Western Medicine Meets Indigenous Healing w/ Dr. Annelind Wakegijig

(upbeat music) - Welcome back to "Shikken Wheat Bad Dan" Indigenous Medicine Stories. I am your host, Daral Manitwabi. Today's episode features Dr. Annalyn Malkikijik from Wheat Kwen Mkong and Cedar Territory on Manitulan Island in Northeastern Ontario. Dr. Walkikijik is the lead physician at Boatin Family Health Team in Batchwanna First Nation near the city of Susane, Rihontario. She is also the investigating coroner with the Office of the Chief Coroner. I spoke with Dr. Walkikijik this past spring. This is what she had to say. - My name is Annalyn Duwalkikijik. I am a family physician and I'm currently the lead physician of the Boatin Family Health Team here on the Batchwanna First Nation. I'm originally from Wheat Kwen Mkong and Cedar Territory on Manitulan Island. - McGwech, so you mentioned you're a family physician. Can you share your journey into medicine what inspired that career choice and some experiences along the way? - Sure, so my journey into medicine actually started when I was in high school. I had an original intention to go to college to become a lab technician. I was always fascinated by science, biology, and whatnot. And then I actually went on a tour. An opportunity arose when I was in grade 11 to tour the University of Toronto. And there were different faculties. It was actually something that was coordinated by Diane Longbow at the University of Toronto when she was there. So there were several students chosen from across the province to attend this week long orientation into the different faculties at the University of Toronto. So part of that was the faculty of nursing, dentistry, physiotherapy, pharmacy, and medicine. And we actually had an opportunity at that time to do tours of the different facilities. And one of the tours was through the operating room. And we were given an orientation by a woman who was very tall, very regal looking woman. And she was giving us an idea of what the OR was like and what would happen in the operating room and such. And it wasn't until at the end of her talk I realized she was a surgeon. And so I had never in my life heard of a female surgeon. And so my eyes sort of opened wide. And then later on had an opportunity to meet Dr. Marlon Cook. And she was an indigenous physician who had just at that time graduated from the University of Manitoba. So my eyes were opened even more by seeing another female physician, but a female indigenous physician. And so there was a small grain of excitement that I feel ignited in myself when I thought, wow, a female and an indigenous person can be a doctor. So I went back and from that experience, I took back the sense of excitement that there can be something more for me, I think, should I choose. And it was actually at that point I decided that it would be an ambition of mine to become a physician. My original intention other than lab technician was to be a veterinarian. But I didn't know how to even go about becoming a veterinarian. But with the experience at the University of Toronto and getting the idea of what was required to be a physician, I chose that route. And I thought, this really does mean helping people. So I sort of combined my love of science and my desire at the time to learn. And so that's where I directed my energies, was go into university and I took science courses. And then I applied to medical school. So I actually applied to the University of Alberta and had wonderful support there. And I got into University of Alberta. So I spent a few years out west and did my medical training there. It was an eye-opening experience, many good and bad. And I think nothing in life goes without good and bad experiences. So at the end of it, I graduated from the University of Alberta. And then from there, I actually wanted to come back home. So I came back and I did my family medicine residency training based out of Sudbury. So that's my journey into medicine in a nutshell. Can you talk about a little bit more on what it was like to be an Indigenous medical student? And we have, you know, I'm at the Northern Ontario School of Medicine University. And I teach Indigenous medical students and some may want to know a bit more about what things were like during your time when you went through the program. Sure. So my time, you know, being Indigenous, you're a minority. Being an Indigenous female was even more of a minority in the time that I trained. I was back and way back in the '90s. There was still more male to female in the classes, although that was starting to shift at that time. But being out west, I was away from home. I was away from all what was familiar to me. And there were Indigenous people around me. But in terms of the experience of going through medicine, we were very small in number. Each class, I think, had to identify as Indigenous students. And so in my class, there was two of us that had gotten into the class. And it was, in many ways, isolating for me because I was so far away from home. I was away from the language. I was away from my grandfather who lived with us. So, you know, that physical proximity was-- and not having that really had, I guess, I didn't anticipate that. So there was times of loneliness and a sense of isolation from that. You know, as far as the academics, it really is a marathon. You know, anyone who studies in medicine will know that there's