A Navajo doctor tends to the spirit and body

Patricia Nez Henderson integrates a concept of balance and harmony into her thinking about medicine.

When Patricia Nez Henderson, M.P.H. ’94, M.D. ’00, was a child in rural Arizona, her grandfather would come to her house early in the morning and splash water on her and her siblings. “Get up! Get up! Go run and meet the rising sun,” he told them in Navajo. “If you sleep too much, you’re going to be left behind, and the morning gods are ready to bless you.” The children would jump out of bed and run toward the glow in the east.

From growing up in a Navajo-speaking community without electricity or running water to completing medical school as Yale’s first female American Indian graduate, Nez Henderson’s was a remarkable journey. Her interest in medicine began early, influenced by her grandfather—a medicine man—and other traditional healers in her family. Most of her relatives worked as shepherds, and she recalls listening to lambs’ hearts with a stethoscope her mother had bought her. “I’d come home smelling like manure,” she said. “My mother says that’s when she first realized I’d go into medicine.”

Nez Henderson earned her M.P.H. at the School of Public Health in 1994 after earning a degree in biochemistry at the University of Arizona. Then it was on to medical school.

It was there that culture shock took hold. Having grown up among healers who took patients’ spiritual as well as physical health into account, Nez Henderson felt miserable at an allopathic school. “My heart was dissected from my head,” she said. “I felt it immediately upon getting into med school, and there were no other Native students there, so it was hard to explain to students or even my professors what I was going through.” One day a faculty member made a thoughtless comment about her imperfect command of English. It devastated her. At that moment, she said, she understood why so many American Indian students leave school. “All I saw was a room full of men in white jackets, predominantly white, and I just began to cry, [thinking] ‘I don’t belong here.’ ”

Shortly afterward, Peterson Zah, a former president of the Navajo Nation, came to speak at Yale. Before his speech, Nez Henderson met with him privately and told him what had happened. Later, as he addressed the crowd, he turned directly to her and spoke words of encouragement in Navajo, whereupon she decided to stay at Yale.

After earning her M.D., along with an award in her name given to recognize a graduate committed to improving health among American Indians, Nez Henderson went to Colorado. Her sense that allopathic medicine is in-sufficient—as well as the frustration among physicians she had witnessed during clinical rotations at underfunded Indian Health Service sites—had convinced her to pursue public health research. She joined the faculty of the University of Colorado Health Sciences Center’s Native Elder Research Center for a two-year program that trains Native health professionals for research careers. Funded by grants from the National Institutes of Health, the Centers for Disease Control and Prevention, and the Robert Wood Johnson Foundation, she began to study tobacco control and prevention among American Indians, an interest that continues today.

Tobacco has long been sacred to Native communities, but its abuse leads to disproportionately severe health consequences for them. Nez Henderson studies American Indians’ reactions to nicotine, which may have genetic underpinnings. She has also designed Web-based interventions and smoking cessation classes that incorporate tribal practices like prayers, visits to sweat lodges, and fasting, and that emphasize the sacredness of life. “Navajo tribes use a word, hozho, which means ‘in balance’ or ‘it’s beautiful.’ There’s that harmony,” she said. “Anything that impacts hozho and makes it go out of balance, we know that’s toxic, like cigarettes. … It’s a more holistic approach. Instead of just telling a person to do these things that are backed by evidence, you combine it with things that are spiritual.”

Nez Henderson lives in South Dakota with her husband Jeffrey A. Henderson, M.P.H., M.D., an internist who is Lakota Sioux, and their daughter, Zahlanii, 7, and son, Mato, 5. They head the Black Hills Center for American Indian Health in Rapid City. In addition to her research, Nez Henderson works with tribal leaders to effect tobacco policy changes within the Indian nations. “With sovereignty comes responsibility,” she said. “A lot of tribes are looking at ways to bring economic development into their communities, but if they put health first, all that they’re looking for will come next.

“I work all the way from prevention to cessation to policy,” she said. “I absolutely love what I do.”

—Jenny Blair

At 86, head and neck surgeon still contributes to medicine and hospice cause he helped found

One medical school memory that Donald P. Shedd, M.D. ’46, HS ’53, holds dear is of the day he walked into the “croup room” at Grace-New Haven Community Hospital and peered through the mist that was then used to treat children with the characteristic barking cough. There he caught his first glimpse of his future wife, a Yale nursing student named Charlotte Newsom. “You can imagine how glamorous a woman looks in a steam room,” he said. She turned out to be lovely, a gifted pianist who played Chopin beautifully. They married and launched two brilliant careers.

