Health Insights of Oglala Lakota Elders: From Wellness to Illness by Mary Catherine Dennis A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Social Work and Sociology) in the University of Michigan 2013 Doctoral Committee: Professor Fatma Müge Göçek, Co-Chair Professor Michael Spencer, Co-Chair Associate Professor Renee Anspach Assistant Professor Sandra Momper © Mary Catherine Dennis 2013 Dedication For all the Indian people who have come before me and whose sacrifices made this possible ii Acknowledgements I humbly offer gratitude to the elders who generously shared their time, stories and wisdom. You have changed my life in deep and meaningful ways. I wanted to highlight the grace, beauty and life lessons. I hope the younger generations listen closely and carry your wisdom into the future. Additionally, I appreciate the family, friends and community of the elders who assisted in connecting me their loved ones and helped make this project possible. Bobbie Jacobs, from the bottom of my heart, this project would not have been possible without you. You were there at the beginning as we sowed the seeds of this project in your studio apartment in St. Louis. Key elements of discovering the path I was meant to follow include: Korean cigarettes, breakfast burritos and the kittens – George & Charlie playing at our feet and Myrtle sleeping nearby on a pile of articles. You have supported me from the very beginning, never wavering in knowing what this could be. I always worried about the wrong things; you were always there to assure me that things were just right and to keep going. Also, you have shared your home and your family, which was my soft place to rejuvenate as I moved through the program. To the rest of family: Tom & Wes, Tell, Trevor, Boo Boo (Bruce), and Sis (Taylor) & Poppy (Mataya). I love you guys. I have appreciated the camaraderie, the teasing, and the adventures. Always reminding me what is really important and not to take things too seriously. Poppy was in the womb and born during the transcription and writing portion of this dissertation. I was fortunate to welcome you into this world - thank you sharing that special moment with me. I have so much to tell you about your elders, I can’t wait. To my inner circle – you folks have been on the ride - Matthew Crawford, Sarah Manaher, Rosalyn Campbell, Tor Parker, Karla Washington, Regev Nathansohn, and Briggett Ford. There are not enough thanks in the world. I hope I can repay you for always being there with love, laughter and support. Your reassurances were essential for reaching the finish line. We can all raise our hands in victory, it’s finally over! To the Committee: Fatma Müge Göçek, Chair. Müge, we were an unusual match. I have appreciated your mentorship, support, confidence in my abilities and seeing in me what I was not iii always able to see in myself. You have held my hand, celebrated my victories, analyzed the defeats and helped me keep it moving. You brought out the best in me. Thank you for understanding my elders and helping me to bring to light their grace and kindness. Michael Spencer, Chair. Mike, you have always been there when I needed you – for the good and the bad. I appreciate all you have done for me and I’m grateful. Your kindness has always been appreciated and was much needed along the way. Renee Anspach. Renee, you have always been a source of positive support, offering insights into my scholarship and highlighting my contributions. Your calm energy, accessibility and support of students have been appreciated, especially in the early years as I made it through the prelim. Sandra Momper. Sandy, my fifth Beatle. How we’ve grown over the years! We sort of figured all this out together. Thank you for opening your books to me as we developed this partnership in research and publishing. You have been my PR representative while I was on the reservation. Having a faculty member who understands the rez has been a breath of fresh air. You’ve been there for me in a pinch – helping my grant to make it to completion while I was away and moving from the shadows to formally being on the committee. Thanks for the support, the friendship, the meals and always being there no matter what. Hold my seat at Knights. There are people along the way who have made the journey lighter and more interesting: Sara Crider, I love your sense of humor and have enjoyed being on this path together. If only Ben Folds knew how he got us through Stats! Lorraine Gutierrez, I affectionately call you our Mom because you were the doc program director, herding us along the way. You were there at some of the darker moments. Many, many thanks for your calm presence and advice. Kris Siefert mentored my first publishing experience and offered a solid foundation in health disparities. Shirley Petersen, you offered insights on the reservation from an outsider’s perspective. I appreciated the s’mores and friendship while we were on the rez at the same time. I am certain there are folks who are worthy of being named and these acknowledgements could go on for pages and pages. There are many people with whom I have crossed paths, enriched this experience for even a short time and those moments and people are not forgotten. iv Table of Contents Dedication…………………………………………………………………………..ii Acknowledgements…………………………………………………………..........iii List of Appendices………………………………………………………………....vi Chapter One: Introduction………………………………………………………...1 Chapter Two: Identifying the Population, Constructing the Theory and Developing the Methodology………………………………….