At times I feel I am really out of place here, and at times I really am. I have this thing about putting patient care in front of policy. I have never seen an organization with more policies than the IHS. I suppose it's a governmental thing. I mean, how would they spend all our tax dollars if they didn't have 10 policies, written by 20 people to cover 1 thing. Last week I did battle with the pharmacy. In the rest of the world a physician sees a patient, comes up with a diagnosis, and writes for medication, if needed, on a prescription that the patient takes to a pharmacy and waits for the pharmacist to fill the prescription and educate the patient about the medication. (except for if you pick it up through the drive through, as I discovered when I treated a bus full of puking, and other things, baseball players).
In this system, we not only have to provide the diagnosis to the dispensing pharmacist, we have to complete our chart note so he can review it before he will dispense the medication. No big deal, you say. Well, I counted mouse clicks and waiting time whilst trying to create a note on a patient in this ridiculous EHR system the IHS uses. Between 60-70 mouse clicks and 2 minutes watching the circle go round before you can enter a note into the system. An average of 7-10 minutes all together. Per patient. If I see 15 patients, I have spent about 2 hours looking at my computer. So I see a patient, type for 10 minutes, see a patient, type for 10 minutes, and get further and further behind. And at 4 I have 3 more patients to see, but the problem is, the clinic staff walk out, literally, at 4:30. I am supposed to be done. If I'm not, I should be. After all, the government contract says so. Unfortunately the patients have not read the contract and don't know that they can't show up septic (really, badly infected) and withdrawing from alcohol at the end of the day. So I stay until all patients are cared for, AND notes are written, and then get called to task for being here too late. There must be a separate Hippocratic oath for docs who choose to do this full time. And what, may I ask, does a friggin' pharmacist need my note for to give a drug I have ordered????
There, I got that out. On to fun stuff. Kind of.
On Saturday I decided to find an out of the way trading post that is supposed to have an incredible Navajo rug museum. The reviews say it is great, but expect to have some loose teeth after traveling over the bumpy, unpaved road to get there. So I head north, past the community where my clinic is located, and see the sign to Toadlena about 50 miles north. Then my phone dies. No problem, I will follow the signs. Except there are no more. I am bouncing over roads that make NW logging roads seem paved and see nothing nor nobody. But maybe around the next turn....Well after 30 minutes of this I decide the further I go the further I will have to walk when I pop a tire on one of the many rocks I have been trying to avoid, so I turn around. Then I have to pee. But I am afraid to turn off the engine for fear it won't start and I literally have seen no signs of life in a very long while. (altho the scenery is pretty). I stop the car, put it in park and brake, and step behind the car to take care of my bladder and then realize that I am in rattle snake country. I am envisioning the head lines: local doctor run over by own car after getting bitten in the butt by a rattler, when the only car I have seen in 45 minutes drives by. Timing is not my strong point. Turns out the place I was looking for was 5 minutes from the highway.
Sunday I toured the beautiful Canyon de Chelly with an old residency friend that is working in Chinle, my favorite place in the Navajo Nation. I will try to post pics on Facebook, but internet connection is slooooowwww tonight. This place is magical. Ruins and pictograms from the 13th century. Red rocks and green trees. And homes placed 50 feet up a solid rock cliff. And I complain about the 3 steps into our house from the garage!!
Speaking of my garage, I will be home for a week soon. Can't wait. This is a long time to be away from my chickens!!
Tuesday, July 22, 2014
Sunday, July 13, 2014
Rugs and royalty
On Friday I attended the monthly Crown Point Rug Auction. On the second Friday of every month Navajo weavers from all over the SW convene in this little town out in the middle of nowhere to auction off beautiful works of art that they may have spents months working on, especially if you count the raising and shearing of the sheep, the spinning and dying of the wool, and the hand weaving on the loom. Some of the rugs were no bigger that coasters and some were 4x6 feet. All were exquisite.
By the end of the night they had submitted for sale (not all sold) probably 200 rugs. Some sold for $40, some for $2000. All were worth every penny. I managed to keep myself from buying the big ones, knowing I had nowhere to display them, but did walk away with 6 smaller rugs to use as gifts and remembrances. To know that the weavers that created these pieces were sitting at tables in the back of the room was pretty special. So much better than going to some "trading post" knowing that the artists were paid so much less than the sellers would make.