Shedd, now 86, ended up joining the Yale faculty, later became chief of head and neck surgery at the Roswell Park Cancer Institute in Buffalo, New York, and serving as national president of the Society of Head and Neck Surgeons, which became the American Head and Neck Society in 1998. Charlotte Newsom Shedd, M.N., R.N. ’46, who passed away two years ago at the age of 84, co-founded Hospice Buffalo, often working from the dining room table while caring for her aging mother and the youngest of the four Shedd children. She traveled around the country as an early pioneer of the hospice movement at the national level.

Both Shedds had high levels of energy. Now professor emeritus at SUNY Buffalo, Shedd still attends weekly tumor board meetings. He also maintains a database of head and neck operations at the cancer institute, where he was chief of head and neck surgery for 29 years. In 2007, the department published his fifth book, a history of head and neck surgery at Roswell. Shedd is also the author of Historical Landmarks in Head and Neck Cancer Surgery and The Early History of Hospice Buffalo.

“You become conscious of a decrease in energy in your mid-80s,” said the surgeon, who gave up windsurfing on Lake Erie around age 75. But he still plays tennis and maintains a regular exercise schedule. He has helped build houses for Habitat for Humanity and is an active member of the Unitarian Universalist Church of Buffalo, where he moderates a discussion group, serves on committees, and participates in a monthly book club.

Shedd earned his bachelor’s degree at Yale and began his study of medicine in an accelerated program during World War II, when faculty members were leaving to serve in the military and medical students were hired to deliver emergency anesthesia at night. During his 14 years on the Yale faculty, he became increasingly interested in the care of head and neck cancer patients. He moved to Roswell Park in 1967. “The job offer in Buffalo was an excellent one,” Shedd said. “It was one of the best positions in the field in the country.”

Shedd describes himself as “a modest contributor” to head and neck surgery during what he calls “a fascinating period” of advances in medicine. “I’d say there have been modest gains in head and neck cancer survival and major gains in quality of life, both cosmetically and functionally,” he said. “One of my contributions to care at Roswell Park was the incorporation of the use of the surgical microscope in endoscopic diagnosis. It made diagnosis more precise,” he said. As a faculty member at Yale, he conducted radiographic studies of swallowing in inpatients after head and neck surgery. “I did some work at Roswell in surgical approaches to speech rehabilitation after laryngectomy,” he said.

In addition to his clinical work and research, Shedd helped train fellows and residents who began their careers at Roswell Park. He was involved in medical service in Peru and Nicaragua, as well as short surveys of oral cancer research in India, Pakistan, and Ceylon (now called Sri Lanka). He also held a visiting professorship in South Africa.

While his own career was demanding enough, Shedd shared his wife’s passion for hospice care. The contemporary American hospice movement began in New Haven when the Shedds and others attended a talk at Yale by Dame Cicely Saunders, the Englishwoman regarded as the founder of the modern hospice movement. “We kept talking about it after we came to Buffalo. We realized there was a need for such a facility here, so we formed a founding committee, then Charlotte took the initiative,” he said. The couple also collaborated on a survey of the final period of life in 60 head and neck cancer patients. Charlotte received a distinguished alumna award from the School of Nursing in 1992.

Shedd said the support he and his wife provided each other throughout their careers and retirement was crucial. He considers it a privilege to have been able to care for Charlotte at home during her encounter with Alzheimer disease. She spent her final day in the hospice inpatient unit she had helped to establish.

“Joseph Campbell said something about following your bliss,” Shedd said, referring to the scholar who wrote about the power of mythology to explain human experience. “I think I have been able to do that.”

—Kathy Katella

Alumni tour Smilow Cancer Hospital

During this year’s reunion, about a dozen alumni toured Smilow Cancer Hospital, which is scheduled to open in October. From the ground floor, the group took elevators to the upper floors for views of still-unfinished offices and suites, with grand views of New Haven. The tour also took in new operating rooms—where all cancer surgery at Yale-New Haven Hospital will take place—and infusion suites. The 14-story facility will contain nearly 500,000 square feet and will include 112 inpatient beds, outpatient treatment rooms, expanded operating rooms, infusion suites, diagnostic imaging services, and floors for diagnostic and therapeutic radiology.


			Originally published in Yale Medicine, Autumn 2009. Copyright © 2009 Yale School of Medicine. All rights reserved.