David R. Kopacz MD & Joseph Rael (Beautiful Painted Arrow)

Joseph Rael (Beautiful Painted Arrow) tells me that in the Tiwa language of Picuris Pueblo, the word for the self is nah and the word for land is nah meh neh―land and self are interrelated, we live in the self-world-place. Our bodies are made of the land and the land is our body; how we treat one, we treat the other.

Martin Buber wrote of I-it and I-Thou relationships. I-it is a secular and technical relationship between a subject and an object. I-Thou is a sacred and intimate relationship between two subjects. Our economic, medical, and scientific systems are based on treating others as its rather than Thous. In medicine, I have written about how our current systems dehumanize patients and doctors, alike.^[1] According to psychoanalyst Robert Stoller, the act of dehumanizing another “dehumanizes the dehumanizer.”^[2] It is as if dehumanization is a chain reaction – once humanity is split, it continues splitting until someone or something can put a stop to the division and bring us back to health – the etymology of the word health traces back to whole and holy.^[3] The way we stop dehumanization is to re-humanize ourselves and Mother Earth.

I Am My Brother’s & Sister’s Keeper

Joseph Rael (Beautiful Painted Arrow), a citizen of the Southern Ute Nation, tells me – again, and again, and again – “I am my brother’s keeper, I am my sister’s keeper.” These simple words convey a world-view of interconnected responsibility. If I am my brother’s and sister’s keepers then I am responsible for them. If we listen to these words, if we follow their directions, we would have good public health – because we would embrace our responsibility as caretakers of each other and we would be whole as a species.

Joseph extends this net of kinship and responsibility beyond the human species to include non-human animals and even what we consider inanimate objects. We make the distinction between animate and inanimate – the judgement of whether something has a soul (in Latin, anima). Things that are soulless are objects – its. What would happen if we began treating ourselves as sacred beings and treating all the Earth and her creatures as brothers and sisters, as sacred beings? We would have emergent justice from a living geography.

I have been working with Joseph Rael for the past six years. Joseph tells me that his grandparents at Picuris Pueblo taught him that “work is worship,” so this work is a kind of worship – I see it as learning to see all the world as Thou. We’ve written books and papers together and the next book that he wants to write is for children. Joseph tells me that, Around 5th grade, children begin to lose the sense of themselves as holy, sacred beings. In Picuris we were taught from the earliest age that we were Holy Beings and that what we are made of is the same thing that the stars are made of. We were taught that we were Children of the Stars and Children of the Earth. We should have a disclaimer though, ‘Beware because you will eventually become a Holy Being if you read this book!’

If we are born holy and the stars are holy and the Earth is holy, then how have we lost health and justice? When I asked Joseph about writing an essay for this Geographies of Justice issue, he told me, All humans are looking for that – some justice, a just place where we can feel adjusted and feel safe. A just place is where you are adjusted to justice.

Where is justice located? How do you find it or create it? Joseph would say it is already there when we are born, we are adjusted to the land, because we are self in the self-world-place. We lose this sense of justice when we lose our sense of ourselves and the world around us as holy. When we speak of Geographies of Justice, justice must occur everywhere – if it is only present in some places or for some people, then it is not justice, but rather privilege or inequality.

Leslie Marmon Silko, from Laguna Pueblo, has written of the Indigenous relationship with nature.

All places and all beings of the earth are sacred. It is dangerous to designate some places as sacred when all are sacred. Such compromises imply that there is a hierarchy of value, with some places and some living beings not as important as others. No part of the earth is expendable; the earth is a whole that cannot be fragmented, as it has been by the destroyers’ mentality of the industrial age.^[4]

Silko tells us that dividing things into sacred and profane is dangerous. It is injustice to say “this is sacred and that is not sacred,” or “you have a soul and you don’t.”

Land and Health

The etymology of the word indigenous relates person to place – to be of the land, or born within the land.^[5] An Indigenous people is therefore a people in relationship with the land. An Indigenous perspective would not separate the health of the land from the health of the people.

