The End

Doesn't seem real yet, but my 2 years are over.

All my stuff, piled up and ready to be transported to Air Cargo

In some ways, it seems like this was the longest 2 years of my life.  In other ways, it went by in a blink of an eye.  COVID-19 shaped a lot of my experience in the Arctic, for better or worse.  I knew I was going to a remote region of the world and that my interactions would be limited.  With COVID, the isolation became all the more real.  Thankfully we never fully stopped seeing patients in person, so at least I had some people to interact with when I was working.  But social distancing as a single woman living alone really affected my social life, things sure felt extra lonely.

I have put together a couple lists that help sum up my experience in my own biased way.

Things I will miss:

• My apartment view out over the lagoon.  I really came to appreciate all the sun rises/sun sets, spying on the birds and watching the planes take off from my couch.  Everyone that visited were jealous as only a few of us had the privilege of such a fabulous view.
• The smell of the sweet, fresh air in the tundra.  There is nothing like it.  In the winter, the air is cold and crisp.  In the few short weeks of summer, there was the freshness of new brush.  And late summer/early fall with the berries.  The tundra was a place to get away, intensely feel the remoteness and connect with nature.  
• The excitement every time I got to go on a bush plane.  With COVID, I didn't get to travel to my village as much as I wanted/expected.  But I also got to go on a few bonus trips to provide vaccinations and such.  The little planes are different.  There is no security check, you can take your full bottle of water along and no-one's there to check if your seatbelt is buckled or if your phone is in airplane mode.  The seats are small and sometimes a bit hard to get to (and get in to).  The views from the planes are incredible since we flew fairly close to the ground- you could see it all.  Landing was also fun, bouncing along the gravel runways.
• All the offers to give me a ride.  I chose not to purchase a vehicle during my 2 years, which means I did a lot of walking.  To work, to the post office, to the store.  I did eventually get a bike which got me places a bit quicker, but my legs were still my #1.  Of course, there were times when I needed a taxi (like to the airport) or I would borrow a car/ATV/snow machine.  When I walked, people would often stop and ask if they could give me a ride, especially in bad weather.  It wasn't scary (stranger danger) as everyone knew who I was even if I didn't know them.  And sometimes I would take them up on it, other times I wouldn't.  It was nice that people wanted to help.
• The way people spoke/phrased things.  Instead of "I was dizzy" they would say "I was trying to faint".  Or instead of "it's getting worse", they would instead say "it's worst".  You had to get used to how people expressed themselves in order to come up with the best way to help them.  And learn the random Inupiaq word they would throw in a sentence.  After a while, I would ask them questions using their terminology.  Something I will probably need to unlearn now.  Makes me smile.
• Curious little faces of the Native children.  The kids were my favorite patients.  I would ask the schedulers to put all the babies in with me.  Most of them were chubby with bright, dark eyes staring right at me.  And the older kids were precious (well, most of them), trusting as I examined them.  And when I was walking around town (especially in the villages), kids I had never met would run up to me just to say hello or to tell me a story.  I'm not the first white face they've seen, but they still wanted to find out about me and somehow knew I was safe.
• Hearing people's stories.  Not everyone opened up, but those that did really helped give me insight into the Inupiaq culture and way of life.  It took time to build trust, but I felt privileged to hear their stories and give them time to share about their lives.  Appointments were not as rushed as they are in the lower 48.  If people wanted to talk, they could.  I was honored to be the recipient.

Things I won't miss:

• Having to trudge through wind, ice and snow.  I liked not having a vehicle, but there were days when I just didn't want to leave my apartment.  I learned to dress for the weather quickly after a few cold walks where it felt like frost bite had for sure settled in.  I also learned to keep my things close as the wind stole several items right out of my hands, never to be seen again.  But even with all the preparation, leaning in and willing my feet to lift up and move could still be a challenge.  I gave myself many a pep talk, "just a few more steps, you can do it".
• 24 hours of darkness.  To be fair, we always had a little hue of light, even on the darkest days.  It didn't happen until early afternoon, so on work days, I never saw it.  And on weekends, I scheduled my walks/skis to correspond with the hue.  Of course, there were plenty of lights inside and some street lights.  Also head lamps and such for treks into the tundra.  But the absence of light was something to get used to, at least for the couple months when it was most intense (December/January).
• 24 hours of light.  This was maybe more difficult, at least before I figured out how to black out my bedroom window.  There was never any indication that it was night.  Never a clue that it was time to wind down, get to bed.  Because I worked, I had to force myself to go to sleep, otherwise I couldn't function well.  Many of the Native people flipped their schedule, sleeping during the day and staying up all night.  Getting people to show up for appointments in summer was a challenge!
• The tight grip alcohol has on this people group.  What a terrible curse alcohol is to the Native people, not just in Kotzebue though I saw it in them first hand.  Alcoholism starts young and grips people to their core.  There are a few that manage to give it up, but there were plenty that did not survive long enough to tell their story and help positively influence the next generation.  Kotzebue had a liquor store in town, the villages did not though there were plenty of home brews.  One man told me he was still mad that Kotzebue allowed the liquor store to come to town.  Others moved to a village in hopes of escaping the temptation, with varying degrees of success.  It was hard to see, hard to feel like I had nothing useful to offer.
• Not having access to things.  All the things, but especially fresh fruits and veggies.  We did have a couple stores, even restaurants.  They were pricey and offered the basics.  There was Amazon.com that usually eventually delivered whatever was ordered, but not always.  And often by the time it arrived either you didn't need it anymore (like my mosquito net) or you had forgotten all about it.  This is a 1st world problem and one I survived just fine.  But man, without the things you take for granted, you get a different perspective on what's really important.  

Of course, these lists could go on and on.  Hopefully my previous blogs fill in the rest.  I feel honored to have had this experience but also grateful for a change.  Oh, and did I mention my student loans are paid off?!?!  Mic drop, I'm out.

The lagoon with a forming sheet of ice reflecting the rising sun

My mom came up in August for a fun trip to the Kenai Peninsula

We got to see so many bears on our tour, it was AMAZING!

Bear! 
He walked just feet from us, paid little attention to the human onlookers.

Summer #2

Just like that, it's summer.

The snow and ice lasted well into May this year.  That resulted in a lot of puddles.  Thankfully Kotzebue got some road levelers to push around the dirt/gravel which helped a lot with our massive pot holes.

The lagoon with ever-shrinking snow piles

For Memorial Day, I went to Talkeetna with a couple other Alaska physicians.  One of them has a cabin on one of the lakes, it was wonderful to be there.  We spent a lot of time chatting, also kayaking and hiking.  Talkeetna is just south of Denali National Park, so though we didn't hike Denali, we got a peek at it through the clouds.

Denali (right peak) off in the distance

I slept up in the loft of the cabin.  On night #2, I was just lying down when I saw/heard something fly over me.  I went downstairs to wake the owner and when she came up with me to investigate, we found a little bat!  We tried to shoo it out without much luck so ended up removing screens and leaving windows open overnight while I slept on the floor in the kitchen.  We never saw the bat again, so presumably it found it's way out.

The beautiful cabin in Talkeetna

Then there was an earthquake on night #3.  We shook for a minute or so, my metal water bottle tipped over and the cast iron stove lost one of it's sides with the shaking.  Nothing terrible, but was still a significant quake, mag 6.1.  One of the docs was out in an Airstream and was rocking and rolling.

Headed out to explore the lake

That trip helped remind me how much I value connection.  Of course, my colleagues up in Kotzebue help some with that.  But we don't spend time together outside of work, don't go to each other's homes due to COVID-19 precautions.  What a bummer all that is!  So being with a couple fellow physicians and being able to feel comfortable and relaxed, what a glorious escape.

Miss Arctic Circle in the 4th of July Parade

I've been to a few villages over the last few months: for vaccines, school/sports physicals and to my village of Noatak for a week to see my chronic patients.   A PA (physician assistant) student joined me in Noatak.  I enjoyed the help she offered during our busy days and her company on our evening walks.  Then a friend flew up to Noatak and instead of flying back to Kotzebue, I found a local to take us back by boat on the winding Noatak River.  The weather wasn't perfect and the river was a bit rough.  But it was fun to return back to Kotz in a new way.  I was surprised at how many seals were on the river banks and sand bars fishing as we passed by.

