Reflection by Prof. Richard Budgell

Spring 2021 has been an odd season, in an odd year, for many of us.

Where normally we would be looking forward to the beginning of Montreal summer, and in this second pandemic year, the gradual loosening of restrictions – we were also following the deeply disturbing revelations from the coroner’s inquiry into the death of Joyce Echaquan.

While the inquiry was proceeding, on May 27th we learned about the discovery of the graves of 215 First Nations children on the grounds of a former residential school in Kamloops, British Columbia.

Those two events have been painful, and galvanizing, for many of us. I hope that they will push us to embrace more change.

For me, this comes at around the time of the first anniversary of my appointment in Family Medicine. The past year hasn’t been the easiest introduction to a completely new career: I’ve barely seen my office, and know most of my colleagues only as two-dimensional boxes on a Zoom screen.

Nevertheless, I think a fair bit has been accomplished in terms of expanding the Indigenous place in Family Medicine. In that pursuit, my esteemed colleague Alex McComber has been crucial; and I have frequently leaned on my long-time friend Neil Andersson. And the unfailing and enthusiastic support of our Department Chair, Marion Dove, has fostered this progress.

In the past year, we have:

• presented a workshop at the departmental retreat on decolonizing Indigenous health that was enthusiastically received;
• held ‘kitchen table’ discussions with faculty and students, and the Indigenous community within and outside McGill, that generated lively discussions on the creation of a physical Indigenous space in the expanded office of Family Medicine;
• hosted ‘5 à 7’ educational evenings with a Labrador Inuit filmmaker and writer about the Spanish influenza epidemic, and with a Labrador Inuit family practitioner about her extensive experience in a wide range of settings;
• received approval to proceed with the development of an Indigenous studies minor in Family Medicine;
• received approval for an expanded 3-credit course on Indigenous perspectives on health, and a new 1-credit course on Inuit health (possibly the first in a Canadian university).

That’s the short list.

Given that there was no existing course in Family Medicine that I could teach, I’ve busied myself with guest lecturing wherever I was asked to – which has included in Nursing, Population Health, Medicine, and Architecture (!).

I’ve also done local, regional and national media, which has been interesting and instructive: I’m trying to get better at sound bites.

We live lives of enormous privilege. We have the power of daunting titles; letters after our names; and our places in a prestigious institution.

We need to, as a department, as a faculty, and as an institution, examine and act to continue to enlarge the place of Indigenous peoples, and knowledge, in our work. I cannot emphasize enough, this is the work of all of us.

Here are some things we can do:

• We need to use vocabulary correctly and precisely. Using specific terms – “First Nations, Métis and Inuit” – which correspond to the constitutionally-recognized peoples in Canada, is appropriate. The generic “Indigenous” is so frequently conflated with “First Nations” that people mistakenly say “Indigenous and Inuit…”. We need to remember that “Indigenous” is as broad a term as “European.” To refer to people more precisely, such as “Kanien’kehá:ka” or “Nunavik Inuit”, is a good practice.
• We need to ensure that all of our course content includes First Nations, Métis and Inuit examples, case studies, and perspectives. This needs to be more than pro-forma, and in fact transmit aspects of Indigenous ways of knowing and being.

• We need to figure out how to do better on Indigenous student recruitment; in this year’s cohort, there are no First Nations, Métis or Inuit students. We have an astonishingly impressive cohort of students, many of them international (who have great openness to Indigenous knowledge, from what I’ve seen). But competent, culturally-aware family practitioners and researchers are in very short supply in all Indigenous settings. More of those practitioners and researchers should be Indigenous, to continue to demonstrate that we belong in and are accepted in those important roles.
• We need to participate in the modernization of tenure criteria to fully value the life experience and intercultural knowledge of Indigenous candidates. There is a confluence of marvellous possibility in the fact that the Ingram School of Nursing, Global Health and Family Medicine are all in the process of recruiting for Indigenous-targeted tenure-track posts. When those faculty seek tenure, they should be able to feel confident that their experience and knowledge will be fully considered.
•  

Although I have only met most of you in two dimensions, I feel great collegiality and warmth for and from you. I know that you believe in the crucial social and cultural dimensions of health. The work on Indigenous inclusion in our own department, and faculty, is a central part of that. I know we can do it.

Have a great summer, everyone, see you in September!