As I was standing in line to complete my purchases a man walked up and said he had won the bid on 6 rugs, but only got 5. The clerk found the last rug and said she thought he had bid $75 for it. He had really won it at $140. She was going to take $75, but he said he couldn't do that. It was worth so much more. He paid $140. Just like NYC, right Rich??
I experienced my first road check point that night. As I rounded a curve on the very dark and isolated road I saw a bunch of police lights. I thought there had been an accident. But it was a random check point, where they stop all cars going in both directions to screen for DUIs. This is a good thing, I thought. The car in front of me was being questioned for a particularly long time. Eventually the driver got out and literally stumbled around to the passenger side and the woman that had been a passenger became the driver. 3 miles down the road I saw them by the side of road exchanging seats again. This is why you have to be very careful driving after dark here.
Yesterday was the weekly Flea Market again. I decided to make a quick trip to see if there was anything new and different. Still lots of used tires, socket sets galore, and food and jewelry. And DVDs. Lots of them. As I was passing by a picnic table in the glaring sun I saw this regal elder Navajo woman, scarf on head, traditional skirt and jewelry, sitting there eating an ice cone. I smiled at her, wishing I had the guts to ask to take her picture. After mustering up my courage (yes, this is one thing I have a hard time attacking) I went back and asked if I could take her picture. She obviously spoke no English, but I think she understood my hand gestures. As her ice cone dripped in the mid day sun I took one quick pic of her with the usual stern face that you often see on Navajo elders. When I returned with a few napkins for her, she busted out the most beautiful toothless grin. OH, thank you!! she said. The extent of her English I am sure, and I got to hear it.
By the end of the night they had submitted for sale (not all sold) probably 200 rugs. Some sold for $40, some for $2000. All were worth every penny. I managed to keep myself from buying the big ones, knowing I had nowhere to display them, but did walk away with 6 smaller rugs to use as gifts and remembrances. To know that the weavers that created these pieces were sitting at tables in the back of the room was pretty special. So much better than going to some "trading post" knowing that the artists were paid so much less than the sellers would make.
As I was standing in line to complete my purchases a man walked up and said he had won the bid on 6 rugs, but only got 5. The clerk found the last rug and said she thought he had bid $75 for it. He had really won it at $140. She was going to take $75, but he said he couldn't do that. It was worth so much more. He paid $140. Just like NYC, right Rich??
I experienced my first road check point that night. As I rounded a curve on the very dark and isolated road I saw a bunch of police lights. I thought there had been an accident. But it was a random check point, where they stop all cars going in both directions to screen for DUIs. This is a good thing, I thought. The car in front of me was being questioned for a particularly long time. Eventually the driver got out and literally stumbled around to the passenger side and the woman that had been a passenger became the driver. 3 miles down the road I saw them by the side of road exchanging seats again. This is why you have to be very careful driving after dark here.
Yesterday was the weekly Flea Market again. I decided to make a quick trip to see if there was anything new and different. Still lots of used tires, socket sets galore, and food and jewelry. And DVDs. Lots of them. As I was passing by a picnic table in the glaring sun I saw this regal elder Navajo woman, scarf on head, traditional skirt and jewelry, sitting there eating an ice cone. I smiled at her, wishing I had the guts to ask to take her picture. After mustering up my courage (yes, this is one thing I have a hard time attacking) I went back and asked if I could take her picture. She obviously spoke no English, but I think she understood my hand gestures. As her ice cone dripped in the mid day sun I took one quick pic of her with the usual stern face that you often see on Navajo elders. When I returned with a few napkins for her, she busted out the most beautiful toothless grin. OH, thank you!! she said. The extent of her English I am sure, and I got to hear it.
Sunday, July 6, 2014
All alone again
Here I sit with Otis. Rich just left, and I am wondering what I am doing here. Had a great weekend. Rich is not his usual active self due to a knee issue that is hopefully getting fixed on Tuesday, so I was able to keep up with him.
