[dropcap]I[/dropcap]f I were to write about all the impressions that filled my mind or of the interesting people I met or of all the strange situations I encountered around Shiprock; it easily could fill a book. In the editorial meeting for this issue of the RHQ and the topic of tribal health was discussed, my mind was flooded with memories my time spent around Gallup, New Mexico and the four corners region. One feature of those seasons of life was around Shiprock; which to me is more than a geological anomaly. It is that; a massive rock that juts up 1500 feet above a flat plain that can be seen for miles. The geological term for that phenomenon is a monadnock, a rock that has been weathered over time so that only the hardest most resilient stone remains. A feature as enduring as the quality of my time there.

As legend has it, the Navajo people on whose land the rock resides, were brought to the four corners area by a great bird. A loose translation in Navajo is something like, “Winged Rock.” As I approached the area, on Highway 64 out of Farmington, the ice in my giant cola had not fully melted into water, when I could see it on the horizon. It reminded me of a great schooner far out to sea. I had seen something akin to that once when I had come up from Van Horn on the way to Carlsbad where El Capitan rises up in the northern most reaches of the horn of Texas. I thought both memories were fitting considering that I was feeling like a pilgrim at that time in my life.

I had just finished training as U.S. Public Health Service Fellow and particularly liked the component that prepared us to be Epidemiologic Intelligence Officers. I thought that training was near perfect for my interests and the thought of being a member of a specialized team that investigates epidemic outbreaks appealed to my sense of adventure.  It was anything but ordinary work. While I was too young and full of myself to worry about things like what my Dad called needing a “good paying” job, what thoughts I had along those lines were tied up in being a member of the U.S. Public Health Service Corp. There was only one problem with that, the Nixon Administration had decommissioned it about the time the military was being downsized after Viet Nam.

There were many “old salts” that were scrambling for the relatively few civilian positions that were available. So I took what I could get. As one Chief Petty Officer proclaimed, “sonny boy, your best bet is in the middle of nowhere”. He was right. I was headed for at best a two-year posting in Gallup. Then I would need to figure out what was next in my life. It was a place where I knew no one. It was a long way from home. And like the theme of a country and western song, my true love had dumped me; in my case not for another guy rather for graduate studies in another state. My Dad summed it up pretty well as he set me on the journey. His words went something like, “I’ve been in your position; only difference is where I was going they wanted to kill me.” He was departing for war and I was going to the land of Shiprock.

He went on to remind me, “…practice being half as smart and twice as tough…and you’ll be okay in the end.” That was my state of mind when I pulled into town that hot July afternoon. In those days, the main feature of town was the Indian Health Service Hospital and some other government buildings to support the people assigned there. It was a sleepy desert town where Soviet-style architecture seemed oddly fitting since to me it felt like a kind of gulag.

Looking back with the perspective of a career nearing its end after almost fifty years, some of the best times and life lessons came about in the land of Shiprock. The most important for me is simply this; not having a plan doesn’t mean that there isn’t one if you are willing to accept that opportunities may not look like that at first. Careers have trajectories and if one can think about how to fit what you know to a need then you can find a world in need of your service. There will be interesting people you meet along that way.

“You are never alone here, but you must look longer to see.”

One such person was a Navajo man named Jo. His name came from a syllable in the spoken phrase which when translated to English is the phrase, “remembering the loved ones”. Written it would look something like, Ayoo’ adajo’ ninigii Beedahahaniih without the stress marks over vowels. But enough on the linguistics, as the story of Jo is much more interesting.

Jo was relatively tall for a Navajo man of his age. He was lean and his skin was brown and he had classic features of his people. In that era, most Navajo people did not talk much to people like me. I don’t think they were unfriendly as much as their culture and traditions are not based so much on words as on actions. Trust is important. The communications that matters is in looks, the subtlety of which develops over time and mostly outdoors in very inhospitable conditions. I had seen Jo around the hospital and once in a neighborhood in Gallup where some patients stayed when they came for care that extended over more than a day or two. That area of town was replete with old mobile homes and traditional round houses with their doors oriented to the east and west to catch the first and last lights of the day, and a few shacks that made no sense in any culture. That area was off limits to active duty personnel.

