August 2013 Member Profile
The three months Katherine Baltazar spent amongst the Lakota tribe in South Dakota after she graduated from a Psychiatric Nurse Practitioner program were eye-opening. With the Lakota she experienced “spiritual strength,” unique humor, and resilience, coupled with substance use, poverty, and teen suicide. In this combination Baltazar, who is a Catholic Medical Mission Sister, found not only a deeply-rooted empathy and desire to help, but also an opportunity for her own personal development. Those three months were simply the starting point to a professional and personal journey.
“The three months on Rosebud happened to be during a time that Rosebud was experiencing a rash of teen suicides,” she says. “It lead me to seek for an understanding of this tragic way of ending one’s life.” In 2009 after leaving the reservation and returning to Philadelphia, she had a realization – the suicide rate at the time for the Army, 20.2 per 100,000, was the same as that for Native Americans. “I felt a need to speak about this to a national audience,” she remembers. So she prepared a presentation for the 2009 APNA Annual Conference: “Theme of Betrayal in Native American and Military Suicides.” The room full of VA nurses to whom she presented agreed with her premise, but pointed out an ethical dilemma that would be a barrier to further research. “Our men in uniform still had to depend on the very system that betrayed them…which is true for our native peoples, as well,” she says. “I had not considered this, and now that I am living longer among the Lakota people, I see the lasting effects of the ignoble history of broken treaties, forced re-location and assimilation.”
After gaining more experience in substance use treatment to provide her with the background necessary to treat the almost 100% alcoholism on the reservation – “There is no one not affected by it,” she says – Baltazar returned to the Lakota people, this time on the Cheyenne River Sioux Reservation in South Dakota. Since September of 2012, she has worked for the tribe as a Psychiatric Nurse Practitioner, a Supervisor for the Social Work Department, and as a nursing teacher at their Presentation College. “The main focus of my day is to stay flexible and to remain culturally sensitive,” she says. “I seek for my time here to be mutually enriching, where I too learn from the persons I treat their ways of respect and humor.” Baltazar works with a team of two other providers, seeing patients most days. She also attends Lakota classes two days a week after work, sits on the Suicide Prevention Team for the schools, and is a member of the Advisory Board for the Horsemanship Grant (a 3 year Department of Justice grant to teach horsemanship to typical and at risk youth).
“A major theme I deal with in the therapy sessions revolves around coping with family losses and dealing with the emotions of grief and loss,” she says. Too often the method of coping she sees is numbing these feelings through alcohol and substance use, which has lasting effects across generations. “One of the shameful wounds that does not get the attention it needs in Native American country, is Fetal Alcohol Syndrome,” she says. The varying degrees of physical and neurobiological effects it has are “from a purely medical perspective, 100% preventable”. Her team, in conjunction with the University of South Dakota’s Center for Disabilities, has begun a Fetal Alcohol Spectrum Disorder awareness campaign on the reservation, building a coalition with the courts, police, hospital departments, schools, young mothers, elders, etc.
Baltazar has seen her practice evolve over the last 11 months she has spent working with the Lakota. “My interpersonal communication has had to rely on a greater cultural sensitivity and awareness,” she says. “I have found that my work with persons with addictions, where I could use the vocabulary of the 12 Step principals, has carried over in my work with the people here, where substance abuse is endemic.” She has also discovered parallels between the 12 Steps and the 7 Lakota virtues: Wocekiya – Prayer, Waohola – Respect, Waunsila – Compassion, Wowicake – Honesty, Wawokiye – Generosity, Wahwala – Humility, Woksape – Wisdom.
Baltazar speaks eloquently of how she has been affected by working with the Lakota: “In my current cultural context, I marvel at the humor and laughter I hear every day in the presence of these people,” she says. “What joyousness. For a people who are burdened with so much past and present suffering, how is this possible? To me, it speaks not only of their spiritual strength, but to the mystery of suffering and its capacity to be transformative.” She continues, “I have always believed in the resiliency of the human spirit, but hearing their poignant stories gives me glimpses of a mourning that much of America is totally unaware of, a mourning that reveals heartache, humor, but above all, a drive to endure.”