“The Medicine Bag” is a first-person coming-of-age story that relies heavily on shifts in tone and perception to drive plot and character growth. Rather than focusing on external action, the story is primarily driven by Martin’s internal conflict, which comes from his existence within two contrasting cultural contexts. The use of past-tense reflective narration provides emotional depth, illustrating both Martin’s initial immaturity and his gradual movement toward understanding: “I stood on the curb, unable to move even though I wanted to run and hide” (1). This line shows Martin’s inner conflict manifesting in his intense, contradictory impulses upon seeing his grandfather approach. When Grandpa arrives, Martin’s emotional state is one of hesitation and embarrassment, and his observations pinpoint what he sees as flaws, like Grandpa’s weariness and frail appearance. He does not yet recognize that these are signs of an experienced man who has wisdom to share. Martin also goes through a process of understanding and overcoming shame related to his background at the beginning of the story, as he feels like his grandfather stands out too much and is too different from the people Martin knows. After Martin sees how his friends revere Grandpa, his attitude begins to shift.

The story’s narrative structure follows a typical arc, but its emotional core is in moments of realization rather than dramatic events or a grand climax. The inciting incident occurs with Grandpa’s unexpected arrival, which disrupts Martin’s social world and triggers his confusion with his identity. This moment introduces tension, as Grandpa’s appearance draws attention from the neighborhood: “[T]he yippy dogs were growling and nipping at the old man’s baggy pant legs and […] he poked them away with his cane” (1). At the same time, the moment exposes Martin’s internal tension, which is his fear of judgment and his discomfort with his heritage. This relates to the theme of Connecting With Heritage and Culture as Martin’s heritage is thrust upon him and his two worlds are forced to meet. Sneve builds this tension through pacing and sensory detail by emphasizing Martin’s physical reactions (“I felt cold and hot at the same time” [1]). The climax involves a ceremonial passing of the medicine bag. In this significant moment, time drags on as Martin discovers The Link Between Masculinity and Ancestry. This deliberately slow pacing creates a sense of importance without relying on overt dramatization. 

Sneve’s use of first-person point of view is central to the story’s effect. Because the narrative is told entirely through Martin’s perspective, there are flaws in his perception that affect how the story unfolds. Early in the narrative, his descriptions are shaped by embarrassment and insecurity, resulting in a vision of Grandpa that takes away his dignity. Later descriptions of the same figure are filled with admiration and respect, which indicates a shift not in Grandpa himself but in Martin’s perception. Nothing has changed about Grandpa—like how he dresses or how he acts—but his clothing suddenly appears impressive and even noble: “Of course, he had his old black hat on—he was seldom without it. But it had been brushed and the feather in the beaded headband was proudly erect, its tip a brighter white” (5). This technique of reframing the same details in a different light demonstrates character development through changing language and tone. 

The story also makes use of imagery and symbolism as narrative devices, particularly in the scenes involving the medicine bag. The bag is initially introduced indirectly as Martin helps Grandpa undress. It is felt rather than examined, which creates a sense of mystery and foreshadowing. Before it’s finally opened, a spontaneous ritual occurs: “I stood up, somehow knowing I should. Grandpa slowly rose from the bed and stood upright in front of me, holding the bag before my face” (7). This shared, unspoken understanding is a moment of deep ancestral connection and revelation for Martin. 

Another key literary element in the story is the contrast in setting, which reinforces the story’s progression. The urban neighborhood at the beginning is depicted as noisy and judgmental, but this turns out to be a flaw in Martin’s perception. It contributes to the story’s initial tone of anxiety and discomfort. In contrast, the final setting on the prairie is quiet and expansive, creating a reflective and almost meditative atmosphere. This shift in setting mirrors the resolution of Martin’s internal conflict and supports his growth from shame to acceptance. The natural imagery associated with the prairie—the native land of the Sioux—also introduces a different narrative rhythm that is slower and more contemplative, harkening back to traditions that Martin may not yet know but to which he feels connected.