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Native-American health care: One medical student's plan to make a difference

Micah Treuer had just come off 30 hours on call at Children's Hospital in Minneapolis, where patient need was great and sleep was in short supply one day recently.

Yet, stoked with caffeine, this soft-spoken, third-year medical student shared his remarkable story.

The son of a Native American mother and a white father, Treuer grew up near the Leech Lake Indian reservation in northern Minnesota, an impoverished rural stretch around Bena and Cass Lake. Graduated from Bemidji High School, he went on to Princeton University. Named a Fulbright Scholar, he planned on graduate work and teaching English literature to college students.

Death intervened.

Now, instead of teaching Shakespeare, Treuer, 32, is learning the practice of medicine on full scholarship — $128,000 over four years — at the University of Minnesota Medical School, thanks to the Minnesota Medical Foundation, one of only 15 in his class of 230 medical students to be so honored. This summer he was also one of 13 in the nation to receive a 2010 Minority Scholars Award of $10,000 from the American Medical Association Foundation. 


Talking about his Aunt Barbara's death some five years ago, he grows solemn. "It was just so vivid,'' he said, a man of quiet dignity sharing his life story over a lunchtime bowl of chicken wild rice soup.

His mother's sister, like Treuer's mother, grew up "really poor" in Bena, and couldn't break away from the poverty and chemical dependency and unhappiness of her life, particularly after a daughter's violent death in an automobile accident, Treuer said.

"She just wasted away, mentally, physically withered away after that,'' he said, 'til one night the woman swallowed "a bunch of pills," locked herself in her trailer home with a loaded gun and pulled the trigger.

As he tells it, paramedics rushed her to the Indian Health Service hospital nearby, though his mother pleaded frantically with authorities to send her sister to a hospital in Bemidji, outside the Leech Lake Indian Reservation, a better facility equipped with CT and MRI machines, radiologists and surgeons.

But either because the message didn't get through or protocol prevented it, the injured woman ended up at the Cass Lake facility, where a physician's assistant struggled to save her, but couldn't. "She died of respiratory failure.''

Treuer said he couldn't help but think: "If I'd only known what was going on, I might have been able to save her.''

Princeton grad
After graduating from Princeton in 2001, Treuer had come home to serve as Indian home-to-school liaison at the Cass Lake Area Learning Center, charged with motivating truant Leech Lake Reservation Leech Lake Band of Ojibwe kids to come to school. At a place where Native Americans made up around 90 percent of the student population, he was the only native teacher.

His aunt's passing rekindled his early desire to become a physician, so he applied to the University of Minnesota Medical School Duluth, ignoring the attitudes of some of his Native peers. His accomplishments cause some to look at him as "somewhat alien,'' he said.

Micah Treuer, right, chats with Joycelyn Dorscher, M.D., Director of the Center of American Indian and Minority Health at the University of Minnesota Medical School-Duluth Campus.
Courtesy of the University of Minnesota Medical School-Duluth
Micah Treuer, right, chats with Joycelyn Dorscher, M.D., Director of the Center of American Indian and Minority Health at the University of Minnesota Medical School-Duluth Campus.

"My desire to become a doctor and improve the quality of health care for Indian people is deep and personal, rational and emotional,'' Treuer wrote in his application to the Duluth school, which offers a two-year curriculum focusing on family medicine with the goal of growing more physicians for rural and American Indian communities. After two years, students may transfer to the medical school in Minneapolis to complete their medical degree. 

He's a "powerful role model" for other Native Americans said Lillian Repesh, associate dean for student affairs and admissions at the Medical School on the Duluth campus. "He's very smart.''

"He has this burning desire to help others,'' she said. "He's got a really profound commitment to serving Native American people. Behind his quiet demeanor there's a man who's really sincere in his passion for helping others." Repesh said, talking by cell phone from Albuquerque, New Mexico where she was a presenter for an Association of American Indian Physicians workshop aimed at helping American Indian students become doctors.

Repesh, who has a doctorate in anatomy and cell biology, remembers Treuer as a team player, "kind and so helpful" to fellow students in the anatomy course she teaches. "I think that really demonstrates how he will be as a physician in the future,'' she said.

"There's a quiet strength there,'' explained Dr. Joy Dorscher, assistant professor in family medicine and community health at the medical school and director of the school's Center of American Indian and Minority Health.

"He's just quite an exceptional young man. He knows his traditions,'' Dorscher said, demonstrating his involvement with the Indian community and modeling for Indian youth. "Being a part of some of these traditional ceremonies and things, you know that a large part of that is being available for young people, showing them the way.''

Parents invested in eduction
Treuer describes his upbringing as middle class, his father, Robert Treuer, a school teacher and writer, his mother, Margaret Treuer, an attorney and semi-retired tribal court judge enrolled with the White Earth Indian Reservation.

"My parents were always very invested in education. There was the expectation, of course you're going to college, of course you should be reading books.'' And there was some opportunity for travel, particularly to Austria where his father had grown up.

Through the years he's been exposed to racism, though some would say his light skin masks his heritage. "Looking like I do, I have not had the kind of experience of getting followed around a department store, whereas my brother, Tony, who is a lot darker, had that experience.''

On the other hand, he's found himself exposed to groups of people making racist remarks or jokes. "I've had that experience many times. Sometimes it pisses me off and I say something. Other times I slip away.'' 

Micah is proud of other family members. His siblings: Anton is a distinguished authority on the Ojibwa language who teaches at Bemidji State University, David is an English professor at the University of Minnesota, and Micah's twin sister Megan is a lawyer in Cass Lake providing legal defense for Native Americans. His wife, Ronna, directs the Leech Lake Area Boys and Girls Club.

They're living apart while he does medical rotations in the Twin Cities through September. He will return to Bemidji in October for a rotation in the Rural Physician Associate program.

Treuer advocates for better health care among Indians. Health disparities between Native Americans and non-natives are alarming he says, even comparing like socio-economic status. Indians have higher rates or diabetes and diabetes-related illnesses, and experience more violence, suicide, alcoholism and other drug abuse, he said. 

He dreams of doing his part to change those numbers, as a practicing physician or by taking on some broader health administration role.

"Right now, I'm just want to learn how to take care of patients the best I can,'' he said. For now he's learning about ill children, how to deal with asthma attacks and meningitis, febrile seizures and pain.

He gets little sleep some nights, but he doesn't complain. Learning's the thing.

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Comments (2)

Careful about suggesting that a 20-mile extra trip to North Country would have saved Mica's Aunt... First: working for Leech Lake Ambulance as an EMT, we were often met with requests to bring patients to Bemidji because they ASSUMED that the Indian hospital would provide lesser care. How about a trip there with a critically-injured patient who dies en route? Who would be blamed for that? Also, beware of suggesting that a Physician's assistant is less skilled at saving someone's life than an ER doctor. Some ER doctors have no degrees in emergency medicine, but are Family Physicians staffed there to fill a void. They may be good. Or they may not. Actually, some of the ER-trained physicians may be very poor. Give me a skilled PA (who might be an ex-paramedic) over a lousy physician in an emergency situation any day of the year. Good luck Mica - we'll look for you up here!

This article could have been written over 40 years ago when I was a young Indian pre-med student at the university. Nothing's changed.