Week 1 in New Town (October 26th, 2026)
I’m in New Town, North Dakota for the month. I arrived at my hotel after two plane rides and a two-and-a-half hour car ride, and already from the plane I knew it was going to be an interesting month: as we flew over the state I noticed a peculiar marbled pattern in the geography—winding rivers and mountain ranges appeared as if blended together, and within the rocky, hilly plain itself, large swathes of darker, more igneous looking stuff was all mixed in with lighter, sedimentary stuff. It did from high up actually have the appearance of marbled halvah. This was the first thing I noticed about North Dakota, though perhaps this was just a mirroring of my emotions at the time: some darker, igneous sadness mixed throughout with a lighter, sandier optimism.
First of all, igneous rock–which takes higher pressure and longer time to form larger crystals–I feel is an apt metaphor here: those larger crystals I picture like hardened hearts, formed from the crystalline consolidations of molten lava. I am imagining garnet crystals here specifically, for their dark and dusty blood-red color. Right. What were the conditions that created that kind of igneous sadness? The conditions: for one, leaving home for a month to an unfamiliar place is difficult for me, especially when I was already coming back from a two week trip in Europe. Also, there are important events going on at home that I’m missing out on. I already missed E.’s fifth birthday party, for example, and several others. But not just physical events–I’ll be missing out on those kinds of passive feelings and sentiments that take time to grow and develop. Will my loved ones think of me any differently when I return? Or what will S. look like when I get back? He’s practically been doubling in size each month at his age.
Travel medicine must be the epitome, the culmination of the archetype of the self-sacrificial physician. This isn’t to compliment myself or any other doctor, god knows, but to lament rather how medicine takes away much of one’s time with loved ones and gives it to strangers. Travel medicine all the moreso, and how it takes away even deeper time and gives it to (initially, at least) even deeper strangers.
Speaking of strangers, these crystals of sadness quickly found root in their new home and immediately began to grow. And it wasn’t simply the isolated nature of the place, either, but this kind of lacuna-like, vacuumed-out kind of feeling. I felt this in the way that the landscape is both bare and–where it is populated–being uprooted: oil wells and construction sites, mostly. Of course this observation also comes from a vantage point of pure ignorance, and the energy that’s created here likely goes to heat my apartment back in K.G., but still–I don’t think it lends much beauty or nourishment to the people living here (forced to live here, I should say, which is a fact evident from the dark history of our shared nations). I only write this because a day or two later when Erik and I met L. he confirmed my suspicions: much of the cropland here is not even owned by those who live here. It was bought out a long time ago, even though it’s on the reservation. And as for the oil wells? Though they’ve brought a huge amount of money to the reservation, they haven’t come without their catches.
The main thoroughfare of the town felt to me at first like an abandoned version of a ‘Stranger Things’ set: low, brown buildings with outdatedly colorful signs, all strapped to the facades like faded tattoos. There too is an abandoned railway car sitting on the east side of town, covered in graffiti, and on the west side of town, a huge row of steel, apartment-building-sized oil drums. Slowly over the first week all of this has started to become more normal, maybe even sort of endearing to me now, though I’d be naive to discount my initial observations: first impressions and whatnot.
And my first impression of the local grocery store–“Jack and Jill’s”–went similarly. The store just as easily could have fit on the ‘Stranger Thing’s’ set: a giant 80’s-era “Pepsi-Cola” sign stood tall by the entrance, and on the building’s facade, huge cartoon faces for Jack and Jill that could’ve been lifted straight out of a ‘Dick and Jane’ book.
On the inside of the market I found about half of the products to be ultraprocessed, packaged foods. And what wasn’t made in a factory was double the price of its counterpart in New York. At a similar market in a nearby town Parshall, a bushel of asparagus was nine dollars. What seemed to be the apotheosis of all of this was a brand of neon purple ‘juice’ called “Hog Wash” which of course was very aptly named.
It’s hard to capture though what exactly about the town saddened me most upon my arrival. More than the barrenness, more than the food desert, there was this overwhelming sense of expulsion, almost like I had been banished here. And of course this was just a very hasty first reaction but I wondered—was this how anyone else felt about the town? Clearly to the town’s original inhabitants this was the case, namely via the construction of the Garrison Dam and the flooding of the bottomlands, but again, I wondered if this feeling was still present among the townspeople.
Still I have much time to learn what beauty this plain has to share, even if it is perhaps the product of an expulsion. The thing about igneous rock is that because the crystals are large and slow-growing, they’re easy to overestimate. Much more subtle perhaps is sedimentary rock, which is composed of very fine grains and needs to be spectated with just the right perspective in order to actually be seen, like a Pissarro. Perhaps my optimism is like this, and I just haven’t got the right perspective yet. That’s the promise at least, right off the bat.
