Warning: This story contains photos of a medical condition that some readers may find distressing
In March, Joseph Naytowhow was suffering from an uncomfortable pain below his ribcage, so he sought help at a walk-in clinic in Saskatoon.
He says he was shocked when the first thing the doctor asked was, "whether he took drugs and alcohol."
"That's the last thing on my mind. I'm there, I'm in pain, I just want to remedy this," Naytowhow said. "What's going on with the physicians' training today? Is that how they're trained, to ask questions like that if they see an Indigenous person?"
Naytowhow, 69, is a Plains/Woodland Cree man, a prominent interdisciplinary artist, a storyteller and a cultural advisor. He said he again explained his pain to the doctor and they suggested he take painkillers.
"That doctor needed to check my body, needed to check and ask me different kinds of questions," Naytowhow said. "[They] just ignored something that was going to be very debilitating, was serious in nature."
He left the doctor's office confused, angry, hurt and without a remedy or answers.
A few days later his discomfort had escalated into agony and he went to the emergency room.
"They said you have shingles, and it was already progressing front and back, so they immediately put me on medication."
Shingles is a viral infection, caused by the dormant chickenpox virus, that can produce a painful, blistering and itchy rash, among other symptoms.
He said the rash felt worse than a scalding hot iron clamped around his torso.
"You're just completely debilitated. You don't want to move. You don't want to do anything, so you lose all sense of. who you are as a human being."
The open wounds eventually closed, but intense nerve pain lingered.
Naytowhow can't help but wonder if the illness would have been more manageable and less severe had he received a diagnosis from the first doctor he saw.
Consequences are far reaching
Racism and discrimination within the health-care system takes a toll far beyond the initial interaction, said Dr. Nnamdi Ndubuka, the Northern Inter-Tribal Health Authority's chief medical officer. It can negatively affect a person's health in numerous ways both short and long-term, he said.
"Not just physical health, but also their mental health and well-being overall," Ndubuka said.
Naytowhow said this was true for him. Not only does he think he suffered more than he needed to because of a delayed diagnosis, he feels hesitant about seeking care in the future.
"My first reaction was I would never go back into the medical system," he said. "It just turned me right off, and when that happens you're going to get sicker."
Naytowhow is a residential school survivor who has spent years focused on his own spiritual healing. The doctor's question was a racist stereotype, he said, and was emotionally triggering. Naytowhow said he doesn't consume alcohol or drugs, but has seen loved ones suffer with addictions and trauma.
"I realized that when this gentleman said that, made those statements. That's the last thing I wanted to hear."
While he doesn't want to publicly name the doctor, he had some advice for him.
"Get some sensitivity training. Don't ever do that to anybody again."
Change within system is 'accelerating'
Ndubuka is part of the Saskatchewan Medical Association's equity, diversity and inclusion (EDI) committee, which was formed in 2020. He said the committee is working to make education on cultural sensitivity and awareness training available to their members.
"A lot of work is underway to dismantle racism within our system," he said.
He said the committee has been hearing from members about their own experiences and offering education.
The committee's next free, online training series for its members is focused on racial bias, microaggressions, intersectionality, power and oppression. He said this work can help doctors understand the nuances and realities of racism and discrimination, but also help them create change within the system.
"It's been a long journey, but we're beginning to see incremental [change]."
Doctor says patients can lead to change
Dr. Alika Lafontaine said he understands it takes great courage for people to share their experiences of racism at the doctor's office — a place that should provide trust, communication and support. He said it's critical people speak out.
"I really encourage patients, if you have an experience that you feel was racialized, come forward. The system needs to learn from you," said Lafontaine, who is from Treaty 4 territory in Saskatchewan and is the first Indigenous president of the Canadian Medical Association (CMA), the largest advocacy group for medical doctors in Canada.
Lafontaine has spoken out about racism within the health-care system for years. He said change isn't happening fast enough, but agrees it is accelerating.
He said the CMA is also committed to change, noting it is amplifying the voices of Indigenous physicians and funding a mentorship program. They also supported The Unforgotten, a five-part film exploring the health and well-being of Indigenous peoples living in Canada. Lafontaine hopes new and old doctors alike will use it.
"Change will accelerate as we bring more and more people into the understanding that, number one, this exists and number two we can address it," he said. "At the end of the day systems are just people and we know people can change, so there's no reason why systems can't."
Naytowhow said he's faced racial profiling and stereotypes before, but he keeps the experiences to himself. However, he hopes sharing this experience will make a difference. He doesn't want others to be hurt like he has been.
"I'm in the field of healing, I help people through ceremony. In that practice, I know you have to be very sensitive when you ask questions," he said, emphasizing kindness and trust. "You can't make assumptions."