The peak of the mountain

By Arne Vainio, M.D.
News From Indian Country

This morning I’m drinking coffee and writing a letter of recommendation for a student applying to medical school. The application process is long and difficult and there aren’t anywhere near as many open medical school seats as there are applicants. I remember when I was applying to medical school all those years ago and I vividly remember not knowing what the next step was.

This is especially difficult for students who are first generation college students, meaning they are the first in their families to go to college. It makes a difference if someone has been on that path before you and can help you with the process.

I work with lots of students who want to go into the field of medicine. There are great careers to be had in nursing, pharmacy, social work, behavioral health and others and all of these professions bring benefits to the general population. Going home at the end of the day knowing you made a difference is fulfilling in and of itself and most of these professions are in high demand. That means you can pretty much work anywhere you want.

I have to admit I have a soft spot for anyone who comes from adversity. Poverty is all too common among us and it makes it difficult to see the path ahead when you’re just trying to get by. A broken taillight and a ticket from that can take forever to pay off and lead to a spiral of court costs and time off work and even job loss. A car that quits running can also lead to loss of a job or loss of opportunities. A sick child or a sick relative or an elder who needs help are enough to derail the best of plans. Most of this isn’t taken into account by someone who can simply afford to take care of the problem when it first arises.

Most times, these are younger students going from high school, then into college and aiming toward medical school from there. Sometimes forgotten are the nontraditional students, those who are older and have either been raising a family or working for years. Leaving a job to finish college is scary and fraught with money problems and oftentimes with no support from friends or family who don’t understand why someone would quit working to go chasing something no one else understands. The world is set up to quash these dreams and it’s the path of least resistance to let that happen.

Getting into and finishing medical school is difficult and the road is long and all too often traveled alone. From the time before we kept track, those chosen to be healers have been apart from their families so they can learn what they need to know from those they will be replacing and this has always been a lifelong process of learning. No one can know everything and that education is never complete. Much of the information needed is acquired along the way from places not expected and those places need to be watched for.

Today I am helping a student from Africa. She grew up in a war torn area and by age four knew to lay down wherever she was and stay there if she heard machine gun fire. Her best friend was raped by a soldier and left for dead when she was twelve. She lived in a refugee camp without clean water or adequate sanitation or a regular supply of food and cholera ran rampant through the camp most of the time.

She met a doctor from Doctors Without Borders there and the brief interactions she had with someone dedicated to helping others imprinted her with wanting to be a doctor for the rest of her life.

I always consider being a doctor the peak of the mountain in the medical field. It makes a difference where you started from when you’re standing on that peak. This is not to say someone whose entire family before them are doctors are not good doctors, but to say that some start from the deepest of valleys and it’s those students who need the most help and the most support. When I first started medical school, I wasn’t fully sure of what the next step was or what the next year held for me. It seemed to me most of the students would talk about the next steps in familiar ways and I didn’t want to show my ignorance or the ignorance of my family or my people by admitting my complete lack of that knowledge.

No one should have to face the future like that.

In the course of twenty years as a physician, the way I see my role has changed. I still see patients every day and I still do the same things I’ve always done, but more and more I want to find the future physicians among us. Many of them are only four years old and there are too many possible futures for them. Some of those futures are bad. I want to find them before they choose the wrong path or before the wrong path chooses them.

We need to be reading to our kids from the moment they’re born and that will make them love to read. There are whole worlds out there available to our children, but only if they know about them. Not every child is cut out to be a physician and that’s OK. We can still help them find the path they were meant to be on. I was a heavy equipment operator for years and I loved every minute of it and I did it because that was the opportunity available to me. New opportunities open up all the time, but we need to be taught to watch for them.

We live in a world that wants to separate us and divide us and wants us to fight and argue amongst ourselves. This is not the path we are meant to be on.
We need all of us. We need to support each other. We need to watch out for each other’s children and we need to encourage and help our own. Watch the little ones, watch those who are older and trapped in lives they want to change.

There are whole worlds available out there, but only if you know about them.

Do you see somebody who could be a doctor, but never thought it was possible or never even considered it? It’s a lot of work, but it’s the peak of the mountain.
Send them to me. My email is at the bottom of the page.

Arne Vainio, M.D. is an enrolled member of the Mille Lacs Band of Ojibwe and is a family practice physician on the Fond du Lac reservation in Cloquet, Minnesota. He can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it..


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