While
Pember’s meticulous recounting of this history can at times drag, when she
pulls back from these recitations to draw connections to her mother’s
experience, Medicine River sings. Bernice
may not have been successfully assimilated at the Sister School, but she did
learn to be ashamed of being Indian. That shame was fueled by fear and trauma,
and fueled Bernice’s lifelong stubbornness and rage. “Her vengeance would be
disproving all the prejudices the sisters held about Indians as lazy, dirty,
and biologically inferior,” Pember reflects. “She started work on the outsized
chip she forever carried on her shoulder, sometimes nearly collapsing under its
weight.” Pember and her brothers were raised in the shadow of that chip on
Bernice’s shoulder, struggling with her “harsh and baffling ways” and
attempting to avoid the hidden triggers that set off anguished spells of hand
flapping and head shaking.

Pember
completes her exploration of her mother’s time at the Sister School and the
history of Indian boarding schools within the first half of Medicine River.
In the remainder of the book, she moves far beyond that history, without losing
sight of how it continues to color the contemporary Native experience. In this,
Medicine River stands out against typical historical accounts of the
boarding school era, which tend to focus only on what happened between 1819 and
1969. By expanding the frame up to the contemporary moment, both by telling her own life story and by
examining the efforts of boarding school survivors to demand accountability
from the Catholic Church and the federal government, Pember illuminates how Native cultures have
resisted and persisted through centuries of attempts to eradicate their people,
and how their long-standing traditions and spiritual practices can light the
path forward for healing from the ongoing traumas the schools wrought. 

Native
researchers, such as the social worker Maria Yellow Horse Brave Heart, explain
these aftereffects using the theory of historical trauma. In the first phase, a
population is subjected to a mass trauma by the dominant culture—for Native
Americans, colonialism, wars, and cultural genocide. That population displays
physical and psychological responses to the trauma, as Bernice did. Finally,
the population that experienced the trauma passes their responses on to their
progeny. The historical trauma theory makes sense of “the high rates of
addiction, suicide, mental illness, sexual violence, and other ills among
Indian peoples,” Pember writes. She now understands her mother’s anger, aloofness,
and bitterness as trauma responses, and her own struggles with alcoholism as
the only coping mechanism that she was given to handle the anger and fear she
inherited.