One weekend when I had had enough of doing nothing in Gallup, I decided to go out to the sacred mountain and see what I could find. I was told how to go around to the back, away from the side easily visited by tourist. I parked and started up the foothills following along what looked like a footpath. I realized quickly that it was just where wind and on rare occasion rain had made a way down to the bottom. It wasn’t an easy climb, and the brush and thorns that populated the area gave refuge to all kinds of odd creatures and some rattlesnakes that seemed only wanting to be left alone. I had managed to climb to a kind of ledge that gave me a perch to survey the vista below and to provide a brief respite to catch my breath. It was shaded and I was surprising how much cooler it felt out of the blazing sun of that morning.

That ledge was a great place to appreciate how bored I was when I wasn’t working and, yep, in the middle of nowhere. I sat there a good while, feeling pretty lonely. It was somewhat amazing to me that an entire nation of people could make this place home and even prosper in such a harsh environment. I could see from the stark landscape how they would be stoic and appear so remote. I could see how they might even resent having intrusions into their space and their solitude. Even still, there was something appealing about the solitude. I don’t remember why, but after a while I was aware that I was not alone on that ledge.

It was an uneasy feeling. When I climbed up to perch there I didn’t notice much as my goal was to get to the ledge without falling. As I looked around to my left there were but a few inches before the ledge played out. As I looked to my right, I could see that, except for a small outcrop of rock, the ledge went around and appeared to be broader. Sitting there leaning against the outcrop was Jo. He was looking at me but did not say a word. Oddly, I did not think that was creepy nor did I feel threatened. It was more like two people sitting in a pew at church, both there to experience something more, united by a common purpose, but not feeling the need to talk. I nodded to him, again like in church, while we gazed out over the landscape below for several minutes. It wasn’t that I didn’t wonder what he was doing there or whether he had been there when I climbed up or what to do next. One thing was certain, I didn’t expect he would be any more likely to speak to me on that ledge than he was in town. So I sat silently, wondering.

He did finally speak. He said, “We are not alone.” That surprised me. I knew that much!  “Look behind you,” he said nodding toward the rock face behind. I thought; ‘to see what – a rock face?’ but I did look. There were cracks in the rock but I could see nothing more. I looked over at Jo. He nodded again and said, “Look longer.” I did, and then I did feel creepy, as there was something in most of the cracks. Movement was what I could discern, but then, I could see tiny eyes. Jo said, “it’s na’asho’ii. We call them ‘grandpa’.”  One plopped on the ledge and I jumped a bit. I knew, ‘grandpa’ back home in Texas, but we called them horny toads. Jo smiled and I smiled. It was the first time I had seen him express any emotion. Many years later, we would recall this moment as students at the University of Oklahoma in the School of Public Health.

We sat a while longer, and then just like that Jo was gone. When I was back on level ground, I began to make my way back to where I started. Soon, Jo was striding along with me. He definitely knew how to make a silent entrance and exited the same. He said only one thing as we walked that day even though we had many conversations since. “You are never alone here, but you must look longer to see.” We parted company as my path led to my car down a slight rise and he went another way.  I never saw him in a car back in town; he seemed to walk everywhere.  When we did meet, communication was always with a look or a nod which became so nuanced as to be our own language.  One thing for sure came of that day, I began to look longer at more than just cliff faces, real enduring relationships are built on communications and much of good communications isn’t spoken.

My time in the land of Shiprock ended much sooner than I expected and very little of it was spent alone although I probably talked less in that season of my life than ever before or since. Many people that know me would say that is a good thing most especially Jo.  He had become my friend and as it happened was a community liaison working for the hospital. Jo, knowing how I had talked so much about my esoteric training in disease outbreak investigation, revealed his concern for some of his people that had all had a similar illness that led to the hospital. I recall what he said: “We know this illness from my grandmother’s generation, but we have not known why it afflicts only some of us and only then when the creeks run with water.”

