By Jeremy Hawkes, Sun Devil Media Relations
On March 18 of last year, Michelle Tom was able to realize her prevailing life's goal of returning to her hometown and becoming a licensed physician for her native Navajo people in Winslow, Ariz.
It was a selfless objective, knowing she would be providing care for one of the most vulnerable populations in the United States. She would not have the resources and equipment available to her that she could have had at any number of locations across the country. She would be subjecting herself to extreme conditions in underfunded and understaffed health centers. She would be overseeing a community riddled with health disparities, poverty and sometimes even the simple deficiency of the fundamental means necessary to ensure quality of life.
But, they were her people and, for Tom, it was an untenable notion to even consider that she would not inevitably return to the Diné. And she would do whatever was necessary to provide for those people when she got there.
"It just comes from the way we are brought up as Navajo people," Tom said. "Our belief system revolves around balance and healing and giving back to your elders and community. You, as an individual, never come first. What comes first is your family and the community."
Her one-year anniversary of becoming a doctor could have been a time of celebration, of the concretization of a decade-and-a-half of studies, to luxuriate in the euphoria of achieving a lifelong ambition.
Instead, Dr. Michelle Tom found herself on the front lines against a virus that has ravaged the world and especially the Navajo Nation and the surrounding areas.
Dauntless in the face of that faceless enemy, Tom has put in countless hours in service of her people. Her fortitude and devotion started with her upbringing, but continued through her time as a basketball player at Arizona State University – an opportunity to receive a higher education that helped pave her path through medical school and into her current position.
COVID-19 is a conflagration that has torn through the Native American communities across Arizona, Utah and New Mexico and strained health care workers across the globe.
But for Tom, it remains her duty to protect her family, her elders and the communities that raised her.
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Tom knew from a young age the challenges that faced the indigenous people when it came to matters of health and well-being.
"Being a product of the Indian Health Care Service, I grew up in that. I saw the disparities with my people," she said. "I saw how few doctors and nurses there were and especially how few there were that looked like me or even spoke Navajo. So I wanted to be a provider for them. That was always my goal."
You could even say that Tom was destined for a life in health care. Both her paternal grandfather and maternal uncle were traditional medicine men or Hatalii, the "singers". The medicine men hold great respect among the Navajo people and perform the main healing ceremonies during times of sickness.
While medicine men are relied upon for the knowledge of herbal and holistic medicine, they are also revered for their extensive knowledge of Navajo heritage and culture and serve as a "bring to the past", preserving Navajo history, legends and myths and passing on the principles of goodness and prosperity to the younger generation.
Her grandfather and uncle played key roles not just in her love for medicine, but also for her dedication to her people.
"If I wasn't going to be endowed with the special gifts they were given by the Creator, I thought the next best thing I could do was become a doctor."
The idea had always been in her head, but for a time she thought it was more fantasy than an achievable goal.
Just under 15 percent of persons 25 or older living in the Navajo Nation have earned their bachelor's degree or higher according to the most recent U.S. Census data, compared to close to 33 percent of the general population that have achieved the feat. In general, just 17 percent of Native Americans continue their education after high school, according to a report by the Postsecondary National Policy Institute, compared to 60 percent of the general population.
For many on the Navajo reservation, education is one of the immense issues facing the tribe with many school-aged kids coming from impoverished homes with close to 40 percent living below the poverty level. Approximately one-third of the educational facilities themselves are reported to be in poor condition while the domiciles on the reservations are scattered and lacking a network of paved roads to connect homes to the schools.
The abundance of issues facing the Navajo educational system take their toll on young boys and girls, with American Indians and Alaskan Natives graduating from high school at just 72 percent – the lowest rate of any ethnicity in the United States.
The numbers were even more devastating when Tom was still in high school in the mid-1990s. The 2000 U.S. Census noted that only about 30 percent of American Indians and Alaskan Natives earned a high school education. In the Navajo Nation, only 0.23 percent of the 25 and over population (206 out of 88,662) had received a doctorate degree – and only 89 of those were female.
For Tom and others, even the thought of medical school at that time was a pipe dream given the statistics and the circumstances. But for a select few, basketball could provide an outlet to achieve those dreams.
"Rez Ball" is a way of life for the Navajo people. It is an escape from the struggles of day-to-day life on the reservation.
"You don't have to have wealth to play basketball," Tom said. "All you need is dirt and a hoop."
It is a sport that connects tribes across the nation with cross-country tournaments such as the Native American Basketball Invitational, the first All-Native basketball tournament in the country sanctioned by the NCAA. There were 128 teams in the tournament last year, which has created an economic impact of approximately 1.3 million dollars over the past three years.
The NABI Foundation has raised over a quarter of a million dollars in scholarship funds since it was founded in 2003, and hosts career and trade fairs at its annual tournaments in order to give young students both exposure as athletes and a chance to connect with colleges and universities academically as well.
Any drive through Navajo territory will provide glimpses of hoops made of bailing wire or garbage pails fastened to any vertical surface they can be affixed to. There aren't movie theaters or bowling alleys. But there is basketball.
Any given night, a high school gym will likely feature several thousand fans in attendance enjoying the run-and-gun style of play up and down the court. The Wildcat Den in Chinle, Ariz., seats up to 7,500 in a $23 million facility that is likely among the paramount high school arenas in the Southwest – if not the country – and would put many a college basketball arena to shame.