many hours spent studying. There's many hours on the wards and clerkship. So those in themselves, like I say when I say their marathons, you are left physically and mentally exhausted, being on call, and having, you know, difficult cases, and being exposed to those things for the first time. The hands-on training, the procedures, all that, you know, it's a very steep learning curve. So I think at times it felt overwhelming, you know. But thankfully, I was in a time we didn't have face time. We didn't have Zoom or anything like that. So it was lots of phone calls. And it was also a time where I learned resiliency in a sense. I was able not having known anybody when I first got out there. I quickly made friends. And I think it's the shared experience of that toll that studies take on your mind and your body, that you bond with those that you're around. So I actually made some very good friends who I still keep in contact today. And I consider them some of my very good friends, and some of my very best friends. So that was my experience being an Indigenous student. Whenever there were some aspects of the social determinants of health and such, there was often talk about the Indigenous experience. But the people telling us about this were not Indigenous educators. So they would look to us oftentimes for reassurance that we were getting it right. So it kind of put us on the spot, which in a time when you're trying to blend, that made it a bit more challenging. So that was an interesting experience in itself. But again, you do learn what your challenges, they bring you strength, I think. So that's what I felt as time developed. I was able to sort of find in myself that I didn't think I had in terms of my own internal resources. And one of the experience that I can say-- and I wish I could say it's changed. But there was a lot on the words of subtle, and sometimes overt racism against Indigenous people. So that was a very uncomfortable experience and experiences at times. And I just remember my dad telling me, even when I was younger, you pick your battles. And when you're going to speak up and when to stay silent. And there were times where I thought, I'm just a lowly medical student. This to me is a very insensitive comment. But how do I say that without repercussions or fear of punishment? And so for a lot of times, I didn't say much. I would say some things. But as time has gone by, I think you develop layers of protection. And I liken it to a metaphor of an onion. You get these different layers of protection. And I think that's what I had started-- that was what I started to develop in my experience. So when I say good and bad experience, in terms of good experience, the University of Alberta for me was an amazing place to learn about the human body and how beautiful it is and how amazing it is from the scientific perspective. In terms of a bad, which I think, if you look at silver linings and clouds, there was something good that came out of those bad experiences because A, it gave me a voice. And B, it showed me that I had something to offer. You get intimidated. Many people have what it's often described as imposter syndrome. I shouldn't be here. I'm not good enough to be here. And I mean, as indigenous people, we've heard that probably our whole lives about as being citizens of this country and being on Turtle Island that we're not good enough. So it wasn't a feeling that I wasn't completely on a custom too. But in terms of medical school, I thought that very thing was very much a feature for me. But when I say the silver lining in terms of the bad experiences that, as I said, A, it helped give me a voice. And B, it helped me realize I did have something to offer and that I did see a place for myself in the future as being an educator. In terms of being culturally safe, being culturally informed. So that is something that I took away from those experiences. We watch for that. You mentioned your father. So you're in a unique situation. Your your late father, Ron Wakakishik, was a well-known traditional healer. Can you share what that experience was like growing up with someone like that and your choice to pursue a medicine? Sure. So yes, as you say, my dad was a traditional healer. And when I was a young child, he was still in his learning stages. So we were able to see what he was learning kind of indirectly. He wouldn't share with us directly what he was learning. But you could see the evidence of it by all the plants and all the medicines that were hanging in our basement and the things that he was talking about. And all the people that kind of came in and out of our home and his travels. Because he had many teachers from out west. So he was traveling a lot. And so I was able to see that. And we would have ceremonies at our house sometimes. And we'd as kids be recruited as helpers at times for helping him in ceremony. And my dad's model was always keep it simple. So the ceremonies were direct to the point. And the one thing that I think in terms of his healing is it wasn't that vastly different than what a physician does. Because essentially, he was on call. And we talked about being on call, being available for a case or an issue or a problem that somebody brings to you. My dad was on call. So we would have people come to our house at all hours. And you're sort of as a child in the background and seen but not heard kind of thing. But many