Abstract
As an old, white, male settler who uses the pronouns he/him and was born when atmospheric CO2 was 313 ppm. I have only my personal experience and my reading to guide me.
For the past 3 years, I have immersed myself in social and environmental justice issues, working with Doctors for Planetary Health – West Coast and the Canadian Association of Physicians for the Environment. For a longer period of time, I have followed Media Indigena and Warrior Life, 2 podcasts that provide a different worldview.1,2 My personal library is shelved with writings by indigenous authors.
I have presented grand rounds on planetary health in many places and always opened with a land acknowledgment. At the Department of Surgery in Saskatoon, I was told by the Cree family physician from northern Saskatchewan and then Vice Dean of Indigenous Health, Janet Toottoosis that “it would be better coming from me; they might listen to a senior, white surgeon,” than from her because she would be “seen as just another Indian.” Such is the tragedy of our time.
That being said, I make no claim to expertise in this area and will present ideas from indigenous authors to support the position of Burghardt, Shade, and Temple-Oberle. 3
Western culture lives by rules (usually derived from the Judeo-Christian tradition). You can think of the “Ten Commandments … the thou shalt nots ….” These are the rules that presage colonialism, control, punishment, and exploitation.
Indigenous cultures live by teachings. These are ways to look at life, ways to solve problems, ways of being and are pro-social. Following the teachings leads to harmony.
The 6 teachings of the Musqueam people are:
These were offered to the Provincial Health Services Authority by Musqueam Elder and Knowledge Keeper Shane Point—Sulksun to guide the work of the PHSA.
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He says “The teachings are wonderful, at the same time they’re law.” “Positive change is wonderful … all of the words are helping leadership to move ahead.”
Richard Wagamase presents the 7 sacred teachings of the Ojibway grandfathers: One by one the Grandfathers offered him the Teachings he would carry to the human beings—the Teachings that would guide them to a good life.
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These are the guiding principles of how to live. Plastic surgeons can easily relate to guiding principles. We use our guiding principles to solve wound-healing problems and help our patients every day.
Two-eyed seeing—
Ojisto Horn, Mohawk from the community of
Upstream we have our “world view” which reflects the morals, values, beliefs, and spirituality of our society. It is based on either a linear or circular conception of time. The worldview informs how we look at rights (humans, animals, the earth, and corporations). This in turn develops our legal order (laws, acts, declarations, constitutions, accords, treaties, and contracts). You can already see how the written word is dominant. The legal order defines our institutions (roles, responsibilities, policies, procedures, enforcement, and accountability). Programs live within these structures (pedagogy, curriculum, health care, social services, youth, and family). Finally, at the end of the stream, the structure defines our conduct (personal and corporate). Change needs to happen at all levels.
The medical paradigm is the world of disease and diagnosis; cure, treatment, or palliation. The wellness paradigm is the achievement of an optimal state of well-being. Many people are now working on the transformation to a well-being society. 9
All of these views of life and our place in it, and the earth and our place on it have profound meaning and resonate with me as a physician. In these times of great social and environmental stress and strife, we must be true to our roots and our teachings.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