It's not uncommon for the Arizona Interscholastic Association to shift around its schedule in semifinal and final games for boy's and girl's hoops when a team or teams from the reservation are scheduled to compete. Most states hold the marquee matchup between schools from the highest enrollment class division in the final slot of the day, but Arizona has been known to reserve that spot for any "Rez Ball" teams that qualify, given the large influx of attendance figures they provide. In fact, the highest recorded high school basketball crowd in AIA history was the 2000 3A boy's championship game, where 16,010 packed the gymnasium to watch Tuba City narrowly escape Winslow in a battle between two Navajo Country powers.
Tom's first passion was horses, calling herself a "little cowgirl" who inherited her dad's love for all things equine. She took part in barrel racing and the rodeos but developed such a bond with her quarter horse thoroughbred that it was hard to continue when it passed in her early teen years.
That led her to basketball. And she instantly fell in love with it.
Tom was a standout at Winslow High School, where she played under coach Don Petranovich – the winningest girls basketball coach in Arizona history and member of the National Federation of State High School Associations (NFHS) National High School Hall of Fame.
At Winslow, Tom made it to several state championship games. She earned all the accolades, led her team in scoring and was the Arizona 3A Player of the Year. She never won a state title, a fact that she claims will lead to her next career goal: coaching at Winslow High School and leading the Bulldogs to a championship run.
Most importantly, she discovered an outlet - the ability to continue her education.
Her high school efforts earned her a shot at Phoenix College, where she competed for two seasons and earned All-America honors at the junior college level before a then-upstart Arizona State head coach came knocking.
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Charli Turner Thorne inherited a Sun Devil women's basketball program that had won just 20 total games in three seasons prior to her arrival in 1996-97. The cupboard was bare and the eventual winningest coach in ASU women's basketball history needed immediate help.
As such, she hit the local community colleges hard, simply looking for bodies to fill out the roster. Having posted a successful tenure at Northern Arizona University, Turner Thorne was familiar with the prominent Navajo reservation programs and knew she would be getting a winner with anyone out of Winslow High School.
Tom checked off the boxes. She was a good shooter. Crafty skillset. A genuinely good human being.
"She helped build this into the program that it is now," Turner Thorne said. "We recruited character and players that loved that game and that was Chelly Tom."
One area that Tom didn't particularly excel at the time, however, was in her grades. And so, it came as a surprise to Turner Thorne and her staff when the first thing Tom told her upon receiving an offer to Arizona State was that she wanted to become a doctor and go back and help her people.
"To be honest, I don't even know if I was saying that I would become a doctor with the expectation of actually doing it," Tom said of the exchange, laughing. "I think maybe I was just trying to impress Charli as this confident Native Rez girl."
She had been studying biology at Phoenix College but decided to take the plunge into pursuing medicine once she arrived in Tempe, changing her major to microbiology with an emphasis in studying infectious diseases.
She was no slouch on the basketball court either. Tom led the Pac-10 in three-point shooting percentage at a 42.0 clip as a senior. She accumulated 300 career points in her two seasons with 48 three-pointers. She provided one of the early highlights of Turner Thorne's career, drilling a pair of threes "with a defender in her shorts" at the end of regulation against seventh-ranked Washington to send the game into overtime before nailing a buzzer-beater to hand the Huskies their first loss of the year in the 1997-98 season.
But for Tom, her time at ASU was meant for something greater. A career in medicine would be her end goal. She wouldn't just settle for a game-winning shot against a ranked team.
She earned her bachelor's degree in microbiology and pre-medicine and accomplished something so few of her people had been able to do.
"She had to work so hard in those classes," Turner Thorne said. "And she did. She got through them trying to get her pre-med classes together but she couldn't get into med school right away."
Tom simply didn't have the grades she was going to need to make an attempt at attending medical school. Her MCAT scores were admittedly "horrendous" and her science GPA was nowhere near where it needed to be. She was becoming used to people telling her to "pick something else".
But she had a support system with the basketball program at Arizona State and she credits Turner Thorne for instilling in her the qualities she would need to persevere when times were tough.
"Charli is such a great teacher when it comes to giving us life lessons," Tom said. "She would teach us how our basketball skills were things that we would utilize in our professional careers and tools we would have to use with our family and our kids someday."
In the face of adversity, Tom never hesitated to push forward, noting that "if no one else was going to take me seriously, I would just have to do it myself". With the urging of Turner Thorne and Turner Thorne's mother, Gloria, Tom briefly diverted from the med school path to earn her Master's in Public Health with a concentration on administration and policy from the University of Arizona.
"A big thing with Charli was always knowing 'What's your role? What's your strength? What are you bringing to the table?'," she said. "As a point guard she taught me how to be able to see the floor and know who I could or couldn't go to with the ball at critical times."
It was that "court vision" that helped Tom find another path to achieving her goals, even if she was going to have to take the long way around to get there.
The master's degree might have been enough for most people, especially someone who came from such roots as Tom had. She found herself in a well-paying job. She had made it out of the reservation like so few had and had found success in the real world.
But it was not enough.
She persisted in trying to get into medical school, but her MCAT scores and her GPA remained too low. She was faced with a flurry of rejection letters. She knew it would take an extreme step to realize her goals.