times, he'd do his medicine and ceremony with people that came to him for help. So you saw the protocols. You saw what was done. And you were sort of gently reminded of what not to do. So that was one thing. And he would share with us all this medicine. People think is a weed. But it's actually used to help with infected wounds, for example, just in your backyard. So we grew up sort of learning about that indirectly. My grandfather lived with us as well. And so the lucky part of it for my siblings and myself was that we were exposed to the language. And because our grandfather, like his preference was to speak in our language in Shnaba and when. So we were around that a lot. And so one of the things that I, one of my clear and fondest memories of my dad in his role as a traditional healer, was when he would sit and he'd ask the creator for help. He would do it in the language in prayer. And that is one thing I say in all these years that I've passed since he's left us is that what I miss the most is hearing that request and assistance for help in the language because it was so musical. It was in itself soothing. And I've come to realize that those words themselves are medicine because they brought a sense of calm to the people that were there. And so that's what I miss the most. It was so, if you were to listen, you would think that he was saying one long word. That would be several minutes in length because it was so fluid. And I think just by the cadence of those prayers, it really brought a sense of calm. And I came to realize that that, to me, was the essence of what he was doing to help people. So that's something that, like I said, I miss. But I do hear it periodically in some of the traditional healers that I've encountered in the meantime. But people used to say to us, you must argue all the time with your dad, being trained in the Western medical model in him as a traditional healer. And as I mentioned in a few times before, that was never the case for us. We used to have these long discussions. And again, you take for granted in the moment that these are times that you don't get back. But I do reflect on those conversations a lot, especially in times where I feel where I need some spiritual fortitude. I think back to what our discussions were and the nature of this work. He used to give me advice. And I think he learned that from his own experience as a healer, because if you're comparing and contrasting Western and traditional medicine, there are similarities being on call, having people depend on you for help. He could understand that piece very well when we would have the chat about that. There weren't, at the end of the day, that many differences, though, when you think about the ceremony and the protocol, well, there's protocol in Western medicine, as well. When we do, for example, biopsies, you have to have what's called a sterile field. So you have the equipment, you have it all laid out, and you have to do things in a stepwise manner. That's not that different than what's done in ceremony. So that was one thing we came to realize is actually not so different. There is your protocols in both. But in terms of the differences, though, in terms of when we had our discussions, the difference is with Western medicine and traditional medicine is that in Western medicine, there was not that much focus on spiritual. And I think it's probably many reasons, but one is you can't measure it. You don't have quantitative data on how to measure that. And I think that's where the traditional medicine really comes to show its strength. And when we talked about working together one day, and that was a dream that we both suffer ourselves, is that he would deal with that part of it in the emotional part of a person, whereas I would deal with the physical-- but having an understanding that those are equal and equally powerful aspects of health. So we used to have talks about that. When my dad was not well, he took all his work, and his own issues, took a physical toll on his body. But his spirit always remained strong. And he sort of accepted whatever fate would have for him. And that wasn't itself a lesson. But it also taught me, too, that as a provider of care, that you also have to be really mindful of your own care, your own spiritual and physical health. Because when you give too much, you don't have anything left in the tank. So you have to be very careful to balance that. And so that's always-- that's been a challenge. And he did say to me, as he got sicker, that that would be an ongoing challenge for myself. But he did say, you know, travel. See as much as the world as you can while you still can, so that the end of the day, you have no regret. So these are things that I'm so honored and blessed when I reflect back on those times when we had a chance to visit. Because in times of weakness, his words do still come through. They come through in feeling. They come through in these remembered phrases that he would say to me, things like, keep it simple. But he's also-- the lessons over time have helped me realize, for us as indigenous people, there's many-- when we talk about our language is disappearing. Our traditional healing practitioners are also disappearing. I think a part of that might be that, if we look at our language as medicine, and we work at restoring that, that strength of that language in our people, that brings back a medicine. So-- and