Papago Plague

Papago Plague is the novel’s locally used name for diabetes, connecting one man’s diagnosis to a disease described as prevalent on the Tohono O’odham reservation. The expression gives the illness a community-wide scale, while Fat Crack Ortiz’s response shows how an individual’s beliefs and choices shape the experience of treatment.

Meaning and Use

The term is applied directly to diabetes: after Fat Crack Ortiz is diagnosed, the narration notes that the disease is so prevalent on the reservation that it is known as the Papago Plague. The name therefore conveys more than the fact of a diagnosis; it marks diabetes as a familiar and significant health concern in the community. The evidence does not specify the expression’s origin or establish that it is an official medical term.

Fat Crack Ortiz’s Diagnosis and Response

Diagnosed a few months before Brandon Walker asks about his health, Fat Crack Ortiz refuses the services of Indian Health Service physicians. He objects to being subjected to medical procedures and instead tries to manage the illness through diet and exercise, together with treatments drawing on both Christian Science and Native American practice. His response reflects his position as a Christian Science student who, in middle age and reluctantly, answered a summons to become a Tohono O’odham medicine man.

Lani Walker, home from North Dakota during Christmas vacation from her pre-med studies, learns of the diagnosis while visiting Fat Crack Ortiz and Wanda Ortiz at their home in Sells. She is frustrated that he will not accept a doctor’s care and argues that he should be under medical supervision. Her concern gives the phrase a family dimension: the disease is presented not only as common in the community but as a source of conflict between a patient’s chosen approach and a close relative’s faith in conventional care.

Reservation Health Context

The novel also places the diagnosis within a wider account of health services and recordkeeping on the reservation. A study supported by an Arizona State University grant in the early 1990s entered existing records from the Indian Health Services hospital in Sells into computers, using records reaching back to the 1950s to compare longevity and track which diseases accounted for deaths. The study, together with money from tribal casino operations, was among the reasons the hospital had its own kidney dialysis center. These details establish a broader institutional setting for the term, but the text does not say that the study or dialysis center was specifically prompted by diabetes.