As the primary endowed professor and director of American Indian well being on the College of Nebraska Medical Heart’s School of Public Well being, Siobhan Wescott wears many hats and, typically, a pale yellow flower behind her ear.
She was raised by a single mom, herself an instructional, in a small cabin in Fairbanks, Alaska. However all through her profession, Wescott has discovered herself navigating prestigious, predominantly white establishments far completely different from her rural upbringing. As an Alaskan Athabaskan, she has typically been the one Native American or American Indian particular person within the room — although these labels, overly broad and imposed by the federal government, are misnomers she is attempting to repair.
Wescott beforehand co-directed INMED, a College of North Dakota program that has educated greater than 250 Native American physicians. She continues to be working to ensure Native American medical college students are correctly accounted for and given sufficient funding and assets. On the nationwide degree, she is a frequent advocate for ground-up public well being work that features Native leaders and communities in collective decision-making. She helped create the American Medical Affiliation’s Process Drive on Well being Fairness to push ahead such coverage initiatives.
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Wescott is a doctor, a professor, an advocate, a researcher, and a 2022 STATUS Listing honoree. STAT spoke to her just lately through Zoom. This interview has been edited for readability and brevity.
You’ve been by a whole lot of elite establishments and also you’ve defined your talent at being kind of a chameleon in plenty of completely different settings. After school, you briefly labored for a U.S. senator from South Dakota and as a fellow on the Senate Committee on Indian Affairs. Why was {that a} powerful setting to remain in for lengthy?
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I didn’t like what politics introduced out in my character. To achieve politics, you actually — to not sound harsh — however you may’t be true to at least one factor solely. So if in case you have a trigger, as an illustration, that’s not essentially going to be just right for you as you try to make it as a congressional staffer, as an illustration. Now, generally it may be, if in case you have the fitting workplace that you simply’re working for, with an elected official who’s eager about that very same matter. However should you’re championing a very underdog subject, it’s very powerful. To outlive politics and to get forward, you need to bend, and in ways in which I don’t like.
Your mom, Elizabeth, attended Harvard and Stanford, and she or he grew to become one of many first Alaska Natives to earn a Ph.D. How did that upbringing, of watching her pursue her schooling, influence you and form you?
It felt prefer it was attainable. There’s so many first-generation college students who’re like, “I’m attempting to navigate this unknown system,” and that wasn’t the case for me. I really feel like my mother made that attainable for me. Particularly for her, however even when it was my time to contemplate academic choices, the system isn’t arrange for minorities. … I went to a public highschool in Fairbanks, Alaska, and I bought into Dartmouth. That isn’t the traditional approach that one does that, however I simply felt like I shouldn’t tamp down my expectations of the place I would be capable of go to highschool as a result of that isn’t the traditional.
What made you need to research authorities at Dartmouth?
Effectively, I’m simply fascinated by collective decision-making and, actually, the final couple of years have been a grasp class in the way to do it incorrect, simply unfolding proper earlier than our very eyes. It’s the identical with why I really like public well being, versus working towards medical medication. With medical medication, you possibly can have very honest moments together with your sufferers and it’s simply the 2 of you, and that’s extremely highly effective. Generally there’s nothing higher. Nonetheless, should you can change coverage that’s harming these sufferers they usually don’t should have the horrible second that you simply consolation them in a one-on-one physician’s go to, then that’s highly effective too.
Is it troublesome so that you can merge a number of paths — your a number of identities, jobs, priorities — into one?
Completely. I’ve truly simply been combating this just lately, as a result of should you look within the information, in South Dakota there was a Fast Metropolis lodge proprietor who determined to ban all Native Individuals as a result of there had been an incident. And the response of the tribe was to carry a rally of their parking zone. And there’s an obscure piece of legislation — and we’ll see the way it all performs out — that truly you can’t have white settlers if the tribes don’t conform to them. , at what level do you proceed to try to discover widespread floor with folks you disagree with and at what level do you protest? … When you by no means attempt to discover widespread floor, you then’re only a zealot. However are there factors when the opposite facet is to this point off that there’s no level in looking for widespread floor? And I assume that’s the place my experiences in D.C. actually helped me, since you shortly determine who’s saying one thing that they imply and it’s coming from a spot of authenticity, and somebody who’s saying one thing to advance a profession or some kind of deal that’s helpful to them.
There may be a whole lot of range throughout the Native American/American Indian populations, however there are additionally shared histories and cultural norms and context. How do you see that as a gap on your work?
