Respecting Her Elders: Blythe Sanders Winchester ’99 Brings Healthy Dose of Reverence and Irreverence to the Practice of Medicine
Blythe Sanders Winchester, M.D. harbors deep reverence for her elders.
She admires their strength, understands their struggles, and seeks their wisdom. She strives to give them the high-quality medical care that reverence demands.
That’s not to say there’s no irreverence, because Winchester has a big streak of that. From her boisterous sense of humor and disarming candor to her escapades as a Roller Derby skater, Winchester treks boldly.
Some patients remember her as a Girl Scout who danced, played piano, sang and entered pageants. She also spent many quiet hours preparing for her future medical career.
“You know how a lot of little girls want to dress their dolls up in different outfits and cut their hair and put makeup on them?” her mom, Janet Sanders asks. “Blythe performed open heart surgery on hers.”
Today Winchester is that doctor she always wanted to be, taking care of her Eastern Band of Cherokee Indian (EBCI) elders in the western North Carolina community where she grew up.
She’s the rare Native American among geriatricians. She works at the Cherokee Indian Hospital and is chief clinical consultant in geriatrics and palliative care for the Indian Health Service. Winchester also serves as medical director for the nearby Tsali Care Center nursing home and on The Center for Native Health’s executive board. The Cherokee Indian Hospital Authority (CIHA) recently honored her as its 2020 Employee of the Year. In May, the American Geriatrics Society named her as one of its class of 2021 fellows. The honor goes to a select group of health professionals who’ve demonstrated exceptional commitment to high-quality care, research and education in geriatrics.
“She’s widely respected and has great credibility with members of the tribe,” says Dr. Richard Bunio, executive clinical director for the hospital authority. “She strikes a real balance between western medicine and things that are important culturally to her patients. She’s been passionate about protecting the tribal elders and other nursing home residents. I can’t speak highly enough of her contributions to healthcare here.”
The COVID-19 pandemic has hit Indigenous communities particularly hard. Native Americans, including several of Winchester’s patients, have died at more than twice the rate of white Americans. Other patients have endured severe loneliness and depression during months of isolation.
“It’s the most chilling thing I’ve ever had to deal with,” she says. “We care so much about our elders; helping them through their health issues is extremely important. You throw in this monster that is decimating them—it’s been horrific.”
There have been victories.
While outbreaks plagued many nursing homes in North Carolina and across the United States, Winchester battled to keep the virus out of hers. No residents contracted it and the facility had a nearly 100 percent resident vaccination rate by early spring.
“We need to end this disease as quickly as possible,” she says. “I’m fighting to keep as many people safe as I can.”
Winchester grew up in the Qualla Boundary’s Wolftown community with the Great Smoky Mountains as a backdrop. The EBCI, a sovereign nation with about 15,000 enrolled members, owns the 100-square mile land trust that makes up the boundary.
More than a third work for the tribal government in education, public works, social services and other departments. Another third work in local tourism and the tribe’s casino industry. Winchester describes a tight-knit community of people who know, socialize with, and watch out for each other. Family ties run strong.
Her dad, James “Butch” Sanders, who is Cherokee, was a hospital and reservation social worker and county social services director. Her mom, a non-Native, worked at Western Carolina University’s library. Blythe had a close relationship with her paternal grandparents, who lived within walking distance. (Her maternal grandfather died young, and her grandmother lived in Virginia before moving in with Blythe’s parents in her later years.)
Janet Sanders says Blythe presented many parenting challenges. A daredevil from the get-go, she always wanted to be at the center of all action. At eight months old, she’d pull herself up in her crib at night, then run back and forth, waking her sleeping parents up before flopping back down to sleep.
She didn’t climb on as much as she walked on top of the playground monkey bars. At 5, she dressed up in her pink tutu and danced on stage for a local festival crowd. She competed in pageants and singing contests. And loved to learn. Her mom often brought her to the college library, where she spent hours reading, exploring bookshelves and putting on puppet shows to entertain herself.
