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The doctor is in

Washoe physician Loren Simpson heals in his homeland

DOUGLAS COUNTY, Nev. - Like many of his colleagues, Washoe doctor Loren Simpson is an IHS physician helping his people as much as possible with the resources available. From teens to elders, newborns and the unborn, Simpson has come full-circle by providing health care for the rural reservation community he grew up in.

Healing at home was what he set out to do two decades ago. Now, Simpson - the Washoe Tribal Health Center's chief medical officer - says he doesn't recall any childhood feelings of wanting to become a doctor.

''I wanted to be like my cousin - the king of the dump,'' Simpson said as a sly smile took over. ''You could get all the free stuff. We'd always haul trash ourselves, and could get all the toys that other people threw away. We were meager!''

Simpson's move into medicine stemmed from memories of the long drive to the nearest IHS clinic, on the Walker River Reservation, two counties away from his Gardnerville home.

''As Washoe people, we had to drive to Schurz for care,'' he recalled. ''My brother was born in that hospital. I remember the experience you had to go through to get there. I thought it would be nice to have some primary care available for patients here locally.''

By 1987, while pursuing a pre-med degree at the University of Nevada - Reno, Simpson worked at Washoe Medical Center, where he was mentored by Shoshoni physician Sharon Malotte - Nevada's first indigenous medical doctor - who asked if he'd applied to the INMED program in Fort Worth, Texas.

''I said, 'Well, no ... ' and scratched my head. She said, 'Well, get your stuff together and FedEx it!' She made some phone calls, and I [sent] it. The first two years were basically sleep deprivation and torture; gray hair, stress and lack of sleep. It was a tough, rewarding experience.''

Simpson survived and then set his sights on residency in Fargo, N.D., a distant vista that beckoned the Washoe man from Nevada.

''It was a chance to get away from home and see what else is out there, and that was appealing.''

Once he passed the third hurdle of his state board examinations, Simpson sought out the essential emergency room assignments that round out a doctor's professional experience. Those long hours gave Simpson incredible insight - and nerves of steel - into the urgency of emergency medicine. Rather than turn away from the ER's life-and-death drama, however, Simpson discovered his own tenacity.

''That's what I love to do,'' he explained, adding that he works the emergency rooms around northern Nevada - as he did in the Midwest - to keep his skills sharp. Simpson's story includes mentoring another new Washoe physician, Jenny Smokey, who said she's felt the pull toward medicine since she was 15. Intending to pursue writing, her dreams were shattered with the unexpected death of her father following aortic valve replacement surgery.

''I just thought, 'I wish I were a doctor - I could have saved him,''' Smokey recalled. ''I made a decision that day to be a doctor, and my mom supported me all the way through. I just never quit.''

As she approaches UNR commencement ceremonies on May 18, Smokey prepared for pediatric residency at the University of Washington, in the Seattle Children's Hospital.

''I've loved being home. I have cousins that come in; babies I see every week. I'm really not sure when I'll come back, because it depends on if I do a fellowship or not, and if I specialize or not.''

Seeing Smokey's joy over her own journey, Simpson beamed proudly. ''Jenny will be my textbook in pediatrics in three years, or when she finishes her fellowship,'' he predicted. ''It's nice to have not only a fellow physician, but somebody who grew up a hundred yards from me: my neighbor! You always have to network, and our group of physicians - whether there's two or three hundred Native docs across the country - [have] a special tie. We get together once in a while, and to develop those bonds is very unique.''

Caring for the people in the community he grew up in requires dedication and diplomacy for Simpson, who ultimately isn't about to discourage Native youth from pursuing the same lifeblood, brimming with more blessings than burdens.

''Get back up and do it again,'' Simpson advised. ''Persevere. No matter how many times you run into the wall, it's a test of character to see how many times you can get back up and keep going forward. If you want something bad enough, you're going to get it. Keep at it.''