I am a Dakelh (Carrier) physician who grew up in Northern BC close to my traditional territories in both rural and inner-city communities. We were always with family and community, helping one another, participating in gathering traditional foods, and sharing whatever we had. Teachings like “the pride of one is the pride of all” guided me to continuously work to be the best version of myself, as I knew that I reflected onto my family and community. In turn, I knew my culture, family, and ancestors always walked with me. Many weekends were spent at celebrations and cultural revival events. During the week we would organize time for the youth to learn to bead, sew, and drum from our Elders. Even during the darkest moments, my Indigeneity and my culture provided me with the roots I needed to continue to grow. My Indigeneity is my strength and continuous source of health and healing.

The intergenerational impacts of colonialism and anti-Indigenous racism were also present in my family. I have an adverse childhood experiences score of 6/10.[1] I’m the granddaughter of a residential school survivor, and we often struggled to make ends meet. I often heard stories of my family and community members experiencing harm and discrimination when they tried to access services. I saw how my fair-skinned relatives were often treated with more dignity and respect than my darker relatives. I didn’t understand that the discrimination was rooted in associating poverty, trauma, and addiction with Indigenous heritage rather than being oppressed and underserved. I wasn’t alone; tragically, the outcomes of intergenerational trauma (addiction, abuse, poverty, and high rates of disease) form the most common stereotypes about Indigenous people in Canada.

When I entered medical school, lecture after lecture would identify Indigenous heritage as a risk factor for many different conditions or cite Indigenous populations as having higher rates of illness and disease. Every time, I felt a tightness develop in my chest and throat, and I felt sad and angry. It didn’t feel just. I was well aware of the health disparities Indigenous people faced, and I recognized that bringing awareness was important advocacy. The injustice I felt was due to the fact that who I am as an Indigenous person, which is a source of great strength and pride for me, was being outlined as the risk factor rather than the colonial systems and structures that resulted in generations of trauma, displacement, and cultural loss for me and my family.

Medical education continues to frame Indigenous ancestry as a risk factor, and this perpetuates the narrative of Indigenous people being sick, harboring disease, and being at fault for their ill health. Although unintentional, this can form biases that Indigenous people are inferior and less deserving of care. However, there is no evidence to suggest the health disparities Indigenous people face are due to their Indigeneity at all; instead, there is a wealth of information that identifies systemic oppression, marginalization, and colonialism as the root causes of the growing health disparity gap.[2]

Conversely, having a strong Indigenous identity and connection to culture has often been found to be a protective factor for Indigenous people. For example, one study showed that the more cultural practices Indigenous youth engaged in, the lower their rates of suicide.[3] Traditional diets have been linked to improvements in health outcomes, including a reduction in chronic diseases like type 2 diabetes.[4,5] Perhaps most profoundly, the science of how trauma impacts people and how it can be healed also points to Indigenous ways of knowing and being as helping to heal. The work of Yellow Bird on neurodecolonization outlines that Indigenous cultural practices like drumming, vocalizing, loud singing/chanting, rhythmic and repetitive dancing, and being connected to nature are all powerful practices that support healing.[5] Colonial laws that outlawed and demonized our culture restricted the very practices that could help us heal.

In my last year of residency, I was burned out and struggling with the weight of the traumas I carried from before and throughout my training. At that time, I had the honor of participating in a ceremony that helped me unpack the burdens I was carrying. I received clarity that my commitment to giving back to my community now included my profession, and I couldn’t do that while holding onto the pain. I returned to my rotations reinvigorated and with an open mind and heart, which helped me become a better doctor. My Indigeneity continues to be a source of great strength personally and professionally, which helps mitigate the traumatic effects of colonialism and racism.
—Terri Aldred, MD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License [10].

References

1.    Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998;14:245-258.

2.    Allan B, Smylie J. First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. Toronto, ON: The Wellesley Institute, 2015. Accessed 28 February 2024. www.wellesleyinstitute.com/wp-content/uploads/2015/02/Summary-First-Peoples-Second-Class-Treatment-Final.pdf [11].

3.    Chandler MJ, Lalonde CE. Cultural continuity as a protective factor against suicide in First Nations youth. Horizons 2008;10:68-72.

4.    Sarkar D, Walker-Swaney J, Shetty K. Food diversity and Indigenous food systems to combat diet-linked chronic diseases. Curr Dev Nutr 2019;4(Suppl 1):3-11.

5.    Reeds J, Mansuri S, Mamakeesick M, et al. Dietary patterns and type 2 diabetes mellitus in a First Nations community. Can J Diabetes 2016;40:304-310.