Lori Alvord

1958 –

Lori Alvord

First Navajo Woman Surgeon: Integrating Indigenous Healing with Modern Medicine

Surgeon

Indigenous Healing

Navajo

Dr. Lori Alvord's portrait in the middle of her two rooting landscapes: the natural scenery of Crownpoint, New Mexico and the Gallup Indian Medical Centre.

Matriarchal Strength Makes New Pathways

In the 1960s and ‘70s, Navajo kids in Crownpoint, New Mexico, didn’t usually dream of becoming doctors. The doctors at the hospitals were typically male bilagáanas — White men. They often worked in the Indian Health Service only temporarily until getting a promotion elsewhere, so they weren’t there for long. Yet in Dinétah — the land of the People, the Diné, the Navajo, surrounded at four corners by four sacred mountains — a strong current flowed against Eurocentric White male authority. Diné cultural traditions are matriarchal: women maintain cultural and social bonds, keep property, and hold the lineage to clans. These matriarchal traditions combined with the rise of American civil, Indigenous, and women’s rights, energized new possibilities to enhance medical practices by combining the wisdom of two cultures.

In this context, one of a long line of Tsi’naajinii women, a black-streaked-wood person of the Bear Clan and of the Ashiihi, the Salt People Clan, Dr. Lori Arviso Alvord became the first-ever Navajo woman surgeon. The matriarchal tradition prepared Alvord to effectively navigate an American medical world dominated by White men. She broke through societal norms by building a space in modern medicine that drew from both her surgical training at Stanford University in the 1980s and her long-held Diné healing traditions. Bringing the two together, Alvord envisioned how modern medicine could be more inclusive for Indigenous peoples and better serve all patients. Thanks to efforts like Alvord’s, diverse healing paths have been increasingly incorporated as complementary to conventional medicine.

A Diné heart heals both through the physical body and the inner spirit.

Healing Traditions of Restoring Balance

Alvord was supported by her Diné community and her professional peers through her medical training and early career starting in the late 1980s, when she returned to serve her people in an effort to bring greater balance and equity to medical care. Leaving Dinétah in 1997, she fortified this mission as the Associate Dean of Student Affairs and Multicultural Affairs and as an Assistant Professor in Surgery at her undergraduate alma mater, Dartmouth College in New Hampshire. In 2013, she was nominated for the position of the United States Surgeon General. Among her many accolades, she won the Stanford Medical Alumni Award in 2018. Currently, she is Chief of Staff with Astria Health in Sunnyside, Washington.

Long before Alvord pursued medicine and continuing into the present, thousands of generations of Indigenous healers have skillfully observed the relations between the natural world, how people live, and individual health. Diné healers, hataałii, work to maintain health through plant medicines, ceremonies that uplift the people and the spirits, and a goal to restore balance when imbalances — such as illnesses — occur. In the early 1990’s, Alvord observed how in the Gallup Indian Medical Centre where she practiced surgery, Navajo patients were more likely to have a successful recovery from treatable illnesses when traditional healing practices were integrated into their care. Bringing the two together was challenging when allopathic medicine followed a clinical methodology with little or no attention to patients’ family, spiritual, and emotional needs.

The Navajo sand paintings conform a rite in the healing ceremonials of the Hataalii; similar to the surgeons’ tools, they help healing the ones in need.

Easing Fears Through Inclusive Care

Alvord navigated how Diné traditions came with taboos and boundaries that conflicted with conventional medical practices. In her book, The Scalpel and the Silver Bear, Alvord explains that Diné aim to respect each other’s privacy. For example, Diné avoid direct eye contact and probing questions. Diné choose words carefully and take time to consider the causes of illnesses. This way of being conflicts with how conventional doctors are trained to make eye contact, ask direct questions, and touch patients’ bodies to help determine what ails them. As a surgeon, Alvord needed to cut into patients’ flesh to remove tumours and appendices. Yet touching or performing surgery on a patient’s body are viewed as invasions of Diné privacy, of the sacredness and wholeness of the body. As well, words have such power to Navajo people that talking about death is taboo.

Alvord writes that there has been “much to learn, and much to unlearn” to mindfully apply Navajo protocols to help comfort her patients and convince them to receive beneficial, often lifesaving surgeries. Given the Diné fear of contagion when it comes to illness, Alvord found ways to explain in the Navajo language that only some types of illnesses could spread to other people. She worked to bridge the two ways of being through compassion and humility to ease her Indigenous patients’ fears.