“She had so much energy we thought she’d do something great or end up in jail,” her mom jokes. “If I didn’t keep her mentally and physically busy, I could see the potential of her getting into lots of trouble. She was very mouthy—still is—and never minded telling anyone exactly what she thought. People either loved or hated that.”
Blythe was so intent on being a doctor that her parents bought her a white medical jacket, and her dad brought her unused syringes to play with. She’d inject her dolls with cola to change their skin color. She’d cut them open for surgery, then stitch them back up.
At the time, real health care options in her community didn’t garner such enthusiasm, she says.
She didn’t have a regular pediatrician. A trip to an available doctor could be an all-day event. If you were sick, you’d go to the dreary old hospital building and wait for hours to see someone. Doctor turnover was high, with few longstanding physician-patient relationships. Tribal members often felt talked down to by white doctors.
“Looking back, knowing how important these relationships are, I can’t imagine how they ever got anything done,” Winchester says. “Things now are completely different.”
The changes occurred in the 1990s when the tribe took over ownership of the hospital and established its own priorities.
“There’s been a huge shift for the tribe to have health care providers who understand cultural considerations,” she says.
She’s been part of that evolution, serving as both provider and advocate often consulted in policy making. There’s also been a push to encourage more Native Americans to go into medical professions.
People have welcomed the changes. As small towns go, her once sleep-deprived parents often run into her grateful patients.
“People always stop to tell us how much they love Blythe, and how wonderful she is,” her mom says. “She talks to patients like you would to a neighbor. They appreciate how direct she is, and that she grew up here.
“It takes a lot of dedication to be a doctor, and Blythe has always worked exceptionally hard. I’m so proud of her.”
Learning to Stand Out
Winchester credits her time at Davidson for helping prepare her for the rigors of medical school and training, and for recognizing the value her Indigenous experience brought to campus.
None of it came easily. She didn’t know of any other Native Americans at Davidson at the time. She’d attended rural public schools and felt surrounded by classmates from elite private academies and boarding schools.
“I was so intimidated and overwhelmed,” she says. “I could tell I wasn’t from the same means or educational background. I was just trying so hard to fit in.”
She labored through a pre-med track; balancing a hard course load with a healthy social life and a college library job, “and got some tough love from a few professors when I needed it.”
Former Anthropology Professor Rosemary Zumwalt encouraged her to explore and teach others about her Indigenous heritage. A large part of that involved debunking stereotypes and false historical narratives.
“When I did that, people were really curious, they tended to be fascinated by the Cherokee experience. I tried to educate others and provide a more accurate history of what has happened to Indigenous people,” she says. “I also wanted to make sure that people knew that we are still around and that we don’t all wear headdresses and live in tipis. I talked a lot about what modern life is like for Cherokee people.”
She confronted controversy when another student wrote an editorial questioning why people wanted to change Native American sports team names and mascots. “Why is it that some people are offended by something so trivial?” he asked.
One of those names was a derogatory slang word demeaning to women.
“Now you may not find this a significant issue,” Winchester wrote in a rebuttal editorial. “I guess you just think that women should stop being hypersensitive and learn to deal with this kind of insult. Fortunately, not everyone is so ignorant.”
She says it’s the one time she felt singled out at Davidson, and she wanted people to understand the words and actions that degraded Native Americans. She found a receptive audience.
“I’m still honored that I attended Davidson,” she said. “I gained a lot of confidence. To be able to do well in my classes, to get the encouragement from not just students but professors at this fancy private school made me feel like I could do things I never thought I could before. I had a very diverse group of friends who went on to do amazing things. It was one of the greatest experiences of my life.”
Going All In
Winchester took a year off after college “to convince myself there was nothing else I wanted to do,” before heading to UNC-Chapel Hill’s School of Medicine. She was home on a break in 2004 when she arranged to meet friends at a local bar.
Justin Winchester, a non-Native and a few years younger, worked as a bouncer at the bar and knew some of her friends. He’d heard them talk about how smart Blythe was, that she’d gone to Davidson and planned to be a doctor.
