High-Desert Doctor
Miran Song ’87 serves on the staff of the Indian Health Service in Kayenta, Arizona

by Christine Palm

photo: Philip Bouchard

Downtown Hartford may seem light years away from a remote butte in Arizona, but for Miran Joelle Song ’87, the distance is bridged by a longtime passion—fighting poverty. While an undergraduate at Trinity majoring in biochemistry, Song volunteered at a Hartford soup kitchen, where she was especially moved by the plight of impoverished children. After years of medical training, Song has worked since 1999 as a pediatrician, serving members of the Navajo Nation in Kayenta Health Center in Kayenta, Arizona. Now, as then, she is especially concerned with the health issues of children hard hit by poverty and despairing parents.

“I’ve always enjoyed working with children,” she says. “They are incredibly resilient in their bodies and spirit. The level of poverty is striking, and working here can truly have a positive influence on children’s lives and health.”
The Health Center comprises a day clinic and a 24-hour emergency room, where each day, Song encounters a wide range of health issues in her clientele, including trauma from motor vehicle accidents, domestic violence, and assaults. She and her medical team help stabilize critical patients, who are then transported by ground or air to the area hospitals. But since the nearest hospital is 150 miles away in Flagstaff, the demands of her emergency room are enormous.

“We all work in the emergency room on rotating shifts regardless of specialty training,” Song explains. “This can be stressful, but we have many specialists with whom we do telephone consults.”

In addition to emergencies, Song treats major chronic health problems, including diabetes (with the concomitant complications of renal failure, coronary heart disease, and blindness), obesity, depression, and alcoholism. Forty percent of the children she treats have obesity, but while the Native American population in general suffers a very high rate of alcoholism, Song says she sees “surprisingly few” cases of fetal alcohol syndrome (FAS/FAE) because most of the alcoholics are male.

“The severity of infections seems to be much worse,” she says. “This may be due to the fact that about 40 percent of homes do not have running water or electricity, and people do not have access to transportation. So, we have programs to improve general quality of life: dental care, literacy, and child safety, for example.”

After graduating from Trinity with a B.S. in biochemistry in 1987, Song spent time as a researcher at Rockefeller University in New York City and at the Institut National de Science et de la Recherche Medicale in Paris, where she perfected the French she also studied while at Trinity. (She jokes that, “Nowadays, my only opportunity to speak French is if French tourists are injured and come to the ER.”) While she enjoyed research science, she “felt it lacked the human interaction I liked.” So, in 1992, she earned an M.S. in physiology from Universite de Paris. She continued her medical studies at Albany Medical College in Maryland in allopathic medicine (1996) and at New England Medical Center (Tufts), where she did her pediatric residency in 1999.

“Pay-back service” leads to longer committment

During medical school, Song was a National Health Scholar, and chose to do her requisite “pay-back service” with the Navajo Nation.

“I joined the NHSC after my first year of medical school,” Song explains. “I was interested in doing primary care (a NHSC requirement) and wanted to work in an underserved area. The program covers tuition and provides a stipend for living expenses. In return, National Health Scholars work an equal number of years in a designated underserved community. This helped cover the high cost of medical school and since I wanted to work in an underserved community, it was not a sacrifice at all. And the work was so satisfying that after completing my service obligation, I decided to remain in Kayenta.”

In addition to her fierce desire to serve impoverished communities, Song, who is of Dutch and Korean descent, was drawn to the area for the positive things it offered, too.

“I’ve come to love the high desert,” she says. “Kayenta is surrounded by fabulous rock formations, mesas, and canyon systems. There are cliff dwellings and ruins everywhere. The Navajo people have a life concept of ‘walking in beauty.’ There still are people living traditional lifestyles in hogans and herding sheep. It is an incredibly spiritual place to live. There is one stoplight in town, a grocery store, hardware store, and a recently opened movie theater. Life is very low-key.”

Like many of her colleagues in the medical profession, Song decries the role of insurance companies in the treatment process.

“Over the years, medicine has become increasingly controlled by insurance companies,” she laments. “It’s often difficult to get adequate care for a patient due to regulations established by outside institutions. It is difficult to explain to these companies the limitations and needs present in an area without electricity, transportation, or running water. This is one of my biggest frustrations.”

Song praises her time at Trinity for the ways it prepared her for a life in medicine and service. In addition to what she remembers as “fringe” movies at the college theater, Song recalls, in particular, “Dr. Smellie’s chemistry class, Dr. Progodich’s physical chemistry class, and Dr. Lee’s French class. They were all very inspirational to me.”

For more information on the Kayenta Clinic, log onto www.ihs.gov/facilitiesservices/areaoffices/namajo/kayenta/index.asp

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