When the Hippocratic Oath was first penned in ancient Greece, my ancestors were already deeply immersed in our Indigenous ways of being that remain integral today. Regrettably, I feel the modern implementation of the “Do No Harm” principle within Western medicine has yet to fully reconcile with Indigenous cultural practices, including traditional ceremonies and the permanent body markings sometimes associated with them, in all their power and beauty.
Indigenous Traditional Dancer
Many Indigenous Nations around the world have culturally unique permanent bodily markings, such as tattooing or scars, associated with sacred ceremonies passed through the generations. These markings are worn proudly, yet they are not always visible, publically discussed, or something people are open to share about with non-Indigenous people or those outside of their kinship networks.
For many Indigenous people, one of the rare occasions ceremonial body markings are perceived by someone other than a loved one is in a hospital. Whether an Indigenous patient is awake or asleep, conscious or unconscious, adult or child, these moments are vulnerable, requiring a high level of trust and the utmost standards of cultural safety. In the end, rather than automatically viewing all scars on Indigenous bodies through a limited lens of pathological self-harm or abuse, physicians should also have a clinical pathway that appreciates scars as evidence of cultural connection, serving as a protective element of Indigenous health.
Unfortunately, as a Dakota and a medical student, I have personally heard several harrowing stories of Dakota individuals whose ceremonial scars have been harmfully stereotyped by Western medical practitioners, leading to culturally insensitive medical questioning and traumatic interventions. However, these stories are not mine to write on, even if they are anonymous. As I suspect is true for many other Indigenous peoples, Dakota people are often taught not to publicly share specifics of their ceremonial endeavors outside of unique contexts. For this reason, I invite health professionals to keep an open mind and dare to entertain the idea that Indigenous experiences need not be academically documented or fully understood to be believed and inspire tangible changes in practice.
Within the medical literature, there are numerous examples of medical racism towards Indigenous peoples that health providers can study to better understand the complex trauma Indigenous patients navigate in medical centers today. Indeed, medical mistreatment around Indigenous culture is not a present-day anomaly; it has a long history within Western medical institutions. Today, we remain confronted with the lingering traumas of Indigenous cultural practices being castigated as pathological, becoming the very grounds for harmful medical interventions. For example, as recently as the 1930s, Lakota and Dakota elders were forcibly confined in psychiatric insane asylums for participating in their cherished traditional ceremonies. Tragically, hundreds of Indigenous lives were lost within those walls, leaving an indelible mark on our collective memory.
These enduring traumas inflicted upon Indigenous nations by the medical field cannot be overlooked when discussing how ceremonial body markings are percieved in clinical practice. Medical harm is just one example of why Dakota elders choose to take our sacred ceremonies underground, wisely safeguarded from waves of colonial violence and assimilation policies. It is this very dynamic that Western medicine must grasp, as it explains why Indigenous patients today may choose to withhold details about the ceremonial origins of their scars or any aspect of their cultures, seeking to protect themselves from potential harm or retraumatization.
Centuries of cultural suppression and the criminalization of Indigenous ceremonies have sown justified mistrust of Western medicine within Indigenous nations. The act of safeguarding our ceremonial knowledge has become a vital strategy for cultural preservation and resilience, even during hospital visits. These realities should serve as a clarion call for the medical field to adopt clinical approaches that promote Indigenous patient well-being without necessitating detailed knowledge of their ceremonial practices.
In order to provide culturally safe care for Indigenous patients, we must rethink and expand upon the prevailing focus on scars as indicators of only self-harm. Incorporating a more nuanced understanding can equip future healthcare professionals to appropriately navigate scars and body markings that they may have never visibly encountered before, while still preserving a fine-tuned eye for genuine instances of self-harm.
Indigenous ceremonial scars and markings are beautiful and healthy. By respecting Indigenous ceremonial practices and approaching Indigenous patient encounters with the appreciation of historical medical trauma, the field of medicine can move one step closer to truly embodying the spirit of the Hippocratic Oath and bring about a more culturally safe healthcare landscape for Indigenous peoples.