Then she walked in.
“She had these bright red streaks in her hair and a really fun, crazy personality. I thought she was a little wild,” he says. “Then the more I talked to her, the more I realized she was also super-intelligent.
“She wasn’t at all what I expected. I thought she’d be a lot more stuffy.”
They exchanged numbers that night and spent the next few months talking as friends on the phone before dating. They got married shortly after she graduated from medical school in 2006.
Justin Winchester now co-owns a gun and ammunition shop. They live next to her parents and close to her siblings, Lori and James. They have three Labrador retrievers, an English bulldog, a mini-Beagle and cat.
He’s supported her many endeavors, including a five-year stint as a Smoky Mountain Roller Girl, though “she’s super-competitive and sometimes it was hard to watch,” he says. “It was rough out there and I worried that she would get hurt.”
“Sesamean Streak” got banged up a few times and committed her fair share of aggressions and amends. When her opponent dislocated a shoulder, the brawler-turned-benevolent doctor popped it back into place. And treated another opponent’s injuries after they brawled.
“I’m pretty fun and easygoing until I am on the track, and then I try to murder people,” she says.
She pushes herself to excel at whatever she takes on.
When her tribe selected her to represent them on the 2019 Remember the Removal bike ride, she immersed herself in preparation. The annual ride commemorates the northern route of the Trail of Tears. She went from rarely biking to long, grueling treks on steep mountain roads to train for the three-week, 950-mile ride from Georgia to Oklahoma.
She also read avidly about the culture, history and trauma of her Cherokee ancestors. She ramped up her efforts to learn Tsalagi, the Cherokee language. She says the experience, which included stops at historical landmarks, further intensified her commitment to serve her community.
“I cannot imagine the pain and suffering these elders and our ancestors have endured for me to be here,” she says.
Her many tattoos affirm that all-in approach to life.
An arrowhead with the Cherokee Syllabary for “19” commemorates the ride. Her left arm sleeve celebrates nature and feminism with a spider, kissing snails and female bees. A skull sitting on a stack of books reminds her “that I will never stop learning and educating myself.”
“When she has a passion for something she’s 100 percent,” her husband says. “She jumps into it, and she kicks ass.”
She pours that passion into her medical practice.
Her love for her grandparents—and seeing how lovingly her parents took care of them—inspired her to specialize in geriatrics. She says her parents devoted themselves to making their parents’ later years as happy and comfortable as possible. She wants that for her patients.
She’s proud of the gleaming, modern medical facility that replaced the old hospital of her childhood, and of the care she and her team provide.
Her patients come for regular checkups. She knows their health history and issues, medications and home life. They brag about their grandchildren and bring pictures. On good days, there’s a lot of laughter. Other times, she has to have some very hard conversations.
Sonya Arch had been Winchester’s patient for about a year when Winchester completed her specialty certification in geriatrics and shifted her practice to elder care.
“I never let her live it down, I said, ‘I can’t believe you’re firing me as a patient,’” Arch says. “But that turned out to be the best thing ever for my parents. My dad can be stubborn about things, but he loves Dr. Winchester and will pretty much do whatever she asks him to do for his health.”
Arch’s parents, Tom and Ethel Smith, have been Winchester’s patients for about 10 years. They enjoy their visits.
“We laugh and we joke and get a kick out of her,” Ethel Smith, a tribal elder, says. “She has a knack with the older generation, she has a super personality and a way of making you feel good and comfortable about whatever problems you may be having. She’s someone we know we can trust.”
Physician’s Assistant Quana Winstead was Winchester’s childhood friend and hadn’t seen her for years before they reconnected at the hospital. They now work as a team.
“From the time we were little girls to now she’s one of the most fun friends I’ve ever had,” Winstead says. “When she’s around it’s always lively, she’ll just randomly burst into song or have us laughing over some story. If it’s quiet at work, I know Blythe must not be there.
