Two Solitudes

Soon after I moved from Poland to Canada, I was sent to the Sioux Lookout Zone Hospital as part of my pediatrics training. In the bare white examining room I explained to an Indigenous couple that we needed to catheterize their daughter’s bladder. She had had several infections and just finished a long course of antibiotics. “We need urine straight from her bladder to make sure that all the bacteria are killed in there,” I said. The father left the room after I had finished describing the procedure; I assumed that he meant to give his daughter privacy. His wife stayed behind, and, as I retrieved the sterile medical tray from the cupboard, she stroked the girl’s long hair. I covered the girl with a white linen sheet. Her brown eyes stared up at me. “It doesn’t hurt,” I said and patted her leg. I washed her hairless perineum with a brown iodine solution and spread a blue sterile paper towel over her lower belly. I scrubbed my hands and just as I was to insert the lubricated catheter into the tiny pink shell of her urethra, the door slammed open and the husband barged through.

“Did I tell you that you could do it?” he snapped.

He hadn’t. But he didn’t tell me that I couldn’t, either.

“This is my little girl,” he said, pulling up her panties and yanking down her skirt. He scooped her into his arms. “You violated her. Who do you think you are?”

I thought I was a doctor. I was performing a medically necessary procedure indicated under the circumstances. But something seemed to have gone wrong and she now was not going to get it.

Neither before nor during my rotation did anybody teach me how to talk and listen to First Nations peoples. I was an immigrant to Canada, figuring out the vocabulary of body language and in-jokes and the social niceties in which Canadians engaged as part of their verbal exchanges, my own attempts at banter flailing and failing.

It was 1994 and I had no idea about the abuse that Indigenous children had suffered at the hands of government doctors and nurses for several generations. As a medical student and resident in downtown Toronto hospitals, I had met homeless and indigent First Nations patients, but knew nothing about the root causes. In medical school, an Asian professor had delivered a lecture on Chinese folk medicines, but the only teaching on Canadian First Nations was received in passing: Indigenous people were taciturn and had a high level of tolerance for physical pain, make sure to account for that during physical examinations.

Later that day, my supervisor warned me against interpreting Indians’ silence as assent, to always obtain verbal acknowledgement for any procedures. “They don’t talk unless you ask a direct question,” he said. As I was leaving, contrite and chastised, he attributed the father’s behaviour to “troubles with the band council,” and advised me to take it easy.