AUGUST 1, 2002 Smoke Signals 5 Bel Mile's Got Psychology in his Blood Tribe's Psychiatrist Focuses on "Common Elements" of Experience , J. 'ft;,., By Ron Karten How to get by in a world that sometimes is hostile and sometimes just feels hostile, is the nature of problems that many of us face, said the Health and Wellness Center's Psychiatrist - Dr. John Bellville. With a practice in McMinnville in addition to his Monday and Wednesday hours here at the Health Clinic, Bellville's patients may be a cross-cultural mix, but to these problems and many others, he looks for answers in the "com mon elements" of experience. He has lived and practiced medi cine in Minneapolis, (he was born and raised in St. Paul), in Kansas and in Fairbanks, Alaska and now in the McMinnville and Grand Ronde areas. Bellville located in the West Valley because McMinnville is home for his wife, Cindy. In Kansas, Bellville worked at the respected Karl Menninger School of Psychiatry - a place, he said, where they still teach psycho therapy. He finds it unfortunate that the HMOs of the world are drumming psychotherapy out of the repertoire "as fast as possible." Psychotherapy, while often effec tive, takes too long and costs too much for the quick fix, dollar con scious world of HMOs. A down-to-earth guy, Bellville plays bluegrass music and makes some of the instruments he plays -fiddles, mandolins and guitars. Bellville said he has never before lived in climate where flowers bloom in December... outside like they do in Oregon. He and Cindy are skiers and Cindy, with her background in business management, manages his private practice in addition to minding their five kids - ages six through 13. "They (his children) are the top of my priority list." Psychiatry still faces "a lot of stigma," said Bellville. "Some people still think that psychiatrists can read your mind or have as a goal 'to con trol your mind with drugs,' but if Bellville can read minds, he hasn't discovered that talent yet and when it comes to drugs, he too sees them as a problem when they "subdue a personality." He acknowledged that there "may be some truth in back of the idea" that some drugs are too heavily prescribed and "turn kids into zombies. You can give a kid so much Ritalin that it subdues their personality," he said. But because drugs are an impor tant tool of the psychology trade these days, Bellville said that when they're well used, "they help an in dividual improve the way he pro cesses information." The question he asks himself with regard to patients is, 'How can I get to know this person the way they know themselves?' Bellville was raised in a family steeped in psychology. Before his parents passed away, his father was a psychiatrist and his mother was a clinical psychologist. His sis ter still is a psychiatrist. He started out to be a surgeon, but found the hierarchy in surgery too "dehu manizing." It kept young physi cians working for three days straight, he said, and the brow beating behavior was just not for him, so he kind of fell back on psy chiatry. He worked for a time with both his father at a Veterans Ad ministration hospital and in private practice with his sister, who is a child psychiatrist. "Everybody's dilemma is how to get by in the face of a less than ideal system," said Bellville. "Whether a person adapts to one system or goes out to find another one more hospitable is 'a philosophical choice.' And respecting people's choices is a good thing to do." New Public Health Nurse Will Fight Diabetes Barbara Gundrum has been on the job since April. By Ron Karten If Barbara Gundrum, RN, has her way, Grand Ronde Tribal mem bers will have a lower incidence of diabetes in the future and those afflicted will see a later onset of the disease. "There are a lot of things we can do, but most people still don't know about them," said Gundrum, the Tribal Health and Wellness Center's Public Health Nurse. Gundrum, the Tribe's newest dia betes specialist, reports that breast feeding alone can markedly reduce the incidence of diabetes for chil dren later in life. Like a lot of our chronic and debilitating diseases of today - heart disease is another ex ample - diet and exercise also play an important role in delaying or preventing the onset of diabetes, said Gundrum. With the support of Health Pro motion Specialist Darlene Aaron and nutritionist Darcy Trego, Gundrum provides in-office and home visit help on a range of dia betes issues, from eating and exer cise to foot care and blood sugar testing. Today, according to statistics com piled by the National Institutes of Health (NIH), Native Americans are twice as likely (one in eight) to have diabetes as non-Indians and three times as likely to die from it. NIH also reports, however, that if anything; the statistics under rep resent the true numbers. For one thing, in the early stages, diabetes is another of the "silent" diseases, like high blood pressure, because there are no signs of it. As many as one-third of adults who have dia betes do not even know it. Gundrum is a beneficiary of an Indian Health Service (IHS) grant through which she received fund ing to help her through her nurs ing education and in return, is now providing two years of service within an Indian community. Gundrum is an Aleut of the Chugach Region in Southern Alaska and reports a family tree that incredibly includes both pil- grims and Indians. "My grandmother was a Hinckley," she said. "Which is a link to the pilgrims and she married a Kentucky hillbilly, Francis 'Red' James, who was part Cherokee." Gundrum's ancestors made their way to Alaska where the Aleut con nection began. Gundrum joined the Wellness wing of the Tribe's Health and Wellness Center in April, but she comes from a past steeped in the theater. She studied the art at New York University and performed in "Three for the Show" Off Broadway and "Bell, Book, and Candle" Off Off Broadway. Later, in Portland the aters, she appeared in productions of "Hot L Baltimore" and "Hatful of Rain." And as a volunteer parent, she directed elementary school stu dents at St. Mary's Star of the Sea in Astoria in performances of her own Christmas play - "The Little Drummer Boy." Later, she co-wrote with 7th and 8th graders at the school a play called "To Die For." She then directed the children's performance. Ultimately, she turned to nursing to provide a better life for her son, Matt, now 11. The career switch was not the easiest thing to accomplish. For a time during her education at Clatsop Community College, she not only studied and provided a home for Matt, but also earned money as a waitress 6 hours a night, four nights a week. A poster in her room of four great Indians, Chief Joseph, Sitting Bull, Geronimo and Red Cloud hovering above the presidents carved into Mt. Rushmore served as her guide during those days. "I'd be totally exhausted and look at them and say, 'If this is what you want for me, I'll do it,'" she said. Fortunately, by the time she be gan her nursing education at Or egon Health Sciences University, Indian Health Services funding provided for her education as well as a living stipend. Gundrum works among a team in the Health and Wellness Center that provides patients with the lat est information regarding foot care, testing for blood sugar levels, and all the latest thinking on diabetes prevention. The Wellness Center team has established a support group for people with diabetes and has begun an outreach at the youngest levels, by teaching health fundamentals at the community day care center. According to nutritionist Darcy Trego, another staffer dedicated to working with patients with diabe tes or at risk for it, good health, ex ercise and keeping control of blood sugars are key. "The risk of diabetes in the Indian community is just huge," said Trego. Simple measures can make a big difference. A 30-minute walk five times a week, shedding weight from 5-10 percent and cutting sugar in take reduces the risk by more than 50-percent," Trego said. Currently, Gundrum is helping to build an outreach program that identifies those in the community at risk for diabetes. Because he redity is a big factor for those with or at risk for diabetes, the plan is to start by identifying those already diagnosed with the disease and reach out to family members to pro vide information that will prevent the disease from striking, or delay onset of the disease. "The public just doesn't have enough information about diabe tes," she said.