EINSTEIN CELEBRATES NATIVE AMERICAN HERITAGE MONTH In marking Native American Heritage Month, the office of diversity and inclusion asked Breckin Horton, an M.D. student in the class of 2024, to share her perspective as an individual of Native American descent in the medical education and research community. BRECKIN HORTON M.D. student, Class of 2024Rural Roots In November, we honor the ancestry and traditions of indigenous people to mark Native American Heritage Month. Breckin Horton is a second-year medical student at Albert Einstein College of Medicine who is Native American on her father’s side—“my great-great-grandparents were fully Choctaw, so that makes me one-eighth,” she said. We sat down with Breckin via Zoom to trace her path from the eastern Oklahoma town of Spiro, where she grew up with her two brothers, to the Bronx. The area around Spiro is rural—“our neighbors had cattle and chickens,” said Breckin. She estimated that about one-third of the students in her town’s high school were of Native ancestry, mostly Choctaw and some Cherokee. Of the 100 people in her class, 55 graduated. “Just a third of those ended up pursuing higher education, and only two of us left the state,” said Breckin. She attended Lipscomp University, a small private liberal arts college in Nashville, TN, where she majored in biochemistry and brought an interest in medicine that was born in high school. “I had a shadowing experience at a clinic that served those with low-incomes and inadequate insurance, and I had a brilliant high school science teacher who taught AP chemistry my senior year,” she said. Breckin loved Lipscomb. “It exposed me to a lot of different views,” she said. Her classmates learned about her views as well. “I have a Choctaw license plate on my car instead of the Oklahoma state plate, and people would ask, ‘What is that?’ I’d say, ‘I live in the tribal nation of Oklahoma.’ “They’d say, ‘Oh, do you live on a reservation, and do you go to regular school?’ I realized that the concept of a Native American is very different for different groups of people. Our tribal community was integrated into the wider community. The tribe offered supplemental education at the local schools and hosted Christmas parties with a Santa at the Choctaw community center. It's not a reservation the way many people think of a reservation." A recent court decision gave the tribes more power to govern themselves but has brought other areas such as state laws and taxes into question. Breckin explained, "I think it certainly highlights the complexity of the system of nations within the nation.” Finding Einstein Breckin thought she’d be going to medical school in her home state but really enjoyed her time at Einstein when she came for an interview. She noted, “I saw myself as someone who wanted to advocate in medicine, who wanted to serve people who really need to be served, and I felt I would best learn how to do that at Einstein.” When asked what advice she has for Native American students who are considering or actively pursuing a career in medicine, Breckin said, “A big barrier is the overwhelming cost of a medical education. You need to know that there is an abundance of resources.” In high school, a Choctaw Nation administrator from the Youth Education Service gave students sheets detailing full scholarships for which they could apply. Her tribe has supported her every semester with money towards schooling, and also provides technology fees and a clothing allowance. “It’s also helpful to find somebody else who’s done it and ask them how they did it,” she advised. Patient Care Considerations When asked how physicians could better serve Native American patients, Breckin replied, “Be very slow to stereotype patients. Native Americans are incredibly variable and multifaceted; there’s not one Native American experience, there are hundreds. In our Health Systems Health Equity class, the professor brought in a nursing education book that said Jewish patients will likely say this and African Americans may say that—he was pointing it out as something that was not okay. And, the book said Native Americans may be more spiritual. I thought, ‘I know so many Native Americans who aren’t spiritual at all!’ The best thing that education systems can do is remember that we’re all humans with individual experiences.” Those who serve the Native American community are meeting a definite medical need. American Indian and Alaskan Natives (AI/ANs) have a life expectancy 5.5 years shorter than the United States average. They suffer disproportionately higher rates of kidney, liver, and stomach cancers. Causes include poverty, inadequate education, and discrimination within health institutions. And while AI/ANs make up 2 percent of the U.S. population, only .2 percent of individuals who matriculated to medical school identified as AI/AN in the 2020-2021 cycle. This underrepresentation in the medical community contributes to the cultural barriers that AI/AN patients often encounter. It also reduces the quality of their care. Connecting with Community In 2020, Einstein began a dialog with the American Indian Community House (AICH), a nonprofit that serves the health, social service, and cultural needs of Native Americans residing in New York City, in the hope of enhancing opportunities for Native American students at Einstein and for broadening understanding of the unique cultural perspectives of the AI/AN community. Looking Forward October 8, 2021, marked the first time a United States president officially proclaimed an Indigenous Peoples' Day observance. Breckin felt hopefulness upon hearing President Joseph Biden’s declaration. “It represents the country's desire to right wrongs. Though just a title, it is such a meaningful way to honor the role Indigenous people have played and continue to play in this country. It offers visibility to Native tribes and acts as a reminder that atrocities have occurred in a way that I hope will prevent future atrocities.” To Learn More A number of major organizations provide educational resources as part of Native American Heritage Month; among them are the Library of Congress, the National Archives and Records Administration, the National Endowment for the Humanities, the National Gallery of Art, the National Park Service, the Smithsonian Institution’s National Museum of the American Indian, and the United States Holocaust Memorial Museum. To expand your knowledge of our country’s Native American heritage, you can take advantage of the variety of virtual cultural activities these sources offer—webinars, webcasts, films, and more.