….33 Chapter Three: Physical Health and Lakota Older Adults: From the Past to the Present………………………………….….71 Chapter Four: The Mind, Mental Well Being and Lakota Elders…. …………...102 Chapter Five: Spiritual Health and Lakota Elders……………………………...142 Chapter Six: Conclusion………………………………………………………….194 Appendices…………………………………………………………………….…203 v List of Appendices Appendix A. Interview Protocol………………………………………………..204 B. Community Assessment Protocol………………………………..207 C. Maps of Pine Ridge………………………………………...….....208 D. Photos of Wounded Knee Memorial……………………………..210 vi Chapter One Introduction The first seeds of this dissertation were sown when I was a second year Master of Social Work (MSW) student at the Washington University in St. Louis. Encouraged to apply to doctoral programs, I had assembled the applications and started thinking about the essay I needed to include as a part of my application. I agonized for weeks, often seeking counsel with my close friend Bobbie Jacobs, who is Lower Brule Lakota and at the time also fellow MSW student. After much deliberation, I decided to go for what had always been my 'dream project,' working with our elders. I had always been tailoring my social work education, through coursework and in writing papers, about Native elders. So I essentially wrote this project as my doctoral application essay: I wanted to immerse myself in the world of the elders, uncover the stories I had heard growing up, but more broadly, I yearned to work with many grandmothers, not just my own. In the academic literature, the life histories and experiences of the generations of Native elders’ living today are largely unknown. As Native students, we know that they survived many adversities, sacrificed a lot for their children and grandchildren to “succeed” in the educational system; we are also acutely aware that their wisdom fuels our ability to thrive today. Yet we are located in such a different environment. As students in the western educational system, the elders often describe us as living in two worlds – the 'Indian' world and the 'white' world. When these worlds intersect for Native people in the past, present and future, we have been irrevocably changed, yet we continue to survive and make strides moving forward. This intersection is the area that I was and still am most interested in – how did the elders manage to age into their late older adult years with negative traumatic forces acting upon them? How did they maintain their culture? How has this faltered in the face of modernity? How do we live our values in the modern context? What can we learn from them as we continue to evolve in the future? In seeking answers to these questions, I wanted to capture the wisdom of the elders before it was too late. 1 They are rapidly dying and the direct connections to the time before colonization are disappearing with them. Once admitted into the doctoral program, I honed the details and initial research questions of my project through my interactions with elders on the Pine Ridge Indian reservation while visiting my friend Bobbie (and her family), who had lived, worked and raised her family there. Actually, during the course of my doctoral studies at the University of Michigan, they were my respite, allowing me to refuel my physical, mental and spiritual reserves as I made my way through the doctoral program. This study was developed in partnership with them, allowing me to learn about the generations of elders living at Pine Ridge that I would not have otherwise had the opportunity to meet. Indeed, the Lakota elders who participated in this study opened their lives to me, shared wisdom, jokes, hardships, and victories. They quickly showed me the inadequacy of western medicine, scholarship, and social programs; this was the case because of the very limited ability of western ways of approaching the world to fully serve their physical, mental and spiritual health needs. When I was on the reservation and actively deciding on my sample population, I would often ask my peers, community members and elders I met, “with whom should I talk?” They all unanimously agreed that I had to first talk to Johnson Holy Rock.