But the dawn the following morning was one of such promises. In the mornings here the entire eastern sky lights up with a rosy glow, and since there’s nothing in the way of the sunrise, e.g. buildings or tall trees, the sunrise feels like it lasts straight through until noon. Another promise of hope was a morning I spent alone at the local diner, “Better ‘B’ Cafe.” On my walk there I had a seagull fly over my right shoulder (always a good omen), and the main street was much busier. I questioned if my initial assessment of the thoroughfare was obscured by my own loneliness. In fact, the main street is quite busy now that I’ve spent more time walking it, and I’ve also since realized that Better ‘B’ is one of the central hubs of the whole town.
I’ve learned much about the town from Better ‘B’, in fact. That morning when I sat down for breakfast, I noticed a family of three sitting at the table across from me: a dad, his son, and a daughter-in-law.
In feeling-tones their conversation conveyed a sense of hopeful defiance, a war-worn malaise, and yet also a bravery. Defiance, firstly, in the face of a certain “they” that they were referencing. Whether this “they” referred to corporations, drugs, venture capitalists, the white man, or something else entirely, statements like, “they can’t keep us down!” were all I had to go off of. Still—and I will be the first to pin all of my problems against a nebulous “they”—their fight has clearly been ongoing, as each mention of this “they” was said with both a kind of well-accustomed tone as well as real tiredness. This was also the tone in which they spoke about a friend’s drug addiction (“it’s sad…”). It was a kind of tiredness that comes about after a whole life—or multiple lives—of near-constant resistance. (To a lesser extent but also worth noting, when I got up and went to the bathroom, I merely sighed and rolled my eyes at the many swastikas etched into the inner stall door. “They” had been there too, evidently.)
And of course this was only me eavesdropping on a single conversation, but as the father prepared to leave, the conversation hinted at the wealth of bravery and love that rested just beneath the tired-looking surface. The son got up and offered to pay the check because “[he] made money down south and [he] wanted to come back and give some love,” and the two went back and forth for a bit but eventually the father caved. Then the son went and paid the check.
For me though, this generosity was tinged with the bitterness of the knowledge that the son had left town and was only stopping by, even if he did have a lot of love with him. I wondered what had forced him out of the town in the first place. Work, evidently. Sadly, I concluded, this was just par for the course in modern America. Too often, “they” allure children from their hometowns with the allure of “success.” And yet I wondered if there was also a force that was pushing him out of New Town, more than just the regular pull of capitalism.
Nevertheless the son’s love for New Town was overflowing. Whether it was honest or merely because he had been away for a long time I couldn’t tell, but as he described the sunrise over the bridge above Lake Sakakawea, he mused about what it must’ve looked like in ancient days before the bridge was constructed, before the billboards were raised, when the sun fell straight over the “open pastures” before the Garrison Dam flooded them all: “what a great difference and change!”
If the energy in Better ‘B’ Cafe—nearly all of the tables full—was any indication of the locals’ love for New Town, then there’s a lot of it. Sitting at that table, the feeling was palpable: everyone knew everyone, and laughter and handshakes spread between tables like great waves. As an older pair of men walked out, the dad greeted them and then turned back to his son, “those two built New Town. He’s ninety-two years old!”
Since then Erik and I have had many other unique experiences: we’ve driven to a few surrounding towns and cities, gone on a few long hikes, been to the rehab center, worked in the clinic, and all of these things have been noteworthy in their own way. Initially, everything was noteworthy for its novelty, and surely my initial judgments were harsh, possibly just plain inaccurate. This is the experience of travel. But as I come up on my second week here and my experience becomes less like travel and more like living, I hope to embrace more the “medicine” half of “travel medicine.”
But really Erik and I are here as emissaries of healing. In the most direct sense, this means providing one-on-one medicine, though that’s just a fraction of our job here. We were sent here not just to work in the clinic, but to share, to teach, and to learn: more broadly defined, healing encompasses all of this. And at the risk of sounding very conceited, I posit that we’re also here as emissaries of cultural healing. Meaning that in whatever capacity we may, we’ll try to bridge gaps between people: rural and urban, MHA and non-MHA, self and other.
No doubt this bridging must also transpire within myself: let me put aside my crystal metaphor altogether here in order to acknowledge that my feelings may very well exist in flux for the next few weeks. Things at home will transpire while I’m away and surely I will be missing a ton. But true change in itself also requires a kind of healing, a bridging of the gap between past and future. My first week has had much of that. Hopefully I can grow through my second week too.
Herein lies a once-in-a-lifetime opportunity, so let me make the most of this. That is to say let me begin the process of healing where I can, learning where I can’t, sharing everything, and giving it all my closest attention.