She left her job, left her apartment, took a pay cut and worked part time and slept on her friend's couches. All so she could study more prolifically for another shot at the MCAT. The result "wasn't the greatest" but it offered her a chance to attend the University of Mexico in a postbaccalaureate program in an effort to boost her science GPA.
Tom bet on herself and it was a gamble that paid off. She was able to bring her grades up and finally received a letter of acceptance into medical school at Nova Southeastern University in Fort Lauderdale. Michelle Tom would become a doctor.
"I've never met anybody so determined to do what they said they were going to do when it was so hard to do it," Turner Thorne said. "She is the greatest success story of my life."
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Medical school was a trying time for Tom, who left the Southwest for the first time in her life to take on one of the pinnacles of academic achievement. She had suffered numerous trials and tribulations just to get to that point, and it certainly wasn't going to get any easier.
"Being away from your family and your culture and your heritage and your language, it was hard," she said on the challenges of having to be so far away from her family and her people. "On the reservation, life is very matriarchal but when you get to western medicine, it's very patriarchal."
Despite that, she knew in the back of her mind what her people were dealing with on the Navajo Reservation and she knew she was going to have to be there for them when the time came.
"When I was in Florida and I didn't know a single soul, I knew that someone that looked like me and spoke Navajo was going to be needed at home." she said "It motivated me probably more than anything to keep going, knowing my time away was temporary. I was always going to go home. That gave me great strength."
She earned her medical degree in osteopathic medicine in 2015, spending her residency internship at Stony Brook Medicine in Southampton, N.Y., on Long Island before heading just about 200 miles down the coast to the Inspira Medical Center in Vineland, N.J., to complete her residency in family medicine.
After she finished her residency, she wasted no time returning to her people and came straight back home to assume her role at the Winslow Indian Health Care Center and the Little Colorado Medical Center, both located in Winslow, Ariz.
She barely had a moment to breathe after a decade-and-a-half of higher learning before facing perhaps the greatest challenge of her life.
The Navajo Nation covers over 17 million miles of territory across Arizona, New Mexico and Utah. With a population of around 170,000 living on the reservation as of 2016, it is the largest land area retained by an indigenous tribe in the United States and covers a larger area of land than 10 U.S. states.
Sitting on the southern border of the reservation, the Winslow Indian Health Care Center oversees a user population of close to 17,000 people as an outpatient facility while the Little Colorado Medical Center cares for approximately 30,000 people in North Central Arizona, including emergency services. While the two facilities cater mostly to the Navajo population, there are still members from the Apache and Hopi tribes that trek nearly three hours to be treated in addition to the non-indigenous patients that reside in the area near Winslow.
The facilities are strained at the best of times for personnel, funds and resources. But COVID-19 has revealed the glaring gaps in health care treatment along the Navajo Reservation.
"Our resources are limited," she says. "Rural medicine is hard enough. We've always been short staffed in general."
When Tom is on shift in urgent care, she is typically the only doctor on her level and works closely with her nurses, the pharmacist, respiratory therapist, clerks and even the janitorial services as one cohesive team, something she emphasizes was a key takeaway from Charli Turner Thorne's selfless style of coaching and team-first basketball.
"They're my eyes and ears and they protect me and I protect them as much as we can," Tom said. "Communication is huge and these tools I got from ASU have come through more for me through medical school residency and especially even now than anything else."
But even with that preparation and years of practice, Tom and her fellow health care workers are stretched thin in facilities that were simply not built to handle this kind of outbreak, especially within a culture that is so inherently familial and communal.
"We are generational homes. We hug, we kiss," Tom said. "And then you have the poverty, the lack of education and socio-economic disparities."
Within a matriarchal society that puts so much emphasis on the community and social gatherings, it is hard for a people like the Navajo and neighboring tribes to come to terms with the concept of self-isolation and social distancing. It is not uncommon for several generations to live in squalor under one roof in Navajo territory. In a culture that puts so much emphasis on the reverence of elders and the oral history they are meant to pass down, it is hard to separate those members of the population who are most at risk.
That's not even considering a population that is ravaged by asthma, heart diseases, diabetes and obesity, underlying health conditions known to exacerbate the effects of COVID-19.
Contact tracing on the reservation is difficult given the lack of telecommunication infrastructure, with cell phones and the internet being a luxury for many of the indigenous people. Then there is the necessity of sometimes having to drive hours at a time on dirt roads just to reach one single home. Many households – as many as 40 percent - lack running water, a vital flaw with the continued emphasis on being able to wash one's hands and face for at least 20 seconds.
"So many see it as a foreign disease and something that's just outside the reservation that they see on TV. It's not reality to them," Tom said. "It spreads so rapidly because of our large households and large community functions."
Tom, herself, moved out of her family's house once the outbreak took hold in an effort to not expose them to the potentially life-threatening illness. She now lives with a fellow medical worker and they do their part to look after each other during these trying times.
There are only 12 health care centers and only four inpatient hospitals located on tribal land roughly the size of West Virginia. The federal government spends $2,834 per person on health care in Indian Country, while it spends $9,404 per person on veteran's health and $12,744 per person on Medicare, according to recent data.
