Don't Get Sick After June

An elderly woman with long, grey hair drawn back into a single braid sat in the padded chair adjacent to mine at a conference table. "We have a saying around here," she said. ”Don't get sick after June.”


I was eating my lunch while partaking in casual conversation about fry bread in an overly air conditioned, multifunctional room of a small health clinic. The room's door was propped open, offering me a direct view across the small waiting room to the clinic entrance and allowing me to fulfill my receptionist duties whenever a patient arrived. It had been a slow morning. 

I didn't know why this local woman was at the clinic, as she didn’t care to see a doctor, though I suspected her presence had something to do with seeking relief from the mid-day heat during that unseasonably warm May afternoon.

"Don't get sick after June." 

Her unexpected words didn't internalize right away, and looking back, the casual tone of my response reflected hers. 

“Hmm,” I wondered allowed, “why’s that?” 

She looked up at me and smiled. ”Well, after June, appointments get booked, funding runs out, and we are stuck waiting months to get treatment." 

Almost instantly, my casual approach dissipated, and the stark differences between healthcare here in Pine Ridge — the Oglala Lakota Native American reservation in South Dakota — and what was familiar to me in my home of Wisconsin took sudden form.

As a 20-year-old pre-med student at a rural health clinic supplementing the permanent Indian Health Services clinic, I’d come to Pine Ridge with the hope of learning about health and healthcare in an unfamiliar place as a receptionist and to shadow visiting physicians. I knew of the Pine Ridge community's catastrophically high diabetes rates and low life expectancy, and assumed that this additional clinic would be flooded with patients. It wasn't. 

“Don't get sick after June.” 

To me, it rang over the clinic as an implication of a healthcare services shortage. But was that the whole story? Soon, it was clear that this woman had many more stories to tell. I was bathed in details about a community that expand far beyond the walls that surrounded us. 

Many people on the reservation didn’t have running water or electricity, she told me. The roads were a mess. A rainstorm could wash them out at any point, isolating the people that relied on them. The details went on and on, each seemingly non-healthcare related topic revealing the impact that outside forces could have on the health of a community. 


"Don't get sick after June" was about so much more than just the healthcare system.

That conversation sparked my exploration into the influences of human health beyond healthcare. In the time since, I’ve learned of numerous ethnographic narratives critical to understanding the health of the people in every community. 

An effective healthcare system complements the geographical settings, available resources and cultural practices that shape the health of the local people. This inherent complexity of human health, paired with the importance of embracing those complexities in a healthcare setting, inspired me me to be a physician.

As I drove away from the rolling, grassy hills of Pine Ridge, I reflected on what I’d learned.

”Don't get sick after June.” 

I imagined myself as a physician in a place like Pine Ridge, attuned not only to the systems upon which that community's health depends, but also to the unique, multifaceted stories of individuals which make them who they are. Today, I’m proud to be on a course toward making that daydream a reality, wherever I may end up practicing.

Hannah Udell

Osteopathic Medical Student - 2nd year (OMS II)
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences

Hannah Udell