What are the motifs in The Scalpel and the Silver Bear by Lori Alvord?

"Breaking the glass ceiling" is a recurring idea in the book. Becoming a surgeon led Alvord to break two glass ceilings—one for Navajos and another for women. Alvord is the first Navajo woman surgeon in history, to our knowledge. Becoming one presented a number of challenges. First, as a Navajo, Alvord would not ordinarily have been encouraged to excel. Navajo are rarely encouraged to compete and, especially, are not encouraged to bring attention to themselves in order to secure advantages. Thus, many Navajos do not dream big futures for themselves. When Alvord reached Dartmouth, she faced a fantastic culture shock, finding white culture to be overly competitive, loud and stressful. She did not have the heart to compete and stuck almost exclusively to interacting with other Native American students.