Is Medical School Just for Rich Kids? This Native American Woman Says Yes

Dear Dr. Wible, 

This will be my last e-mail to you because I am giving up on my dream of being a doctor.

I’ve contacted so many colleges and medical schools hoping to find one that would help me become a doctor for my tribe. Today, I finally got a response from the University of Pennsylvania! But when I opened the official e-mail, all I saw was a pretty girl with beautiful eyes staring back at me. She introduced herself as Lily, a premed majoring in biology with a specialization in neuroscience. She is a sophomore just like me.

Lily

Lily

Lily writes: “I am currently a research assistant in the neuroscience lab, where I am analyzing the neural circuits underlying the development of empathy in young children. Over the summer I volunteered at Children’s Hospital where I shadowed a pediatric neurosurgeon and attended my first brain surgery! This year I am President of Student Affairs so I’ll be organizing all the fun large-scale events on campus. Currently I am on the dance team and I love it! My biggest project right now is working with a mobile clinic in Peru. Being able to shadow local doctors, dentists, and gynecologists, build sanitary bathrooms, and educate the people on basic hygiene was a great experience for me. . .” She ends her marketing pitch by inviting future students to participate in her exciting activities.

Lily and I have similar dreams. The difference is that she is from Asia while I’m Native American. She will be a pediatrician while I want to be a family physician.

Me

Me

Despite being accepted by an Ivy League college, I’m at a low-tier school near my reservation while Lily studies at a super-elite university. Lily is already attending brain surgeries, but our local doctors don’t allow Native Americans to shadow them. While I am struggling to find money to take premed biology this summer, Lily is a research assistant in a neuroscience lab. While I’m scratching my head trying to figure out how to come up with money to buy the biology textbook, she’s analyzing neural circuits underlying the development of empathy in children. By the time I get approval to take biology at the closest college where it’s offered, Lily will have coauthored at least one scientific article from her research. While I struggle to find money to travel to Mississippi and rent an apartment so I can take biology, Lily has already been to Peru where she shadowed local doctors, constructed sanitary bathrooms, and amply padded her resume for medical school.

Now I am a winner. I like to win. I absolutely hate to be in a situation where I could lose. The situation I am in is guaranteed to make me lose.

An African medical student just visited our tribe. His family has seven servants. Barely 23, he owns two planes. They’re small planes. One seats two people and the other seats four, I think. He’s the kind of person who gets into med school with affirmative action, not me.

Many whites are now legally Native Americans. Why? Oral history tells us mainly because their white ancestors were fraudulently enrolled by government agents to get Native American benefits and land. These whites have federally-recognized Native American status, so medical schools are fooled into thinking they are legitimate Native Americans. One federally-recognized tribe built a casino over their dead ancestors which NO real Native Americans would do. Now many are millionaires. Once accepted into med school, these white Native Americans choose lucrative specialties, move to affluent suburbs, and serve white patients without helping Native Americans in any way. White Native Americans benefit from affirmative action, not me.

I have dark skin. I look Native American. Because I am Native American. But I am non-status Native American so I cannot legally claim a tribe or receive benefits. My grandparents belonged to different tribes, so no tribe accepts me, even the tribe whose reservation I live on where my grandfather was Chief and my grandmother was Medicine Woman.

Racism is real. My college professors think I’m stupid because of my skin color, my shabby clothes, my status as a single mom. They warn, “This class is hard. Be prepared to get a failing grade. I’d drop this class if I were you.” My doctor asks, “Have you been drinking again?” I tell him, “I’ve never touched alcohol in my life.” But he always asks me the same question.

Native Americans struggle with diabetes, alcoholism, drug abuse, suicides. Natives like me struggle to pay for our next meal. We carry water home because we have no running water. We have no bathrooms at home. We use outhouses or buckets. It may be thirty below, but there’s no heat at home. We had electricity shut off Friday because we couldn’t afford our bills.

I want to be a family doctor. I want to return to my reservation and heal my people. But primary care is no way to pay off a quarter-to-half-million debt I’d accumulate as a student.

My tribe is poor. They can’t pay tuition or give benefits. Even if I were a card-carrying member, the only benefit I’d get is funeral expenses which hardly helps me because I’d be dead then. Even with my near-perfect GPA, my local college won’t grant scholarships. How can I hope that a medical school will grant me a scholarship when they won’t send me a personal e-mail?

I recognize a system that is designed to set me up to fail and I refuse to be part of that system. I’d rather spend my life on the rez as a teacher saving our dying languages. After all, I am one of four people who speak our language and probably the only one with a real shot of saving it.

I want to win; not be part of a system that frustrates me at every step. Medical school is not for me. The current system ensures that my dream of being a doctor is just for rich kids.

Love to you<3

Sage

This letter was received and edited for clarity by Pamela Wble, M.D. She is a family physician who pioneered the community-designed ideal medical clinic. Dr. Wible trains medical students, physicians, and patients to create ideal clinics nationwide. She is author of Pet Goats & Pap Smears and blogs at Ideal Medical Care. Watch her TEDx talk “How to Get Naked with Your Doctor.” Photos by Geve.

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135 comments on “Is Medical School Just for Rich Kids? This Native American Woman Says Yes
  1. Steven says:

    I hope you told this promising young physician about such opportunities as National Health Service Corps and the Indian Health Service, if she wasn’t familiar with them already! The barriers to becoming a physician in this country are indeed too many and seemingly insurmountable for her, but we so need perspectives like hers in medicine!!! It’s not impossible – she can do it!

    • Pamela Wible MD says:

      I think just being premed and getting the prerequisites seems insurmountable when sitting on a honey bucket with no running water to wash one’s hands. Yes, this is the United States. Don’t have to travel to Peru if you want to build sanitary bathrooms and help the poor. Our own people are suffering right here and obviously need our help.

      • Mary DeForest says:

        Amen—I’ve also seen guilty of being Asian, if your family isn’t rich.

        I live in the Southwest. In photo-journalism we had groups to make a video. I was left out because of my age. Jennifer, a hot poor Latina decided to stay with me-we were both Honor English students, and we always got a 4+ when we teamed up. We were looking for anybody to fill our group. I saw a Navajo woman standing, slumped over. I pointed to her, and Jennifer marched over with me. We asked her if she was in a group. She said that she was Navajo. We said-So-Do you want to join us or not? Jennifer asked her if she had anything against Latinas from small pueblos and no plumbing. I asked her if she had anything against people with Acoma in-laws. We picked up a German Heavy Metal drummer, and we were ready to go. We were the only group that had a 4+ for our video.

        She carried her weight. We quickly found out that in the previous projects that the assigned groups that she hadn’t been allowed to touch a camera, and she hadn’t been able to do one. Her group just pushed her away. I explained that to the prof too. She worked overtime. I explained to the camera department- so they made sure that she was at the top of the list-which pissed off the other groups. She did double time, learning what she should have already learned very quickly.

        It’s not a matter of not having opportunities-it’s also a matter of being put down-like the prof asking if the med student was drunk. The groups saw Jenn, the drummer-who was a wicked sound man for our production, and me talking to this Navajo woman-so they come over and start telling drunk Indian or Native American jokes quite loudly. Jenn said quite loudly- I can tell who spreads their legs for a passing grade, and we all marched off.

        Unless you’ve seen this happen to your family members, your friends in school, on a military base, even a mixed race neighborhood, you have no idea of what really goes on to a Native American– signed Irish-American

  2. Nu Neteru says:

    This is absolutely an incredible story and it must go viral!

  3. Brenda says:

    Sage, your story makes me so sad, which doesn’t help you one bit. Here in this country New Zealand, they hold 4 x seats open each intake for the ‘native Maori’ and rarely do all four positions get filled.
    I can only hope some petrol company, some one like Donald Trump gets to hear of you, or maybe even a Du Pont reads your story, and offers you a scholarship. I can only say “Don’t give up,” but don’t know how to encourage you or show you the way to move forward

  4. GB says:

    We should crowdfund her education! Hope she will contact me. I’d love to help!

    • Pamela Wible MD says:

      That would be great!! With her permission I will pass on her name or she can contact you directly. Please share this blog widely as these dedicated young people need assistance.

      • Nick Maneck says:

        If GB initiates a crowdfunding for Sage, I am sure to do my tiny bit.

        • Mary DeForest says:

          How will we be contacted about a crowd funding for Sage—I’m far from rich, but–

          • Pamela Wible MD says:

            She needs to remain anonymous for her own safety. She could face even more discrimination if her identity is revealed. The woman in the photos are models, by the way.

  5. Taylor says:

    Healing others shouldn’t be a classist profession.

  6. Jody Gordon says:

    As a “white” native myself (my Father’s family being Cherokee and Blackfoot, and my mother’s family being Irish), a recent university graduate and current medical school applicant, who was a single parent at one point in time, this story resonates with me in some ways, and disturbs me in others. First – and with no intention of denigrating Sage’s heart wrenching experience, I have to say that my own experience was quite different. I did not grow up on a reservation, though I have family who did, and more family who’s recently relocated from here in Oregon back to the reservation in Oklahoma. With my good grades, I was able to obtain scholarships and grants that paid for my first two years of community college fully, and helped significantly offset the costs once I’d matriculated to the university – I graduated magna cum laude with relatively (for modern America) little debt. I do not come from an affluent background, and I do not aspire to one. I too intend to go into family medicine, and didn’t find it all that difficult to find information about scholarships and loan repayment options available through National Health Service Corps, the Indian Health Service, and the American Indian College Fund (which is geared almost exclusively to individuals attending tribal colleges). Locally, OHSU in Portland – ranked as the #2 medical school in the nation in clinical medical education (as opposed to the separately ranked research medical education that is dominated by Ivy League schools. They make “better” researchers, we here in the Pacific NW make “better” clinicians – which I prefer) places very strong emphasis on heritage. Their admission criteria now explicitly places preference both on “Oregon Heritage”, and on the admission of members of groups that are under-represented in medical education. Native Americans are currently the least represented group in this setting, and thus, receive primary preference. The medical school application has a personal photo submitted with it, so even if a person hasn’t been able to trace their ancestry back to the Dawes Rolls (the Native American Registration Act-mandated list, to which virtually all native persons in the US must trace their ancestry to claim membership in a nationally recognized tribe), if they “look” Native American and claim it, the school will likely give it enough credence to at the very least interview them and obtain more information on them.

    I feel for Sage – her story is a modern tragedy in a long line of tragic circumstances surrounding the Native American world. The system is far from perfect, and in the interest of social justice, expanded opportunities should always to extended to those with the largest barriers to obtaining an education, especially in a service field. I caution only, however, that her experience is not necessarily representative of the experiences of all Natives, myself included. While the system is not perfect, many aspects of it have improved for under-represented groups. Her account reflected a sense of frustration and of hopelessness, and I’m sorry that her tribulations seemingly turned her away from her calling. However, in my own experience, there is both opportunity and good reason for hope. I suppose that’s my message – it’s not all cloudy days and closed doors for the Native student today, at least not all of us.

    • Mary DeForest says:

      Part of her problem is that she’s not a registered tribal member. I have a grandson that was raised on military bases. My grandson isn’t registered because his mother didn’t want to register a half-white son. She told the family that she was taking care of it, but never did. He doesn’t get tribal health care- nothing. He was in an accident and has brain damage-so he gets a little from SSD

      Then there are tribal politics that can interfere with tribal benefits, especially with the casinos. The casino by the Morongo tribe near Palm Springs is run by African-American so called Morongos.

    • Rentara says:

      I think you have also missed the part where “Sage” specified that the affluent white “Native Americans” she is speaking about are the ones whose “white ancestors were fraudulently enrolled by government agents to get Native American benefits and land.”

      These people are actually fully white, or have Native American heritage that is so minute and obscure that they possibly know absolutely nothing about it. And yet these people are using resources that are supposed to be relegated to Native Americans who are far less privileged.

      And as Mary has already said, Sage is not (and apparently cannot) register to receive benefits, but also her tribe(s) as a whole is/are so poor (again in part because of other falsified situations), they are entirely unable to help her.

      Sage belongs to no world, and so receives help from no world. There is tragedy in more than just her giving up, but also in her inability to go elsewhere.

  7. Lisa Goins says:

    There is always being a Nurse Practitioner with a Doctor of Nursing Practice. There are other ways out there than just being a physician in helping our people.