"People lack the access to health care. The death rate is high because the access is slow," Tom says. "We can't shuttle them out as fast as they come in. We don't have a trauma level. We don't have ICU."
Tom's hospital has just two ventilators at the Little Colorado Medical Center. There are only 22 beds in the facility, none of which are ICU beds. The ventilators are truly supposed to only be used for an emergency, one so dated that Tom compared it to looking like an "old-school robot". There is only one emergency room doctor during the day and just two ambulances.
There are only two negative-pressure rooms in the facility, used to isolate those at high risk away from the general population. Unfortunately, Tom had nearly 10 COVID-19 patients during the week preceding this interview, forcing them to share regular rooms within the hospital.
The facility reached its capacity recently and forced doctors to effectively operate under triage-like circumstances, deciding who can be taken in on a case-by-case basis. In extreme cases, Tom and her fellow doctors would send their patients to larger hospitals in Flagstaff and Phoenix. However, Flagstaff has already stopped accepting patients from the Winslow facilities due to its own overcrowding situations.
Despite the circumstances, Tom felt she was in a good position to handle the challenges in stride despite only being on-site as a doctor for just over a year. Tom effectively prognosticated the outbreak on Navajo land even before the first reported case. She ordered a hazmat mask and ventilator for herself early in March. She picked it up from a friend's house in Chandler, noting that her friend looked at her wild-eyed like she was donning some sort of "sci-fi costume".
She remembers driving home that same evening on March 13 and pulling over because she couldn't get it out of her head. She took to Facebook to make a post warning her friends and family of the dangers that would come and the importance of starting to brace for a change in day-to-day life.
The first report case on the Navajo Reservation came just three days later on March 16. The outbreak is believed to have started at a religious gathering on March 7 in Chilchinbeto, Ariz. When congregants began to display symptoms, family members and friends came to their aid and exposed themselves to the virus in turn.
As of Sunday evening, there are now over 1,700 positive COVID-19 cases and 59 deaths in the Navajo Nation. The Navajo Nation now has a per-capita infection rate that sits behind only New York and New Jersey. Twenty percent of the deaths in Arizona have been Native Americans, despite making up just five percent of the population.
For Tom, none of this was unexpected. She knew what was coming based on the history of her people – the Navajo tribe saw death rates more than four times that of the general population during the H1N1 pandemic in 2009 and has seen similarly lopsided numbers throughout recorded history.
But it was her education in these matters that left her feeling comfortable with being able to handle the onslaught
"The irony is that all that time and training that I put into my medical career, this wasn't a surprise," Tom said. "Because of my emphasis on microbiology and public health and the study of the spread of a virus or disease and now that it's here I'm just like 'Wow, I know what's coming. I know how fast it's going to spread. I know what to do.'"
Tribal authorities have been firm in their response to the outbreak, enforcing a 57-hour weekend-long nightly curfew for the past three weekends and a standing shelter-in-place order. The National Guard has brought in supplies, initially from its own stockpile of masks and other protective gear. The CARES Act was slated to provide $8 billion of critical relief for Indian Country in the face of COVID-19, but the more-than 500 sovereign tribes had asked for closer to $20 billion. Even with the $8 billion in funds, there was no legislation as to how the money would be dispersed among the tribes, tying up the process and leading to difficulty in attaining the much-needed funds to combat the threat.
As for Tom, she has been an activist in raising awareness to the fundamental lack of quality health care within the Navajo Nation to combat this crisis. She has recently taken part in national interviews for NBC, CBS and PBS, while appearing alongside celebrities such as Paul Rudd, Mark Ruffalo and Taika Waititi on a Facebook Live Zoom call to discuss the current hardships facing the indigenous people.
A year ago, she was realizing her lifelong dream of becoming a doctor. Now, she's able to be there for her fellow Navajo Nation and use her platform to help her people in a time of its greatest need.
"The timing was perfect for me to help my people," she said. "And look what I'm doing now."
PPE (personal protective equipment) supplies are still lacking and in high demand, but many members of the Navajo community are coming together to provide for the neighbors, delivering food to elders in need or hand-sewing protective masks for front-line workers. The efforts, while admirable, can only cover so much and those who are able are encouraged to donate whatever supplies they can or are willing to the Little Colorado Medical Center, addressed to Christy Ross/Dr. Michelle Tom at 1501 N. Williamson Ave., Winslow, AZ 86047.
"The community has really tried to take hold of this," Tom said. "I've had everyone from friends and family to professional colleagues and even patients reach out to me to ask me what I need, what I can use."
It is that sense of family and community that strikes a chord with Tom, who sees all the great and positive and wonderful traits of her Navajo people exhibiting themselves in the tribe's darkest hour.
"It's tremendous the amount of hope and giving and sacrifice I have seen so far," she says with tears welling up in her eyes and her hand across her heart. "It just gives me the strength to keep doing what I'm doing."
On March 18 of last year, Michelle Tom was able to realize her prevailing life's goal of returning to her hometown and becoming a licensed physician for her native Navajo people in Winslow, Ariz.
It was a selfless objective, knowing she would be providing care for one of the most vulnerable populations in the United States. She would not have the resources and equipment available to her that she could have had at any number of locations across the country. She would be subjecting herself to extreme conditions in underfunded and understaffed health centers. She would be overseeing a community riddled with health disparities, poverty and sometimes even the simple deficiency of the fundamental means necessary to ensure quality of life.