This led to an adventure that could have been fatal and proved that what I knew might have saved lives even though I thought it was nearly useless in the practical world of work. The people, according to Jo, had all come from a village in the Four Corners area. All arrived with flu-like symptoms and high fevers and all but one young woman had survived and returned home. My boss, knowing my training, agreed to allow us the use of some sanitary suits, respirator mask, and related gear. A couple of our bio-lab crew members were up for a break from the monotony of daily routine and away we went.

Except for Jo, it was the first trip that I had made into the reservation lands. There really weren’t towns, more like little clusters of traditional houses, doublewides, dilapidated shacks, and camper stacks that weren’t any longer in the bed of a pickup truck. Everything other than the traditional houses were faded and worn and looked run down and old. Even a few newer houses soon faded in the desert like conditions of that region.

When we arrived in the general area where most of the patients lived, Jo took over and led us from house to house. Often, we’d follow dirt roads until there was a house with people, and then we’d stop and ask questions and talk. This went on for a few days with us living out of tents and camping over the nights. We always seemed to find a way to have some fun. Jo told us that many of the people wanted to know why some got so ill, but it was clear it was more a curiosity than a worry for them. After all, they had lived with this type of thing across generations.

The day that we found the house of the woman that had died we recognized it by the way it was left. Jo told us that in Navajo tradition, the front and back doors to the house had been left open, a gesture to allow the spirits to come and go. It would take time after the burial and the doors would need to be removed before the next woman to own the property could come and sweep it clean. In the Navajo custom, women own the property. It would be known that the house had passed to the next hands when new doors had been installed and the spirits would be welcome there no more.

We were there at the right time as, technically, the house belonged to no one in this world yet because the doors were not new. So we began to investigate. I had brought the usual gear for that – sanitary suits, respirator masks, eye covers, gloves and the like. Once we were garbed and taped, all air joints were taped, we had about 30 minutes to work before our body temperatures would raise above a safe level. Disrobing those garments was another process to avoid contamination, and so from start to finish it was about an hour of mostly being really hot and sweaty!

Dressed like space aliens gowned in white suits, we took samples of dust, mouse feces, cobwebs, corn, and the list could go on for pages. Everything that might possibly be a causative agent was bagged and logged and properly stored. We then set up our dousing station and washed the suits and followed all the other disrobing procedures. Even though the team was coed, we all stripped down to as little clothing as possible, while upholding personal modesty, to cool off. It was late in the day when we cruised down the road back to Gallup. We were all very grateful for air conditioning in the car, although we did not appreciate yet what an adventure we had had.

It was weeks later when the news came. The analysis of our many samples had found one thing that was interesting, a viral strand; it was likely that it came from Hantavirus!  I remember studying about an outbreak during the Korean War in the early 1950s. Flu-like symptoms of pulmonary disease with renal syndrome that characterized the deaths among the 3,000 troops that became ill. It was later found to be associated with a virus common in some kinds of mice. In Navajo land, it was the deer mouse that was the culprit. People were exposed when the droppings of the mice that carried the viral fragments were aerosolized, as would be common when sweeping during spring cleaning. Jo and I would later learn in an epidemiology class at OU that the virus was common in deer mice when there had been abundant rain in the Four Corners region and lots of food that led the mice to have larger liters. As if to confirm the custom of leaving the doors open where deaths had occurred, we learned that the virus survived only briefly and was killed by ultraviolet light; the light from the sun that shown through from the east in the morning and the west in the afternoon. It was a study in how such things might be learned over the course of many lives to become traditions and customs of an aged and wise people.

So my dear reader, read well this issue of the RHQ.  You may not know what you will learn but there will be something here for you. If nothing more you might remember this – be half as smart and twice as tough, there is a plan even if you don’t yet see it, talk less and look longer, and be grateful for the memory of the friends that remind you that you are never alone.

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