    Dr. Lisa Goins PhD, APRN, FNP-BC, RMT

  8. Steve Vaughn MD says:

    I live in New Mexico. Lily is right. If you want to know America, go to a reservation. Those are how Americans live, work, how Americans really are. If you are Visible, America really is a nice place, with all these opportunities. But only a tiny few Americans are Visible. None are Indians/Native Americans.
    Lily, do not give up because you know the truth. Fight the truth. Look up Elouise Cobell. She fought the truth, and won. She is passed now. We need another Elouise Cobell. Do not give up. It is not right – it is not respectful. You know the difference between right and wrong now. There is no turning back. Now you know why people on the Rez crumble up on the inside, if you already didn’t.
    If I could give justice, I would give you all I have. If I could give you fairness, I would give you all I have. I give you respect.
    I will crowdsource.

  9. Medical School is tough to get into, no doubt. There are ways to do it and yes it will require a certain amount of very hard work and loans. If you do not come from a family or at the top of academics then you will not be able to avoid loans and they are substantial.

    That said my parents are blue collar workers who had five children. I’m number 4. There was no money to pay for a collage education for me. I was not the 4.0 student I was the 3.5 which is often considered to be “low” among premeds and it may well be. Even though I do have a significant scientific background you would be surprised how little it is considered during the admission process. I was accepted. I do have loans. I want to go into internal medicine.

    With all of that I still think it is worth it. It’s not easy but hey good thing usually never are, like love. And if your heart is really set on this path then explore all of your options before giving up on it. Because, even when you think you have exhausted your options I bet you that there is a way you haven’t thought of. Ask. Never be afraid to ask.

    There are three year programs now for GP training. Have you looked into the osteopathic schools? Have you thought of the difference in requirements for applying to both MD and DO? What if you took and extra year to work in order to be able to pay for the testing and the med school applications? (That’s what I had to do) Oh, and there are scholarships, but if you don’t get them then you can take out the loans. Look closely into repayment options. (I follow the legislation, on this one very closely)

    My point: It is possible. It will be hard. It can be done. Ask, its always okay to ask.

    • Joseph says:

      I believe the issue isn’t hard work or not giving up. From what she rights, Sage clearly works hard, it is the poverty and lack of documentation that bars her. I come from a poverty background and can relate. It is very different than saying there are options. She has a school she can go to, but she would need to move there and get a place to live. Financial impossibility. She doesn’t have running water and electricity. Which means a large part of her day is involved in survival. She cannot afford books. Which means that she cannot have the knowledge afforded by the books. She lack access. In addition, she stated she has contacted many schools for help and due to her lack of documentation she is not being considered.

      All these issues become insurmountable when added together. One or two or even a few may be overcome with hard work and some help. But too many and there is obvious disparity of care and disparity of access.

      I know how it is and it is not easy to imagine if you have not lived it. I am not native American. I’m Asian. But there are poor people all over the nation who are poor through no fault of our own.

    • Tina Euresti says:

      Great advice. How is school and all your loans doing? Are you burned out or financially secure. Do you get burned out trying to stay financially secure, or from saving lives? Do you feel over worked by choice and dedication?, or debt and exploitation? Do you feel you made a mistake and regret debt because of mannerism or situation? Are you hopeless and or penniless, and questioning your education or your participation in the field you chose and or paid for via student loans or scholar ship, and determination and dedication of exploited completive drive and determination a provider of care gives to succeed and without questioning and noticing anything but policy and participation of test and procedure given to become a future practicing physical in a respectful and credible setting. Well if you can address this please if you have not committed suicide. got burned out and quit is the question. I agree with your advice and admire your determination to serve and protect life. Nothing good is easy. You may even think free. But I wonder if you truly wanted to do good and it was easy to learn and question why you paid so much for nothing good. I am wondering if you are still trusting and working for desire to practice and give to humanity trying to avoid and question policy and procedure developed and exploited to manipulate and segregate people who are choosing a calling and blessing that is priceless and useless to the giver and receiver so I want to know if you are feeling useless, or priceless. And most important why? it has been 3 years so I hope you can answer this. Please Pam if you can find someone who can relate to question, I trust you can find others who can share the experience and information I am asking, feel free to edit and ask without changing or inturpiting my question, Only articulating and respecting the question and appreciation I have in you as a person who demands respect and compassion to the love you have for yourself and others that care for anything and everything that is true and earned with financial and person dedication that should have never made you consider suicide and question why others did not get the chance. Your calling is similar to mine. Your asking and fighting for people and situations that have no ryme or reason to anyone until they live to experience it or felt the same feeling and know and understand the feeling is the most important question. Not the policy or procedure or even the position. You really need to question why am I so affective and dedicated to something that is not changing or developing, not even intimidating the system I am questioning and wondering I have nothing to win or loose, I am not asking to be heard as a person in it for competitive or vindictive change, I can say I am not ever going to benefits even if I lived to see it. I am only even writing on your site because you requested me and invited me into a place that is a question that keeps me evolving. Amazing how your suffering is something distracting and personalizing, To a profession and system Priceless and useless to anyone only to the dying and questioning pointless and senseless actions for service and dedication allowed and not only financially exploited and manipulated from care that is priceless and generous to the giver and receiver. Ok thanks for letting me vent. I am interested in donating and helping people like sage is the fund set up? I know this is old.

  10. Lynne says:

    College-level biology courses for credit are offered online for a nominal fee. You may find other courses as well. Computer access might be available at a library near you.

    http://education-portal.com/articles/7_Universities_with_Free_Online_Biology_Courses.html

    Good luck!

    • Tina Green says:

      Medical schools generally do not accept online classes for science credits, nor AP, nor IB. They pretty-much want to see classroom-based grades.

  11. Sandy says:

    I will help fund her education – I don’t have much but I will give to the cause and I will pass this email on.

  12. stuartg says:

    Don’t blame failure to get to medical school on “the system”. Many people fail to get into or through medical school because they are not capable of doing so, no matter how hard they try, no matter how much they want to benefit their community.

    One person I know did have the ability. He grew up in the North of England: rental terrace housing, outdoor toilet (night soil collectors), over 20% unemployment. Loans to get through premed and medical school because there were no special entry schemes. He’s now the equivalent of board certified in two specialities. The toilets have improved, but he has a salaried job in an environment close to where he grew up.

    Medical school is not about class, or about race, or money. It’s about whether a person has the knowledge and capabilities to become a doctor. Please remember that simple fact when you read an article like this and the comments it generates.

    • RC says:

      I’d like to disagree.

      As someone who is just finishing an application year, getting into medical school is ENTIRELY about money. Let’s break it down.

      -$5-10,000 for summer experiences, be they extra classes, a week in Tanzania, or a summer in a bio lab. Some schools, usually the most elite, will cover these summer fees. Most will not. I’d like to think that a good-hearted admissions counselor would consider a student’s family income in relation to the number of opportunities she lists on her resume, or that there are those who would value a student who spends a summer working to pay rent over a student who spends a summer as an unqualified HIV/AIDS counselor in a foreign country. But let’s be honest, Stanford doesn’t want former waitresses. It wants researchers/start-up founders/children of the elite.

      -$2000 for an MCAT prep class. Optional, but almost all students who can afford it will opt for one. If you think the SAT is unfair to poor students, try the MCAT. Most advisors will tell students to take an entire summer off from work or school to prepare.

      -$1000-3000 just to **send** in applications (each school charges $75-150 to submit an application). The average number of schools an applicant applies to may range from 10 to 30, or even as high as 40, depending on his/her confidence in his/her application. There are fee assistance programs for up to 10 applications. Keep in mind, however, that fewer than 50% of all applicants will matriculate, and most students risk not receiving any acceptance if they apply to too few institutions.

      -$5-10,000 for flights/hotels/cabs/food to interview at various schools. All schools interview in person, and there is no assistance programs. Telephone calls or Skype interviews are not offered. THIS IS THE KICKER. Unless you live in NYC, most schools will be a considerable distance from home and require an airplane flight.

      And then, if you’ve made it this far lucky you! You face tuitions ranging into the mid-$50,000s at private institutions, $30,000s at public. And rising.

      There are certainly loan forgiveness programs, but the trick is getting there. Most students without proper support won’t make it. Not saying it’s impossible, but I certainly couldn’t have done this on my own.

      It’s the same for elite undergrad institutions. The admissions system, and the emphasis it places on test scores and too-good-to-be-true extracurriculars, favors the elite.

      • Michelle W says:

        This is interesting. I am from a regular white family, no one in the medical field, not affluent. I went to a state school in Illinois for undergraduate. I did not do any “summer experiences” other than working as a nurses aid emptying bedpans and making a little over minimum wage. I did not take any MCAT prep courses.
        I did not apply to 30 schools, I recall 6 or so. I got into 4 of them. I took out loans for 100%, paid tuition and lived on that. I did not have any scholarships, did not have the best MCAT scores, and did not have a 4.0, but close. I worked hard, studied hard, and if I can do it, anyone can. Money had nothing to do with it, although I recall people telling me it did and that I’d never make it without a doctor in my family or a large donation to a school from my family. Pure BS.

      • Alicia says:

        I’d like to counter every financial “barrier” that you have stated in order to try and support the author of this article. I came from an underprivileged community and graduated from a drop-out factory high school. My mother is a single parent who makes $38k a year and supports my elementary school-aged brother.

        I studied abroad with the help of financial aid and scholarships. I spoke with my adviser and applied to special ones put aside by my university to pay for traveling abroad. I know dozens of other students that have raised the funds to pay to study abroad by fundraising and even creating a gofundme account. I got my paid job as a lab assistant studying Chronic Neutropenia because I went LAB TO LAB introducing myself to professors and Primary Investigators asking them if I could work in their lab. This is not an orthodox thing at my school, but because I wanted it, I made it happen.

        I worked closely with my pre-med adviser who saw my determination and passion to go to medical school and she provided me with a FREE certificate to take the Kaplan MCAT course. She receives several a year, but I put in the work to make her remember me, and she did.

        If you are unable to afford the fees for medical school, there is a FEE ASSISTANCE PROGRAM (FAP) through AMCAS which will offer you a free subscription to MSAR online, practice exams, a $150 discount to take the MCAT, and WAIVED FEES for up to 14 medical schools. 14 is the recommended amount of schools that my adviser says I should apply to.

        Many medical schools make offers to room you with current medical students when you go to visit the campus for an interview. There are also scholarships available through many pre-med programs that will help to offset the costs of flying to interviews. I know the Latino Medical Student Association has one, possibly SNMA as well.

        As for the cost of tuition, loans can be forgiven if one chooses to dedicate some time to serving underprivileged communities after graduating.

        Sure the system may not be “fair” but when there is a will, there is a way. This article was extremely discouraging and unnecessarily prejudice (towards Asians) as well. Clearly the writer is angry and irrational. Your justifications for not trying are barriers to be overcome but not good reasons not to try. I would know, because somehow I’ve found a way to overcome every single one of them.

      • Donna Heffernan says:

        Is this true now? Incredible. I didn’t need any fancy experience to get into med school. I volunteered with an ambulance service to get clinical experience and worked in a lab after undergraduate degree. Only expense was for the emt course at community college. I did work as waitress in undergraduate school. Came from lower middle class. Med school 1996 – 2000.

    • Mary DeForest says:

      That’s not true in America. I had a vietnamese friend that studied-had to take off from school to help his family. He worked as a coroner’s assistant. He ended up being on an organ harvesting team. He makes good wages, but he doesn’t have that MD behind his name. He even was part of a cancer research team, did GYN and rectal exams-the study was about if there is a genetic correlation between some anal cancers and ovarian cancers.
      He had glowing recommendations from profs, doctors, researchers, coroners. All he got was letters saying- Sorry, but—I think it was held against him that he didn’t have any education while in a Malaysian refugee camp, so he was older. Then he dropped out occasionally to help pay the tuition for his younger siblings-never mind that he spoke 3-4 languages. I don’t think that the schools considered him dedicated.

      • Joseph says:

        Yes, I agree Mary.

        While the system works for the most part and not something easily to improve upon. It has it’s flaws. In medicine, there are hoops to jump through and some are impossible to do depending on your situation. I was a refugee as well, but younger than your friend and not as talented. I can attest to situations like his.

        While it is nice to think that America is the land of opportunity and there’s always a way. It is not true. If you are a doctor you should recognize that there are situations beyond anyone’s control.