But, they were her people and, for Tom, it was an untenable notion to even consider that she would not inevitably return to the Diné. And she would do whatever was necessary to provide for those people when she got there.
"It just comes from the way we are brought up as Navajo people," Tom said. "Our belief system revolves around balance and healing and giving back to your elders and community. You, as an individual, never come first. What comes first is your family and the community."
Her one-year anniversary of becoming a doctor could have been a time of celebration, of the concretization of a decade-and-a-half of studies, to luxuriate in the euphoria of achieving a lifelong ambition.
I could not be any more proud of former @SunDevilWBB great Dr. Michelle Tom. She is serving on the frontline at a hospital in Winslow, AZ, a small town on the southern border of the Navajo Nation. Thank YOU Michelle! pic.twitter.com/lyShdyXY0v
— Charli Turner Thorne (@ASUCoachCharli) April 3, 2020
Instead, Dr. Michelle Tom found herself on the front lines against a virus that has ravaged the world and especially the Navajo Nation and the surrounding areas.
Dauntless in the face of that faceless enemy, Tom has put in countless hours in service of her people. Her fortitude and devotion started with her upbringing, but continued through her time as a basketball player at Arizona State University – an opportunity to receive a higher education that helped pave her path through medical school and into her current position.
COVID-19 is a conflagration that has torn through the Native American communities across Arizona, Utah and New Mexico and strained health care workers across the globe.
But for Tom, it remains her duty to protect her family, her elders and the communities that raised her.
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Tom knew from a young age the challenges that faced the indigenous people when it came to matters of health and well-being.
"Being a product of the Indian Health Care Service, I grew up in that. I saw the disparities with my people," she said. "I saw how few doctors and nurses there were and especially how few there were that looked like me or even spoke Navajo. So I wanted to be a provider for them. That was always my goal."
You could even say that Tom was destined for a life in health care. Both her paternal grandfather and maternal uncle were traditional medicine men or Hatalii, the "singers". The medicine men hold great respect among the Navajo people and perform the main healing ceremonies during times of sickness.
While medicine men are relied upon for the knowledge of herbal and holistic medicine, they are also revered for their extensive knowledge of Navajo heritage and culture and serve as a "bring to the past", preserving Navajo history, legends and myths and passing on the principles of goodness and prosperity to the younger generation.
Her grandfather and uncle played key roles not just in her love for medicine, but also for her dedication to her people.
"If I wasn't going to be endowed with the special gifts they were given by the Creator, I thought the next best thing I could do was become a doctor."
The idea had always been in her head, but for a time she thought it was more fantasy than an achievable goal.
Just under 15 percent of persons 25 or older living in the Navajo Nation have earned their bachelor's degree or higher according to the most recent U.S. Census data, compared to close to 33 percent of the general population that have achieved the feat. In general, just 17 percent of Native Americans continue their education after high school, according to a report by the Postsecondary National Policy Institute, compared to 60 percent of the general population.
For many on the Navajo reservation, education is one of the immense issues facing the tribe with many school-aged kids coming from impoverished homes with close to 40 percent living below the poverty level. Approximately one-third of the educational facilities themselves are reported to be in poor condition while the domiciles on the reservations are scattered and lacking a network of paved roads to connect homes to the schools.
The abundance of issues facing the Navajo educational system take their toll on young boys and girls, with American Indians and Alaskan Natives graduating from high school at just 72 percent – the lowest rate of any ethnicity in the United States.
The numbers were even more devastating when Tom was still in high school in the mid-1990s. The 2000 U.S. Census noted that only about 30 percent of American Indians and Alaskan Natives earned a high school education. In the Navajo Nation, only 0.23 percent of the 25 and over population (206 out of 88,662) had received a doctorate degree – and only 89 of those were female.
For Tom and others, even the thought of medical school at that time was a pipe dream given the statistics and the circumstances. But for a select few, basketball could provide an outlet to achieve those dreams.
"Rez Ball" is a way of life for the Navajo people. It is an escape from the struggles of day-to-day life on the reservation.
"You don't have to have wealth to play basketball," Tom said. "All you need is dirt and a hoop."
It is a sport that connects tribes across the nation with cross-country tournaments such as the Native American Basketball Invitational, the first All-Native basketball tournament in the country sanctioned by the NCAA. There were 128 teams in the tournament last year, which has created an economic impact of approximately 1.3 million dollars over the past three years.
The NABI Foundation has raised over a quarter of a million dollars in scholarship funds since it was founded in 2003, and hosts career and trade fairs at its annual tournaments in order to give young students both exposure as athletes and a chance to connect with colleges and universities academically as well.
Any drive through Navajo territory will provide glimpses of hoops made of bailing wire or garbage pails fastened to any vertical surface they can be affixed to. There aren't movie theaters or bowling alleys. But there is basketball.
Any given night, a high school gym will likely feature several thousand fans in attendance enjoying the run-and-gun style of play up and down the court. The Wildcat Den in Chinle, Ariz., seats up to 7,500 in a $23 million facility that is likely among the paramount high school arenas in the Southwest – if not the country – and would put many a college basketball arena to shame.