I believe that it is now time for the Elders all over the world to talk to their people and instruct them. As elders we have more responsibility… a responsibility to talk about the sacredness of the Earth, and the sacredness of the people on the Earth. One of our journeys is to help the people as they walk on Mother Earth. Mother Earth is our land and she belongs to us because we are her children. She belongs to us and we belong to her. So we can take care of her the way she has been taking care of us. (Joseph Rael)^[6]

Maybe the way we treat the land is also how we treat the health of the people. How have we treated public land? How have we treated public health? We have private land and we also have private health care in this country. The United States is the only industrialized country that does not take care of the health of all of its people.

Sometimes this land is called Turtle Island. A turtle is a reptile who lays its eggs on land and some turtles live in the sea and some on the land and some live in lakes and rivers. When you see a turtle in the water, there is more than meets the eye, like an iceberg where you only see ten percent above water. This is how our history of the United States is – we tend not to look at ninety percent of our history: how we took the land from its original inhabitants, we enslaved Africans, we purposefully and accidentally introduced disease, and we made people sick and unwell in body, mind, and spirit. Some scholars say that up to 90% of the Indigenous People of Turtle Island perished during colonization and the formation of the United States of America.^[7],[8]

I work with a Vietnam veteran who has a one hundred percent VA disability rating for Post-Traumatic Stress Disorder (PTSD) and is a member of a Northwest tribe; he said I could share his story. He was exposed to Agent Orange in Vietnam – he felt his own country used chemical weapons against him. When he returned home to the United States, he felt rejected by his own tribe, by his family (who called him “Baby Killer”), and by his own country. Like many Vietnam veterans, he feels the war never ended. Sometimes he thinks he would rather go back to Vietnam because he felt more at home at war than he does “at peace” in the USA. Now with the Covid-19 coronavirus, he feels that the whole US knows what it is like to be “chemical weapon-ed.” His view of the United States is a government that lies, attacks its own citizens, destroys its own lands, breaks treaties, and does not live up to its obligations. He often starts our appointments by saying, “I have no home. I have no tribe. I have no country.” In listening to this warrior elder, I have realized that what I see as an anomaly of the over 30,573 lies^[9] and power grabs of the former president, he sees as just another example of US history. When he heard that the president opened the Tongass National Forest with the stroke of a pen, he said, “People don’t know that the Tongass is the lungs of North America, just as the Amazon is the lungs of South America. You Americans are crazy – you are dead-set on destroying everything, including yourselves.”

Health Care in the United States

We are the only country in the industrialized world without a universal health care system. Even after the passage of the Affordable Care Act, our cobbled together patchwork leaves 43.4% of U.S. adults underinsured, and 12.5% uninsured.^[10]

The virus has exposed our lack of a health care system and lack of a public health system. We are suffering more than we need to because we do not have a health system that cares for us all. Our health care system is founded upon injustice.

Indigenous peoples of the United States currently have the highest mortality from Covid-19 of any ethnic group.^[11] Wilkinson & Pickett have summarized the international research on economic inequality and health, finding that more unequal countries have lower levels of trust, life expectancy, educational performance, and social mobility, and higher levels of mental illness, addiction, obesity, homicide, and imprisonment.^[12] In other words, the injustice of inequality adversely affects the health of all the people of the land. If we are not caring for all, then we are dehumanizing ourselves – making us incapable of caring for self or other. Power et al. tell us that colonialism is a social determinant of health:

Colonization is known to have a negative effect on the social determinants of health and cultural determinants of health…Indigenous Peoples in colonized nations share similar histories of invasion, displacement from traditional lands and relocation onto missions or reservations, stolen generations, forced assimilation, genocide, decimation from introduced infectious diseases and the attempted erasure of culture through the banning of languages and cultural practices.^[13]

Colonization is a public health hazard for the colonized as well as the colonizers.