        The thing about the system is that, to the system, excluding those few very capable people so that it can find a large number of capable people is good enough. The paper trail and hoops exclude some but not all of the people that are not capable. And also excludes a few of the very capable. But in the large picture, unless you can deal with each individual on a personal basis, you end up with situations that are far from an ideal America.

    • Tina Euresti says:

      Wow! He must be a very generous person that truly cares for his communities and would do it for free and would even pay for it without questioning bill. Nice to see his gratitude for toilet. I know he would have been better than a sanitized hospital even with out. Because he would understand the importance of washing hands and germs. I hope he does have water and soap. Is this a third world country and can we please let his respect and dedication to communities and care be appreciated and acknowledged. Just for the principle never give up or in it is priceless and selfless to provide care. I get your point. How did he do it and how is the practice going. I would imagine people love and respect him like he is a blessing from God and I wonder what the 2 specialty’s he has is in and if he feel god blessed him to provide to anyone anywhere?

  13. KB says:

    A sad story indeed. But, is she a good candidate for medical school? Does she have the education required from a low level college? She has no research experience. She’s never shadowed a doctor– is she sure this is the right career for her? I agree that only those with the financial means shouldn’t be the only ones getting into med school. But, I do think the the best and the brightest should be the ones getting in. Our healthcare system is in enough trouble as it is, and to start letting in unqualified students just because they make up a certain racial demographic– I totally don’t agree. If this woman has the high MCAT scores and the GPA to get in great– there are loans then to fund her education (I took out hundreds of thousands of dollars to fund my 5 years at an Ivy League dental school and medical school– so the money is there.). If she doesn’t, and only gets in because she is Native American, then she probably won’t survive long without the required education. (I also think she spent a lot of time on all the things she didn’t get, if she continues with that poor me attitude, she won’t get far in life– and if she shows up in med school singing that same tune, she’ll get torn apart on her first surgical rotation– those guys won’t tolerate all that belly aching.)

    • Pattie, RN says:

      I agree that this letter reeks of entitlement and self-pity. What stood out the most, however, was the lack of mention of the letter-writer’s grades. And, how much of the “edited for clarity” was correction of poor writing skills?

      No one would choose to live in poverty, but it appears that there are many, MANY programs this young woman has not investigated. In addition, being a single mother makes almost EVERYTHING more of a challenge….and this is one life circumstance that was entirely a result of personal choice.

      • Pamela Wible MD says:

        Edited for clarity meaning that I combined a few e-mails though 90% came from one particular letter. There is nothing wrong with Sage’s ability to write or express herself clearly.

        • Pattie says:

          Sage can write clearly….good to know she has this essential skill.

          Yet, I note that my other concerns stand without comment or clarification. Attitude and locus of control notwithstanding, what are this young woman’s grades…and in what type and rigor of course(s)?

          • Pamela Wible MD says:

            Her grades must have been good enough to get into an Ivy League.

          • Mary says:

            I myself read and noted the words “near-perfect GPA” in the article. GPA stands for grade point average, does it not?

          • Mary says:

            Pattie, if you see this all these months later, I have copied and pasted the following from the beginning of one of Sage’s comments: “Even with my near-perfect GPA”, to address your concern.

        • Tina Euresti says:

          This reaks of judgmental and critical reaction that reaks of authority and ability to think you are a bullie who I think is a woman who may have children who screwed everyone and anyone to get to the top and I am not sure of what because just because you say you are a RN patty does not make it true. So respond now if you can agree or disagree, I promise I did not even finish 9 th grade, and have to kids and did you work and even more and get this for self respect. I did more than you can even comprehend while driving and for less pay than a fast food worker. Now you are nothing special so don’t go puling out your chart. This is a generic message to well you know who you are Tom, Dick or Paula. I forget what person The RN Paula was agree was using self pity and entitlement for her misfortune. Oh yes! Sage, The native! Not sure or remember being a mother was an issue, Or her clarity due to education or writing skills, LOL. I love myself. Any how. I am not sure if my post was posted, I am sure you will not read it, It is not edited and I promise I am no writer and but I do know I can use your post to expose and justify why I am fucking going to snap and I hope right across the face of a person who can take me to the top of my class, and I know she is right were I seen her before. Because and if you don`t mind I know you are not qualified to say. But you are to justify and give a abliy. WINK! WINK! I am crazy and agree, I do need to be evaluated ASAP! Next. Any who, I am using and accepting feed back, I don’t expect it and hope I can live to dream about it. LOL. Never know you know the lady you are agree about died shorty after her post? No in case you think a suiside, Because that is the main objective of site. It was the car accident. At least that is Pam unfortunate information I learned right when I was in it to win it. Just not sage personally, Just her what stood out to me, Need to investigate a medical school or even a way to pay for it, And the place and information she found in the reply. Did stop to think about Motherhood and your advice on her right to chose to be a Mother a single mother makes EVERYTHING more of a challenge and I am not sure if you were sure about this life choice and circumstance and if it is entirely her a result of personal choice you are saying makes everything a challenge. I know you are a RN! not a writer. And it does stand out that her grades were a possible explanation, Being a mother is the real challenge for EVERYTHING ! I do not think your title can fix this. Really that is everything that I expect from your title and reality! It is not EVERYTHING, but something that wont stand out if you can not right. We have argued charts are not everything because of installs.. I know I have.

        • Tina Euresti says:

          Pam who are you speaking to or clarifying meaning to? And is it for your editing or Sage`s writing and why would you care? And I read this ignorance from Patty the RN!! and so I am wondering if you are saying single Mother are going to have challenges to EVERYTHING, and that it is a result of personal choice that is entirely form life circumstance. It makes no sense even if I was to edit it to the way it is written. I am not sure if I am stupid or crazy. That is a question I never ask. I don’t expect or require an answer,

  14. Nu Neteru says:

    This is totally unacceptable and must not continue.

  15. Marv Brilliant says:

    Grades are the key, not the race!

  16. Mahnee Dinsmore MD says:

    Yes it is possible to be a Native American and get into Med School with little money, I did it. But the path is almost impossibly treacherous and getting an MD is not the end of the “Hunger Games” I endure. If she feels so compelled she should attempt to apply to Darmouth which waives tuition for Native Americans or my alma mater Boston University which has a strong history of helping Native Americans. BUT can you pay for the cost of med school with a Family Practice salary, I don’t think it will cover the student loans. I think that medicine truly is an example of the Hunger Games, you can never get off the train once you board. Being a doctor is a nightmare.

    • Stephen Vaughn says:

      I am also from Boston University. I agree that Dartmouth, which has Indian/NA roots, has some support.
      People who come from cultures where aggression and competition is encouraged, do well in navigating the medical machine. People who come from cultures where human dignity, respect and politeness, being unassuming and quiet are part of people skills – they are Invisible and get left behind. That is true in much of American culture. I know people from a number of tribes, and they are generally quiet and polite, which is liability on riding the Medical Machine. But Sage, I really mean it about Elouise Cobell. She had to stick her arm into the cesspool that was the management of the Individual Indian Trust Fund. After 200 years, the Government had to admit that it had been pretty much stolen. So she fought the truth. Once you know, you cannot turn back.

    • Dawn Barnes says:

      Dr Dinsmore, where are you now? I loved you as my doctor! I’d gladly follow you. Dawn Barnes
      mssh@frontier.com

  17. Ana says:

    I’m with GB. She needs to crowd fund her education. She also could use a mentor.

  18. med minority says:

    This is very whiney. Yes, being a poor minority makes getting into med school harder. I happen to be the type of minority that is least likely to get into med school: Asian. My family is not wealthy as none of us were born in this country.

    If she really wants to go to med school, she should at least know how the process works. Going to Africa as a resume padder is not a good way to do it – it reeks of rich kid privilege and if you don’t think ad coms see through that, then you’re nuts.

    Also, last I checked, I’m being taught to screen for alcohol use every chance I get. I’m guessing that’s what the doctor was doing, you know, his job. You have the frame of mind that everyone is out to get me, and if I think it may be racist, then it’s definitely racist.

    You haven’t even taken college biology, and you’ve already given up. I spent 7 years in undergrad because I admittedly messed up early on. I had to work my ass off to make up for it, and apparently, you think you’re just as deserving. You’re entitled to a med school seat because you’ve faced adversity.

    Protip, med school is hard. The process for getting into med school is also hard so as to screen those who can’t make the cut.

    You also don’t just ‘choose’ a specialty. Rich kids that get in must be very smart just to survive. You act like once you’re in med school, everyone just starts goofing off for 4 years, then they go and collected million dollar salaries when they graduate. You are delusional.

    If you really want to go to med school, take out loans, move to a college town, and study your ass off. Learn to stop giving a shit about who is and isn’t racist and just get straight As. Assuming you pull all of that off, you’ll graduate with 200-300k of debt just like the rest of us. That’s also assuming you don’t get any scholarships.

    Grow up and stop blaming everyone else for your failures.

    • Michelle W says:

      Ditto as per my comment above. Race has nothing to do with it, and it’s time people stopped even looking at that. We are all members of the “human race,” and that’s all. Hard work, hard work, hard work. That will get you there. Not focusing on your families roots.

  19. samedame says:

    Okay, I call BS on this.
    “I was accepted at an Ivy League” then why didn’t you go there? The Ivies all fill 100% of need with aid, and have very excellent packages for those with no money. If you refused the Ivy to go to a local school, that is your own fault.
    “Scratching for money to buy a textbook” Yes, been there, done that. That is the purpose of student loans. I took out student loans to cover these costs and so can you. I also engaged in “work study.”
    “Local doctors don’t allow Native Americans to shadow them.” I also call BS there. Nobody is going to refuse to let you shadow them because of your race, sorry. Chances are that you did not ask enough doctors. In any case, shadowing is completely useless, and I never did a single second of shadowing prior to my medical school days.
    “Med school is for rich kids” well, no it isn’t. I grew up far below the poverty level and received exactly zero financial assistance from my parents and family. Once again, that is the meaning of the word “student loans.” The VAST med students do not have their parents paying for med school. Is med school too expensive? HELL YES. But everyone takes out loans.
    How does it feel to be a URM and to know that you will have all the advantages of race based preferences while still maintaining the ability to call yourself a poor little victim? Pretty good, I would guess. Stop b****ing and start working.

    • Curious says:

      If you “never did a single second of shadowing” prior to your medical school days” how did you get into medical school? Influential, rich white dad pull some strings?

    • Pamela Wible MD says:

      Without shadowing, how did you know you would den want to be a doctor? Just curious. Both my parents are docs so I was shadowing my entire life. I have no earthly idea what it would have been like to have a disadvantaged background and pursue medicine. Like I mentioned in another comment, I barely made it through med school with every possible advantage. Proud to say I came out the other side with my heart ad soul intact. Yes, I’ve needed a lot of counseling to handle the trauma of what I witnessed in my training.

    • Stephen Vaughn says:

      Be gentle – be gentle. If our American way of training doctors was just, then by analogy, we should legalize dogfighting and select the biggest and nastiest to be our service dogs and guides for the blind. It calls itself “competitive;” it is merely cruel, especially the premedical days.
      There is a common rule that is all too prevalent in America – conformity + mediocrity + time = success. American life is very gentle and pleasant for the Visible and Beloved.
      The system is very kind to Visible Minorities, too. Look at Barack Obama! But because the system is kind to the Visible, does not say anything about the Invisible.
      But there is no truth to the idea that there are two choices – that you have to turn OREO, or quit. Your judgment is not ripe now. It is not about what has happened to you as a young woman – it is what has happened since you became an old woman. Fifty years from now – that is your day to decide. Just live now, Sage. Learn first of Yellow Bird Woman. They laughed at her – a Blackfeet who wanted to take on the BIA! What a fool!
      My home town has a long history of beating Indians into whiteness and civilization, for centuries. We had an Indian School. We made some good White Indians. It was cruel. Do not believe in either-or. You are here for a reason, Sage – don’t you see? Disrespect comes from the outside – dishonor from the inside. Do not confuse them.