“As a team, we laugh a lot with each other and our patients, but when it’s time to get serious, we do. Blythe is a huge advocate for her patients,” Winstead says. “She’s very honest with them. She doesn’t shy away from serious discussions or letting them know what all of their options are. It’s important to her that they know what to expect.”
Respect & Traditions
One of the things Winchester loves most about her community is the respect given to its elders.
There are Senior Games, Elders Day at the annual fair and an elder council that advises tribal leadership. Elders get special holiday dinners. The tribe also offers lawn mowing, home repairs, and food, housing and utility assistance for elders in need.
Winchester enjoys the variety of personalities among her patients. She has some in their 90s who seem decades younger. Genetics, lifestyle, outlook and environmental factors play roles in longevity, she says. “And sometimes it’s funny because that person might be mean as a snake, and you think, that’s how she made it this long—it’s the spicy factor.”
Her elders have lived through wars, forced relocations, and banishment to boarding schools designed to strip away their culture, language and traditions. She believes the trauma they’ve faced factors strongly into their increased risk for chronic illnesses such as diabetes and heart disease.
“How much different would our health be if we could have continued our use of plant-based medicine and preserved our food sovereignty? Or practiced our traditions?” she asks. “It often sickens me to think about what has occurred and how our tribal communities have been fighting for centuries to preserve what we know is right for us.”
Treating her elders can lead to some heartbreak.
She’s had to tell patients that it’s not safe for them to drive anymore. Or that the confusion and forgetfulness is dementia. And sometimes the hardest news—that a life is about to end.
“There’s a way to handle it so that it’s not so depressing. I try to talk to them about the goals they have for this time,” she says. For some, it’s seeing loved ones or working through a bucket list, for others, it’s ‘I want to sit and watch my western shows on TV.’
“I don’t ever want to be the authoritarian who says, you have to do this and this,” she says. “They’ve had enough sadness and grief in their lives. I try to make things as uplifting and positive as I can.”
Her recent CIHA award cites her leadership and integrity, noting that preventing nursing home residents from contracting COVID-19, “did not happen by chance. This is the direct reflection of the hard work, dedication, and countless hours that Dr. Winchester put forth in ensuring the health and safety of some of the Tribe’s most vulnerable elders.”
One of her greatest frustrations has been Americans’ mixed reactions to pandemic restrictions; and the politicization of mask-wearing, social distancing and vaccines.
“Our elders have suffered horribly because of people who were so cavalier and careless. Some act as if these elders, who offer so much wisdom, experience and counsel, are disposable,” she says. “Just because you’re 80 or 90 doesn’t mean it’s your time to die. And too many people have died before their time because of COVID.”
She especially misses a beloved patient.
“My entire team loved him and love his significant other, who always came with him on his visits. They were both such special people and so much fun and such a joy to be around,” she says. “You know when these elders get COVID, the odds are against them. He had medical problems but had been doing so well, and then something this horrible just removes him from this world.”
She hits vaccine skeptics with facts; urging them to consider the virus’s devastation. She often enlists social media as an educational tool, reinforcing the message with her usual bluntness.
“Thank you to everyone who asks me questions @ the vaccine to help you make a decision @ fighting the battle,” she posted on Twitter. “I have scienced the crap out of this.” #Vaccinate!
Her patients teach her so much. And she still has much to learn.
“They’re truly amazing people,” she says. “They are often humble and completely calm in their approach to the world. They have the best sense of humor and their resilience is unmatched. They are tough.
“I love the stories they have to share. The wisdom and knowledge they’ve amassed in their lifetimes is amazing. I’m trying to give them the care they deserve. Being able to do that is an honor.”
Through childhood, college, medical school and as a doctor, she’s never doubted that this is where she’s meant to be.
“I know that is one of the reasons I have been able to find my path easier than others,” she says. “The roots here are not just a place—it’s that thousands of years of resilience and knowledge is buried inside of me.”
This article was originally published in the Spring/Summer 2021 print issue of the Davidson Journal Magazine; for more, please see the Davidson Journal section of our website.