With morning temperatures already approaching the level of uncomfortable triple-digit-fidget and birds of prey circling overhead riding thermal currents that rise up from the distant bottom of the Grand Canyon, Dr. Ken Jackson expertly cinches the saddle on Molly, his 10-year-old gray mare, puts his foot in the stirrups and swings his leg over his mount. Satisfied that he’s ready to ride, he tilts his wide-brimmed hat to an appropriate angle, and heads down the eight-mile dirt trail for another visit to Supai Village — the most remote community in the lower 48 states.
Supai Village is remote to the point that the small post office there has the distinction of being the only such facility in the U.S. that still has its mail delivered on the backs of mules. “Twenty-five thousand tourists descend annually to the tiny village, not to seek out the 400 Havasupai inhabitants—something for which the Indians are grateful—but to gaze upon the spectacular waterfalls and to camp in what some have called Shangri-la,” according to Flora Gregg Iliff��s book, People of the Blue Water.
Here is where the Havsuw ’Baaja, the Havasupai Tribe, have made their home for hundreds of years, partly because U.S. President Chester Arthur usurped most of their aboriginal lands in 1882 and delegated a mere 518 acres for a tribal plot in Cataract Canyon, and partly because of their belief that the Grand Canyon is a sacred area, perhaps the very origin of the human race. (In 1975, the tribe gained trust title to 185,000 acres.)
There are only three ways to get to Supai Village—a hike, a horse or a helicopter. The hike can take up to six hours over a seemingly endless series of switchbacks. You can shave an hour or two off travel time on horseback, depending on the condition of the mount and the equestrian skills of the rider. The helicopter option only requires that you settle in, buckle up and five minutes later you’re at the bottom.
Jackson has used all three modes of travel to Supai Village over the course of several years of making regular monthly visits to the village’s small clinic facility, generally attired in traditional cowboy checkered shirt with pearl buttons, boots and jeans, and comfortable in the saddle for the ride back into a gentler time. “I get up at 5 a.m., drive 125 miles to the trail itself where I tack up and take off about 9 a.m. By the time I see my patients, turn the horse around for the trip back to the top—and the drive back home—the horse and I may not get supper until after 7 p.m. Just another 14-hour day.” In the winter, or when his schedule gets too hectic, Jackson’s horse stays in the corral while he opts for the speedier chopper ride down in the canyon to Supai Village.
Jackson, board certified in family practice, specializing in obstetrics, brings something Supai Village desperately needs: obstetrical/prenatal care to a population with one of the highest incidences of chronic disease in the nation—and an average life expectancy of less than 50 years. “Although Supai has a staffed health clinic with a primary care physician available, there’s no one to do prenatal care, and cultural differences and the geographical isolation involved here become issues that wouldn’t be a concern in a larger city or town,” Jackson says. “If a woman goes into labor down here, it’s a long wait before she can get helicoptered out of the canyon and driven a couple of hours for a hospital delivery in Kingman or Flagstaff.”
Over his 36-year medical career, the doctor has helped bring more than 4,000 lives into the world, including delivering two of his children. But sometimes even the best plans go awry because the women wait too long. “We try to schedule inductions and C-sections far enough in advance,” he says, “but a lot of women here aren’t even aware of prenatal-care benefits—they just show up to deliver their babies—and more than one woman has waited too long, giving birth mid-flight on the helicopter ride out of the canyon.”
Clinic Coordinator Fawn Manakaja looks forward to Jackson’s arrival each month. “We’re happy to see him because he works well with our people and they respond to him,” she says. “Before Dr. Ken showed up to provide prenatal care, everyone was referred out to Kingman or Flagstaff, and we had to arrange their transportation and take care of airfare, lodging, meals and all of the other expenses. Now it’s simplified because this doctor is still willing to make house calls to our patients.”
And the doctor enjoys seeing his patients as much as they enjoy being seen by him. “You have to earn their trust and respect and if you’re real, they can tell that in a jiffy. Even after all these trips, I still enjoy coming out here and making a difference,” he says.
