Montana State University

Mountains and Minds


The Long Road Home October 12, 2011 by Evelyn Boswell • Published 10/12/11

LeeAnna Muzquiz dreamed of returning to her Flathead Nation as a doctor. An acclaimed regional medical program helped make it possible.
Even before LeeAnna Muzquiz became Montana State University's first minority recruiter in 1994, she promised her new boss that she would quit.

By all accounts, Muzquiz did a stellar job traveling to all seven Indian reservations in Montana and crossing the country from Alaska to Georgia, recruiting minority students to MSU. But instilled with a strong sense of community, she believed that Native Americans with education and skills should return home to help their people, so she promised MSU Director of Admissions Ronda Russell that she would eventually leave her job to attend medical school. Her dream was to become a physician on the Flathead Indian Reservation where she grew up.

A native of the Pablo area, graduate of Ronan High School and member of the Confederated Salish and Kootenai Tribes of the Flathead Nation, Muzquiz said getting involved in their communities is what Native people do. Whether it's cooking meals for a wake or participating in a ceremony, they want to contribute.

Fast forward 17 years when a promise kept has become a dream fulfilled.

Muzquiz is now an alumna of the WWAMI regional medical education program that trains students in Washington, Wyoming, Alaska, Montana and Idaho (WWAMI is the acronym for the five states) to become physicians. Like the Salish and Kootenai tribes, the program encourages its graduates to return home. If not in their hometown, WWAMI students are encouraged to practice somewhere in Montana or elsewhere in the five-state region.

Muzquiz is also an established family physician whose practice is based in the new three-story Tribal Health Building down the street from Flathead Lake in Polson. Since the clinic treats anyone who qualifies for Indian Health Services as a member or descendant of a federally- or state-recognized tribe, Muzquiz estimates that she could potentially treat almost 4,000 patients from around the country. She sees most of them in Polson, but she also visits Ronan half a day a week and Elmo one day every other week.

On one typical Monday, Muzquiz welcomed four-year-old firecracker Ryanne Rider into her exam room. The Ronan girl with a wind-burned face wore polka dot pants and a shirt bedazzled with the word, "Fabulous." Her mom, Dusty, said Ryanne has had a variety of health problems since she was nine months old, so they started visiting Muzquiz in Ronan. When Muzquiz moved her practice 12 miles north to Polson, they followed.

"She really listens to the problems your child is having," Rider said. "She's always willing to find an answer."

Besides that, Ryanne "thinks she's the best doctor ever," Rider said.

Kate McDonald was even more enthusiastic. As the Polson woman waited for Muzquiz to give her an injection in the neck, McDonald said the doctor is "awesome. She's the greatest person there ever was. I'm serious."

In other duties, Muzquiz admits patients to the Mountain View Care Center in Ronan. She assists researchers from the University of Montana who are conducting a genetic research project on the Flathead Indian Reservation. Still a big fan of WWAMI who says she marvels at the opportunities the students will have and the high-quality doctors they will become, Muzquiz mentors WWAMI students at various stages in their training. She also serves on the committee that selects the Montana students who will enter WWAMI.

"I felt I was trained well. I got a very good education," Muzquiz said. "I was surrounded by great and amazing people that were very real in terms of faculty and the other students. It (WWAMI) is just such a unique opportunity."

Muzquiz is one of more than 700 Montana students who have participated in the WWAMI program in the 38 years that Montana has participated.

WWAMI was founded 40 years ago by the University of Washington School of Medicine to help area states, including Montana, that lacked the financial resources and populations to build their own medical schools and recruit and retain physicians. Students accepted through the WWAMI program are admitted to the University of Washington School of Medicine, regarded as one of the best medical schools in the country. It has been rated the number one primary care medical school since 1994.

WWAMI students attend their first year of medical school at a campus in their home state. In Montana, their first year is spent at Montana State.

Their second year is at the University of Washington's Seattle campus. The students spend their third and fourth years in six-week rotations throughout the five-state region. An increasing number of WWAMI students are now able to do much of their third and fourth years away from Seattle--in Montana and the other regional state locations.

According to WWAMI records, about 55 percent of the students--both Montanans and others--who went through the program returned to Montana to practice, well above the national average of 39 percent who return to their home states to practice medicine.

But another important advantage that WWAMI offers is that it makes medical careers possible for Montana students. Some of them, like Muzquiz, are excellent physicians, yet didn't always follow a traditional track to medical school.

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Muzquiz said she always knew she wanted to become a doctor even though she had no clue as to what the journey might entail. She had no mentors. No one in her immediate family had studied at a university.

But the path seemed a natural one, Muzquiz said. She had always been good at math and science. She took honors courses in high school. Teachers steered her toward advanced opportunities. She even had her share of ear infections that sent her to a doctor who, unlike many, stayed around long enough to have a good relationship with her family.

So she enrolled at MSU and signed up for the pre-med program.

But, the sociable young woman found college life a little too fun that first year. The distractions were too many, and courses were challenging. Two-thirds of the way through her freshman year, her grades had dipped enough that she was considering a new career.

"You don't see a lot of future surgeons with Cs and Ds," Muzquiz said.

