“From the beginning I knew I had to do a similar thing with the strands of my story—to tell how a girl from a small and remote town on an Indian reservation was able to become a surgeon, able to work in the high-tech realm of a surgical operating room, and combine that with another story, about how ancient tribal ways and philosophies can help a floundering medical system find its way back to its original mission: healing.”

This passage summarizes the two primary purposes of Lori’s autobiography. The first is for her journey to serve as inspiration to minority groups, especially Navajo girls, so that they know they can do anything, even in a career pathway previously closed to minorities. The second is to argue that western medicine needs to integrate elements of Navajo healing practices in order to realign itself with its central purpose: healing. These two strands initially seem like they don’t go together. As Lori notes, “Navajo female” and “surgeon” are not words typically found together. Yet, it is possible for a minority woman to pursue her dream and change the medicine world for the better.

“But from her we saw what it meant always to be slightly outside a culture, somewhere on its margin, in a place where we could not completely belong. We learned what it was like to feel peripheral.”

Lori’s mother was white. While their Navajo neighbors and friends grew to love Lori, there were still cultural and language differences that separated her from the majority Navajo group on the reservation. This challenge extended to Lori and her siblings. They were from two worlds, and because of this, felt like they never truly belonged to either. Lori notes the irony of their situation. They felt peripheral to a group that was itself on the periphery of the broader American culture. 

“Living between two worlds and never quite belonging to either, I have learned from both.”

During her childhood, Lori struggled with living between two worlds, yet this is what allowed her to be the best physician that she could be. She learned technical and clinical skills through traditional western medical training. When she found this training lacking, especially when it came to communicating with people, she was able to turn to her Navajo beliefs and concepts. She realized that the best form of medicine would actually bring together western medicine and Navajo healing practices.

“To leave this place is to invite imbalance, to break our precious link with the tribe, to leave the Walk of Beauty, and to court danger. It was a dangerous step, that into the unknown, unguarded world.”

As Navajo teenagers graduate from high school, they must make a critical decision: leave the reservation to get an education or stay on the reservation and stick to the traditional ways. This passage exemplifies this fear of leaving. Going to college means leaving family and friends behind, breaking their support link. They are entering a world that is unknown to them and often their parents. 

“The college’s unofficial mascot was the ‘Dartmouth Indian,’ a tomahawk-wielding red man whose presence was everywhere on the campus, in spite of the Native community’s protests.”

The ways in which Lori and her sisters were instructed to live and the beauty of the Navajo culture starkly contrasts with the ways Native Americans are portrayed in the broader American public. The Dartmouth mascot illustrates this contrast. As Lori notes, Navajo people are modest and would not travel around barely clothed. In addition, there is a cultural taboo against touching dead bodies; thus, they would never carry around a piece of a dead person. This image is deeply offensive to the Native American community, yet used by the college as its mascot. This situation illustrates that cruel caricatures of Native Americans still persist in the US.

“Seeing the connection between the two cosmologies, Navajo and scientific, I felt a new passion begin to grow inside me.”

At Dartmouth, Lori struggled with math and science classes, partly because her high school had not academically prepared her for the material. As a result, she thought a career in medicine was out of reach for her. Her first job post-college demonstrated that this was the case. As Lori began to take science classes again, she realized that scientific method and Native American cosmology are more similar than she originally believed. Both focus on the universe’s balance. Seeing this connection reinforced to Lori that she should become a physician.

“I noticed things no doctor would ever notice—such as the fact that the hallways were cleaned by large noisy machines in the middle of the night; my roommate would change every few days and another patient and all their relatives would appear, just a curtain away; strangers were constantly coming into my room, unannounced, without introducing themselves, and physically probing my body. Their hands prodded my body. Doctors and nurses gazed into my eyes, and for the first time I was profoundly aware of the experience of a Navajo person in the medical system.”

For Lori, getting seriously sick in medical school was one of the most valuable parts of her education. It allowed her to see what the experience was like through a patient’s eyes, especially one who as Navajo. The doctors and nurses were violating a number of Navajo cultural taboos around touching, making eye contact, and invading personal space. These interactions would be deeply unsettling for a Navajo person. From this experience, Lori began to recognize the importance of culturally competent care.

