
A typical client was a 59-year-old woman who had been born with
fetal alcohol syndrome. Her father left home when she was four; her
mother died of alcoholism eight years later. She then moved in briefly
with her diabetic grandparents. But the grandparents, burdened with their
own serious health problems, soon sent the girl away to an out-of-state
boarding school. There her problems worsened.
At 16 she was charged with and convicted of assault. After spending
five years in prison she returned to the bleakness of the reservation.
She soon became an alcoholic, and then a diabetic. When I met her she was
an unmarried mother of six, filthy, covered with tattoos and wandering
the reservation begging for food and drink. Despite regular sessions that
lasted more than a year, her condition never improved.
Even more distressing was the case of an 18-year-old boy who
regularly stabbed himself with a knife. His self-mutilation was a classic
call for help and attention. Ignored or abused by alcoholic parents, his
desperate acts were the only way he could elicit any show of concern from
them.
After four months of therapy he seemed to be making progress. He
was bright, could see the nature of his problem and wanted to change.
Then one night my beeper sounded. He had stabbed himself again and would
do so three or four more times over the next year. I was devastated. It's
bad enough to watch an adult succumb to despair, but truly horrible to
see a promising, young person abandon all hope. I live with the terrible
fear that one day his wound might be fatal.
In the face of such misery, I felt like someone who was trying to
attack a tank with a slingshot. Tragically, these cases were far from
unusual. Daily I met people with problems that dwarfed any I had
encountered off the reservation: severely depressed jobless men and
women, many of whom had lost limbs, vision or both to diabetes; teenagers
with no hope for the future; and far too many young people who had
attempted suicide. I began to realize that my task would be much more
challenging than I had naively expected.
In addition to the overwhelming problems confronting my patients,
for which any therapy would be but a Band-Aid on a gaping wound, there
was also the question of trust between us. Why should any of these people
listen to the advice of an Anglo professional? How could mere words help
them cope with unrelieved poverty, serious illness and the utter lack of
opportunities for improving their lives?
What can be done for the Pima?
Additionally, what can the Pima themselves do? First, we as a
nation cannot ignore the destitution common within so many reservations.
In the case of the Pima, the tribe could promote the educational
opportunities available to its members. The tribe offers full four-year
scholarships to all high school graduates, but this program receives
little publicity, and I know of only one student who has ever taken
advantage of it. The Pima could use the income from its two casinos to
pay not just for college, but also for four years of graduate training-on
the condition that the graduates work on the reservation for a few years.
The reservation needs Pima professionals-physicians and psychologists-not
only as role models, but also as individuals the community knows, trusts
and respects. And the reservation-which has about 12,000
inhabitants-needs its own high school.
It has been more than a year since I left the Gila River community
and reservation. I am now completing my residency in a neuropsychology
clinic in nearby Scottsdale, Arizona. I keep in touch with the Pima
through colleagues, and I run into former patients at a store up in the
valley. No words are ever spoken, only big smiles are exchanged.
Often, I find myself thinking about one particular patient, one of
the first to visit me for treatment. She was in her late 80s, and she
gave me a glimpse of another world. She was depressed about the recent
death of her daughter, and like most Pimas she was diabetic. She told me
how one night while she was cooking dinner her daughter came back from
the dead to visit her. At this point, I started taking notes. "Ah, she's
schizophrenic," I thought to myself. "Just one week into the job, and I
already have a meaty case. I'll have to refer her to a psychiatrist for
medication."
But as she continued, I realized she was far from schizophrenic.
She said, "Yes, she visited me while I cooked. She came as a white bird
and perched on my windowsill. She always liked my cooking. She flew off
after dinner."
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