The Pastoral Clinic: Addiction and Dispossession along the Rio Grande

Garcia opens the book with a story from her time working at Nuevo Día, an addiction clinic located in the Española Valley. She describes sitting outside with three patients, each of whom is eagerly awaiting their next round of medicine. Garcia encourages the patients to join her on a walk to the river. John carries out the full walk with her, but when they reach the river, they find a heroin cooker and syringes. John declares that the river is dead, a stark contrast to the vibrant river of his childhood. This introduces the idea that the personal struggles of individuals in the Española Valley parallel this environmental decay and the loss of land and opportunities for self-determination in the community.

Garcia argues that loss and space are intrinsically connected and that a person’s experience is shaped by how these contexts intertwine. The rate of heroin addiction in Española Valley cannot be understood outside of the context of the history of the land and the effects of colonization. Situated between Santa Fe and Taos, the Española Valley consists of the Rio Grande and its badlands. Española marks the first Spanish colonial settlement in the Southwest, which dates back to the 16th century. Many residents of the Española Valley can trace their ancestry to these original colonists, though Indigenous people had been living on the land for centuries. In her work, Garcia highlights tensions between the Latinx community and Pueblo communities, a tension that began with Spanish colonization. Additionally, the communal lands and individual land grants that residents enjoyed under Spanish rule were taken away when the United States conquered the land in the 19th century. When New Mexico became a state, many of these people were left with nothing, a legacy of poverty that has extended into the 21st century. Garcia argues that this created generational trauma, and the sense of this loss pervades the culture in this region, contributing to high rates of drug use.

This connection is further complicated by the opening of the Los Alamos National Laboratory (LANL), which created huge wealth disparities. Residents of Los Alamos have higher rates of wealth and college education than surrounding areas. This comes with a cost, however, as the plant leaches hazardous material into the soil and water. The subjects that Garcia interviews describe the differences in the land as it exists now compared to their childhoods and the continuous reminders of what has been lost. Abandoned adobes, along with the markers of personal loss—descansos—shape their perception that the cycle of grief is without end.

As Garcia struggles to grapple with how these connections function and how institutions can both alleviate and contribute to their dysfunction, she questions whether marinating in the past harms or helps the individual: “Young and old insist that to meaningfully address the heroin problem, one must also address the region’s deep historical scars” (93). Garcia emphasizes that she wants to be careful about offering a naïve solution. Her work as a researcher is not to tie up the narratives of her subjects with a tidy bow, presenting an idealized picture of the future. However, she finds hope in the changes made at Nuevo Día when she returns to New Mexico a few years after her project ends. A return to the land through farming offers hope to patients, giving them something to look forward to in the future. This approach juxtaposes the patient-prisoner model, which fails to consider what lies outside of the rehabilitation clinic. Instead, by engaging with the land, patients recapture the connection between land, loss, history, and culture by investing in the future.