Then came spring break 1991, and her outlook suddenly changed. Muzquiz's 45-year-old father, LeRoy Irvine--a college student at Flathead Community College--had a heart attack. He was rushed to the St. Patrick Hospital and Health Sciences Center in Missoula, and his family gathered around him. Irvine died a few weeks later, leaving behind his wife, Muzquiz, two sets of twin daughters and a large extended family.

"That was probably one of the things that became a motivation and obviously a life-changing event," Muzquiz said.

Muzquiz took the spring quarter off to be with her family and mull over her options. As the months went by, she couldn't wait to get back to MSU, Muzquiz said. She returned in the fall with new resolve.

"I knew I was better than the performance I was giving," she said.

Changing her approach to school, Muzquiz moved into the Phi Beta Phi house where she joined other students pursuing professional careers. She switched her major to microbiology, became an MSU AdvoCat, married Tony Muzquiz, then graduated in 1994 with a bachelor's degree in microbiology and a minor in Native American Studies.

Along the way, she decided to become a medical technician in a hospital, but ultimately, she couldn't suppress her desire to become a doctor, Muzquiz said. She shared her thoughts with Tony and was relieved at his response.

"Oh, thank goodness," he told her. "I don't see you sitting in a lab all day, by yourself all day, with nobody to talk to and taking orders from somebody else."

Muzquiz's dream of becoming a doctor was back on track, but school costs money and studying for the Medical College Admission Test and applying to medical schools takes time, she said. She figured it would take her 1 ˝ to two years, so she took the recruiter's job in the MSU Office of Admissions.

"She was just a fabulous admissions rep," said admissions director Russell.

But there was that looming promise Muzquiz made.

"When I hired her, I said, 'You have to quit and go to medical school,'" said

Russell, who also once entertained thoughts of going into medicine. "'You have to follow your dream.'"

Russell calls Muzquiz a superstar.

"LeeAnna always said she wanted to become a doctor and go home and help her people," Russell said.

"By gosh, she did it. She followed her dream and made it come true."

Muzquiz left the recruiter's office after two years to join 19 other Montanans who entered the WWAMI program in 1996. WWAMI is more affordable than other medical programs that would have charged her out-of-state tuition, but medical school was still an expense that required scholarships and "gigantic loans," Muzquiz said. Muzquiz attended her first year of medical school at MSU, then spent three years in Seattle before completing her residency at the Seattle Indian Health Board through Swedish Hospital-Cherry Hill (formerly Providence Hospital). The urban clinic serves predominately Native Americans, a focus Muzquiz knew she wanted from the beginning of medical school.

WWAMI provided her with a tailored education that introduced her to a variety of specialties and finally made it clear that she would most enjoy being a family physician, Muzquiz said. She likes variety and challenges. She enjoys seeing the big picture. She relishes the personal interactions that are so important for a physician who cares for patients from birth to death.

She is still part of the WWAMI family because of her role in selecting new students and mentoring them during their first and fourth years of medical school. Muzquiz said she enjoys interviewing young candidates who have excitement and passion about medicine. However, it's "horribly difficult" to pick just 20 Montana students a year to enter the program.

"We could easily admit 30 to 40 and still have a good quality pool," she said.

It's also hard to predict if a student will return to Montana after four years of medical school and three years of residency.

"Life changes. People have things happen. They learn more about themselves," Muzquiz said.

She basically looks for Montana students who would make good doctors, provide good care and return to the state, Muzquiz said. Those who have a weighted grade point average of at least 3.5 and high MCAT scores are generally considered competitive.

"But there really isn't one thing we look for or one kind of person," Muzquiz said. "We look at people from all over. At the end of the day, are they good people who would make good doctors and have some semblance of a commitment to Montana?"

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Her own family had its share of diabetes and intermittent cancers, Muzquiz said. Her father was not a "go-to-the-doctor kind of guy" and had health issues that reflected his eating habits and sedentary lifestyle. She said people in her family and community die younger than those in other cultures, and she wanted to change that.

"For lots of Native Americans, death is as much a part of life as anything else," Muzquiz said. "We go to wakes and funerals quite often. For me growing up, it was not unusual to have spent the night before at somebody's wake, then getting up and going to school the next day."

Admittedly, her background works both for and against her, Muzquiz said. As a Native physician, Muzquiz said the tribes forgave some of the loans she took out to attend medical school. And she may have an easier time than doctors from other cultures in understanding why patients react in certain ways to their instructions. Her background might make it easier to ask patients about their use of traditional medicine. It could make them more responsive when she offers advice. Those with heart conditions should be careful about spending too much time in sweat lodges, for example.

Jim Burns, adviser to Native American students at MSU, said that the people in the community have life-long bonds.

"They probably know your parents and grandparents," he said. "Your name and family name carry a lot of weight. When you have that family connection and connection to a place, your tribal homelands, it's going to make a difference. It's the fabric of your being. You are in for the long run. You have that trust from the community, and you want to make a difference."

At the same time, Muzquiz said returning home presents a balancing act because patients see her in a different role than when she was growing up.

Despite that level of familiarity, Muzquiz said she is happy with her decision to return home. Not only does it allow her to serve her people, but it lets her, Tony, and their two children get together often with her mother, four sisters and their families. They generally meet every Wednesday for game night, a tradition that started when Tony was hooked on "Smallville" and the family drove to Muzquiz's mother's house to watch it on TV.

"I'm very happy with my choice," Muzquiz said. "I enjoy my practice. I'm really fortunate to be where I am." ■