At War with Ourselves

We are at war with ourselves because we have not had truth and reconciliation from our wars of slavery and land theft. The United States has the greatest levels of inequality of any Western nation.^[14]

We are at war with ourselves because we are at war with the Earth through extractive capitalism – the view that others and the Earth are resources to be exploited to the fullest.

We are at war with ourselves because we are constantly preparing for war and we are the largest producer of weapons.^[15]

The first country that the United States attacked with an atomic bomb was itself – the first A-bomb was the Trinity Test in New Mexico. Joseph says, You see, we were at war with ourselves. We thought we were preparing to try to get them before they got us – but we didn’t realize they are us, so we were at war with ourselves.

Rebecca Solnit has written about the protests on the land of the Nevada Test Site, land unceded by the Western Shoshone who have been involved in legal battles with the government. Solnit writes that between 1951–1991 we attacked ourselves with over a thousand nuclear bombs. Solnit heard Newe (Western Shoshone) elder Corbin Harney say, “The stones are alive here, everything’s alive here. But the bombs are killing them. We are killing our mother today.”^[16]

Joseph Rael grew up around atomic weapons and radiation, living 50 miles from Los Alamos.

When the Picuris people heard about the explosions over Hiroshima and Nagasaki, they buried all the war implements and made a dedication that they were not going to have war anymore.

Why can’t we all do that? After the atomic bomb we could stop making bombs, but the problem with that – the fathers that be, of the ruling class, or whatever you want to call it, of the United States, said, “No, we need to keep experiencing this phenomena of killing hundreds and hundreds of people with one blow, with one bomb.”

Then some smart guy said, “Maybe we should share it with the Russians, so the Russians have it and it will be better and we’ll be even-steven.” Then we have a bomb and they have a bomb, we have three bombs, they have three bombs, and then they have six bombs and we have six bombs and, well, we better make a thousand bombs and they say the same thing and they make thousand bombs. Pretty soon the whole thing gets out of hand, you see?

Is it possible, do you think, that when we say (Joseph then counts out the numbers one through ten in the Tiwa language) weh-mu, weh-se, paah-chu, wiii, paah-nu, maa-tschlay, cho-oh, wheh-leh, whiii, tehn-ku-te – tehn-ku-te means stop, you have reached ten now, stop, stop what you are doing, you can’t go any further, stop. But because we are human beings we say, we don’t stop at tehn-ku-te – 10. They just kept going: 11, 12, 13, 14, 15, 16, 20, 100, 1000 – they didn’t stop. What was their wisdom? What is it that we are doing wrong that we haven’t been able to stop anybody from making more bombs, is the world any safer than it was?

Caring for the Land is Caring for Ourselves

There are a lot of resources on the land that we take care of and they take care of us.

We need to start with the origin of the land, the place before everything broke apart – Pangea. We start at 1 – that’s Pangea. Then the scientists say the continents broke apart, and then people came out of Africa, then the Indians walked across the Bering Strait into the Americas – that’s how the scientists tell it.

Remember the planet is rolling around in space like a ball. Inside the Earth is a mass like a bowling ball – that is what is driving the planet’s movement in space. You have Breath-Matter-Movement (the Tiwa word for God is Wah-Mah-Chi, which Joseph translates as Breath-Matter-Movement). The planet is alive because it has movement, matter, and breath. The planet is always breathing carbon dioxide and oxygen.

With the rising of the sun there is an awakening of two consciousnesses – that is what the sun is saying when you listen to it – awakening of consciousness. So, what is the pandemic all about? It has to do with the sun and the heat of the sun. It is about an awakening of consciousness to new things that we have to do, new things that we have to learn. Now they say, “Wear a mask, don’t hang around in crowds – you’ll pass the virus around.”

We can learn from our environment, from our geographies. We cannot have justice unless we learn from our geographies. Pangea was created and all around it was Panthalassa, the great ocean. Then Pangea spilt and you had the Pacific and the Atlantic Oceans eventually, and the Americas, North, South, Central, and then you had all these tribes in North America, and you had tribes in South America. For all these tribes, their religion was based on geography. The Eskimos had igloos and they would have ceremonies that reflect where they live, all the tribes would have ceremonies that reflect where they live.

