An Interview with Dr. Eileen Gavin on Serving Native Communities During the COVID-19 Pandemic.
By: Avery Nennmann
Date Posted: Sep 16, 2024
On June 19, 2024, Avery Nennmann, Paige Gavin, Daria Dzen, and Martha Greenwald interviewed Dr. Eileen Gavin on her experiences during 2020-2021 of the pandemic for the More Than a Healthcare Hero Initiative. Dr. Gavin currently works as a travel doctor, going where the people need her, with short stints throughout the year in various indigenous reservations across the Upper Midwest. During the first year of the pandemic in 2020, Dr. Gavin was working on the Bad River Reservation in the northernmost part of Wisconsin on Lake Superior. The reservation had one clinic that serviced the entire tribal territory causing most tribal members to travel 30-40 minutes from their residence to receive any sort of medical care. The closest tertiary care hospital was in Duluth, MN, a car ride an hour and forty minutes away.
Dr. Gavin, an outsider to the Bad River Tribe, relied heavily on building doctor/patient relationships with community members who were suspicious of Western medicine. To do this she acknowledged traditional medicine as a healing tool alongside her Western approach to medicine. She contended that she didn’t “have anything [better] to offer them and [was] not going to argue with a 1000+ year practice” during a time filled with such uncertainty and fear. Dr. Gavin also noted that no one was well prepared to deal with a pandemic, especially when it came to tribal governments that are often the last to receive care and feel the effects of policy changes from the federal government. She waited for the Centers for Disease Control and Prevention and the federal government to step in and bring resources, but nothing came. With no one but herself and one other nurse practitioner, Dr. Gavin resolved to creating a system of care to mitigate the weight of the pandemic felt by the community. She anticipated what was coming early in February of 2020 and took it upon herself as an independent contractor to tell the clinic director to close the casino. She began holding meetings to brace for the imminent pandemic. At first, everyone thought she was blowing circumstances out of proportions, but her fail safes became safety rafts in the months to come.
Dr. Gavin likened the initial year of the pandemic as “kind of like being a firefighter” with her gear and respirator on for protection – she saw the fire coming but only had a fire hose to put it out. She stated her “biggest concern was the feeling of helplessness. There was nothing to do, there were no treatments, there was no vaccines, there was just supportive care, even if we hospitalized them.” Since COVID-19 was a novel virus, Dr. Gavin had no idea how it worked or mutated but thankfully Indian Health Services kept the clinic stocked on the necessary PPE to stave off the disease as much as they could. The Native community wanted to protect their elders by keeping them separated and prioritizing their care – a difficult feat as many households were multigenerational.
Alongside the Nurse Practitioner, Dr. Gavin treated all sick patients outdoors, with one day of the week dedicated to only seeing respiratory patients to screen them for COVID or other infectious diseases and diagnose treatment. During the interview, Dr. Gavin mentioned multiple times how overwhelmed and hopeless she was throughout that first year. She was working four-five days a week, with ten-twelve-hour days, and an additional two-three-hour commute from home and loved ones. Despite the medical necessity of the pandemic, Dr. Gavin continued to care for everyday health matters as “we still had to practice medicine. People still got pregnant, people still got pneumonia, people still had diabetes.”
Dr. Gavin disclosed that at the beginning of the pandemic, it was “a lot easier for me to manage it mentally, physically, spiritually, psychologically because I just had that education and pandemics and how they work, and knowing that lots of people are going to die. And I was much more comfortable with that, than a lot of most of the other people that I worked with. Having worked in hospice and palliative medicine, I mean, that’s what you do all day long is death and dying, and you just become used to it just as a natural state of life ending and not as a horrific event, it’s not a failure.” Despite this sentiment, Dr. Gavin was not immune to infection or her own impending burnout.
As the pandemic wore on, she became more depleted and fatigued as the commute and futility of care took its toll on her body and mind. As she dedicated her life to her oath of care, she was not able to be with her aging parents, nor her husband and daughters, which made it more difficult to persevere through the initial year of the pandemic. She said she wished she would have known we would have gotten the vaccine so quickly because she would have had more hope and wouldn’t have been in such a panic during that time. Dr. Gavin reiterated that it “was the most stressful year of my career. Hands down. I can’t stress that enough.” In December of 2020, COVID caught up to Dr. Gavin despite her precautions, leading her to take a year-long break from medicine. Dr. Gavins’s story is reminiscent of the moral injury and fatigue faced by physicians with little resources and an inability to save everyone from a devastating disease.