Walking in Beauty and Two-Eyed Seeing

Alvord’s philosophical approach truly came into being when she was a resident surgeon in 1987. She suffered from staphylococcus pneumonia and found herself in the position of the Navajo patient. Alvord experienced the direct gaze of physicians and nurses, the noises of the hospital paging system, and other things that disrupted her Diné sense of calm and privacy. She perceived the illness was made worse by the intense workload of her residency. Her life had fallen out of balance, and the importance of Diné principle of hózhó, Walking in Beauty, became especially clear.

Hózhó 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.” (Alvord, 1999)

In this, one might think of Mi’kmaw Elder Albert Marshall’s notion of etuaptmumk, Two-Eyed Seeing, where one can see both through Indigenous ways while simultaneously seeing through the strengths offered in Western knowledge. Alvord herself has a Navajo father and a White mother, two cultural worlds intersecting during her upbringing. With her liminal position in these identities, a more integrated whole came into focus. For Alvord, simultaneously seeing through the eyes of the medical practitioner and the patient, through both Diné and White lineages, awoke a vision of integrating both Indigenous and Western healing expertise to make medical care culturally responsive and patient-centred.

Opening Doors

Key mentors, both Indigenous and bilagáanas, supported Alvord’s mission. It began with her Navajo relations in Crownpoint, who funded her higher education. Her admittance to Stanford was thanks to Dr. John Collins, who committed to integrating women into the surgical field. This made space for Alvord at a time when 4% of American surgeons were women. Today, the number of female and male surgeons in the United States is near parity, but women surgeons have reported how it remains a difficult path given its male-dominated structure.

As a resident surgeon working not far away from her hometown, Alvord’s mentor was an Indigenous male surgeon, Dr. Ron Lujan of the Taos and San Juan Pueblo tribes. She observed the time Lujan took with Indigenous patients to talk over things that were important to them in their daily lives. He made house calls and asked questions in a way that didn’t feel invasive. In this, Alvord saw the methodology to attain balance and harmony in action. Furthermore, Lujan and Alvord often worked in all-Indigenous medical teams. This made history and demonstrated how modern medicine could be more equitable and culturally responsive. Lujan encouraged Alvord to work hard as a medical resident, emphasizing how she had to, “study harder, train longer” in order to overcome others’ skepticism of her abilities as an Indigenous female surgeon. In forging an Indigenous patient-centred approach, Alvord simultaneously answered the conventional medical need to, “achieve better results.”

The path of Hózhó harmonizes each aspect of life to find wellness and balance: from nature that nurtures us, to the relationships we conform with others and the inner fluctuations of our own organism. The power to heal surrounds us.

Remembering How to Bring Healing to All

Measuring the impact of Alvord’s work is hard, but the intention to bring equity speaks powerfully today when Indigenous peoples continue to face intense inequities. The hope that arises comes with global efforts to truly consider the value of Indigenous ways of knowing, being, and doing—both for Indigenous and non-Indigenous peoples. Integrating Indigenous ways of achieving balance becomes more critical as the world’s scientists have reached a consensus on the imbalances of industrial-capitalist systems. These systems exact environmental and humanitarian tolls through anthropogenic climate change and health crises. Indigenous knowledge enriches how we understand balance in our world and within our bodies. Alvord’s work exemplifies how to consider the whole, and how to achieve balance when the effects of imbalance persist and grow.

Alvord’s work is not a single scientific discovery; it is a holistic integration of what has been forgotten in conventional medicine. Her great contribution to medicine has been remembering Diné holistic approaches to well-being and health. Through more harmonious approaches and spaces for healing, Alvord has sought to overcome the imbalances and inequities that afflict Indigenous peoples. She has modelled a way to build trust and acceptance among patients: by respecting what they need to feel “comfortable and at ease.” This, in turn, strengthens people’s ability to heal. To Walk in Beauty is to slow down, carefully consider, and observe — to show in the interrelationships where balance can be restored. In that, Alvord writes that the healer is a teacher in how to do this.

We have authored and illustrated this entry with care and respect, aiming to achieve the highest standards through diligent, balanced research. We also strive to maintain the highest standards of accuracy and fairness to ensure information is diligently researched and regularly updated. Please contact us should you have further perspectives or ideas to share on this article.

• References

  Alvord, L. A., & Cohen Van Pelt, E. (1999). The scalpel and the silver bear: The first Navajo woman surgeon combines western medicine and traditional healing. Bantam Books.