There are different areas of land. You become your place before you live in your Mom and Dad’s house because they come from the land and you come from them. They teach you about the weather. The ceremonies are related to the climate of their place. First there was Pangea, and then it split and you had Europeans and Americans, but we are all from Pangea, we are all related.”

We Are All Related

Joseph is echoing the Oceti Sakowin saying, Mitakue Oyasin – we are all related. Angelique EagleWoman (Wambdi A. Was’teWinyan) writes of this interrelationship, as well:

“We are all related” is a piece of Indigenous wisdom that is embedded in our Tribal Nations since time immemorial…With this pandemic, it brings to mind what our ancestors faced during the waves of illness and disease that devastated our communities documented as early as 1518 with the smallpox epidemic to various other epidemics…

We are all related and we are responsible for each other in not spreading this latest coronavirus…Remember that seven generations ago, our ancestors prayed us into life and we will continue to pray for the next seven generations to come.

Mitakue Oyasin!^[17]

Public Land/Public Health, Private Land/Private Health

If we are all related, then the poor health of one affects the health of all. If we wanted to improve the public health of the land, then we would start with improving the health of the Indigenous people of this land as they face some of the greatest inequities. The 370 million Indigenous peoples across the globe face higher burdens of disease and the pandemic is disproportionally affecting Indigenous peoples.^[18],[19] Many Indigenous Nations have sought to protect their populations during the pandemic, for instance, the Mandan, Hidatsa and Arikara Nation’s mask mandate in North Dakota, the Blackfeet Nation’s closure of the entrance on their land to Glacier National Park, the Navajo Nation’s curfews, and Picuris Pueblo ban of outside visitors.^[20] Yet, political anti-science and anti-public health propaganda has interfered with the right to health and tribal sovereignty. When Cheyenne River Sioux Tribe set up road blocks on entry points to tribal land, South Dakota governor Noem called them “unlawful,” demanded their removal, and appealed to the federal government to put a stop to social distancing. Harold Frazier, Chairman of the Cheyenne River Sioux Tribe replied in a statement, “We will not apologize for being an island of safety in a sea of uncertainty and death.”^[21]

It has been said that more “than 500 treaties have been made between the government and Indian tribes and all were broken, nullified or amended.”^[22] Public land and public health go hand and hand, as do private health and private land. The distinction between public land and private land is at the heart of the tragedy of European colonization of the Americas. Chief Raymond Yowell of the Western Shoshone stated, “The land cannot be sold. That is a religious belief.”^[23] Culture, religion, and identity are interwoven with the land. Land is medicine, culture is medicine, relationship is medicine.

Curtice et al. write that “Indigenous communities have much to teach us about how to live sustainably and communally in a time when individualistic efforts seem to trump care for the most vulnerable; investing in their health is an investment in all of our futures.”^[24] Angelique EagleWoman (Wambdi A. Was’teWinyan) invokes John (Fire) Lame Deer’s prophesy “that one day everyone will need to live like Indians…other cultures would need to respect the earth and her resources, realize that all of life is interconnected, and take seriously our responsibilities to each other and all that lives.” EagleWoman argues that we must place “human health before an emphasis on employment or increasing corporate wealth.”^[25]

Why is the United States the only industrialized country without a universal public health system? Could it be that our history of taking the land from the Indigenous peoples, cordoning them off in little plots of unwanted, out-of-the-way land, and our history of taking Africans off their land and enslaving them to work on “our” land – that this is why we cannot commit to a public health system for all? Perhaps when we conduct our own truth and reconciliation with our past, we will be able to create a health system for all.

Joseph Rael tells us, Justice is right here in the room with me and it is right there in the room with you and it is right there in the room for all the people on the planet – it is here.

[1] David Kopacz, Re-humanizing Medicine. Ayni Books, 2014.

[2] Robert Stoller, Observing the Erotic Imagination. Yale University Press, 1992, 32.

