"I Choose Life": Contemporary Medical and Religious Practices in the Navajo World by Maureen Trundelle Schwarz (review)

Maureen Trundelle Schwarz weaves an intricate tapestry blending contemporary Navajo religious pluralism with the sources of Navajo attitudes toward healing by examining intrusive medical procedures such as blood transfusions, amputations, and organ transplants. The strength of the book rests on an impressive number of conversations and discussions with Navajos who represent traditional practices, two forms of the Native American Church as it exists in Navajoland, and six different expressions of Christianity. Schwarz grounds Navajo beliefs regarding healing in three sources: traditional Diné accounts of the creation and formation of the world and of the Navajo people; historical memories that recount Anglo violence toward the Navajos, the introduction of foreign diseases, and efforts to destroy Navajo culture; and the arrival of western-style medicine and medical practices.

Schwarz locates the key to understanding Navajo attitudes about healing in a moral covenant between the Diné and the Holy People. The covenant rests on the principle of reciprocity. The Navajos have been given the resources, knowledge, and rituals to sustain and reestablish the harmony initially established by Changing Woman. In turn, the Navajos are obligated to seek harmony, repair disruptions for which they are accountable, and live in balance with the Holy People. For Schwarz then, illness and health is a moral issue.

Schwarz's moral argument depends on two factors. The first centers on Navajo behavior. Failure to honor the moral covenant through bad behavior or unfortunate circumstances results in illness. Restoration of harmony occurs through the performance of certain rituals specific to particular illnesses or circumstances. Schwarz discusses two of these rituals directly related to the types of medical problems caused by intrusive medical procedures. For example, when a Navajo receives blood transfusion from another Navajo, the Evil Way ceremony is appropriate to protect the recipient from possible harmful contamination. However, when a Navajo receives blood from a non-Navajo, the Enemy Way is performed. Enemy Way protects Navajos from harmful contact with non-Navajos and, in the case of intrusive medical procedures, from Anglo physicians who perform surgeries.

Contact with non-Navajo donors or surgeons also involves a second dimension of Navajo healing. Navajo identity entails a radical distinction between Navajos and outsiders. This distinction arises from Navajo oral traditions involving Changing Woman. Changing Woman locates the Navajos in a particular place and establishes a moral covenant between the Navajos and the Holy People-both of which are exclusive to the Navajos and differentiate them from other peoples.

The historical experiences of Navajo contacts with Anglos reinforces the sense of difference. Anglo policies of cultural genocide, the Long Walk and forced internment at Fort Sumner, and the diseases that resulted from contact all buttressed the Navajo identification of Anglos as enemies and produced an historical trauma that contributed to illness such as heart disease, diabetes, and cancer. Traditionalists, according to Schwarz, view these diseases negatively as a "metaphor for assimilation into mainstream American society" (94).

This creates a moral dilemma for Navajos who need Western medical treatments. On the one hand, these treatments are necessary because they provide the only remedy for these foreign diseases, but on the other hand, participation in the Western medical system forces Navajos to compromise their traditional values and to subject themselves to potential danger.

Schwarz also discusses the linguistic problem that Navajo encounter when they interact with English-speaking medical personnel. Since the Navajo language is performative and calls into being what is spoken, discussion of the disease itself actually contributes to the illness from the Navajo perspective. Thus, Navajos who suffer illness may be reluctant to accept Western-style medical aid.

Schwarz builds her argument carefully. The first chapter situates the discussion within Navajo oral traditions. Through a detailed presentation of the Navajo creation narrative as it relates to health and healing, Schwarz demonstrates the relational nature of Navajo beliefs and practices. Through the interactions of Changing Woman, Monster Slayer...