“Although I always knew I’d come home, I had not known what it would be like. I thought home would feel like a pair of old, worn-in moccasins, perfectly molded to the shape of my feet, that I could slip back into. I thought Dinétah and I would always be a perfect fit—instantly and instinctually right, the way that the air, dry and clean, scented with piñon and wood smoke, always smells right to me. But when I finished my education and returned home, I found that in many ways coming back to the reservation was as hard as leaving it had been.”

To succeed in medical school, Lori had to adopt traditional western medical thinking and practices. Many of these, however, were at odds with traditional Navajo concepts. In the beginning, it was hard for Lori to establish the right relationships with her Navajo patients. Her experience with Evelyn as well as remembering her own illness at Stanford made her realize that she needed to adjust the way she viewed and interacted with her patients. 

“This would be a very strong kind of medicine, I thought, mixing together the best of both worlds.”

This passage reflects the central theme of Lori’s story. She believes that the strongest kind of medicine is one that combines western medicine and Navajo healing practices. Medicine men help patients realign their thinking to be more harmonious and balanced. By fortifying their spiritual and mental wellbeing, it helps the healing process go more smoothly. If western medicine incorporated the Beauty Walk more frequently into its doctrine, it could have far reaching impacts on the health and wellbeing of many people.

“The physical genocide of the 1800s, followed by the cultural genocide of the 1900s, left behind a tribe whose roots and foundation were shattered.”

Lori illustrates how centuries of trauma from federal policies continue to negatively impact the psychological, social, physical, and economic wellbeing of the Navajo people. Several generations of the Navajo nation have been taught to feel shame about their culture and language. Because of this, many parents do not teach their children traditional Navajo beliefs. To Lori, the Navajo culture should serve as a source of strength and guide them how to live their lives. Yet, institutional racism have disrupted the very root of their culture.

“Ceremonies are magical and powerful things.”

An important reoccurring component of Lori’s argument is that song and ceremony can help to heal people. These aspects don’t appear in traditional western medical practices. Yet through numerous examples, Lori shows the power that they have. Ceremonies usually involve family and community, and include healing chants and gods dancing. All of these elements help to create a positive energy that realigns a patient’s thinking. By guiding their spirit and mental wellbeing back to balance and harmony, these ceremonies also play a critical role in guiding the patient’s body back to health as well.

“My pulse slowed as my mind focused. I envisioned myself walking in the bear’s body, breathing his warm breath, and I began to feel his strength. It is an image I use often to clear my mind.”

The silver bear symbolizes Lori’s Navajo heritage and is her guiding light. During times of stress or isolation, she often envisions herself becoming one with the bear and pulling the bear spirit to her. By doing so, it gives her strength and courage. The importance of the bear spirit to Lori also appears in her child’s name (Kodiak), as well as her wedding present to her husband (silver bear fetish on a necklace).

“As surgeons, we travel to these places on a special visa that makes us invited guests in a secret, forbidden country.”

Many Navajo people are wary of surgery because it can disrupt the body’s natural harmony. This perspective is not one that Lori ever forgot. She always treated her Navajo patients with respect and allowed them to make decisions on when and how to have surgical procedures. For example, she would often schedule surgeries to accommodate healing ceremonies.

“Their medicine was for the whole human creature–body, mind, and spirit, their community, and even the larger world. I had come to think of this philosophy as a gift that could be given by Navajos to the medical world.”

The central tenet of Navajo healing practices is that everything is connected. Because everything is related, the causes and cures for illness also weave into all aspects of the human being and their relationships with others and the natural world. This viewpoint starkly contrasts with that of western medicine, which focuses solely on the body. Modern medicine is at a crisis. Patients feel left out of their care and are frustrated with their experiences in hospitals or at doctor visits. By incorporating this Navajo philosophy, Lori believes this is the solution to this crisis. 

“Odd things occurred almost daily. I decided to relax and be open.”

Lori and the other doctors at the Gallup Indian Medical Center saw rare medical conditions, including the hantavirus, and heard stories from their patients about skinwalkers stalking them, and of bewitching. They had to learn to adjust to these realities and be open. In so doing, Lori also met her husband. He was not someone she originally thought she would date. Yet they made one another happy.

“The two worlds were colliding. The solution lay somewhere in an unchartered territory between them.”