It's not uncommon for the Arizona Interscholastic Association to shift around its schedule in semifinal and final games for boy's and girl's hoops when a team or teams from the reservation are scheduled to compete. Most states hold the marquee matchup between schools from the highest enrollment class division in the final slot of the day, but Arizona has been known to reserve that spot for any "Rez Ball" teams that qualify, given the large influx of attendance figures they provide. In fact, the highest recorded high school basketball crowd in AIA history was the 2000 3A boy's championship game, where 16,010 packed the gymnasium to watch Tuba City narrowly escape Winslow in a battle between two Navajo Country powers.
Tom's first passion was horses, calling herself a "little cowgirl" who inherited her dad's love for all things equine. She took part in barrel racing and the rodeos but developed such a bond with her quarter horse thoroughbred that it was hard to continue when it passed in her early teen years.
That led her to basketball. And she instantly fell in love with it.
Tom was a standout at Winslow High School, where she played under coach Don Petranovich – the winningest girls basketball coach in Arizona history and member of the National Federation of State High School Associations (NFHS) National High School Hall of Fame.
At Winslow, Tom made it to several state championship games. She earned all the accolades, led her team in scoring and was the Arizona 3A Player of the Year. She never won a state title, a fact that she claims will lead to her next career goal: coaching at Winslow High School and leading the Bulldogs to a championship run.
Most importantly, she discovered an outlet - the ability to continue her education.
Her high school efforts earned her a shot at Phoenix College, where she competed for two seasons and earned All-America honors at the junior college level before a then-upstart Arizona State head coach came knocking.
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Charli Turner Thorne inherited a Sun Devil women's basketball program that had won just 20 total games in three seasons prior to her arrival in 1996-97. The cupboard was bare and the eventual winningest coach in ASU women's basketball history needed immediate help.
As such, she hit the local community colleges hard, simply looking for bodies to fill out the roster. Having posted a successful tenure at Northern Arizona University, Turner Thorne was familiar with the prominent Navajo reservation programs and knew she would be getting a winner with anyone out of Winslow High School.
Tom checked off the boxes. She was a good shooter. Crafty skillset. A genuinely good human being.
"She helped build this into the program that it is now," Turner Thorne said. "We recruited character and players that loved that game and that was Chelly Tom."
One area that Tom didn't particularly excel at the time, however, was in her grades. And so, it came as a surprise to Turner Thorne and her staff when the first thing Tom told her upon receiving an offer to Arizona State was that she wanted to become a doctor and go back and help her people.
"To be honest, I don't even know if I was saying that I would become a doctor with the expectation of actually doing it," Tom said of the exchange, laughing. "I think maybe I was just trying to impress Charli as this confident Native Rez girl."
She had been studying biology at Phoenix College but decided to take the plunge into pursuing medicine once she arrived in Tempe, changing her major to microbiology with an emphasis in studying infectious diseases.
She was no slouch on the basketball court either. Tom led the Pac-10 in three-point shooting percentage at a 42.0 clip as a senior. She accumulated 300 career points in her two seasons with 48 three-pointers. She provided one of the early highlights of Turner Thorne's career, drilling a pair of threes "with a defender in her shorts" at the end of regulation against seventh-ranked Washington to send the game into overtime before nailing a buzzer-beater to hand the Huskies their first loss of the year in the 1997-98 season.
But for Tom, her time at ASU was meant for something greater. A career in medicine would be her end goal. She wouldn't just settle for a game-winning shot against a ranked team.
She earned her bachelor's degree in microbiology and pre-medicine and accomplished something so few of her people had been able to do.
"She had to work so hard in those classes," Turner Thorne said. "And she did. She got through them trying to get her pre-med classes together but she couldn't get into med school right away."
Tom simply didn't have the grades she was going to need to make an attempt at attending medical school. Her MCAT scores were admittedly "horrendous" and her science GPA was nowhere near where it needed to be. She was becoming used to people telling her to "pick something else".
But she had a support system with the basketball program at Arizona State and she credits Turner Thorne for instilling in her the qualities she would need to persevere when times were tough.
"Charli is such a great teacher when it comes to giving us life lessons," Tom said. "She would teach us how our basketball skills were things that we would utilize in our professional careers and tools we would have to use with our family and our kids someday."
In the face of adversity, Tom never hesitated to push forward, noting that "if no one else was going to take me seriously, I would just have to do it myself". With the urging of Turner Thorne and Turner Thorne's mother, Gloria, Tom briefly diverted from the med school path to earn her Master's in Public Health with a concentration on administration and policy from the University of Arizona.
"A big thing with Charli was always knowing 'What's your role? What's your strength? What are you bringing to the table?'," she said. "As a point guard she taught me how to be able to see the floor and know who I could or couldn't go to with the ball at critical times."
It was that "court vision" that helped Tom find another path to achieving her goals, even if she was going to have to take the long way around to get there.
The master's degree might have been enough for most people, especially someone who came from such roots as Tom had. She found herself in a well-paying job. She had made it out of the reservation like so few had and had found success in the real world.
But it was not enough.
She persisted in trying to get into medical school, but her MCAT scores and her GPA remained too low. She was faced with a flurry of rejection letters. She knew it would take an extreme step to realize her goals.