  20. Vera says:

    Gonna be blunt here. This article is either not legit, or is written by a young person who needs to do some serious introspection. There are too many fishy inconsistencies here. It reads as a not too skillful ploy for sympathy and cash.
    If you are a straight A student why have you failed to apply to a nearby school that will financially assist you? If you are the granddaughter of a chief and a medicine woman
    who lived on your reservation and you are a lineal descendant you should not be excluded from tribal membership even if one parent is from another tribe. Educate me differently if this is not so, and from what tribes you come. You are of only four speakers of your tribal language and the “only one with a legitimate shot” of preserving it in your entire tribe? Being a supporter of a tribal language initiative myself leads me to believe there also is something in this statement that does not meet the eye.
    I also am not understanding why Native Americans are not allowed to shadow your local doctors, implying that students from other backgrounds are. That is so blatantly discriminatory that a phone call to the media or the ACLU should get the wheels rolling and if that phone call hasn’t yet been made by anyone in your tribe, ever, even anonymously, something doesn’t quite sound right.
    Med school and residency require a hide of steel and an iron will and at some point no matter how rich or poor or black or white or Native you are you will be broken down and need to build yourself back up. Not racism, just fact. Nobody gets a free ride.

  21. Vera says:

    Also, respectfully, the photos of models particularly of the Native woman which reeks of cultural Hollywood stereotype are not reassuring as to this article’s legitimacy of content.

    • Pamela Wible MD says:

      These models live in (or near) my town and have been used to protect the identity of those in the piece. The Native woman could lose tribal housing and have all sorts of repercussions from being identified. I do not claim to know what it is like to live in this much poverty. I know nobody else in the USA going to the bathroom in buckets with no running water in this day and age. I barely made it through medical school with running water and 2 parents as doctors. VERY, VERY, VERY soul-sucking hard. I signed papers to drop out in my first year of med school. A classmate convinced me to stay. He later died by suicide after graduation leaving his young daughters and a wife. See physician suicide letters here: http://www.kevinmd.com/blog/2014/04/physician-suicide-letters.html

      I know I am on a tangent from the model photos, but I guess I’m asking that we all have some empathy for others. We do not know what their lives have been like. We have not walked in they shoes nor sat on their honey bucket.

      What is the purpose of discounting someone’s life story anyway?

      • Anon says:

        > What is the purpose of discounting someone’s
        > life story anyway?

        Any time a persecuted group stands to gain something, they are attacked and their life stories and events are discounted and dismissed as fabrications. You see this when decendants of Jews who were massacred by the Nazis are given reparations. You see this when anyone talks about reparations to descendants of black slaves. Sage stands to gain something from crowdsourcing, so the gunners from the pre-med and medical groups on Reddit attack her. Those on the Reddit pre-med and med groups and those on Student Doctor Network have only one name – ruthless gunners.

  22. Bronwyn says:

    Forgive this post, it gets grandiose at the end.

    One of the cultural facets of mainstream American culture – maybe a mythology based in the opportunities afforded by the “open” frontier in the pioneer days – is the “success against all odds” narrative. We like to celebrate those who overcome all obstacles and win. But what we don’t see is the ten people who don’t succeed. Their stories are not the ones we recount. And, if someone doesn’t succeed, we tend to blame it on them, not on fortune, or the opportunities they were not afforded. I hope Sage doesn’t give up – and I hope even if she doesn’t become and MD, she still takes up a profession that allows her to help others. The flip side of this story is how hard it is for some Aboriginal people to receive healthcare (for example: http://www.vice.com/en_ca/read/why-are-native-people-who-use-community-clinics-in-toronto-dying-by-age-37)

    There is a book called Outliers, by Malcolm Gladwell, in which he describes a huge cultural difference between upper/middle class parents, and working class parents raise their children. Middle class families engage their kids in a litany of activities, extra-curriculars, tutors, etc., and from the outset teach their children how to interact in assertive ways, with authority figures, for example. But if you are from a working class family, it’s far more likely that you spend time unstructured, and learn to see authority figures as “other.”

    What has this got to do with Aboriginal people seeking to get into medical school? Well, a big difference between Lily and Sage, based on the narrative, appears to be an underlying cultural difference – but only part of it is race-based. It could and does happen regardless of race, too. If you are from an Aboriginal family, the likelihood that you are disadvantaged in less obvious ways than wealth (per se) is high. I bet Lily was trained from birth to work constantly, be social, participate in every club, etc., and possibly taught that conventional success is important. I also bet she’s an extrovert. I bet Sage had a lot of unstructured time – maybe playing outside with her siblings, and that her socialization and value system is structured in a different way…a way less conducive to dealing with / taking best advantage of the system.

    I also wonder how it must feel to be a “non-status Indian” as we say in Canada. Here, Status or registered Indians (First Nations) have a range of benefits, including funding for post-secondary education. However, non-status individuals do not have the same access because they fit outside of the legal definitions which oblige/allow a government to institute “Indian” policies. That must feel unfair.

    I would also add, that the racism and cultural legacy of mistreatment endured by Aboriginal people in North America is its own beast. Not that it is “worse” than other racism, just that there are some peculiar aspects about it, which I don’t think people understand, because they don’t have a deep knowledge of Aboriginal traditions, cultural values, or history. I just read a study about cross-cultural adoption and it found that such adoptions have very high success rates generally – except for Aboriginal children! For Aboriginal children, cross-cultural adoptions are often disastrous. The reason being that their culture is more often denigrated or denied, avoided as if it were shameful.

    Is Sage should read this – I’d like to say, keep trying to go forward and become a doctor. If you feel that things are unfair – they are – maybe not in a direct and overt way, but in fact in a way that’s too deep to fix with any policy. But please, don’t let your heart get broken. I’ll tell you this – if all the Indian hearts get broken, we’re all fucked, not just Indian people, but everyone. This is because for a very long time European people made an assumption that our technological capacity and will to expansion was it’s own justification, and inherently superior. But this is not true. The fact that we couldn’t appreciate what we were destroying was a symbol of the weakness in our culture. Don’t let yourself be discouraged. I really hope you find a way, and that you can act a bridge.

  23. Pp boy says:

    Sage,

    Come on sistaa! It took me 5 attempts before I got into med school. If you reeeeaaaallllyyyy want it, you can do it. Stop whining about being disadvantage. So was Ben Carson, the brain guy. Look at him.
    Bottom line, if you want something bad enough, you put your mind to it. Take out loans, join the military, use your Indian heritage to get free cashola! Move to Chicago and apply there. They dig disadvantaged.
    Come on sista, no excuses. I am FM doc and still paying loans.
    Through the violin away and bag your head on reality.

    It’s America. Anything is possible.

    Cheers,

    • Your [hopefully] Average Concerned Citizen says:

      I read Ben Carson’s book. Not sure if you have as well. Either way, he was lucky in some ways. He did have cultural and financial struggles that those who are white or who have money will never know. I am proud of him and all who overcome. Please, note: it is perfectly acceptable, and indeed reasonable, to praise one for overcoming struggles while also supporting ans sympathizing with another who is still on the other side of overcoming their own. I truly do not understand why people are restive towards this objective, case-by-case method of looking at different people who come from different situations. I mean, I’ve learned of the cognitive steps that these narrow-mindned individuals take and have learned of insecurity and what-not.

      Every struggle is different. No two situations are the same. Even though one may have to go through hell to achieve the same end as another who didn’t, doesn’t make it okay. Just because it is doesn’t mean it ought to be. Again, shouldn’t have to spell these out.

      I’m assuming I’ll have to spell the following out as well. sigh. Here goes. First off, I’m not a Republican or “right supporter” but I do admire and respect Ben Carson. A friend gave me his book when I was an undergrad and it inspired me. He sounds like a wonderful person and I’m happy every time wonderful overcome the odds and fight through and succeed. Notice: “overcoming odds” – so not even close to everyone in these situations overcomes. For every Ben Carson, there are hundreds of others who didn’t make it – to no fault of their own, mind you. Just because some were gifted with that much more strength and intellect, doesn’t make it possible with those who just didn’t have enough strength and intellect. The problem is, the system isn’t balanced. It is not fair. Nor is it okay that it functions in the unjust way that it does. Do we want to victim blame and enable a flawed and abusive system, or do we want to listen and help those who struggle. Ben Carson had to function at a higher standard than the kids who came from better means. He had to be better than they had to be in order to get to the same place in life – and, indeed, to get into the same schools. It should be obvious that this is not okay. It’s not just. Do we want to hate on people and allow such a society. Or do we want change the system and make things better for the next guy. If you were disadvantaged and suffered, why allow things to be that bad for the next guy in your shoes. Makes no sense to me. Ben Carson also got lucky in other ways. He had an absolutely phenomenal mother who cleaned houses for a living. She worked extra jobs to take care of her kids. She even sought out houses of wealthy people who had libraries so that she would have access to those materials for her children. She made them read a book a week and write weakly reports in the summers. She encouraged and pushed her children. Most lower class children do not have this experience.

      I do not relate all this to belittle Dr. Carson’s struggles or achievements. I look up to him and would love to meet him one day. I feel I need to state this because I’m sure statements claiming that I feel otherwise are the sort off-topic attack/response some would be tempted to write. Not here to fight. Here to open people’s minds and hearts and to help to make the world a better place – for everybody.

      Thanks to all of those who have been encouraging towards this woman. I too hope she doesn’t give up. Just like Dr. Carson, she will one day be able to encourage others like her and will be in a position to change the system which treated her so unfairly – making it a little more fair for the next guy. Isn’t that what we all want. It will be harder for her than it will be for others. It will take longer. when people say it can’t be done, they really mean it just can’t be done in the same time frame that others were able to do it in. They mean that it will be harder than think it’s worth. They mean it will harder than they would be too hard for them. It will be emotionally harder and she will have to somehow be stronger than all of her peers. But she can do it. The fact that she wrote Pamela, says a lot. She’s out there searching, trying, reaching out! I am so amazed that she has made these steps. That gives me faith her abilities. Life is full of ups and downs, make-or-break moments. I guarantee that she wrote this letter because she was at a low, hit a point of great desperation, and she really didn’t want to quit. Something in her, whispered, just try this – try a little more – one more time. Sometimes people have to quit their dream to be a doctor and then come back to it. I had a friend with kids who got a phlebotomist job for awhile before continuing her pursuit. There’s no timeline. And for some people, I think knowing you’re meant to be a physician is a lot like falling in love. You just know. You don’t need to shadow to know. I’ve met people from lots of different professions and this isn’t only true for physicians. It’s true for many other professions. Anyone who is passionate or feels a calling to follow a certain career, will just have this innate, indescribable (at first) pull towards that field. Those who can’t relate, often feel bitter about this. It’s okay, you don’t have to be passionate to be good at something. I mean that wholeheartedly. Just. If you don’t understand the guy who is, don’t blacken out their sunshine. We all shine in our ways.

      Anyway, I wish this woman all the best. If you have to take care of your little one and build up a life around you for a few years, it’s okay. A future medical school – one that appreciates you – you give you props for that. Just don’t give up. Don’t do it. Don’t let the unjust win. Prove yourself right. I believe in you!

      ~ all my love, Katye 🙂

      • Pamela Wible MD says:

        Thanks for your wisdom and insight Katye. Sage actually died in a car accident soon after this blog was published. Let us hope that we can all learn to have compassion for ourselves and each other while we’re here. You never know what struggles people face. Each person is unique in their capacity to deal with the adventures/misadventures of their lives.

        • Your [hopefully] Average Concerned Citizen says:

          Nooo… So sad to hear this. Breaks my heart.

          Thank you for your lovely words and for sharing Sage’s story.

          Perhaps your efforts gave her comfort and hope during her final days. That’s a gift in itself. I’m sure her story will touch and inspire others from all walks in life.

          ~ Thanks to her and thanks to you.

  24. Pp boy says:

    One more thing to make the playing field even;

    I put myself through college and med school. Got a job, worked between semesters. Lived in an efficiency apt, on my own, went without food, and got fined for paying bills late due to lack of funds. Canceled semesters because I had no doe.
    I even had a college career counselor tell me to give up on medicine because I got rejected twice. Uuuhhhmmm, if I would have listened to her……
    Oh, I forgot to mention, I’m Hispanic.

    Cheers,

  25. Vera says:

    I’ve seen this dynamic before. When statements are made that result in offers of long term monetary support from compassionate strangers it seems wise to question when some of those statements are a bit suspect.
    Life is hard and rez life is extraordinarily difficult. I myself within my limited means assist a young Native man with his schooling and have spent a lot of time there.
    There are resources for those who are persistent and have a good mentor.
    Does she have one?
    If she wants to be a doc, debt-free, there is also the
    Military.

  26. V Valle says:

    Actually, you are mistaken about Affirmative Action. It is not only for African Americans You would have a much better chance at being admitted to an elite institution than most African Americans because under-representation of Native American Indians at such schools is so much more acute. Affirmative Action is aimed at reducing disparities based upon historical injustice. So, I would say, based upon a 40 year career in university and college admissions and enrollment management, that your chances of being admitted to elite institutions is quite good is you are academically prepared.

