Black Elk digresses from his story to explain that it is necessary to perform a vision before its power can be used; he could become a healer only after he had acted out the heyoka ceremony. He also explains that power works through him; if he thought it originated with him, it would be gone. He says that, in talking to Neihardt, he has for the first time told as much of his vision as can be told in words; even his son and his friend Standing Bear have not heard it before. He worries that he may die now because he has described the vision, but he thinks it is best to leave some record of it.
After healing Cuts-to-Pieces' son, Black Elk goes to Fox Belly, a medicine man, to tell him the bison part of his first vision so that he can help his people walk the red road of that vision. Fox Belly helps him perform a bison ceremony, in which Black Elk and One Side are painted red and act like bison. The Indians drink from the sacred cup, which will help them follow the good red road. After performing the bison ceremony, Black Elk feels confirmed as a healer and a man. The next year (1883), he performs an elk ceremony, to represent the mystery of growth. He uses six men dressed as elk and four virgins, who represent fertility, and many of the colors and sacred objects of his first vision.
Black Elk here comments on his own story, emphasizing the exclusive nature of his conversation with Neihardt. His commentary offers further proof of his modest character; he does not claim extraordinary power for himself, but is content to be an instrument of power.
The bison ceremony illustrates once again the sacred nature of the bison for the Indian. Black Elk performs the ritual to direct his people onto the right road, the red road of his vision; they have been following the black road of trouble. In performing the ceremony, therefore, Black Elk assumes to a greater extent the role of guide among his people.