I finally checked out some of the local restaurants. Hadn't gone out at to eat at all since I've been here. The El Rancho "Home of the Movie Stars" is a great old structure from the 30s which is supposedly where the stars stayed when out west filming some of those great westerns I grew up with. Really cool inside. Food? Not so much. The El Matate Tamale Factory is a family run business where Mom cooks and serves and the kids take orders and deliver water. We were the only folks there on the 4th of July and couldn't help wondering why she stayed open, but were glad she did. Found an Italian place that will do in a pinch and they make their own gelato. Not nearly as good as Stella's, but will come in handy when the monsoons hit next month and the humidity goes up. The best is Earl's. Good food, good service and they allow local artists to not only set up tables outside (and they provide shade) but they also come through the restaurant, very quietly and not at all pushy. You say no thank you and they move on. Bought a beautiful horse hair pot from a young woman named Renalda and a cute set of earrings from a clearly autistic young man wearing a t-shirt for a local program that provides special services for special kids.
These artisans will sit there all day waiting patiently to sell their goods. They greet you with a smile, say good morning, and thank you for stopping by, but don't try to guilt you into buying anything. No pushy sales man approach as we have seen in some of the shops run by non Native folk. More on that later. And not a single person sitting on a street corner asking/demanding money for doing nothing productive. It's a completely different, and frankly refreshing, scene from Eugene and other cities I have visited recently.
We drove to the Zuni Pueblo on Friday. 35 miles from Gallup and a completely different place. Instead of Hogans on every homestead, every home has an outdoor Kiva or oven. Most have more than one. It makes sense, when the temperature is routinely in the 90s, to do your baking outside. I stopped to talk to a gentleman who was constructing a new oven and got some pointers. Guess what I am re-building when I get home!! Turns out it isn't unusual for them to break down after a few years, so I can blame Rich and his riding lawn mower entirely for the demise of my last one.
It was in Zuni that we were hit with capitalism in it's finest, however. After visiting 2 shops run by locals, one of which is cooperatively owned by the artists that sell fine Zuni jewelry and fetishes, we visited Pueblo something or other. We were immediately greeted by a man who clearly did not come from these parts. Selling "totally unique" everything that he would give us a very good price on. His stuff was unique all right. The only shop where I can guarantee you that everything was made in China. He isn't breaking the law. He doesn't advertise that it is Indian made. But he sits smack dab in the middle of this beautiful village that was settled 5-600 years ago, hawking garbage for the same price that true artisans that have lived here for generations are trying to get by selling. I didn't smack him, but I sure felt like it. Rich said he visited a shop or 2 in Gallup like this as well. Apparently some families from the middle east have discovered they can sell fake wears, originally marked with outrageous prices, but then "giving it away" for a price just under what you could purchase the real thing for, and stupid bargain hunting Americans will bite. It's absolutely disgusting. And there is something about being greeted by a saleswoman in a burka here, where woman are not only considered equal, but the elder women are treated with a great deal of respect, well it just makes you want to........walk out without even looking.
Enough of that. Yesterday we had an archaeologists dream day. We drove and walked through the Painted Desert, then on to an old pueblo from 1200 AD where some remnants of the walls are still standing and there are petroglyphs everywhere, some 2000 yrs old; on to the Petrified Forest, where we walked trails surrounded by the most colorful huge pieces of trees believed to be 21 million years old. Thousands of huge pieces of timber now turned to red, yellow and purples pieces of art. These trees provided shade for dinosaurs. Pictures and words cannot express the feeling of walking through this piece of history. And all within a 28 mile stretch of road in Arizona.
I introduced Rich to mutton sandwiches on fry bread sold at the food cart by the nightly Indian dances. Every night from Memorial day to Labor Day members of various tribes come to dance and sing and tell stories in the sacred circle by the courthouse. Yes, some of them are clearly Indians dancing for tourists, but not all. And it is nice to see this tradition being carried on. Some are very old story tellers with young family members doing the dancing. And I am always pleasantly surprised to see young and old American Indians there. On Thursday I had my head straightened out, once again. There is a basket out for tips. A young, disheveled appearing Navajo man approached the circle where the basket was placed. I had suspicious thoughts. The man then bowed to the sacred circle and emptied his pockets of what little change he had into the basket. This was repeated by another young Navajo, dressed in the fashion of the day, literally having to hold his baggy jeans up so they didn't slip completely off his butt. I get my head rearranged frequently here. Maybe that is why I am here.