I'll give you an example. I do have in my practice some people that see me, that do still speak the language. And the experience is different. And this is where Western and traditional medicine differ, because I feel like it's a hybrid. When I say language is medicine, when somebody comes to see me and they speak in the language, and the one thing that people will observe that are on the outside of the room is that there's laughter. There's a level of comfort. And I think that translates. When you measure somebody's blood pressure, just as when we talk about Western medicine, they come in and have their vital signs checked. People are very nervous to see the doctor. And you'll notice that by their blood pressure is being elevated, or they're anxious, or they're tense, because they're unfamiliar. It's a clinical four walls. It's a clinical world. The smells, the sights, and the topics of discussion are intimate. So there's a lot of anxiety that comes with that, especially for if you have trauma in your background, where it distrusts in your background, your vital signs are going to reflect that. So that's the physical manifestation of all that trauma potentially. But when somebody comes in and they know they can speak the language, you can see the body language change. There's a relaxation. There's more of a sense of trust and comfort. And again, laughter. We talk about laughter being medicine, and it truly is. So you go back, and at the end of the visit, if you do the blood pressure again, you'll notice it's come down. And I've had colleagues say, there's so much laughter coming from your exam room. What are you talking about? If it's something serious, a person's come to see you, but what's so funny? And it's not laughing at a person. It's laughing with them. They tell you funny stories, or you tell funny stories. And that really, I think, opens up that rapport and that trust level. So especially with our own people. And for me, it's such a gift because I learn new words in terms of anatomy, in terms of the description of symptoms, I learn new words. So I think it's a mutual education. You're talking about something in the medical education curriculum that's called cultural safety. And I think what you're describing is something that existed even before that term arose. I wonder what your thoughts on that and why is it important for an education patient, based on all of what you've described. Can you elaborate on why that's important for Indigenous patients? I think that cultural safety is extremely important, especially when we're dealing with our Indigenous people. And I think part of that necessity is that you need to know, providers need to know what the history is of Indigenous people. And we know our history. It's not up to us to educate people, because if you tell somebody they have to learn something they want, and we see that, that's every day, that's in everything, not just on this topic. I think that we know our history, and there's assumptions on both sides, right? So we're assuming as Indigenous people, that non-Indigenous people know what we're talking about, and non-Indigenous people make assumptions about us, based on our lack of knowledge of our history, I think. So as far as that education piece, I think it's really important, and I've said this before, people are dangerous when they don't know what they're supposed to know. And there's danger in making assumptions about our people. And I think that's a big one. I want to come back to, you mentioned earlier, that you interact or you engage with traditional healers at your end at the present, but also the fact that your late father did collaborate. So he's a bit of a pioneer in this area with Dr. Jack Bailey. What are your thoughts on that, that collaboration, and what's needed for that to work, that collaboration between traditional healing and medicine, and you know, your dad was collaborating with the late Jack Bailey, who was a physician on Manitoulin Island, on research, on traditional healing, and things like that. What are your thoughts on that? I think that the boundary between those two worlds needs to drop away. And I think that starts first with education of the other, in terms of practitioner. So in my dad's case with Dr. Bailey, that wall came down where they realized they could work together. And I think that doesn't happen now because we're all encased in our own separate worlds, and never in between shall meet. So I think there are some physicians out there that are interested in what we do in our ways and our traditional healing people, but there's still that distress. And I think that comes from a lack of understanding of what that other practitioner does in their work. So my Western colleagues, you'll see, they'll say, oh, they're taking this herbal medication, but I don't know what it does. So I can't comment on it. But instead of saying, you know, I'll look into it or I'll find out what the active ingredient is. They'll just say, I don't know how this works. And sometimes they'll give the advice that they should stop taking that medication and vice versa. And so it's a parallel communication, I think, between those two types of practitioners. And I think that it's time that they start listening to each other and extending the proverbial olive branch across that aisle to each other. Because I really think that what power can be had in terms of helping somebody