[3] Online Etymology Dictionary, “health,” https://www.etymonline.com/word/health.

[4] Leslie Marmon Silko, Yellow Woman and a Beauty of Spirit. Simon & Schuster, 1997, 94.

[5] Online Etymology Dictionary, “indigenous,” https://www.etymonline.com/word/indigenous.

[6] Joseph Rael, Sound: Native Teachings + Visionary Art. Council Oak Books, 2009, 256.

[7] Roxanne Dunbar-Ortiz cites 90%, An Indigenous Peoples’ History of the United States. Beacon Press, 2014, 40.

[8] Dobyns estimates 95% depopulation due to disease, cited in Charles Mann, 1491: New Revelations of the Americas Before Columbus. Vintage Books, 2011, 106.

[9] “The Fact Checker’s database of the false or misleading claims made by President Trump while in office,” 1/20/21, The Washington Post, https://www.washingtonpost.com/graphics/politics/trump-claims-database/?utm_term=.27babcd5e58c&itid=lk_inline_manual_2&itid=lk_inline_manual_2.

[10] Sara Collins, Munira Gunja, and Gabriella Aboulafia, “U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2020,” 8/19/20, The Commonwealth Fund, https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/looming-crisis-health-coverage-2020-biennial.

[11] “The Color of Coronavirus: COVID-19 Deaths by Race and Ethnicity in the U.S., APM Research Lab Staff, 2/4/21, https://www.apmresearchlab.org/covid/deaths-by-race.

[12] Richard Wilkinson and Kate Pickett, The Spirit Level: Why Greater Equality Makes Societies Stronger. Bloomsbury, 2011, 19.

[13] Tamara Power, Denise Wilson, Odette Best, et al. “COVID-19 and Indigenous Peoples: An imperative for action.” J Clin Nurs. 2020;29(15-16):2737-2741. doi:10.1111/jocn.15320, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272911/.

[14] Wilkinson and Pickett, 2011.

[15] Niall McCarthy, “The World’s Largest Arms-Producing Companies In 2018,” Forbes, 12/9/19, https://www.forbes.com/sites/niallmccarthy/2019/12/09/the-worlds-largest-arms-producing-companies-in-2018-infographic/?sh=2171be491d7d.

[16] Corbin Harney, in Rebecca Solnit, Savage Dreams: A Journey into the Hidden Wars of the American West. University of California Press, 2014, 157.

[17] Angelique EagleWoman (Wambdi A. Was’teWinyan), “An Indigenous perspective to COVID-19,” Indian Country Today, 3/31/20, https://indiancountrytoday.com/opinion/an-indigenous-perspective-to-covid-19-V419mlmYKEenMJJm2vNFyw.

[18] Kaitlin Curtice and Esther Choo, “Indigenous populations: left behind in the COVID-19 response,” The Lancet, Vol 395, Issue 10239, 6/6/20, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31242-3/fulltext.

[19] Tamara Power et al., 2020.

[20] Nick Martin, “Kristi Noem’s War on Tribal Sovereignty Is Going to Get People Killed,” New Republic, 11/17/20, https://newrepublic.com/article/160198/kristi-noems-war-tribal-sovereignty-going-get-people-killed.

[21] Jeremy Fugleberg, “South Dakota COVID-19 checkpoints highlight fractures, strength in tribal relations,” Post Bulletin, 9/23/20, https://www.postbulletin.com/indigenous-impacts/6641313-South-Dakota-COVID-19-checkpoints-highlight-fractures-strength-in-tribal-relations.

[22] Samuel Vargo, “With more than 500 treaties already broken, the government can do whatever it wants, it seems…” The Daily Kos, 11/21/14, https://www.dailykos.com/stories/2014/11/21/1345986/-With-more-than-500-treaties-already-broken-the-government-can-do-whatever-it-wants-it-seems.

[23] Chief Raymond Yowell in Solnit, 1994, 186.

[24] Curtice and Choo, 2020.

[25] Eaglewoman, 2020.