One of many articles that I’m engaged on is a research of the phrases which might be used for our inhabitants in PubMed-listed articles. So are we American Indian, Alaska Native, Native American, Indigenous, Amerindians (that’s a time period)? However what was most fascinating about it’s we ran by all of the analyses and there was one thing not sitting proper, after which we realized, nicely, let’s depend how most of the phrases have been imposed or have unclear that means, and what number of have been clearly significant. Over 90% have been imposed. Even the time period, or the authorized title of the Navajo Nation, the time period “Navajo,” is Spanish, it’s not their time period. So it reveals, even within the easiest issues — what can we name ourselves? — we don’t have a say in that. And the authorized time period utilized by the federal authorities in all reporting of knowledge is American Indian, which is predicated on a 500-year-old mistake. So what I’d wish to see is for Native leaders to get collectively and supply some steering, maybe new phrases, after which for there to be authorized adjustments in what the federal authorities makes use of.
If you obtained your Covid vaccine from an Indian Well being Service clinic, you had the chance to “smudge,” which is a conventional Native cleaning ritual. How can we develop extra culturally delicate approaches to public well being and medication, taking into consideration how many individuals don’t contemplate science and spirituality or pure medication to be at odds with each other?
So, let me provide you with my abstract of med faculty: You by no means know when a child’s going to be born … you by no means know when somebody goes to die. There are a whole lot of mysteries in between. And I don’t suppose we have now the solutions. Now, I don’t suppose that we must always abandon Western medication. There’s some actually profound advances, and with correct care, there’s a whole lot of issues that may be handled and should not lethal, which have killed hundreds of individuals over the ages, the place there’s a easy intervention, whether or not antibiotics and even an appendectomy. What works for the affected person? … There are lots of people who actually cling to Western medication, who work in Western medication and should you try to go exterior of this, you’re “incorrect.” Now, ought to everyone exit and do some kind of sweat lodge as a result of they heard that that’s what Natives do and that appears to be therapeutic? No. Nothing ought to be absolute. There’s plenty of room for knowledgeable choices and exploring what is perhaps proper, however I simply suppose clearly Western medication shouldn’t be sufficient.
What else is piquing your curiosity proper now?
The Division of Schooling has, similar to the Census, for U.S. college students, they’re requested their ethnicity after which they’re given six decisions for race. And you’ll test as many packing containers as you need, or as apply to you, however should you tick a couple of field, none of your race information is reported. You’re solely thought-about in racial information should you chosen one race and that’s it. Everybody else is misplaced in a class referred to as “two or extra races” and there’s no additional evaluation. And that’s required, so I’d like to vary it. For Native med college students, there are 1,010 at present in med faculty. However solely 177 of these report being solely American Indian/Alaska Native. So 83% of them beneath these necessities are misplaced totally, and that impacts funding choices to assist help new college students. That’s one of many issues that I’m attempting to vary, after which there’s extra broad issues, the place I’d actually like to listen to from communities what they need, after which to have the ability to match researchers with them. There’s a complete motion referred to as community-based participatory analysis, the place there’s a researcher who has an curiosity space, they strategy communities and say, “Would you wish to be concerned?” in order that they’ve group suggestions even earlier than they apply for funding, and never, like, per week or a pair days earlier than it’s like, “Hey, are you able to ship a letter of help?”
Quite a lot of medication is constructed on this basis of a hierarchy, with the doctor on the prime and the affected person on the backside, which may really feel very paternalistic. You’re attempting to flip that paradigm, starting with group and build up from there. How easy is that?
It’s very troublesome. And I’m laughing as a result of the query actually jogs my memory, there was a time I took a motivational interviewing course for physicians. It’s not about you coming in and saying, “Effectively, right here’s what I believe your issues are, how we’re going to handle these.” It’s coming in and largely listening to the affected person, nonetheless you’re additionally, basically, placing a mirror as much as them. In order that’s, on a macro degree, what I’m attempting to do is embrace tribes, embrace Native leaders, embrace Native communities in decision-making.
You appear to at all times be carrying a flower behind your ear. Is it symbolic or only a ornamental flourish?
My pandemic delusion is I’m truly in Hawaii. … Hawaii is such a vacationer vacation spot, it’s forcing out a whole lot of Native Hawaiians – they only can’t afford to stay of their homeland. They don’t need vacationers coming there, and so it’s even higher in some ways in which I’m carrying the flower however I’m not in Hawaii or planning to go to Hawaii. I’m paying homage to the aloha spirits.