  27. Disgustedwithracists says:

    I am absolutely disgusted with those who are attacking Sage. They are not just outright prejudiced but also fail to understand the enormous complexities of the Indian system. For example, one poster ‘Vera’ says Sage’s story is not legit because she says if Sage is the granddaughter of a chief and a medicine woman then she should not have been excluded from tribal membership even if one parent is from another tribe. Sage actually wrote, “My grandparents belonged to different tribes, so no tribe accepts me, even the tribe whose reservation I live on where my grandfather was Chief and my grandmother was Medicine Woman.” There are many such full-bloods who are not eligible for membership in any tribe. AND I AM ONE OF THEM!
    Let me give Vera a hypothetical example in a simple form (even though the realities are FAR more complex with not just tribes but bands and clans and villages where some follow patrilineal descent and many follow matrilineal descent, where some bands belong to some tribes but the federal government classifies them as entirely different tribes, and where some band members live with different tribes). So here is a simple example with all complications removed. Suppose Sage’s lineage is as follows –
    Grandpa-1 is from the Match-E-Be-Nash-She-Wish tribe
    Grandma-2 is from the Navajo tribe
    Grandpa-3 is Ḵwiḵwa̱sut̓inux̱w tribe and the Chief there
    Grandma-4 is Oglala Lakota and a medicine woman
    Grandapa-3 gets married to Grandma-4 and grandma-4 starts practicing her traditional healing skills with the Ḵwiḵwa̱sut̓inux̱w tribe treating the Ḵwiḵwa̱sut̓inux̱w people all her life. Now many tribes have BQ requirements (BQ = blood quantum). This may be 33% or 50% or something else. Suppose the BQ requirement for Ḵwiḵwa̱sut̓inux̱w tribe is 33%. Sage’s lineage is from four different tribes, so her Ḵwiḵwa̱sut̓inux̱w percentage is only 25% which is lower than the 33% required for Ḵwiḵwa̱sut̓inux̱w tribal membership. So even though Sage is full blood Indian, her own Ḵwiḵwa̱sut̓inux̱w tribe where her grandpa is Chief and grandma is the medicinewoman, does not allow her to enroll. Consequently, she is not eligible for tribal membership. Legally, in the eyes of the federal government, this full blood is NOT Indian and she cannot claim Indian status. And remember, this is a much simplified example; the realities are far more complex. So keep your prejudice bottled up and don’t mouth off without knowing anything elementary!

    • SteveofCaley says:

      To really understand the matter of Indians/Native Americans TODAY means looking back at a long and ugly history. A great deal of American prosperity came from the theft of land and labor.
      I know very little, but what I do know is awful. Look up Oñate and the Acoma people.
      I try to deal with Indian folks with my ears open and my mouth shut. Jack Utter wrote a pretty good book called “American Indians: Answers to Today’s Questions.” I have little other sources to compare it to, but it seems to be pretty helpful in understanding the things that DWR says.

      Being 100% Bilga’ana of the Wannabee Tribe (Whitebread Band), I remember that person told me that the most offensive word Indians know, is “THEM.” Once we start treating other people as “THEM,” all hell breaks loose. If you’re only telling THEM what to do and where to go, up to killing THEM, and THEIR families and children, it’s not so real if it’s just “Them.”

      The first rule is stop, don’t make it worse. Next, don’t talk about what you don’t know.

  28. Geoff says:

    I had no idea that such barriers still existed. Thank you for posting Sage’s letter. I hope she finds comfort, courage, strength, and financial support for her aspirations.
    It is sad to see the harsh comments by some which respond to vulnerability with vitriol.
    Crowdsourcing for Sage sounds like a great idea.

  29. JonOnTheRez says:

    https://i.imgur.com/UCIA2qS.jpg

    This quote/confession by a white Cherokee is also relevant because it touches on some of the issues mentioned by Sage:

    QUOTE: A large number of our federally recognized tribes are almost entirely white people with ZERO Indian blood who make billions of dollars. And FYI – I am a full blood.

    A large number of federally recognized tribes are full of whites with no Indian blood in them – the best example being the federally recognized Cherokee Nation of Oklahoma which has been close to 100% white for many many generations.

    By “full of whites” I mean these federally recognized tribes have 100% white population with virtually no real Indians. Many federally recognized tribes are whiter than Europe.

    Such white federally recognized tribes still get hundreds of millions in government benefits and casino monies. These are your taxpayer dollars that go to such white people.

    These “Indians” like to claim they became white over generations because of intermarriage. But our Elders tell us this is not true. They were whites who were signed on by Indian agents. The Indian agents were under pressure to enroll Indians who refused to sign away their land. So they signed their own friends and relatives instead to get Indian land and Indian benefits. The descendants of these fraudulent whites make billions in taxpayer and casino monies. We are talking about BILLIONS of dollars here.

    Whites have always been trying to be Indian. Even today, we have whites in every European country who are trying to be Indian. They even live in teepes. Watch this pow wow in Denmark (http://www.youtube.com/watch?v=WKd7VEcTMds). These whites from Denmark get no benefits in trying to be Indian. Or watch this pow wow in Poland (http://www.youtube.com/watch?v=0fbb8vmxnAk). These whites in Poland get no benefit from being Indian. Now imagine what would happen if these whites each got 160 acres of land for being Indian. That is exactly what happened. Whites were signed on as Indians, which is why our federally recognized tribes are full of whites.

    Don’t take my word for it. Read what this Native American Yale professor has to say in her opinion editorial in a peer reviewed journal, The American Indian Quarterly – http://muse.jhu.edu/login?auth=0&type=summary&url=/journals/american_indian_quarterly/v026/26.4shirt02.html

    Sometimes white casino interests will ensure that one white man or one black woman forms a ONE-PERSON federally recognized tribe that makes millions in casinos – read this TIME Magazine article http://content.time.com/time/magazine/article/0,9171,1003896,00.html

    What is the solution? I am afraid I don’t have any good answers because there are tribes like mine that are full of real Indians that live without water, electricity and heat. Then there are many real Indians whose tribes are too poor to have $35 million dollars it takes to get federal recognition, so these tribes get zero benefits. There are many full blood Indians whose grandparents belonged to different tribes, so they are not eligible to enroll in any tribe and these full bloods have no tribal enrollment. There are also many real Indians who were disenrolled from their tribes over casino per-cap politics. So I don’t have a solution. I am just exposing the corruption in federally recognized tribes which the media will never share with you. Even the Indian media because our media is 100% controlled by whites with casino interests.

    This news is censored by capitalistic casino interests, so you never get to hear it in the media. I won’t be surprised if it is deleted on Reddit either – or heavily downvoted after the Indian listservs get wind of this. Please share widely. Thank you my brothers and sisters.

    EDIT – 1: There is a long-term solution to this mess but it is complicated. Americans feel that tribes are “given” benefits. That is incorrect. Americans don’t realize that tribes have prepaid for all these “benefits” in terms of land and lives or that these are nation-to-nation treaty obligations. But the long-term solution would be for us Indians to waive all those benefits and say we don’t want them. The Haudenausaunee Confederacy had suggested that tribes should stop relying on the Feds for ratification, validation and financial support. Tribes have got to be self sufficient and decline all financial support from the Feds. Affirmative action has to completely end. We have to put an end to casinos and payday loan businesses. Once affirmative action is gone, casinos are gone and financial incentives for being Indian are gone, whites in our federally recognized tribes will see no point in being Indian unless they REALLY identify with us and 99% of them won’t. They will go back to being the whites they are after affirmative action ends and financial incentives end. That, I think, is the long-term and only solution.

    EDIT – 2: QUOTE “The secret America does not know is that we (Cherokee Nation of Oklahoma, the BIGGEST tribe in America, federally recognized) have been close to 100% white for several generations now. This is because BIA agents got their white relatives to fraudulently enroll in the Dawes Roll to get Indian land years ago. Today we are close to 100% Caucasian. http://i.imgur.com/Kxy1z4Q.jpg

    By the way, we have been a white tribe for several GENERATIONS! All the Cherokee Nation Chiefs have also been white. Here, check them all out – my former Chiefs and the present Chief:
    http://en.wikipedia.org/wiki/Bill_John_Baker
    http://www.manataka.org/images/Smith,%20Chad,%20Cherokee%20Nation%20Chief.jpg
    http://www.nativenewsnetwork.com/image-files/crittenden-joe.jpg
    http://www.cherokeephoenix.org/Docs/2012/1/5868_cou_120114_Seat1(1)_wc-L.jpg
    http://en.wikipedia.org/wiki/Wilma_Mankiller
    http://www.pchs4allyears.com/old/onlinemuseum/vips/NATIVEAMERICAN/RossSwimmer2.jpg
    http://www.ebay.com/itm/1969-Oklahoma-Cherokee-Nation-Chief-William-Wayne-Keeler-Press-Photo-/251069527624 (this was our Chief way back in 1969 – whites even then).

    How about in the 1800’s? Well, we have been white even then. Check out my Chief in the 1800s: http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GRid=19551734

    Here is another Chief of my nation from the 1800s, also white like everyone else https://en.wikipedia.org/wiki/William_Charles_Rogers

    And yet one more Chief of the Cherokee Nation from the 1800’s, also white like all: https://en.wikipedia.org/wiki/Thomas_Buffington

    Want one more Chief from the 1800s? Here he is also white like the rest of the federally recognized Cherokees – https://en.wikipedia.org/wiki/Joel_B._Mayes

    My tribe has always been a fraudulent tribes of whites who fraudulently got themselves enrolled in the Dawes Roll. And today, for the most part, we are parasites on the hardworking American people. As whites who have Native American status, we get a ton of free things, including benefits like affirmative action.” UNQUOTE

    • Pamela Wible MD says:

      Thanks John for the insight. Racism at its worst. To solve this we must shine the light of day on the injustices. May this blog start the national conversation that is long overdue. Agree with John. Share widely.

  30. JonOnTheRez says:

    Oops, I misunderstood. The quote is by a fullblood who is simultaneously enrolled with the Cherokee Nation of Oklahoma (one of the several fully white federally recognized tribe) and the Eastern Band of Cherokees (which does have a few fullblood Cherokees).

  31. JonOnTheRez says:

    Ooooops I misunderstood again. Looks like that poster is neither with the Eastern Band nor with the Cherokee Nation!

  32. cannotgetrecommendationletter says:

    I cannot get into medical school without letters of recommendation. As an African American at an elite private school, I wondered why no professor was willing to write me a letter of recommendation despite my 3.89 GPA and my extremely agreeable behavior. This article from yesterday tells me why http://www.policymic.com/articles/88731/wharton-study-shows-the-shocking-result-when-women-and-minorities-email-their-professors?utm_source=policymicFB&utm_medium=main&utm_campaign=social

    • Kendra says:

      I have to wonder about this article. I am a female minority and not from a wealthy family who went to an elite school as well, and after spending time getting to know faculty and helping them on projects, they actually asked me if they could write recommendations for me. I bet it would work for you, too.

      With regards to Sage, medical school is tough and what I have learned from medical school it is nothing I had expected, but very rewarding nonetheless. I was disheartened when I thought medical school was about me and what I needed. Medical school is about learning to act compassionately toward others no matter how difficult your life is at that moment. Anyone with solid grades, initiative and a good character stands a good chance at getting in.

  33. anon says:

    Is there any way to get the e-mail addresses of Deans of Admission and Deans of all medical schools, both allo and osteo? I would like to send this link to all of them. They need to read this!

  34. Kitty D. says:

    It is entirely possible – especially if you want to be a family doctor – to go to community college, finish biology/other life science degree at a 4 year state school (with premed focus – like Oregon State or PSU) then go to a state medical school like. All way more affordable than Ivy league and depending on where someone lives – they might have to move to make it happen – lots of students move and find ways to make it work without rich families. Once you’re accepted to medical school, the loans are enough to pay tuition for a state school and to live on. I’ve known poor students who took that route and are doctors or even surgeons now.

