Thanks to the exceptional generosity of the Class of 2010, I was afforded to the unique opportunity to spend an elective block working in Tuba City, AZ on the Navajo Indian Reservation. My goals in pursuing this rotation were to provide care in a rural emergency medicine department and to provide care to a community that has been systematically marginalized by government policy.
My rotation occurred from March 27th to April 19th . During the rotation I worked 12, 12-hour shifts in the Tuba City Regional Health Care Center (TCRHCC) Emergency Department, a 23 bed ED that sees approximately 47,000 patients per year. TCRHCC provides care for a catchment area of 6000 square miles and is the regional referral center for 75,000 Navajo, Hopi, Southern Piute, and the occasional tourist. The patient population is exceptionally poor, with 66% of the population living below the poverty line. Additionally 33% of patients lack indoor plumbing and 25% have dirt floors in their homes. The ER has a 5% admission rate and 20% transfer rate. The TCRHCC ED is the only ED on the Navajo Reservation that is staffed entirely by board certified emergency medicine physicians. The group of physicians pride themselves on bringing cutting edge emergency care to the people of the Navajo Nation.
The rotation is billed as rural medical elective, but it is also a cultural immersion program. Although I transferred more patients via helicopter in one shift than I have in 4 years of residency, it is the interactions with the patient population that I will cherish most. I have never worked with a more caring, friendly, and appreciative patient population. Routinely patients had bypassed outlying hospitals, driving upwards of 100 miles to receive care at TCRHCC.
In addition to a unique clinical experience, days off on the rotation provided opportunity to explore many Navajo monuments and National Parks. During my off time, I was able to visit multiple National Parks including Arches, Canyonlands, and the Grand Canyon. Additionally, I was able to visit Monument Valley, Navajo National Park designated to protect mesas from private development.