What relationship between language, knowledge, and reality would enable us to engagewith differently positioned traditions of knowledge production in the movement to­wards Indigenizing the international academy? This article offers a situated responseto this question, drawing on specific traditions that emphasize existential questionsin Indigenous studies literature. I argue that epistemological pluralism can be under­stood as an effect of specific Indigenous metaphysical assumptions that connect reality,being (ontology), knowing (epistemology), and language very differently from Enlight­enment-inspired ontologies and epistemologies. The conclusion explores some of theimplications of this insight in terms of the crafting of narratives in research and health-related practices.