  Janis, M. (2017, July 15). Navajo surgeon’s career combines science, traditions. Yakima Herald-Republic. https://www.yakimaherald.com/unleashed/navajo-surgeon-s-career-combines-science-traditions/article_776c2cf8-69ae-11e7-89c7-9b5ae95f2062.html

  Karol, S. V. (2022, February 4). Lori Arviso Alvord, MD: The First Navajo Nation Tribal member to be Board Certified in general surgery. Bulletin of the American College of Surgeons. https://web.archive.org/web/20221208152447/https:/bulletin.facs.org/2022/02/lori-arviso-alvord-md-the-first-navajo-nation-tribal-member-to-be-board-certified-in-general-surgery/

  Maffei, K. (2018, July 30). Culturally competent care: Three questions for Lori Arviso Alvord ’79. Dartmouth Alumni. https://alumni.dartmouth.edu/content/culturally-competent-care-three-questions-lori-arviso-alvord-79

  O’Polka, D. (2018, December 3). Stanford University honors Astria Health general surgeon, Lori Arviso Alvord, MD. Astria Health. https://www.astria.health/news/stanford-university-honors-astria-health-general-surgeon-lori-arviso-alvord-md

  Rockey, P. H., & Brotherton, S. E. (2022, July 5). Gender equity in surgery is much more than numbers: Bias and discrimination persist in the field. MedPage Today. https://www.medpagetoday.com/opinion/second-opinions/99566

  U.S. National Library of Medicine. (2015, June 3). Dr. Lori Arviso Alvord. Changing the face of medicine. https://cfmedicine.nlm.nih.gov/physicians/biography_7.html

• Metadata

  Website Name: The Matilda Project

  Title of Entry: Lori Alvord

  Author: Christopher Laursen

  Illustrator: Esther Morales

  Editors Sandy Marshall & Shehroze Saharan

  Original Publication Date: February 16, 2024

  Last Updated: March 31, 2024

  Copyright: CC BY-NC-ND

  Webpage Specific Tags: Lori Alvord; Navajo surgeon; First Native American female surgeon; Integrative medicine; Cultural competence in healthcare; Traditional healing practices; Dartmouth Medical School; Navajo philosophy of healing; Wellness and balance; Author of "The Scalpel and the Silver Bear"; Advocate for culturally sensitive care; Indigenous health practices; Surgery and Navajo culture; Holistic healthcare approaches; Native American women in medicine; Bridging Western and Indigenous medicine; Health disparities in Native American communities; Mentorship for Indigenous students in STEM; Cultural diversity in medical education; Patient-centered care; Healing ceremonies in modern medicine; Leadership in healthcare diversity.

  Website Tags: The Matilda Project, The Matilda Effect; Margaret W. Rossiter; Matilda Joslyn Gage; Implicit bias; Unconscious bias; Gender attribution bias; Scientific recognition bias; Gender discrimination in academia; Stereotype threat; Pay gap in STEM; Glass ceiling in science; Sexism in scientific research; Gender stereotypes in education; Gender bias in peer review; Bias in STEM hiring practices; Impact of gender bias on scientific innovation; Underrecognition of female scientists; History of women in science; Women scientists in history; Notable women in science; Pioneering women scientists; Women Nobel laureates; Female role models in science; Gender disparities in scientific research; Women's suffrage movement; Historical women's rights leaders; Historian of science; STEM gender gap; Women in STEM; STEM education; Challenges faced by women in STEM; Representation of women in tech; Initiatives to support women in STEM; Gender equity in STEM education; Encouraging girls in STEM; STEM outreach programs; Diversity in STEM curriculum; Equity, Diversity, Inclusion; Equity in education and workplace; Diversity training; Inclusion strategies; Inclusive leadership; Gender equality; Racial equity; Pay equity and transparency; Representation in media.

• Citation

  APA Citation

  Laursen, C. (2024, March 31). Lori Alvord. The Matilda Project. https://www.thematildaproject.com/scientists/lori-alvord

Author

Dr. Christopher Laursen

Educational Developer - Office of Teaching and Learning at the University of Guelph

Dr. Christopher Laursen is an Educational Developer in the Office of Teaching and Learning at the University of Guelph in Canada. He prioritizes universal design principles, accessibility, well-being, and belonging to enrich and optimize pedagogy. As a historian and interdisciplinary humanities scholar, Laursen focuses on the socio-cultural intersections of science, spirituality, and the natural world. He has examined how people study and experience phenomena that lack consensus explanations in science, medicine, and society, and how people have worked to study such phenomena. From 2017 to 2021, he was an award-winning instructor at the University of North Carolina Wilmington. He holds a Ph.D. in History from the University of British Columbia and an M.A. in History from the University of Guelph.

Illustrator

Esther Morales

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