It’s funny how thoughts can hit you at the strangest times.
I was in labor, seven centimeters dilated, and I started thinking of my grandpa’s anecdotes about living a morally serious life and how our actions, for good or bad, can have long-lasting consequences. (There is nothing like being in labor to get you to think about deep subjects!)
I was in the hospital at Loma Linda University, where I also work. My contractions had me alternating between pleasant, coherent speech and nearly breaking the bones in my husband’s hand while screaming in agony. Fortunately my husband knows that the best way to distract me from pain is to get me talking about some obscure historical or esoteric area of interest.
So like a master in the art of contraction distraction, my husband commented on how nice the maternity ward was and asked me why it was called the San Manuel Maternity Pavilion. At this exact moment, one of my medical students walked in to check on me and exuberantly reminded me that we had talked about this question, the name of the maternity pavilion, in class a few months prior. The short answer is that Loma Linda’s mission of healing created a relationship of trust between the physicians of Loma Linda University and the people of the San Manuel Band of Mission Indians. That trust led to the creation of the space we found ourselves in, where I was having a baby.
A ministry of healing
When Loma Linda University was founded in 1905, the people of the San Manuel tribe had little hard currency and no access to modern medical care. As a result, their rate of maternal and infant mortality was high. At the turn of the twentieth century, no one seemed to care much about these isolated “Indians.”
Nevertheless, a Loma Linda physician, Lyra George, began to ride out to the reservation on horseback whenever babies needed to be delivered. She did this as a ministry of grace, with no expectation of payment. Through the years, many others from Loma Linda continued that service to the San Manuel tribe. Truckloads of medical students would be driven out to the reservation to provide the kind of high-quality care that Loma Linda was becoming known for. And they, too, did it without expecting payment.
In the nineteenth century, the US government had set up the Bureau of Indian Affairs in the Department of the Interior. Among other things, this department developed public health programs to combat infectious diseases and civil engineering projects to improve the quality of drinking water on reservations. Because of the successes of these programs, Congress passed legislation in 1955 transferring administrative authority for all Native American health services from the Department of the Interior to the Public Health Service, which created a division named the Indian Health Service (IHS) in 1958.
Crass deception
The establishment of the IHS seemed positive at first: it would provide Native Americans with regular, affordable health care. They would no longer have to depend on the goodwill and compassion of neighbors. But within less than a decade, the agency was beset with allegations of unauthorized sterilizations. During the 1960s and 1970s, the IHS oversaw the sterilization of at least 25 percent of the female Native American population between the ages of fifteen and forty-four.1
Women of childbearing age who came to hospitals at the referral of their regional IHS physician for surgeries such as appendectomies would leave having also undergone tubal ligations or full hysterectomies that they never agreed to. In a slew of litigation between 1965 and 1974, courts across the country ruled that the patient must give informed voluntary consent before sterilization. Subsequent investigations in just four of the national regions found that the IHS had performed 3,406 involuntary sterilizations between 1973 and 1976. Still other studies found that between 1970 and 1976 the IHS sterilized between 25 and 50 percent of Native American women of childbearing age without their knowledge.2
Standing on (biblical) principle
How did Loma Linda University Medical Center handle the government’s intrusion into their long-standing relationship with the San Manuel and other Native American tribes in the region? During these nearly two decades of trauma for Native Americans, Loma Linda University Medical Center stayed untouched by allegations or litigation. To this day they maintain a close relationship of mutual respect and support with these tribes.
How did this happen?
My grandpa, Ernest Braun, graduated from Loma Linda University and then served as faculty in the 1960s and 1970s. One of Grandpa’s favorite illustrations of how the choices we make have a ripple throughout time draws directly from the history I just traced. The IHS thought these unauthorized sterilizations were necessary in order to tamp down poverty and other social ills. So agency officials at the IHS told physicians that when performing any form of surgical procedure on a Native American woman, the consent for the procedure covered any other “beneficial treatment” that could be performed simultaneously. For example, if a woman consented to have her gall bladder removed, then a tubal ligation or hysterectomy could be performed at the same time. Physicians were told that it was morally, ethically, and legally appropriate to do so—even if the woman never consented to this additional “health care.”
According to my grandfather, Loma Linda physicians refused to accept these “well-meaning” deceptions. He said that Christian social ethics and the principles that they had been taught from the book The Ministry of Healing prevented them from considering for one second the notion that it was morally or ethically permissible to do this to these women and their community without their consent. The refusal to do wrong, the refusal to do anything to another you would not want to be done to yourself, was beautifully represented in their faith commitment and desire to represent the healing arm of the gospel.
A gift of thanks
Almost 50 years later (in 2019), the San Manuel Nation, represented by their tribal secretary Ken Ramirez, presented a gift of $25 million to Loma Linda University Health, the money earmarked to build a state-of-the-art maternity ward. Ramirez said of the moment, “San Manuel is grateful for the compassion shown to our elders by Loma Linda University Health many decades ago.”3
On another occasion, Ramirez noted that since the tribe had become more prosperous, they received many requests for money. But Native Americans have long memories. They remember those who served them freely when no one else cared and they had no ability to pay. The purpose of the $25-million gift was a symbolic gesture to commemorate the moral and ethical medicine that Loma Linda had performed for them in the past. The San Manuel Nation’s gift was the second-largest gift ever received by Loma Linda University Health, and it made it possible for me and so many other women to give birth in an environment where we felt safe, respected, and cared for.
As I was talking to my husband and the medical student that day while I was in labor, it struck me just how true my grandfather’s words to me were. The Loma Linda physicians were faced with a choice between the ethical and moral principles of Jesus Christ and a morally and ethically wrong professional mandate. They made their decision based on their faith, a faith guided by the morality and ethics of Christ, who spent more time healing than preaching. He witnessed to people by healing them and treating them with the dignity that all humans long for.
The Loma Linda doctors who gave of themselves freely to provide care for tribe members who could not pay did not know the ripple effect that their self-sacrificing actions would have on future generations. Similarly, not all the healings of Jesus resulted in dramatic conversions or immediate tangible results. Jesus simply did good because that is what His Father would do.
So whatever our role in the Great Commission, whether we are medical professionals or pastoral professionals, we can see that the simple life of Jesus did more to change the world than any other human being who ever lived. Only in eternity will we be able to fully trace the ripple effects of the actions we do today, whatever role we find ourselves in.
- Jane Lawrence, “The Indian Health Service and the Sterilization of Native American Women,” American Indian Quarterly 24, no. 3 (2000): 400, https://airc.ucsc.edu/resources/suggested-lawrence.pdf.
- Lawrence, 410.
- “Loma Linda University Children’s Hospital Receives $25 Million Gift From San Manuel Ban of Mission Indians,” San Manuel Band of Mission Indians, Feb. 22, 2019, https://sanmanuel-nsn.gov/news/loma-linda-university-childrens-hospital-receives-25-million-gift-san-manuel-band-mission.