    I guess what I’m saying – it is possible to make it happen even if you’re poor. It doesn’t have to be a “Well they’re IVY league and I’ll suck if I don’t go to Ivy league” – which simply isn’t true. Comparing oneself to a student who’s accomplished when you’re just getting going will do nothing but discourage and be self-defeating… she’s seeing failure for herself before she even gets going and that’s sad. Clearly she can use the internet so perhaps she should use the med school forums to connect with other non-rich/poor students who’ve made it into medical school… ask them how they did it. She’s lacking in -knowledge- on how to go about making it happen… if she can’t seek out that knowledge for herself, she doesn’t belong in medical school – it is grueling and involves a lot of problem solving both in and out of school.

  35. Counselor says:

    > she doesn’t belong in medical school

    You don’t know the first thing about the constraints these Native students face and yet jump to such a judgment. Let me ask you one simple question – fully one third (1/3) of O’odham Natives cannot get a SSN because they were born somewhere on their reservation and cannot document their birth with a birth certificate that is acceptable to the government. So let me ask you one simple question: how will they get student loans without a social security number?

  36. Frozen Doc says:

    Thank you, Sage, for writing this letter and to Dr. Wible for sharing this. I am training to be a family doctor with a focus on health of indigenous communities in Canada. I haven’t been to a reservation in the US, but from my rotations on reservations in Canada, I can see numerous obstacles to someone like Sage being able to go to medical school. She is absolutely right when she says that she is in a system that has been set up so that she will not succeed.

    This is an absolute tragedy, as we need people like Sage to become health care professionals of all types, including doctors. The tuition for medical schools in Canada is still high, but much lower than for many schools in the US.

    It would be incorrect and arrogant for me to claim to understand what it is like to experience prejudice and stereotyping as it sounds like Sage has experienced at her school. Not coming from a minority background, I don’t think it is something that I experienced growing up. It isn’t something that I experienced until I started to study family medicine, and (at least where I live), family medicine residents are typically treated as people who are dumb, lazy, and just “took the easy way out” instead of going into a specialty. Many specialty doctors don’t want to teach us procedures or show us how to do things, because of the stigma of family medicine being for stupid people. The truth is, family medicine is very important and challenging, but I didn’t realize what it is like to be in a system that sets you up for failure and in which you experience discrimination and stereotyping until I had gone through this system. People can rant and rave about how if you just work hard enough and try enough, you can accomplish anything, but that is actually a lot harder when you are working within a system that sets you up for failure.

    If I were to do things over again, I would actually have studied nursing prior to going to medical school. There are a number of reasons I would choose this route: nurses have an interesting and challenging scope of practice, I think they get better procedural training than we did as med students, and when working with so many nurses, I would appreciate having more insight into what it is actually like to BE a nurse. On the reservations where I have worked in Canada, nurses are the backbone of the health care system, and they do amazing work.

    Sage, are there any opportunities for you to study nursing first, have a source of income for medical school tuition, and then apply to medical school?

    Please don’t give up! We need people like you to become physicians.

  37. AnonR says:

    I know white people in their 60’s who “discovered” 3 to 4 years ago on ancestry.com that they had a remote ancestor on the Dawes Roll, used that to become enrolled in a federally recognized tribe and then used their power to get on enrollment committees to disenroll full blood Natives from their tribes. I have full-blood relatives who were disenrolled from their tribes by such white people and are not considered Native American any more. Basically white people are screwing us now from within our tribes.

  38. Helmut says:

    > White Native Americans benefit from affirmative action, not me.

    True and here is an example from today’s news item
    http://indiancountrytodaymedianetwork.com/2014/05/17/choctaw-student-earns-dual-scholarships-duke-154819

  39. This story is a sad reality for many. My upbringing did not allow for me to engage in the activities that would have boosted my medical school application either. I raised two children, worked in nursing homes and laboratories, tutored, and was active in school organizations, but these were all at community colleges, state colleges, and working with the elderly. All of my hard work prepared me to put in a strong application for nursing school, but medical school seemed to be out of the picture.

    Then I discovered naturopathic medicine applied to my top choice of school, was accepted (they called me the next day) and thrived. 5 years, a student loan debt that I don’t like to think about, and two rigorous board exams later, I have realized my dream of being a family doctor. Here in the state of Oregon, I am treated almost the same as an MD, I have full prescription authority, many insurances recognize my status as a PCP, and I love my patients.

    In naturopathic medical school realistic expectations are the rule. Life experience counts and you are seen as a human being instead of a list of accomplishments that will make the institution look better on paper. Even better, we are taught the core of being a primary care doctor (basic sciences, pathology, pharmacology, all of the other -ologies, diagnosis, minor surgery) and we are given additional tools to use – herbal medicine, nutrition, physical medicine, hydrotherapy, homeopathy, and others if you so choose to pursue them.

    I love having so many tools in my toolbox and being able to meet patients where they are and respect their wishes regarding their treatment. I encourage more aspiring doctors to look into naturopathic medicine when they are making their career choices.

  40. Peter Japper says:

    One tribe threw out 25% of their tribal members, so there are many Sages all over the Native American world now (http://www.originalpechanga.com/2014/05/shingle-springs-mass-disenrollment-is.html). The best solution for us is to seek a career in law school to fight for our rights and not medical school. Because medical school erects too many artificial barriers and you waste your life before becoming a doctor. And after becoming a doctor, you put a gun to your brains and blow it all away.

  41. Micaela says:

    I am also a dark skinned non-tribal Native American, and like Sage, I experienced many obstacles in my journey to medicine. My first attempt at pre-med ended in dismal failure. I had three great semesters of all As and one B followed by three semesters of all F’s. When I flunked out of college, I attempted suicide and was forced to return home. I returned to my hometown where I was once again swallowed up by my family members’ alcoholism, depression, illegal activity, schizophrenia and addiction to gambling and debt. Just before I flunked out, my father convinced me to max out on my student loans so he could use the money to “start a business.” Suffice it to say that his “business” caused me to suspect he was the Unabomber (he wasn’t). My default in those loans became a huge obstacle to returning to college.
    My “salvation” came when I connected with my Jewish heritage (my other tribe). I moved to New York, and began the slow journey of completing my degree one to two classes at a time. I was never able to let go of my dream to become a doctor, but I didn’t let that dream rule my life, mostly because I was embarrassed I still harbored that dream, so I kept it a secret. During the 13 years it took me to earn my BA, I married and had two daughters, and moved two Los Angeles. I had a total of 22 jobs, and I worked on my spirituality and studied for the MCAT by purchasing used practice books. I shared my secret with my daughters’ pediatrician, and he hired me to work in his office and encouraged me to re-take all my pre-med classes at the community college. He urged me to get tutoring, even if I didn’t think I needed it. He told me about the NHSC and about osteopathic medical schools. 20 years after I first started college, I entered medical school, as an NHSC scholar. I will be completing my service obligation this summer and starting a fellowship in Child and Adolescent Psychiatry.
    I am providing care in a rural community that is all white, so my dark skin exposes me to racism every day. However, not a day goes by that I am not filled with gratitude that I realized my dream.
    Yes, the obstacles for someone raised in abject poverty are huge. I have nothing saved for retirement, and I have no money to send my daughters to college (I now have a third, 19 months old). Was it worth it? For me, I have to say, yes, it was, because I got so much out of the journey. And, my life is rich.
    If you truly want to do this, Sage, don’t give up.

    • Pamela Wible MD says:

      Brought tears to my eyes. Your story is incredible. Wow.

      • Micaela says:

        Thank you, Pamela. I’ve been following you on kevinmd and on your personal blog, and I really enjoy your posts.
        My one regret is that I kept my dream a secret for so long. Once I “came out of the closet” about it, I attracted people who were willing to help me. Besides that pediatrician, one of my mom friends became my free babysitter for the three years it took me to re-take my pre-med classes. There are a lot of people out there who abhor injustice, and are willing to help.
        Now, I have several young people I am mentoring through the process of pursuing careers in the healthcare field, not just medicine, but nursing, dentistry, physical therapy. There’s room at the table for anyone who wants to heal others.

        • Tina Green says:

          Thank you for sharing your inspiring story, Micaela. The very old saying, ‘where there’s a will, there’s a way’ really is true. Most importantly, you are passing it on.
          I hope Sage can take inspiration from you and others who have posted here. I even bet that a number of you would be willing to be in correspondence and help her navigate her way to what she wants.

  42. joanney says:

    Here are some resources. Below are the names of programs, and links. Hope this helps.

    Center of American Indian and Minority Health at UMinn in Duluth, which graduates the second largest number of Native physicians in the country:
    http://www.caimh.umn.edu/About

    Association of Native American Medical Students:
    http://www.anamstudents.org/

    Indians Into Medicine – University of North Dakota:
    http://www.med.und.edu/indians

    Indians Into Medicine – University of Arizona
    http://www.fcm.arizona.edu/inm

    My takoja at Pine Ridge will be attending an introductory session at Duluth soon called Native Americans Into Medicine. He comes from extremely difficult circumstances, is attending tribal college and is excited to learn what he can do.

    Good luck.

  43. Nailah Cooper says:

    After reading Sage’s comment I have a few things to add.

    I am an African-American single mother of three young children (11,10 and 8) with no financial support from the kids father who just graduated from medical school and will be starting a Pediatric residency in California in a couple of weeks.

    I have learned how much money plays a part in the process of getting in and through medical school. As one person pointed out study aids, test, tuition and living expenses add up. And these are for a single person with no dependents. Can you imagine having to pay for all this and support a family. I was able to do this by asking about discounts for financially disadvantaged students and using them when available. Also by accepting Foodstamps, TANF and housing assistance which were humbling, but I was willing to do whatever it took to ensure a not only a future in which the children had a comfortable life but also teach them a valuable lesson. That lesson was “Do not ever give up with God all things are and were possible”.

    I grew up in poverty in inner city Oklahoma City. I tried using my smarts and got a scholarship to college. I ultimately lost it after entering into an abusive relationship. I lost everything as result of this relationship, my dreams, my family support. It was so bad that I was homeless for a period of time, while trying to escape the relationship.

    Fast forward five years from this time and I finally got the courage to leave. I left in the middle of the night on a greyhound, pregnant with 2 toddlers to Denver. That was the scariest night of my life, the abuse had gotten so bad I fear for my life. I knew if he found me he would kill me.

    I laugh at the rap song with the lyrics “Started from the bottom, no we are here”. Thats our story, I literally had nothing. When I applied to medical school I only applied to two programs. I could not afford to apply or live anywhere else. I didn’t get in the first time, but I was offered a interview in a provisional program and got into medical school this way.

    I graduated from University of New Mexico School of Medicine and there Hispanics and Native Americans are the target for minority scholarships. The majority of my school was paid with loans. I did not accept the Health Service Corps or local scholarship were you promised to stay in NM. I was pretty certain I wanted to do pediatrics, but wasn’t sure. So unfortunately it is also about location in addition to money. I believe Sage would do well in NM, I might have made off better where she was from. While there are no affirmative action programs in place in medicine, it pays to be in areas where there are more people the community and faculty who look like you. I was the only African-American student out of 100 students and often had to deal with ignorance. That was small compared to what I went through. Stress, they would break in my shoes. Imagine staying up with a child in the ER all night and then having to take a test the next morning. This had happened a few times in undergrad and medical school. Boys are wild and accident prone.

    Yes these things sucked and I owe hundreds of thousands of dollars, but it was sooo worth it. I know residency will be hard, but like I’ve said “I’ve been through worse”. I share my story so that those with similar backgrounds will work smarter outside of the classroom too. There are nontraditional ways to stand out. Organize in medical projects in your tribe/community, find people interested in what you are and write them (networking is just as important if not more important than money), find out what the medical schools are looking for in their applicants and put the strengths you have in the fore-front (This is what I did). And finally be confident. You are unique and no one else has your story, just like no one else had mine. We all know minorities are more like to return to their communities (communities usually with few physicians of any race or ethnic group) but you still have to convince medical school admissions committees that this is what their school needs.

    • Pamela Wible MD says:

      Nailah, you are amazing! I can’t wait to see what incredible things you will do in practice. I bet you are such an inspiration to your patients—and your peers!

    • Tina Green says:

      Nailah, that is quite a journey! Congratulations to you! Most certainly your patients will benefit from your experiences. And it’s clear that your kids have an incredible role model teaching them important life lessons, from the beginning.

      Sage, you can be whatever you choose. But I sense a tone of resignation and bitterness in your letter that I hope you can overcome. Poverty has so many toxic aspects that are hard to appreciate if you haven’t experienced them. They can take you down, if you let them. Just don’t let all that stuff defeat you! Let others help you through inspiration and the good information shared here. What you need are mentors; one or two people in a position to offer wisdom and guidance. Then you just have to decide how much and what type of work you want to put in, and to achieve what result.
      Which specific degree (MD, DO, ND ARNP) doesn’t matter, as long as you end up with enough credentials to practice (and get paid) where you wish to work, under that state’s rules.