by understanding that they can be in truly complimentary. Because when you look at it, all of our medications are based on the natural world, plants and our elements. That comes from mother, that comes from Shkukumakwa. And I think if the Western, I mean, obviously, it's been modified, you know, in an unrecognizable form. But when you think about aspirin, you know, coming from the willow, the willow trees, that's the most basic of examples. But you can see that there is room for both. So when I think of just that wall of distrust needs to come down a bit more, and I think a lot of that comes from a cautious interaction, a cautious mutual opportunity for education. And I think they both, there's a place for both. And I think that if we can get them together more often, or if there's opportunity to get together more often, I think either side will see just how helpful that can be to a person, you know, if they have their providers, whether they be traditional healers or Western practitioners working together, just imagine what that would do for that person who's seeking that help from those two practitioners. That only serves, I think, to be able to fortify them and to make them stronger people, you know, both from a physical sense in terms of physical conditions, but also from the spiritual sense that they would get from the traditional healers as well. The medicines that we use, like, or traditional healers, that's just a small part of what makes someone well. And I think that's where Western doctors think that it's all about the plants and these unknown combinations of medicines. That's what gives a certain level of anxiety. It's just 'cause they don't know what's in these medications or what's in these preparations, right? But that's just a small part of what traditional healers do. So I think if there's more understanding on what the other does, then hopefully, I mean, it may be too optimistic to think, but maybe that would help give them opportunity to work together and have open dialogue. - Mm-hmm, so, you know, on this topic, how do you think that would look like? Let's think about, you know, maybe a future where traditional healers are part of the formerly part of the medical system in Canada. How would that look, do you think? Like, how would that, as a practical way forward? How do you see that working in terms of, you know, or would they be right in the clinic with someone like you or would they be, you know, specialists on their own? How do you think that would look? - You know what? I think they would be really more specialists on their own because you can't do healing. Sometimes with four walls, four white washed walls that smells of disinfectant, you know? And as I said, when a patient comes to me, right, they see the sights and smells. That's not a place of comfort. So if you're looking for somebody who needs spiritual help, you want to have them be in a place where they can still connect to Shchukumakoa, like to the environment, the earth. I think that, you know, when you work with traditional healers, it may just be a communication. You know, if we're going to be contemporary, maybe there's a people that have the electronic medical record. If there's a space where a traditional healer has access to put what they did, if they can't talk to the practitioner directly, maybe there's something like that. Or, you know, have a sign a day a week where you're spending an hour talking about a mutual person saying, this is what I did. This is what I suggest. You know, there's, I think there's other ways to do it. And I mean, obviously you got to be practical as well. But I don't, in terms of a physical space, if I was to have any kind of dream, it would be to have one building that has a garden in the back, a healing lodge in the back, that people can go, you know, like they come into the building, they can go right or they can go left in the traditional healing space. And then the other side is the Western healing space. So that would be, that would be really nice. But in terms of what's available now, you work with what you have. If that means that, you know, the traditional healer is off site and has their own sacred space, I think that still should be an option. But ultimately, that would be really nice to see, you know, 'cause my dad had that very vision. And as I mentioned, that was the physical layout of the health center in Wichimokong, 'cause the healing lodge is front and center of the building. So, and then the Western doctors work in the towards the rear part of the building. So something like that, but on a bigger scale, that would be awesome. - We focus quite a bit on, you know, the past and this visit we're having. What about the present for you? What's it like being an indigenous physician? What are some of those, you know, maybe challenges and rewards that you face in your practice? - As far as my place in this moment, in this time, I'm working at, as I mentioned, an indigenous family health team. So here on Batchewana. So I have the majority of my patients are indigenous people. So that to me and itself is a gift. So in a sense, I've really come home. I'm not working in my own home community for various reasons logistically. It's my husband's from this area here. But as far as working in this environment, it's been tremendous. It's such a positive experience for me and the organization that I work for, like, in terms of