Community Wisdom


Community Wisdom

Walking in Balance with Indigenous Cultures

By Tai Mendenhall

May/June 2021


Nan LittleWalker never formally signed up to be one of my teachers. In fact, I first met her as one of my colleague’s patients. Several years ago, during my doctoral training as a therapist who specializes in working in medical settings, I interned at a small family-practice clinic in an old strip mall in a low-income neighborhood on the east side of Saint Paul, Minnesota. The clinic served a diverse clientele of Black, white, Hmong, Somali, Karen, Thai, and Burmese patients. Most were on governmental assistance. Many lived in public housing; others were experiencing homelessness. As the only onsite mental health trainee, every day I felt a combination of excitement, anxiety, camaraderie, and isolation.

Some of my time was structured in ways familiar to conventional therapists—50-minute visits in a comfortable private office—but most was spent running from one exam room to the next, supporting medical residents in calming angry patients, completing mental health assessments, and adding compassion to the delivery of bad news, like when a pregnancy wasn’t viable or a patient had tested positive for HIV.

Nan was in her 60s and small in stature. On her intake form, she’d marked her ethnicity as Native American, and she and her aunt were the only Indigenous patients I’d ever seen at our clinic. She’d been diagnosed…

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