She left her job, left her apartment, took a pay cut and worked part time and slept on her friend's couches. All so she could study more prolifically for another shot at the MCAT. The result "wasn't the greatest" but it offered her a chance to attend the University of Mexico in a postbaccalaureate program in an effort to boost her science GPA.
Tom bet on herself and it was a gamble that paid off. She was able to bring her grades up and finally received a letter of acceptance into medical school at Nova Southeastern University in Fort Lauderdale. Michelle Tom would become a doctor.
"I've never met anybody so determined to do what they said they were going to do when it was so hard to do it," Turner Thorne said. "She is the greatest success story of my life."
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Medical school was a trying time for Tom, who left the Southwest for the first time in her life to take on one of the pinnacles of academic achievement. She had suffered numerous trials and tribulations just to get to that point, and it certainly wasn't going to get any easier.
"Being away from your family and your culture and your heritage and your language, it was hard," she said on the challenges of having to be so far away from her family and her people. "On the reservation, life is very matriarchal but when you get to western medicine, it's very patriarchal."
Despite that, she knew in the back of her mind what her people were dealing with on the Navajo Reservation and she knew she was going to have to be there for them when the time came.
"When I was in Florida and I didn't know a single soul, I knew that someone that looked like me and spoke Navajo was going to be needed at home." she said "It motivated me probably more than anything to keep going, knowing my time away was temporary. I was always going to go home. That gave me great strength."
Current and former student-athletes are stepping up during the COVID-19 pandemic, putting their own health at risk to serve others: https://t.co/IPVXO1ZNSd pic.twitter.com/03bE7Ah0O9
— NCAA (@NCAA) April 21, 2020
She earned her medical degree in osteopathic medicine in 2015, spending her residency internship at Stony Brook Medicine in Southampton, N.Y., on Long Island before heading just about 200 miles down the coast to the Inspira Medical Center in Vineland, N.J., to complete her residency in family medicine.
After she finished her residency, she wasted no time returning to her people and came straight back home to assume her role at the Winslow Indian Health Care Center and the Little Colorado Medical Center, both located in Winslow, Ariz.
She barely had a moment to breathe after a decade-and-a-half of higher learning before facing perhaps the greatest challenge of her life.
The Navajo Nation covers over 17 million miles of territory across Arizona, New Mexico and Utah. With a population of around 170,000 living on the reservation as of 2016, it is the largest land area retained by an indigenous tribe in the United States and covers a larger area of land than 10 U.S. states.
Sitting on the southern border of the reservation, the Winslow Indian Health Care Center oversees a user population of close to 17,000 people as an outpatient facility while the Little Colorado Medical Center cares for approximately 30,000 people in North Central Arizona, including emergency services. While the two facilities cater mostly to the Navajo population, there are still members from the Apache and Hopi tribes that trek nearly three hours to be treated in addition to the non-indigenous patients that reside in the area near Winslow.
The facilities are strained at the best of times for personnel, funds and resources. But COVID-19 has revealed the glaring gaps in health care treatment along the Navajo Reservation.
"Our resources are limited," she says. "Rural medicine is hard enough. We've always been short staffed in general."
When Tom is on shift in urgent care, she is typically the only doctor on her level and works closely with her nurses, the pharmacist, respiratory therapist, clerks and even the janitorial services as one cohesive team, something she emphasizes was a key takeaway from Charli Turner Thorne's selfless style of coaching and team-first basketball.
"They're my eyes and ears and they protect me and I protect them as much as we can," Tom said. "Communication is huge and these tools I got from ASU have come through more for me through medical school residency and especially even now than anything else."
But even with that preparation and years of practice, Tom and her fellow health care workers are stretched thin in facilities that were simply not built to handle this kind of outbreak, especially within a culture that is so inherently familial and communal.
"We are generational homes. We hug, we kiss," Tom said. "And then you have the poverty, the lack of education and socio-economic disparities."
Within a matriarchal society that puts so much emphasis on the community and social gatherings, it is hard for a people like the Navajo and neighboring tribes to come to terms with the concept of self-isolation and social distancing. It is not uncommon for several generations to live in squalor under one roof in Navajo territory. In a culture that puts so much emphasis on the reverence of elders and the oral history they are meant to pass down, it is hard to separate those members of the population who are most at risk.
That's not even considering a population that is ravaged by asthma, heart diseases, diabetes and obesity, underlying health conditions known to exacerbate the effects of COVID-19.
Contact tracing on the reservation is difficult given the lack of telecommunication infrastructure, with cell phones and the internet being a luxury for many of the indigenous people. Then there is the necessity of sometimes having to drive hours at a time on dirt roads just to reach one single home. Many households – as many as 40 percent - lack running water, a vital flaw with the continued emphasis on being able to wash one's hands and face for at least 20 seconds.
"So many see it as a foreign disease and something that's just outside the reservation that they see on TV. It's not reality to them," Tom said. "It spreads so rapidly because of our large households and large community functions."
Tom, herself, moved out of her family's house once the outbreak took hold in an effort to not expose them to the potentially life-threatening illness. She now lives with a fellow medical worker and they do their part to look after each other during these trying times.
There are only 12 health care centers and only four inpatient hospitals located on tribal land roughly the size of West Virginia. The federal government spends $2,834 per person on health care in Indian Country, while it spends $9,404 per person on veteran's health and $12,744 per person on Medicare, according to recent data.
