I am a breast surgical oncologist at two rural cancer centers affiliated with Duke in Laurinburg and Lumberton, N.C. These two cancer centers had medical and radiation oncologists, but I am the first surgical oncologist to serve locally.
My grandfather, Frank Woriax, was the first Native American to graduate from the Duke University School of Medicine and train in Duke Family Medicine in the mid-1970s. I grew up spending time in my grandfather's clinic or my mom's biochemistry lab. She is the current biology department chair at our local university (UNC Pembroke) and has taught there since completing graduate school. In high school, I completed a certified nursing assistant (CNA) program that was a mix of classes and volunteering. I knew I wanted to go to medical school and care for patients, and saw this as a way to enter medicine and have an integral understanding of bedside nursing-related care. I graduated high school at 16 and college at 19. I then took a year off between undergraduate and medical school to work as a science support specialist at UNCP. I then went to medical school at East Carolina University.
I originally focused on internal medicine/pediatrics, but becoming a primary care physician did not feel like a good fit for me. I then did a general surgery rotation, and was captivated with the pace of surgery and the culture of the operating room. However, I still wanted to build a long-lasting relationship with my patients. I did a breast surgery rotation and fell in love with surgical oncology. It can be tough because patients don't always do well, but I enjoy working with a multidisciplinary team.
Seeing patients do well is the most rewarding part of my job. I also love building relationships with them. However, that strong relationship also leads to the most challenging part of my job. It's so difficult when you become attached to a patient, and they don't do well. To me, that is the most disappointing part of my job.
It is easy to feel forgotten when you don't feel seen in your home country. The Native American experience is lacking from the majority of mainstream movies and music, although things are slowly changing. Recognizing this month is a way to be seen.
This month comes at a difficult time of the year for us. During Halloween, people use our regalia as a costume. Then most Americans celebrate Thanksgiving, which is incorrectly portrayed as a peaceful interaction. People dress up the story for children, but this is real generational trauma for us.
Although this month comes at a heavy part of the year, it reminds people that we are here, and it is nice to have that representation.
There have been impactful people in my life, not all of whom were Native American, or a medical minority. These people were not able to empathize with me, but they could sympathize with me.
In the Native American population, especially the Lumbee tribe, you go to medical school with the mindset of pursing primary care — either becoming a pediatrician, a primary care physician or an OB/GYN. Not many of us have gone into surgery. I participated in several science fair competitions growing up. One year I won the American Indian Science and Engineering Society (AISES) National Fair. As part of the winnings, they gifted me a copy of a book by a female Native American surgeon – The Scalpel and the Silver Bear by Dr. Lori Arviso Alvord. That book showed me what was possible. She quickly became a very early silent mentor.
I also had a local mentor. I was doing my preceptorship with a local pediatrician, Dr. Katie Lowry, and she asked me if primary care made me happy. I was honest with her that it did not. She then told me the community needs certain specialists and surgeons was one of the specialties she named. I'm grateful for her guidance, and grateful to Duke for supporting my role at the cancer centers and providing treatment for people close to their homes.
This article by Morag Maclachlan was originally featured on Dec. 6, 2021, in Inside Duke Health. The interview was conducted in November 2021 during National Native American Heritage Month
Morag Maclachlan
