Life Balance and Healing: Native American Alumnus in Rural Medicine

National Native American Heritage Month began at the turn of the 20th century according to The Library of Congress, National Archives and Records Administration, National Endowment for the Humanities, National Gallery of Art, National Park Service, Smithsonian Institution and United States Holocaust Memorial Museum.

The roots of this observance have been in an effort to recognize the incredible support, knowledge of the land and collaborative spirit that Native Americans lived before the continent was explored by Europeans and later when it was considered the United States. Over the centuries, Native first peoples enjoyed a complex community network. This has remained a strong reality through the 21st century. Many leaders and supporters of Native American communities have long attempted to create a national annual observance. While the history is multilayered and the attempts numerous, it was not until 1990 when President George H.W. Bush approved a resolution that marked November as “National American Indian Heritage Month.” The nationally proclaimed celebration’s name has changed over the decades but the support and recognition has continued on an annual basis since 1994. 

Beginning in 1972, the mission of the University of Minnesota Medical School, Duluth campus states that the campus strives to lead by educating physicians who are dedicated to family medicine and to serve the needs of rural Minnesota and Native American communities. Dr. Tenaya Siva, MD, a 2020 graduate from the northern campus, acknowledges how the U of M supported his success. Dr. Siva grew up in a rural Indian Health Service (IHS) area and chose Duluth based on the Native program, which includes resources that support Native students. 

“I intended early on to practice in a rural IHS area,” he said. “And that dream coincided with the mission of the Duluth campus. I knew, even before matriculating into medical school, that I would like to practice family medicine and the program in Duluth is one of the best in the country. After working with many doctors from all over the country and hearing their stories of medical school, I know without a doubt I made the best decision.”

Although Dr. Siva was drawn to the mission, there were additional important factors that played into his decision to pursue his degree in the Twin Ports area. Among those included an appreciation for the holistic curriculum. 

“I valued the fact that the entire program focuses on treating the patient, not just the disease. I knew this was the preparation I needed to practice medicine in a rural IHS system. The sense of community that I felt during interview season was second to none. That really cemented my decision to attend medical school at the U of M Medical School, Duluth campus,” Dr. Siva said.

While he pursued his medical degree, Dr. Siva attended a rural health conference in Minnesota. The multi-day schedule included a variety of speakers and workshops. As a medical student, he appreciated the opportunity to learn about medicine from the experts outside of the classroom. He also looked forward to hearing from Native leaders from a variety of backgrounds. Unbeknownst to him, Dr. Siva’s preceptor – who was in attendance at the conference as the keynote speaker – had planned a gesture of support for his mentee. 

“My preceptor is a local Ojibwe physician who works at a local Anishinabe health clinic. Without my knowledge and in front of hundreds of people, he asked me to come up to the stage to join him. He gave me a gift that day — one that I still have today and consider a prized possession. He gave me the gift of metal, as he said when giving gifts, as his mother told him, ‘give a gift of metal — something strong, something permanent.’ It meant so much to me that day to be recognized by someone I look up to and respect. I know that that experience was only possible through Duluth. To this day, I feel as though my experiences in Duluth have shaped me for the better and have given me a sense of permanence in the world, and in the world of medicine; Duluth is like the gift of metal.”

As a resident, father, and husband, Dr. Siva recalls how he didn’t start into medicine right away. The life path is never linear, and when he was first employed, it wasn’t because of a degree or a dream to pursue a medical degree. It began as a desire to support his partner and first child. 

“I dropped out of school to provide for my family and ended up starting a construction company to make ends meet,” Dr. Siva said.

Once his medical degree became a reality in June 2020, Dr. Siva entered into his residency position and is currently experiencing his second year in family medicine. The Native graduate has taken his education and belief in community near the California-Mexico border. His employment is underway at the Scripps Chula-Vista Family Medicine Residency Program where he delivers babies, manages inpatient hospitalist service and cares for patients from birth to senior citizenry. 

“I love the population I work with as well as the day-to-day variety. I am offered the opportunity to provide continuity of care around many aspects of disease and enjoy it every day. All my fellow residents are strong activists in their fields and I am in awe of them every day we work together.” Even though he enjoys the daily tasks and demands, he is also aware that the fast-paced program is time intensive and incredibly challenging when it comes to personal, family balance. “I’ve learned to make sacrifices where I can, and I appreciate my free time and make the most of it when it’s available, especially now that I have three daughters. I like to spend any opportunity with my family hiking, fishing. I enjoy watching movies and trying new foods with my wife. I have to remember to take that time including my favorite sports, the English premier league’s Chelsea FC. It is important to continue to enjoy hobbies and interests even if it feels like you don’t have the time.” 

Dr. Siva also acknowledges the long history of Native Americans and the culture that he knows deeply and profoundly where community – life balance – is a core part of their tradition. While November is a month to appreciate and observe National Native American Heritage, he lives this observance for more than 30 days a year and shares his insight for a country of people with differing perspectives. 

“One of the most important things to recognize is that we are still here. We never left, nor are we extinct or just a page out of the history book. For those not as lucky to be part of our group, support starts in yourself and recognizing your own implicit biases,” Dr. Siva said. “On a larger level, encouraging respective programs to actively seek out Native students interested in medicine is important. For practicing physicians, it is always significant to recognize that emotional, mental and historical trauma are always present and at higher incidence in the Native population. This affects all aspects of health including lifestyle and adherence. We are a remarkably diverse culture with regional traditions and ceremony, and we have long developed complex societal structures. I think our Native alumni support this by their very existence and continued contribution to our communities.”