Inside Jacket

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“Suicide was common among the Apaches of southern New Mexico.”  So begins Dan McCall’s stunning recreation of two years in the life of an inexperienced young surgeon at a small hospital on a Native American reservation.  Among courageous, stoic people burdened by a cruel history and beleaguered by poverty and alcoholism, Jim, fresh out of medical school, learns the healing power of compassion from a beautiful, talented Sioux-Lakota nurse and school-teacher—Annie Messenger Bird.

 

Messenger Bird is a story of quiet, practical heroism in the midst of senseless violence and despair; of how doctoring triumphs and how it fails, especially faced with the larger ills of society; and of the courage and love that transcend both politics and race.  In McCall’s unsentimental telling, one young doctor’s experience becomes a window onto a troubled, hybrid American culture in which the humane practice of medicine—however flawed—can still provide a glimpse of the fragility and beauty of life.  

 

 

Excerpt - Opening Page

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Suicide was common among the Apaches of southern New Mexico. One night an important chief about seventy years old was brought up the front steps of the hospital and deposited in the front hallway by a dozen wailing family members and friends. The old man had taken a .22 rifle, put it between his eyes, and pulled the trigger. But he was still alive, and I was expected to keep him that way.

 

On closer inspection I discovered that the old man had a neat little bullet hole just above his nose and an exit wound forward on his head. He was only semiconscious and was weakly gasping for breath, but it looked like he might be salvageable.  In a situation like this, before anything else is done you have to establish a good airway to keep the patient breathing, and at first I thought I should do it the easy way, which is to punch a little hole with a knife above that little cartilage like a ring under the Adam’s apple. But even though you can do that very quickly, it can damage the vocal chords. I decided to go for a more permanent tracheostomy, which is a little lower. Then, suddenly, the whole hospital went dark. All the lights had gone out, and I was the only one on duty who knew how to start up the generator. I couldn’t go down into the basement and do it, though, because this old man was lying on the floor dying. His relatives were moaning and crying out.

 

So I got to do my first tracheostomy on a green linoleum floor by flashlight. Perhaps it was better I did it in the dark, because that way nobody could see how badly my hands were trembling. I made a transverse incision across the throat, sort of like for a thyroid operation, and I was able to blot the blood with gauze sponges. I could reach down and feel the thyroid gland, then see the trachea, which lay just behind it and in the center, with those little rings running around it.  It was firm; I pierced it with the knife, making a crossroads cut, and I was able to slip a steel tube right into it. The old guy was still with us. I went down to the basement with my flashlight and got the generator running again. The lights in the hospital came back on, and we were able to take him into the examining room and complete that part of the job.

 

I had neither the equipment nor the training to repair the damage done by the bullet. The hospital in El Paso, where we usually took such patients, was a hundred miles away…

 

....The neurosurgeon in El Paso operated on our patient and patched him all up.  The chief had done on himself a nice prefrontal lobotomy.  When the old man came back to us, he had forgotten every word of English he had ever known, spoke only Apache, and seemed extremely happy.