      Good luck on your journey! Know that many are rooting for you and ready to help when you reach out.

  44. RN2MD says:

    I am a Native American medical student and there are others like me that read this article. The consensus is that we would love if Sage could contact us. We have stories, opportunities and encouragement we would love to share! Go Sage Go!

  45. MS4 says:

    I’m Native, grew up dirt poor in the inner city, and went to Dartmouth for free. I got in there as well as Cornell, Michigan, Northwestern, Chicago, Notre Dame, etc. How did I get so lucky? I knew early on that I didn’t want to live in shit for the rest of my life. I found out how to get fee waivers, summer study stipends, book stipends, scholarships. It’s not that hard.

    I do want to know how this kid wound up with a kid so young. It seems to me that there is more to this story. Maybe she had a little too much fun and now realizes that hard work matters now if one doesn’t want to be poor. Also, maybe her profs are telling her that she should drop out not because the color of her skin but because she has a little one dependent on her.

  46. Denise says:

    FYI, to clarify for everyone who believes the fairy tale, Dartmouth is NOT free for Native Americans. It may have been started that way hundreds of years ago, but sure as heck wasn’t when I went in the 90s. If anyone wants to correct me, please also point me in the direction of how to get a refund on the thousands of dollars in student loans I’ll still be repaying for the next few decades. Medical School was never an option, but law school, if you choose the right one, can be completely fully funded and free for native students!

  47. Caleb says:

    The answer is most definitely no. It is not just for wealthy individuals. It can be very difficult to be accepted into medical schools. But you ultimately create your own opportunities and circumstances.

  48. Jon says:

    About a third of the nation’s 24,000 enrolled members BORN IN THE USA don’t have paperwork needed to prove citizenship. Without birth certificates, they cannot obtain SSNs. Source: http://tucsoncitizen.com/morgue2/2001/11/23/81209-o-odham-citizenship-bid-wins-100-backers/

  49. Sarah says:

    The crowdfunding idea from another commenter is great. What about scholarships, or loans?

  50. Student says:

    I am sorry to hear how difficult it has been for Sage to reach her dreams and I wish her the best in her journey in healthcare. However, I am disappointed to read the example used regarding the person “Lily”. I do not know Lily, but the story presented seems VERY one-sided. The story presented in this article does not sound so different from my own, yet I definitely have not had things handed to me. I too, was a research assistant in a lab, a volunteer in the hospital, and had leadership experiences on campus. My experience is not black and white. I worked as much as I could in high school and worked part-time in a lab throughout college in order to get money to pay for my college education and living expenses. Did I receive publications? Yes. Was I “rich” in money? Absolutely not. I have had to pay for major medical expenses and chronic health conditions. My volunteer experiences were an opportunity for me to give to the community even when I felt there was no time; my leadership experiences were an opportunity to help my peers even in times where I could have also used some help. I value volunteering and leadership and I didn’t do them to “pad” my resume.

    I most definitely have had professors tell me I am stupid, tell me that I will not improve, and tell me I should consider a different major. I have also not had the opportunity to go abroad because of how expensive it is. I grew up on food stamps. My parents cannot pay tuition. I also do not receive scholarships from medical school. However, those are not things you would know about me just by looking at my medical school application.

    I am here because I worked hard and tried my best. I am here because I CHOOSE to power through hard times. I know there are many other people who are in medical school who have also worked very hard to overcome incredibly difficult challenges in their life. These challenges include having a diagnosis of cancer, growing up in an orphanage, and coming from war-torn countries.

    There is suffering and we all suffer in different ways. However, medical school is NOT just for rich people.

  51. J says:

    You know, this story rings true not only for native americans but just people poor in general that are unrecognized (not part of AA). My family is poor and our financial situation has always been unstable. Moving from place to place to find cheaper housing/cutting down, riddled with debt, always in an environment with high tension because of money issues. But tooth and nail I fought and made it into a prestigious medical school with nothing but my grit and a good head. Everything the author wrote about in terms of access and opportunities rang true for me, as it was extremely difficult for someone like me to put together a competitive application. Still, I scored in the 99th% on the MCAT, published in lead journals, and worked my ass off in numerous clinical/volunteering/teaching endeavors. As a medical student, I stand in the top 10% of my school academically, and clinically I am well received by all my patients and peers alike. But I’ve never felt like I fit in and I always have to make efforts to hide the fact that I come from a poor background. The majority of my classmates come from wealthy families, with parents as doctors, lawyers, executives and that sort, or at the very least with stable jobs as engineers and pharmacists. I can never join in conversations about their weekend/vacation plans or how they visited Europe or XYX foreign country or do some kind of activity. And it’s not just the kind of upbringing that’s different, and not even that they may have more access to money. Being poor, and knowing true hunger, is an entirely different experience, always feeling like everything is on your shoulders, bearing responsibility for everything, and that you’re always walking on a tightrope where one slip up will lead to everything falling apart. I’ve had nightmares all the time where I forget something or slip up once leading my life crumbling only to wake up in cold sweat. There is no safety net, no web of security. Not something that people with a wealthy upbringing can understand even if they role play the part of a “starving medical student” because their parents think they’re not spoiling their kids by giving them an illusion of independence. And not to mention the trauma and psychological damage of having to deal with all this crap growing up, like having a parent commit identify fraud and destroying your credit or releasing their anger by smashing the bedroom door down with a hammer when you’re but 10 years old.

  52. P Singh says:

    Pamela, please could you put me in touch with the author? I believe that I may be able to help her realise her noble aspirations of improving the health of Native American communities.

    Sage, Native American health has unique challenges and requires solutions that the ordinary health care worker isn’t trained to handle. Merely training as a physician isn’t sufficient- indeed owing to historical cultural trauma, Western medicine tends to be viewed with mistrust on many reservations and unique engagements and approaches are required- including accepting indigenous beliefs and recognising that up to 90% of health issues in indigenous communities are not treatable through conventional medicine, but rather through social aspects (UNM figures, 2015), of which the health care professional can play a significant role through taking a holistic view. Indeed in urban centres sets one up for specialisation in an urban economic setting. What you need is to be grounded in the challenges and solutions to Native American health from day 1, through correct training- both in the correct professional capacity and in the right setting and being grounded through mentorship with those who are pioneers in Native American health.

    I can help you better understand the challenges and ergo, the best means to make a difference, which may not be as a traditional physician, but in another capacity such as NP or simply a traditional healer. I personally know health care professionals who are pioneers in the area of Native American health and I am certain that they can help you get the training and insight you need, regardless of your financial situation- so long as you have the committment and drive to take upon this noble cause on behalf of not only your tribe, but I would hope, the wider Native American community at large.

    I have great respect for Native American nations- whose ancestors were the most advanced of human civilisations in the history of man, and probably will never be surpassed. I will do my best to help you achieve your dreams Sage. Please get in touch through Dr. Wible.

    God bless.

    • Pamela Wible MD says:

      I am so sorry to tell you (and everyone who has been so supportive) that Sage has died in a car accident. This happened last year in 2014. I have not had the heart to share until now. Please, on her behalf, I would ask that you support other Native Americans like Sage who want the chance to attend medical school.

      • P Singh says:

        Pamela, this is indeed heartbreaking news. I will pray for her. Sage did not die in vain- she has left, courtesy of your globally accessible blog, her story that I hope will inspire others like her to make this world a better place and indeed speak out against economic injustices in modern healthcare, which is a fundamental human right. If you are aware of any others in her position, I would be glad to help in any way I can. In solidarity.

        Rev. Brother Preetam Singh

        • P Singh says:

          The additional unseen tragedy is yet another compound blow to the Native American community at large. Bright and talented people such as Sage need the support of us all. With her will probably die her another ancient and rich language. Although I never met this young lady, her brave story and the trials and tribulations she faced have left a deep impression upon me and I am sure others too. I will pray that some kind of fund is set up in her name to help achieve her noble aims. I’m so sorry that humanity let you down. God bless you Sage.

  53. michelle says:

    My only answer is how bad do you want it. As a full Navajo women who grew up on the reservation in the mid 70’s to late 80’s i to did not have support. I did not receive any aid from tribe until my last year of college. I was told i would never amount to anything because of my 2.7gpa. I graduated with an 8th grade reading level. The boarding school i attended had maybe a handful of certified teachers because no one wanted to teach on the reservation. It was only later discovered in college that i was dyslexic yes a learning disability that landed me on the short bus which many teased me about through out my life on the reservation. I cant tell you want it was in me but i fought and worked hard no matter what i was told. I graduated in 5yrs with a degree in Physiology. I am now a mother of a daughter in her first year of college. She is my biggest success in life. I could not give her much but love and stressing education and the importance of it. She worked hard and loves learning landing her a great scholarship to a top engineering school. We still have to pay as the tribe only gave her 2000 in her first semester not much for a school that cost 66000 a year. But threw academics and much research on my part even though she cried with all the AP testing and graduation work in her last year she managed to fill out 20applications for education receiving a couple extra awards and a nice academic scholarship. Many people always assume she goes for free because she is Navajo. I think through my experience this comment does not bother me anymore but imagine if we all had the same oppurtunity natives have how many doctors we would see like on the reservation (maybe 1 to none). I did not raise my daughter on the reservation but she has informed me she is majoring in biomedical engineering with the intentions of being a doctor. She plans on going to the reservation and working there upon completion. I may not have become a doctor but i am an educator to my children with this there is success in what you do never doubt what you have to give. Keep working hard and something good is bound to happened our ancesters never gave up with what they had and this is why we exist.

  54. Denise says:

    I have to agree to a certain extent that Med School is just for rich kids. Other factors that play into one’s acceptance are GPA, extra-curricular activity,shadowing and so forth.
    I am a proud member of the Navajo tribe and am currently in my last semester at Baylor University. When I initially came to Baylor, I had my tuition covered by financial aid,scholarships,grants and about $3,000 from my parents. The following year, my mother was diagnosed with a terminal illness and spent many days in the hospital. This is when my academics began to fall apart. My days were spent in anxiety worrying about my mother’s deteriorating health and if I was going to lose her. My inability to focus negatively affected my grades despite receiving free counseling sessions at Baylor. My mom was at home in AZ dying while I was in TX trying to do my best so I could become a doctor.
    In fact, it was my mother who first introduced me to medicine and taught me that it was all about being of service to others. At the ripe age of 5, she let me wear her white lab coat down the hallway at the IHS Hospital in Chinle. As her colleagues proceeded towards us, she introduced me to them saying, “This is my assistant, Dr. Phillips.” Her colleagues then greeted me as Dr. Phillips. My mother made me feel like a doctor and planted a seed that day!
    While my academics were suffering at Baylor, I reached out for help and some professors were understanding and others were not. I’ve had a few professors who said, “oh cry me a river, people die everyday,” and “all you want is a pity party.” It wasn’t until this moment that I experienced how someone in the profession of science/medicine could lack compassion. Some of my professors conducted themselves like they didn’t want to help me and would rather fail me. I went to the Dean and cried in front of him as I told him what some of my professors said. Despite this, nothing was ever done.
    The following semester, my dear mother passed on and my grades really began to crumble. She paid a lot of money towards my tuition so I was hit hard financially after her death. I’ve had to take a semester off here and there because my past tuition wasn’t paid in full and therefore could not register. During those times, I worked, paid my tuition and came back the following semester.
    I am now in my final semester at Baylor and have started off with good grades. I am not a bad student. I had tough circumstances that affected my academic performance. I think that if students have financial stability to pay for tuition so that their education is uninterrupted and finances readily available for MCAT resources, then they have an advantage. It’s one less thing to worry about in addition to undergraduate studies. In the end, you can’t let anything become a barrier. Giving up should never be an option. I plan on applying to med school despite not having the money. Where there is a will, there is a way. My mother’s death taught me once more about being a servant. During her illness I was honored to care for her and ultimately delivered her gently into the Lord’s hands. We need more servant doctors and surely I can be one!

    • Pamela Wible MD says:

      I’m so sorry you had to endure your mom’s death without compassion from your school. Sad on so many levels. Many doctors have been so wounded by their training they are no longer caring (and they certainly do not support one another like a family). I’m here for you if you need to talk.