I finally checked out some of the local restaurants. Hadn't gone out at to eat at all since I've been here. The El Rancho "Home of the Movie Stars" is a great old structure from the 30s which is supposedly where the stars stayed when out west filming some of those great westerns I grew up with. Really cool inside. Food? Not so much. The El Matate Tamale Factory is a family run business where Mom cooks and serves and the kids take orders and deliver water. We were the only folks there on the 4th of July and couldn't help wondering why she stayed open, but were glad she did. Found an Italian place that will do in a pinch and they make their own gelato. Not nearly as good as Stella's, but will come in handy when the monsoons hit next month and the humidity goes up. The best is Earl's. Good food, good service and they allow local artists to not only set up tables outside (and they provide shade) but they also come through the restaurant, very quietly and not at all pushy. You say no thank you and they move on. Bought a beautiful horse hair pot from a young woman named Renalda and a cute set of earrings from a clearly autistic young man wearing a t-shirt for a local program that provides special services for special kids.
These artisans will sit there all day waiting patiently to sell their goods. They greet you with a smile, say good morning, and thank you for stopping by, but don't try to guilt you into buying anything. No pushy sales man approach as we have seen in some of the shops run by non Native folk. More on that later. And not a single person sitting on a street corner asking/demanding money for doing nothing productive. It's a completely different, and frankly refreshing, scene from Eugene and other cities I have visited recently.
We drove to the Zuni Pueblo on Friday. 35 miles from Gallup and a completely different place. Instead of Hogans on every homestead, every home has an outdoor Kiva or oven. Most have more than one. It makes sense, when the temperature is routinely in the 90s, to do your baking outside. I stopped to talk to a gentleman who was constructing a new oven and got some pointers. Guess what I am re-building when I get home!! Turns out it isn't unusual for them to break down after a few years, so I can blame Rich and his riding lawn mower entirely for the demise of my last one.
It was in Zuni that we were hit with capitalism in it's finest, however. After visiting 2 shops run by locals, one of which is cooperatively owned by the artists that sell fine Zuni jewelry and fetishes, we visited Pueblo something or other. We were immediately greeted by a man who clearly did not come from these parts. Selling "totally unique" everything that he would give us a very good price on. His stuff was unique all right. The only shop where I can guarantee you that everything was made in China. He isn't breaking the law. He doesn't advertise that it is Indian made. But he sits smack dab in the middle of this beautiful village that was settled 5-600 years ago, hawking garbage for the same price that true artisans that have lived here for generations are trying to get by selling. I didn't smack him, but I sure felt like it. Rich said he visited a shop or 2 in Gallup like this as well. Apparently some families from the middle east have discovered they can sell fake wears, originally marked with outrageous prices, but then "giving it away" for a price just under what you could purchase the real thing for, and stupid bargain hunting Americans will bite. It's absolutely disgusting. And there is something about being greeted by a saleswoman in a burka here, where woman are not only considered equal, but the elder women are treated with a great deal of respect, well it just makes you want to........walk out without even looking.
Enough of that. Yesterday we had an archaeologists dream day. We drove and walked through the Painted Desert, then on to an old pueblo from 1200 AD where some remnants of the walls are still standing and there are petroglyphs everywhere, some 2000 yrs old; on to the Petrified Forest, where we walked trails surrounded by the most colorful huge pieces of trees believed to be 21 million years old. Thousands of huge pieces of timber now turned to red, yellow and purples pieces of art. These trees provided shade for dinosaurs. Pictures and words cannot express the feeling of walking through this piece of history. And all within a 28 mile stretch of road in Arizona.
I introduced Rich to mutton sandwiches on fry bread sold at the food cart by the nightly Indian dances. Every night from Memorial day to Labor Day members of various tribes come to dance and sing and tell stories in the sacred circle by the courthouse. Yes, some of them are clearly Indians dancing for tourists, but not all. And it is nice to see this tradition being carried on. Some are very old story tellers with young family members doing the dancing. And I am always pleasantly surprised to see young and old American Indians there. On Thursday I had my head straightened out, once again. There is a basket out for tips. A young, disheveled appearing Navajo man approached the circle where the basket was placed. I had suspicious thoughts. The man then bowed to the sacred circle and emptied his pockets of what little change he had into the basket. This was repeated by another young Navajo, dressed in the fashion of the day, literally having to hold his baggy jeans up so they didn't slip completely off his butt. I get my head rearranged frequently here. Maybe that is why I am here.
Subscribe to:
Posts (Atom)