Jackson and his working partner, nurse Leah Goldie, take patient vitals, listen to baby heartbeats with a fetal Doppler, arrange for lab tests and ultrasounds and do exams as pregnancies draw to a close and delivery becomes imminent, ensuring the health of both mother and child. “The Supai in the Grand Canyon are especially quiet and reserved—which doctor and I are not,” says Goldie, “but we maintain a good sense of humor and treat all our patients with respect, and that produces good vibes all around.
“I prayed about taking this job because of the pay cut that went along with it, and God gave me Dr. Jackson. I’ve never been sorry about my decision.”
Tribal patients, not usually effusive with their praise, speak of Jackson’s “amazing heart” and “passion for people.” Jackson’s enjoyment in the service he provides is obvious as many of his patients will offer up a hug when he concludes his exams and urges them to “Have a good baby.”
That close patient relationship in Supai Village is one of the reasons Jackson was awarded the 2010 Country Doctor of the Year award by Staff Care, the largest temporary-physician staffing firm in the United States, an accolade given annually to one physician. Many members of the Hualapai Tribe, who are also cared for by Jackson, made the trek to the awards dinner in Kingman, Arizona to show their support of the honoree. At the awards dinner, Richard Walema Sr., vice chairman of the Hualapai Tribe, thanked the doctor for his years of service and dedication to the Hualapai peoples and presented a plaque with the inscription: “There will never be a true cowboy doctor like you ever again.”
In addition to his monthly journey down to Supai Village, Jackson makes two trips per month to another reservation clinic at Peach Springs, the Hualapai tribal capital, a mere 100-mile-roundtrip jaunt. “The Native American has always been an important piece of who I am and what I do,” he says. “I like the idea of serving in an underserved area, being among what were the fiercest warriors of the 19th century. I’m interested in Indigenous Peoples, their plight, their situation, and if it’s true that we grow up seeking our own destiny, I’m happy to have mine intertwined with these people. I never, ever, regret coming out here to go to work.”
There is nothing ostentatious about this 63-year-old one-of-a-kind physician who embodies the spirit of the Southwest. Asked to describe himself, his succinct answer is: “Enthusiastic. Love life and my work. Try to do the right thing.”
After receiving his medical degree from Houston’s Baylor College of Medicine in 1974, he hired on with the Indian Health Service and set out to practice medicine amongst Arizona’s White Mountain Apache Tribe after spending a year working in a migrant health clinic. It was there he discovered both his fascination and respect for Native American culture and discovered his true mission—to make a difference. “I do what I do because it makes me feel good to do it.… It just feels right,” he says. “It’s important to give the best you can to everyone who comes through the door and I can make my mark here, one little thing at a time. Every single patient you take care of gives you a brand new chance to do the right thing. Because service is the highest form of human endeavor, at the end of the day, I feel worthy. What I do is very validating.
“I’m not intimidated by anyone or anything because I do my best to do the right thing every time. This job is a people-profession and should be about patients and doing what is right for them—irrespective of things that get in your way, like governmental mandates and insurance company regulations. The medical field has become somewhat distorted and bastardized and needs to get back to its basic mission of helping people.”
His so-called "free time" is limited by long workdays and the frequent delivery of babies at odd hours, often driving back home in the early morning hours, enjoying the view of Orion in the southern sky. That experience, an event that has happened more than once over three and a half decades, gave Jackson the idea for his current novel-in-progress, a follow-up to his previous book, Manifest West. Like most good authors, Jackson writes about what he knows—being a country doctor in Indian country.
His fiction is rich with the sights and sounds of Arizona and its relationship with Natives from Apaches in the ponderosa pines of the White Mountains to the Hualapai found in piñon pine country.
Jackson says he still greets each day as a new opportunity to help others, noting, “I work hard and get my ass kicked frequently, but I love solving problems—the challenge of difficult patients, and the adrenalin rush that obstetrics with all its risk and danger provides. You never know how things are going to turn out till they turn out, and I like the decision-making that comes with it all.”
Each year the nation loses about a thousand rural doctors and only seven doctors step in to take the place of every 10 that leave. It concerns Jackson that when the time does come for him to take his last ride into Supai Village, that may be the end of something unique. “I don’t think I have any other competition in this arena and I doubt anybody will take my place. I do it because it’s a labor of love, but I can’t imagine anybody else taking over when I’m no longer here. I suspect it will be the end of an era.”
This story was originally published October 17, 2011.