the mom-westing Ontario health team has been very supportive. They've really supported me, I guess, in the endeavors that I have outside of clinical practice and seeing my own people coming through the clinic has been in itself a huge reward because that's really why I went to medical school. I've, in the past, had some negative experiences with interactions with the Western medical model as have family members. And so I thought, this is what I don't want to have happen. This is what I don't want to do when I'm interacting with people coming to me for help. And so working in this space allows me to do that. And again, as I say, being able to speak the language in language is medicine. And I mean, maybe I'm being selfish by saying this, but it really helps me as well. I've left happy in terms of job satisfaction. That is the top of my list is being able to work for my own people. As far as challenges go, it's trying to, I think the biggest one is trying to break down some of those systemic barriers, trying to work through systemic racism, access to care, which is, for all citizens in the country, is a challenge to begin with. But it's even more so for Indigenous people. And there's many, many reasons for that. And just dealing with assumptions, dealing with, again, like I say, lack of access to care, limited resources, a high administrative burden. And these are not things that are unique to just being an Indigenous physician. This is all physicians. There's much expected, but with less to work with. So we're all challenged by that. So that's a big challenge. But really, it's trying to get Western colleagues to accept that traditional healers have a place. They have legitimacy for our people. And working with institutions, the tertiary care centers, I think there's work that's been done on cultural safety, but there's so much more work that needs to be done on that piece. Because you only need to see an example of somebody who refuses to go to the hospital, because they have to wait, yes, but so do all Ontarians, because lack of resources. But they don't want to go, because they say they're going to be mistreated because they're Indigenous. And it breaks my heart to hear that. Because I have patients that come and see me, and they're so sick, they're so ill, or they've got medical problems that need to be addressed acutely in an emergency department, but they won't go. Somebody comes to me with chest pain. They won't go to the hospital because they will say that they're going to be mistreated. And that's heartbreaking. And I think why does that still happen? That's not change since even when I was a medical school, and probably before that, that's heartbreaking to hear. So there's still much work to be done at the tertiary care centers or the higher institutions outside of primary care. That's a big challenge. I'd have to say. Our visit today is coming to an end here. And I wondered if you had some final thoughts to share, maybe something you haven't had the chance to say that our listeners, you think our listeners would need to know? Yes, I think one thing we need to all appreciate every person is that we all have gifts. And if that one of those gifts is learning, then there's nothing stopping a young person from aspiring to be a physician, from aspiring to be a traditional healer. Because I think those two paths are callings. And if you have those gifts, like please use them, we need people to carry on this work. We have to look to the future. And our young people have all these negative messages, this messaging to them that they're not good enough, they can't be what they dream to be. And I don't think that's true. You need to have those people out there to encourage and lift them up. And if that means the lifting up comes from the people in professions. And it doesn't matter what profession or what calling you have, whether that's a plumber, electrician, an x-ray technician, lab technician, anything, those of us that are in those fields need to be encouraging and fostering those gifts. Because everyone has them. And I think that it would be sad to be at the end of your life with regret. And that was the one thing that my dad did say to me, he goes, don't, at the end of your days, sit there and have regrets. And I think if the one of those dreams was to be a doctor or to be a traditional healer, don't have that regret, do it. There really truly isn't anything stopping you, except your own fear is perhaps. If you can find somebody that helps you overcome those fears, I think you're going to be on the right path. Dr. Wauke Gijig came to me to watch for sharing your wisdom with us today. And how many, which? Thank you for listening to this episode that featured Dr. Andaline Wauke Gijig, lead physician at the Wauke and Family Health team in Batchewana First Nation in Northeastern Ontario. The next episode will feature respected Mikmau Elder and co-originator of the two-white scene concept Albert Marshall of Eskisoni First Nation in Nova Scotia. If somehow we can create a network, I'm close to close with our Aboriginal brothers and sisters. To agree on certain objectives, I believe only then we will see the benefits of how and where our traditional knowledge could be instrumental of guiding people so that their actions will not impact the next seven generations. Thank you for listening to Indigenous Medicine stories with your host, Darrell Manitwabi.