  55. debra reece simons says:

    I wish it were true that we are rich. My ex husband is a physician but he is not helping out financially with my daughter’s med school costs which are 60k a year.
    She is not attending his med school so this is not some legacy.
    She did not use his name to get to med school but she worked nonstop to succeed above everyone in her hometown school and at the state university. And now she is taking out huge student loans to get thru med school and their are many ivy league students here but she is at the top of the class in this large private university med school. So good luck to you in your endeavor and don’t give up.

  56. Renaldo says:

    This is a truly lame excuse for avoiding hard work,
    Native Americans have so many opportunities far more abundant than any “Lily white ” person.
    “I’m so poor, I’m so that ….”. What bull shit.
    I worked full time and went to college, and at no ivy league one mediocre. I graduated, and applied 5 different times and finally got into medical school. Paid for it like almost everyone else, student loans.
    Btw, I’m Mexican.
    Have good wallow in your pitty party .

  57. Anonymous hell says:

    Oh Sage your story broke my heart, please don’t give up. I know it’s hard but your community needs you. Even if the world says you can’t, keep trying. I had wanted to study medicine may moons ago. I like you ran out of money had to go to work, finished college with a double major and high GPA but couldn’t afford food/housing/forget books to survive so went to work. But the heavens gave me a gift, a soul’s calling that I couldn’t silence. I went to work for a city hospital and I got a health care scholarship to become a PA worked in poor communities for over 14 years and after saving some money decided with my spouse to finish my medical degree. So at 40 went back to school finished premed and now 45 yrs old applying to med school. If I get accepted I bring knowledge and experience that is so immense I can even begin to tell you, if med school will not take me it will be their loss. I am compassionate, worked as a researcher , speak 4 languages, write medical poetry and I have struggled tremendously to be where I am at. I have climbed a huge mountain to be here but my view has been grand. I am a survivor, strong , a warrior and I still love my community and medicine. People tell me I am too old, too fat ,too ugly, too stupid, why bother at this age and to them I say you just don’t see what I have inside my mind or heart. Besides the strong women in my family don’t die till way into the 80’s which leaves me more than 30 years of life how many more people can I save, how many more can I help and inspire. So, keep dreaming and fighting for whatever is your heart’s calling. My oldest sister also an advanced level nurse who grew up poor like me graduates this may from her doctorate. We are strong and so are you don’t give up even if the system is made for those who have more financial support because if we can do it so can you. So dream big and reach for the stars, what you will bring, the perspective you will bring to your patients is nothing like a kid who’s parents have simply supported them their entire life. Don’t give up keep on living but also keep on fighting please for yourself and others.

    • Anonymous hell says:

      Oh no just read Sage died in a car accident 2004, That was awful news. Poor girl she never got to live her dream. Didn’t she have a little girl. how is she? We sould set a fund for her daughter not to endure what sage went thru. So sad!!!

  58. My Yang says:

    My paternal grandmother used to say in Hmong,”If you don’t have anything positive to say, keep your mouth shut.” She was an orphan who lost her parents and village to disease in Southeast Asia. She had no education and did not speak English. Later, she came to America as a Vietnam war refugee because the Hmong were recruited by and died for the United States.

    It appears to me that among these discussion comments, there are positive and negative (potentially blaming/shaming Sage) ones. What if all these brilliant, educated minds with their vast experiences who are or will be physicians or other health care providers put their minds together, positively contributed, and helped problem solved?

    Before you judge Sage, I challenge you to go walk in her shoes. Be a young single Native American mother living on a reservation with no running water, no bathroom, no heat, no electricity, and barely able to afford your next meal. From my own personal experience, it is very difficult to focus on academics when I don’t know where I’m going to sleep or where my next meal will come from. Maybe then you will see just how strong Sage really is.

    And if you find yourself becoming cynical or bitter about the world, please seek help. You, your family, your patients, and the world will benefit.

    God bless you and rest in peace, Sage.

  59. My Yang says:

    For anyone in Sage’s shoes:

    I have only encountered one Native American physician in my life. Is there a need? Yes.

    The first step is to obtain proper identification paperwork, such as Social Security Number and Driver’s license. I don’t know how this works with tribes/reservations and the USA government. (And for anyone who decries Sage’s situation/challenges, please make yourself useful and go volunteer. See first hand what the process of obtaining paperwork for someone like Sage, who is rejected from two different tribes into which she was born and lives on a reservation, is like).

    Then, you can apply for financial aid (student loans, work-study, scholarships, grants).

    There are many scholarships available from private and public organizations. At the University of Wisconsin, there was an area in the Memorial Library that had books of scholarships/grants. When I was applying for grad school, I would be the only person sitting there going through the books on many days. I believe this scholarship area was open to the public. The entries were not always up-to-date but it was a start. Now, you can also do internet searches for scholarships at a local public library.

    Realize that there are many other fulfilling health care professions as well, such as CNA, CMA, EMT, nursing, NP, PA, and pharmacists. For example, it takes about 2 months at a college technical school to obtain the education/training/licensure to be a CNA. Personally, I believe every physician should be required to be a CNA first because the work is so humbling. For many nursing programs, it is a prerequisite to be a CNA. Additionally, some of my medical school classmates were CNAs, EMTs, nurses, etc… before they came to medical school.

    Though you may not be able to afford to travel the world over to work in an HIV clinic, which is a privilege, please realize that you may have already experienced and lived in poverty (no food, no running water, no electricity, no heat, no bathroom, etc…) first-hand. So no, it is not necessary to travel to a third world country in order to be able to write about what you learned and how the experience changed you as a person. There are many opportunities to help people within our own country and most likely even on your reservation.

    Yes, it will be hard work and there will be sacrifices to make. Sometimes you may feel like you are turning your back on your people, your community, your family, and your children. Sometimes you will feel completely alone. However, when you learn to live with yourself alone, you will become a stronger, better person. When you accomplish your dream of being a physician (or any other profession), you will be able to help your children, family, community, and people.

    Success takes a minimum of ten years to achieve.

    Best.

  60. Gunther says:

    The way education is so expensive these days, only the upper middle class and the rich class will be able to send their kids to law school, medical school, etc. It was that way before the Great Depression of 1929. Only 10% of American high school males were able to go to college. It wasn’t till after World War II, the GIs who came from poor and lower middle class were able to get a college education thanks to the GI Bill. We used to have free/affordable college, but then Ronald Reagan started the ball rolling by getting rid of it because 1) he did not like subsidizing intellectual curiosity (his words) and 2) he believed that there was Communist activity and sexual misconduct at the University of California. He also thought that people should pay fees and tuitions for the privilege of going to college. Since that time, every Republican governor and legislators have not increased funding for higher education, have been cutting back on existed funding, not building more campuses, and now the Koch Brothers are trying to take over the universities.

  61. Joël Pedneault says:

    Hey, for those who might be reading this article and (including maybe Sage), an organization called Pastors for Peace facilitates the process of US students from marginalized backgrounds applying to medical school in Cuba. Medical school there is free and living costs are subsidized, as far as I can tell. More information here : https://ifconews.org/medical-school/.

    I also know someone who started the program there, if anyone wants information, get in touch with me : joelpedneault (at) gmail.com.

  62. Diana Drozdowicz says:

    I felt the same way at times because I am a Hispanic female from humble means. There are ways to get what you need for school. Do not give up. You sound like you already have the heart of a healer but the goals and acomplishments of the girl Lily are not yours nor should they be. I am impressed that you are one of 4 people who still speak your language! That alone is an accomplishment. You must put things in perspective. Your perspective.

  63. Regina Bahten says:

    Wow, lots wrong with this letter, but let me start on a problem-solving note:

    1. Is Sage even looking into becoming a D.O. (like me)? We have all the practice rights of MD’s and our student bodies are unconventional; only about 1/3 of my classmates where “typical” medical students. A couple of my classmates were in their forties and were coming over from other careers. There is significantly less status, though, and I sense that might be an issue.
    2. Has she looked into Khan Academy online? The classes are free, and there is MCAT preparation as well.
    3. I would highly recommend that she read Into the Magic Shop, by James Doty, MD. He had to overcome a horrible childhood with apparently only six weeks of support from one adult (not his parents) to even begin to get an education, but he made a tremendous effort, and is quite the success. He is very open about sharing the secrets of his success.

    That being said, I have some serious problems with the letter, but I will only touch on two: she didn’t mention her college GPA, and she only devoted six words to “my status as a single mom.” Those are HUGE omissions. Being a physician is really hard work even if you are bright, and you have to be able to put in the hours and learn the material and get good grades. No ifs, ands, or buts. You can’t do justice to both at the same time. My DO classmates had to make some hard choices: go to medical school later in life, or give custody of the kids to the other parent. Is “my status as a single mom” really such a small piece of the story, or of her life?

    Honestly, as a solidly middle-class kid, I didn’t have any of the advantages that “Lily” mentioned, either. No one I know did. I went to a “second-tier” university, and I still grew up to be a physician. That meant student loans, but if you’re not in it for the money, then you will have a nice middle-class lifestyle. Sage needs to look at what she can do with what she has, and stop poisoning herself with the resentment she feels for all the “haves.” No one has everything. I bet she would very much resent my protege, who is a tall, beautiful, rich blonde; what Sage would fail to see is that my protege lives each day working with other people’s kids because she can’t have any of her own. So no one gets it all.

  64. Alyssa Pastorino, DO says:

    I grew up with little money & a lot of ambition. I couldn’t afford medical school so I got my associate degree and worked full time until I had enough money finish my bachelor degree, apply & take the MCAT. I did not pay to do any “experience” to get into med school, I just worked hard. I decided to go to an Osteopathic medical school because they care more about life experiences than MD schools. Not having money is never a reason not to do something, if you want it bad enough there are ways. You could get your CNP as well but that costs money too. Keep trying, you can make it happen!

    • Dr John says:

      I went to UNM med school which would have been a solution to many of Sage’s problems. I have an MD degree, had a very diverse class, and my tuition was truly cheap. I don’t understand the DO students and physicians writing on this forum, but my DO friends had debt 6 times as high as mine. Most DO schools are private, from my understanding. At UNM, and U of A,and probably some OK schools, the Indian preference or interest in diversity is not really based on numbers or the federal issues, but based on the need for people to care for people, Indian, white, Hispanic, African American, Asian, and the many other ethnic, racial, and cultural groups on this planet. Like one poster said, I’m only going to say nice things. By the way, as a white man, a term I resent, I feel highly qualified to speak, having grown up white and having gone to Indian school on the Taos reservation. I understand racism, and feel that we as a human race have to put effort into understanding each other. My father IS a physician, huge heart but also tough, dedicated his life to serving Indians(my Indian friends call themselves that, and ask me to use that term). He spent a 25 year career in the Indian Health Service. I am privileged, and yet spent many months in Med school and since with mental health and suicidal thoughts.Pamela, again, I really appreciate what you do. Anyone can do it, but not everyone can do it by themselves

  65. Myron Lafontaine says:

    Your problem is that you did not network. Have you tried Stanford? Have you contacted any on the diversity counselors at any of the Ivy League colleges. As a Native American from North Dakota I am thrilled at all the opportunities for Native Americans that were available to me and our available to my children. Trillions of dollars of our land was traded for these future opportunities. The contracts allow us to take advantage, when we apply ourselves. Stop pointing the finger at everyone else and take responsibility for yourself.

    • Shalena T Garza says:

      She doesn’t qualify, didn’t you read her post? Your last sentence was inappropriate. She is not pointing fingers, only telling the truth of the situation. Do you even know her? How do you know that she needs you to tell her to take responsibility for herself? You are very lucky to have the benefits and she is very unlucky not to have the benefits! You should try to be more kind with your message, it sounds like you have no empathy at all.

  66. Shalena T Garza says:

    I love your words Sage….its so true…. you tell the truth.

  67. Tom says:

    I don’t understand this article.

    IHS has several programs specifically for Native Americans who are interested in healthcare careers, from undergrad through medical school/midlevel education. Just Google IHS + health care opportunities.

    Obviously barriers are huge when coming from the Res, but programs exist to make this route very possible.

    Poor white kid with poorly educated parents who grew up in an urban area? No such luck.

  68. Wendy says:

    I can sympathize. My dream since she 6 has been surgeon however, the nearest colleges that offer my prerequisites is more than 4 hrs away. Pair that with low income, & low to no job opportunity & I feel like my dream is just that…a dream.

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