"People lack the access to health care. The death rate is high because the access is slow," Tom says. "We can't shuttle them out as fast as they come in. We don't have a trauma level. We don't have ICU."
Tom's hospital has just two ventilators at the Little Colorado Medical Center. There are only 22 beds in the facility, none of which are ICU beds. The ventilators are truly supposed to only be used for an emergency, one so dated that Tom compared it to looking like an "old-school robot". There is only one emergency room doctor during the day and just two ambulances.
There are only two negative-pressure rooms in the facility, used to isolate those at high risk away from the general population. Unfortunately, Tom had nearly 10 COVID-19 patients during the week preceding this interview, forcing them to share regular rooms within the hospital.
The facility reached its capacity recently and forced doctors to effectively operate under triage-like circumstances, deciding who can be taken in on a case-by-case basis. In extreme cases, Tom and her fellow doctors would send their patients to larger hospitals in Flagstaff and Phoenix. However, Flagstaff has already stopped accepting patients from the Winslow facilities due to its own overcrowding situations.
Despite the circumstances, Tom felt she was in a good position to handle the challenges in stride despite only being on-site as a doctor for just over a year. Tom effectively prognosticated the outbreak on Navajo land even before the first reported case. She ordered a hazmat mask and ventilator for herself early in March. She picked it up from a friend's house in Chandler, noting that her friend looked at her wild-eyed like she was donning some sort of "sci-fi costume".
She remembers driving home that same evening on March 13 and pulling over because she couldn't get it out of her head. She took to Facebook to make a post warning her friends and family of the dangers that would come and the importance of starting to brace for a change in day-to-day life.
The first report case on the Navajo Reservation came just three days later on March 16. The outbreak is believed to have started at a religious gathering on March 7 in Chilchinbeto, Ariz. When congregants began to display symptoms, family members and friends came to their aid and exposed themselves to the virus in turn.
As of Sunday evening, there are now over 1,700 positive COVID-19 cases and 59 deaths in the Navajo Nation. The Navajo Nation now has a per-capita infection rate that sits behind only New York and New Jersey. Twenty percent of the deaths in Arizona have been Native Americans, despite making up just five percent of the population.
For Tom, none of this was unexpected. She knew what was coming based on the history of her people – the Navajo tribe saw death rates more than four times that of the general population during the H1N1 pandemic in 2009 and has seen similarly lopsided numbers throughout recorded history.
But it was her education in these matters that left her feeling comfortable with being able to handle the onslaught
"The irony is that all that time and training that I put into my medical career, this wasn't a surprise," Tom said. "Because of my emphasis on microbiology and public health and the study of the spread of a virus or disease and now that it's here I'm just like 'Wow, I know what's coming. I know how fast it's going to spread. I know what to do.'"
Tribal authorities have been firm in their response to the outbreak, enforcing a 57-hour weekend-long nightly curfew for the past three weekends and a standing shelter-in-place order. The National Guard has brought in supplies, initially from its own stockpile of masks and other protective gear. The CARES Act was slated to provide $8 billion of critical relief for Indian Country in the face of COVID-19, but the more-than 500 sovereign tribes had asked for closer to $20 billion. Even with the $8 billion in funds, there was no legislation as to how the money would be dispersed among the tribes, tying up the process and leading to difficulty in attaining the much-needed funds to combat the threat.
As for Tom, she has been an activist in raising awareness to the fundamental lack of quality health care within the Navajo Nation to combat this crisis. She has recently taken part in national interviews for NBC, CBS and PBS, while appearing alongside celebrities such as Paul Rudd, Mark Ruffalo and Taika Waititi on a Facebook Live Zoom call to discuss the current hardships facing the indigenous people.
Something I never thought I would see...Mark Ruffalo, Paul Rudd, & Taika Waititi talking on Zoom with the Navajo Nation President & other Navajos about the COVID-19 situation on the reservation...thanks for trying to help bring awareness ???? pic.twitter.com/2nv4u7LB6d
— ?????? Steph7 ?? BTS ???! ???????????? (@PiedPiperedOT7) April 11, 2020
A year ago, she was realizing her lifelong dream of becoming a doctor. Now, she's able to be there for her fellow Navajo Nation and use her platform to help her people in a time of its greatest need.
"The timing was perfect for me to help my people," she said. "And look what I'm doing now."
PPE (personal protective equipment) supplies are still lacking and in high demand, but many members of the Navajo community are coming together to provide for the neighbors, delivering food to elders in need or hand-sewing protective masks for front-line workers. The efforts, while admirable, can only cover so much and those who are able are encouraged to donate whatever supplies they can or are willing to the Little Colorado Medical Center, addressed to Christy Ross/Dr. Michelle Tom at 1501 N. Williamson Ave., Winslow, AZ 86047.
"The community has really tried to take hold of this," Tom said. "I've had everyone from friends and family to professional colleagues and even patients reach out to me to ask me what I need, what I can use."
It is that sense of family and community that strikes a chord with Tom, who sees all the great and positive and wonderful traits of her Navajo people exhibiting themselves in the tribe's darkest hour.
"It's tremendous the amount of hope and giving and sacrifice I have seen so far," she says with tears welling up in her eyes and her hand across her heart. "It just gives me the strength to keep doing what I'm doing."