SCALPEL AND THE SILVER BEAR(ISBN=9780553378009)pdf/txt下载_在线阅读全文

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　　"If you're in the market for a captivating autobiography, look no further."—South Carolina Herald
　　"Sheer pleasure to read from the very first page... Absorbing."—Booklist
　　"Movingly details her quest to unify two cultures and two healing traditions."—The Dallas Morning News
　　"Those who would enjoy an insider's look at how modern medicine and life mix with the Navajo Way shouldn't miss The Scalpel and the Silver Bear."—Tony Hillerman

内容简介

　　The first Navajo woman surgeon combines western medicine and traditional healing.
　　A spellbinding journey between two worlds, this remarkable book describes surgeon Lori Arviso Alvord's struggles to bring modern medicine to the Navajo reservation in Gallup, New Mexico--and to bring the values of her people to a medical care system in danger of losing its heart.
　　Dr. Alvord left a dusty reservation in New Mexico for Stanford University Medical School, becoming the first Navajo woman surgeon. Rising above the odds presented by her own culture and the male-dominated world of surgeons, she returned to the reservation to find a new challenge. In dramatic encounters, Dr. Alvord witnessed the power of belief to influence health, for good or for ill. She came to merge the latest breakthroughs of medical science with the ancient tribal paths to recovery and wellness, following the Navajo philosophy of a balanced and harmonious life, called Walking in Beauty. And now, in bringing these principles to the world of medicine, The Scalpel and the Silver Bear joins those few rare works, such as Healing and the Mind, whose ideas have changed medical practices-and our understanding of the world.

作者简介

　　Lori Arviso Alvord, M.D., is now the associate dean of minority and student affairs at Dartmouth Medical School. She lives in New Hampshire with her husband, Jon, and two children, Kodiak and Kaitlyn.
　　Elizabeth Cohen van Pelt is a staff writer with the New York Post. She lives in New York with her husband and daughter.

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　　Introduction
　　A Navajo weaver takes strands of wool and blends them intosomething of great beauty and magic; warp and weft combine into apattern, and the pattern tells a story and has a spirit. Thispattern then becomes a piece of the culture and has a life of itsown. From the beginning I knew I had to do a similar thing with thestrands of my story–to tell how a girl from a small and remote townon an Indian reservation was able to become a surgeon, able to workin the high-tech realm of a surgical operating room, and combinethat with another story, about how ancient tribal ways andphilosophies can help a floundering medical system find its wayback to its original mission: healing.
　　The first strand of my story shows that anything is possible. Thewords "Navajo" and "surgeon" are not often seen together. But aminority woman can travel across cultural, class, and educationalborders and become a part of a medical world whose doors have beenclosed to minority people for most of its existence. I hope thatnative people will be encouraged by this story, and that they willfollow their own special dreams. The second story is about how Ihave come to understand, after years of reflection, that my tribehas knowledge about medicine and healing, ways of thinking abouthealth and illness that provide solutions to some of modernmedicine's most daunting problems.