While Lori had grown accustomed to balancing her two worlds, they did occasionally collide. The most poignant example of this is when Melanie Begay desperately needed surgery to save her life, but her grandmother was afraid of what the hospital would do to her granddaughter. In this situation, Lori understood both sides. Her medical training told her Melanie would die without the surgery, but she also sympathized with the grandmother’s objections. Rather than rushing to get a court order to take Melanie from her family to perform the surgery, Lori allowed the family to make the decision. This prevented a cultural disaster and likely made Melanie’s surgery smoother.

“My words hung between us in the air like a dark bird. If he listened to me, he would be going against the ancient Navajo ways, in which the women make decisions like these.”

Navajo culture is a matriarchy, meaning women rule the society. Lori explained to Melanie’s father that she was gravely ill and pushed him to speak up to the women in the family. While Lori is not sure who made the decision in the end, if the father did play a role, then he would have gone against traditional Navajo ways. 

“Perhaps it sounds superstitious to a bilagáana consciousness, but sometimes it felt like the universe was drifting off course and that forces I did not know about were gripping my life. I was afraid there was something wrong with my pregnancy, that somehow I was out of sync with the forces of fertility and maternity.”

This passage illustrates a pivotal point in Lori’s journey. For much of the story, she talks about how she has incorporated the Beauty Walk into her professional life. Through this passage and the remainder of the book, she begins to incorporate this Navajo concept into her personal life as well. It is here that she decides to visit a medicine man, both for her and her baby.

“I’d been thinking about it for weeks. It was as much for my baby as for me. With just a few phone calls and a little research, I had found him. While I had wanted to develop a relationship with a medicine man, I never imagined it would be one where I would be the patient.”

Lori mentions throughout the story that she wishes she could learn more about traditional Navajo healing practices. However, if she were to reach out to a medicine man and ask, this would go against Navajo convention. In the end, she was able to visit a medicine man as a patient, something which she never envisioned happening. This personal experience allowed her to speak to the power of ceremonies and chants.

“Speaking Navajo has many levels, and deeper ways of communicating than speech alone. I was acquainted with only the most rudimentary aspects, but others can hear subtleties of meaning in every sound.”

This passage helps explain how the Navajo language is the cornerstone of Navajo culture. Navajo is an unwritten language and does not have traditional symbols or alphabet. Its syntax is extremely complex, making it unintelligible to people who have not had exposure or training. The Navajo language, like any other language, is central to a group’s cultural identity. Through this passage, Lori shows what the loss of the Navajo language could do to the Navajo people. 

“The songs passed over me, around me, and through me. Beauty was above me, below me, behind me, in front of me. It felt like a cool breeze.”

In much of the book, Lori discusses ceremonies that she has attended for other Navajo people. This passage represents the first time that she has participated in a ceremony for herself. Because of this, she can better understand the feelings and reactions these ceremonies invoke for her patients.

“I could now speak from personal experience about the combination of Western medicine and Navajo ways: It had produced my beautiful, healthy baby boy.”

For the first time, Lori experiences the healing power of both western medicine and Navajo ways. She was in a hospital about to undergo a cesarean section. A medicine woman performs a prayer for her baby. This ceremony calms Lori and appeases her nausea from the medicine she took to try and induce labor. She strongly believes that it was the combination of these two medical worlds that produced a healthy baby.

“Sacred Mount Taylor was where I chose to bury it, so that Kodi would always remember who he was, honor the people he was descended from, and always respect their ways.”

Navajo people bury the placenta and umbilical cord in a special place after the child is born, to represent their hopes for their children. Lori has worked hard to follow the Navajo ways. By burying Kodi’s placenta and umbilical cord on the top of a sacred mountain, it symbolizes her hope that he too respect and honor the Navajo people.  

“I began to understand the importance of establishing the right relationships with my patients.”

In the final chapter, Lori summarizes many of the key themes running through her story. This passage represents one such theme. Lori has fully embraced the concept of “Walking in Beauty.” In her early days as a surgeon, she did not fully understand how her relationships with her patients could impact the success of the surgery. She begins to adjust the way she views her patients after Evelyn’s stroke, recognizing that they too are her family. Her and her patient’s spirit needs to align in order for the surgery to go well. For Lori, establishing the right relationship with her patient will help this alignment.