Introduction 
　　A Navajo weaver takes strands of wool and blends them into
something of great beauty and magic; warp and weft combine into a
pattern, and the pattern tells a story and has a spirit. This
pattern then becomes a piece of the culture and has a life of its
own. From the beginning I knew I had to do a similar thing with the
strands of my story–to tell how a girl from a small and remote town
on an Indian reservation was able to become a surgeon, able to work
in the high-tech realm of a surgical operating room, and combine
that with another story, about how ancient tribal ways and
philosophies can help a floundering medical system find its way
back to its original mission: healing. 
　　The first strand of my story shows that anything is possible. The
words "Navajo" and "surgeon" are not often seen together. But a
minority woman can travel across cultural, class, and educational
borders and become a part of a medical world whose doors have been
closed to minority people for most of its existence. I hope that
native people will be encouraged by this story, and that they will
follow their own special dreams. The second story is about how I
have come to understand, after years of reflection, that my tribe
has knowledge about medicine and healing, ways of thinking about
health and illness that provide solutions to some of modern
medicine's most daunting problems. 
　　It is common knowledge that modern medicine is in crisis. Never
before has such an astounding array of medical treatments been
available. The latest breakthroughs in research and methodology are
stunning achievements and should be acknowledged as such, but along
the way we have forgotten some of the things that heal us best–our
relationships, how we live our lives, our feelings of wholeness and
belonging. For all its technological advances and voyages into
previously uncharted waters, modern medicine still has much to
learn about healing. Now more than ever, patients themselves feel
removed and forgotten, powerless in the face of the institutions
that were created to help them. In many ways modern medicine has
become a one-way system–from physician to patient. Physicians do
the directing, talking at their patients. The other direction, the
listening on the part of the physician, is becoming lost. This has
left patients without a role in their own treatment. Patients want
to be involved in their care and the decisions about how medicine
is delivered to them. They want to feel like more than a set of
organs and bones, nerves and blood, and participate in the process
of restoring their bodies to health. Many patients want deeper,
caring relationships with their physicians, and want to be able to
choose their own physicians. Physicians complain that they are
robbed of the time they need in order to create lasting
relationships with their patients. In this new world of "managed
care," both patients and physicians suffer, and decisions about
health care are often out of the hands of both.　　 
　　This book is about my journey and my struggles. From my own
mistakes, my own initial misadventures in patient care, I realized
that although I was a good surgeon, I was not always a good healer.
I went back to the healers of my tribe to learn what a surgical
residency could not teach me. From them I have heard a resounding
message: Everything in life is connected. Learn to understand the
bonds between humans, spirit, and nature. Realize that our illness
and our healing alike come from maintaining strong and healthy
relationships in every aspect of our lives. 
　　In my culture–the Navajo culture–medicine is performed by a
hataalii, someone who sees a person not simply as a body, but as a
whole being. Body, mind, and spirit are seen as connected to other
people, to families, to communities, and even to the planet and
universe. All of these relationships need to be in harmony in order
to be healthy. Even the relationship between the patient and the
healer is important in order to achieve healing. Those types of
relationships, so key to us, are not strongly acknowledged in
medicine today, yet this is precisely what needs to be given
priority. People are looking for a better way to have their health
needs addressed. They want a medicine that understands their health
needs are not separate from the rest of their lives. A medicine
that does not isolate but connects. 
　　Healing is not only a one-to-one relationship, it is
multidimensional. At the basis of Navajo philosophies of healing is
a concept called "Walking in Beauty." It is a way of living a
balanced and harmonious life, in touch with all components of one's
world. This is a path to better health and healing and life. 
　　If modern medicine is lost–and many believe it is–perhaps it can
find its way by looking to the traditions and beliefs of some of
America's first inhabitants. It is my hope and vision that groups
of people can learn from one another–that the culture of medicine
can learn from the culture of Native Americans, and that both can
be richer for the experience. 
　　I hope that my words illuminate the importance of this lesson,
and encourage doctors and patients everywhere that to walk in
beauty is to find the path to a balanced and healthier way of
life.–Lori Arviso Alvord 
　　November 1998–> 
　　Chantways 
　　Music is a healing force all living spirits sing. 
　　–Joanna Shenandoah, Oneida composer 
　　In many places in the world when a person is ill, a song is sung
to heal. For this to be effective, that person must let the song
sink into her body, and allow it to penetrate to even the cellular
level of her being. In a sense she must breathe it in. 
　　A song, in physical terms, is an action made of breath and sound.
It is made by the vibrations of air across a section of membranes
in the throat, which are then shaped by the placement of the tongue
and mouth. That is a literal description of singing, but of course
there is more, much more. A song is also made from the mind, from
memory, from imagination, from community, and from the heart. Like
all things, a song may be seen in scientific terms or in spiritual
terms. Yet neither one alone is sufficient; they need each other to
truly represent the reality of the song. Singing comes from that
misty place where human physiology, feeling, and spirit collide. It
can even be, for some people, a holy act, a religious act, an act
with great power. 
　　Today's medical environment provides more healing options than
ever for a person who becomes sick. CAT scans and MRIs picture the
inside of the human body with astonishing detail; dangerous,
invasive surgery has been made commonplace; and intricate
operations are now performed with lasers. New drugs with
capabilities formerly unimagined are being discovered every day.
The Human Genome Project is mapping our DNA from prehistoric times
to the present, giving us a better understanding of the evolution
of genetic disorders and opening the door to the possibility of
someday being able to manipulate the human genetic strand and
create "better" human beings. 
　　Yet another type of medicine is also being practiced on our
planet. It is one that involves not only the body but the mind and
the spirit; it involves not only the person but her family, her
community, and her world. It involves song. 
　　The notion of singing a person to wellness and health may sound
strange. You may think it irresponsible of me, a trained physician,
even to mention it. But I am not talking about a New Age or
alternative treatment. I am speaking of the medicine ways of my
tribe, the Navajo, where a singer is called in when someone is
sick. As part of the cure, they perform a "sing" or ceremony,
called a chantway. The Beauty Way, the Night Chant, the Mountain
Way: different kinds of songs cure different kinds of illnesses. A
Shooting Way ceremony might be used to cure an illness thought to
have been caused by a snake, lightning, or arrows; a Lifeway may
cure an illness caused by an accident; an Enemyway heals an illness
believed to be caused by the ghosts of a non-Navajo. There even are
songs for mental instability. 
　　Not long ago I learned that Navajos are not the only people on
earth to recognize the power of the human voice. In places in
Africa the people sing to broken bones in order to mend them. Yet
the power of a song lies not in a tested, quantifiable, and
clinical world and it will not be written about in The New England
Journal of Medicine. It will not be discussed at meetings of the
American Medical Association. Many physicians, good ones, cringe at
the very mention of it. 
　　Yet one afternoon, at the hospital where I worked as a surgeon in
Gallup, New Mexico, singing was going on at the bedside of Charlie
Nez. As I stood in a doorway, watching the medicine man leave, I
was surprised to see the elderly man, who had stirred little in the
preceding days, sit up straighter, and look attentive. I glanced at
his chart: his heart rate was steady, and his blood pressure had
stabilized. There was a new red flush of circulation in his
cheeks. 
　　Charlie Nez was being treated with chemotherapy, radiation, and
surgery for an advanced cancer. I know this because I was one of
the doctors participating in his treatment. I had performed surgery
on his colon to remove a tumor. 
　　But this treatment was not the entirety of the medicine he
received. As I stood in the doorway listening to the song of the
medicine man who stood beside him, his voice rising and falling in
a familiar range of tones, I saw a minor miracle. In Charlie's
eyes, for the very first time since I'd met him, was hope. 
　　Any physician–from an exclusive research program at Massachusetts
General, from a team of surgeons in Paris, or with Doctors Without
Borders in Afghanistan–will tell you that unless a dying patient
has hope and emotional strength, the will to live, a doctor can do
little to save him. Watching that hope come back into Charlie Nez's
eyes, I...

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