A porcupine out for an evening stroll

On our Noatak river float back to Kotzebue

We stopped at an old fish hatchery on the way.  There is a family that lives there year-round, it was nice to visit with them and find out about their lives.  They have been catching a lot of fish and served us a few kinds of salmon cooked different ways, that was a treat.  They have super limited connectivity (wifi and such), there is running water but not a flushing toilet and they homeschool their kids.  What a way to live.

Quick stop to an old fish hatchery along the Noatak River

As with last summer, visiting the beach by ATV and kayaking has been a good activity to do on the weekends.  I also got a bike, so a 3 hour walk around the 8 mile loop can now be a 1 hour ride, not too shabby.  It's been very rainy this year so the tundra is wet and boggy.  It makes for a good berry season, though without waterproof boots, your feet get mighty wet & cold!

My new bike, visiting "the mother ship" at the top of the hill

Quite a bone find for this pup, along the 8 mile loop

Softball was a blast.  Because of the rain, we had several cancelled games and other games that were just really wet and muddy.  That led to some unfortunate injuries and all the teams struggled to get players to show up for the games.  Instead of coming in last place in the tournament, we managed to win a game and felt very victorious, despite our subsequent losses.  Overall, it was another fun season.  How I've missed interacting with others, the comradery but also some fun competition.

The Maniilaq softball squad 2021

I only have a few weeks left in this crazy place.  I'll do my best to end strong, maybe add a few more adventures to the list.

The Kotzebue cemetery, up the hill in the tundra

AK Winter #2

It's been a while since I posted.

Maybe because things have been fairly quiet, nothing too exciting.  It's been VERY cold, fairly stormy and overall very Alaskan Arctic 🥶.

Some of the ladies in Long Term Care at the Easter Party

I've gotten to go on a few more vaccine trips to surrounding villages.

In Selawik with another awesome team

One was to Deering, a small village with barely 150 people.  We went on a Saturday, were supposed to return the same day but weather rolled in around noon and never left.  I had brought food for lunch and had a toothbrush but not much else for the unexpected overnight stay.  Thankfully the CHAP (Community Health Aid) was extra kind and brought us some food from her home including homemade caribou sausage.  We all found a mattress or bed of some kind and weathered the storm.  The next morning, the pilot finally agreed to come get us around noon.  So we hopped in the ambulance (a converted pickup truck) and headed to the airport a mile or so away.  Unfortunately there were snow drifts up to 5 feet high and about half way there, the ambulance got stuck.  We saw that the plane had landed and something inside made us panic- what if he doesn't see us and he leaves us here?  So we grabbed all our stuff and started climbing over the snow drifts.  After 5 minutes or so of watching us scramble, a couple of snow machines miraculously arrived to give us a lift the rest of the way.  And of course, the pilot was laughing as he watched us scrambling with our bags and gear, trying to reach him.  Good times 😂.

The Deering store with such a nice façade

The very next day, I flew to my village of Noatak for a week.  This is the first time I've physically been there since I was assigned to them in March 2020.  I had spoken to many Noatak patients on the phone, but meeting them in person was so much sweeter.  It was January, so the days were cold and the daylight was limited.  But what a beauty Noatak is, inland and located right on a winding river.  It was nice to be there, nice to see where my patients live and also to finally meet the CHAPs that run the clinic.  I spent the week seeing patients, doing home visits, exploring a bit by foot and overall enjoying being somewhere new.

The bell tower along the bank of the Noatak River

I've had many press requests since being on GMA.  What an adventure that has been.  There have been a few other interviews published (see links below), but most we had to turn down.  Just last week AccuWeather asked for an interview.  Unfortunately, my work doesn't like being on the news or bringing awareness of the challenges we endure working in the Arctic.  The opportunity I was most sad to forgo was Ellen.  We spoke with the producers, it was all so exciting.  But in the end, my work said no.  So that was that 😕.

My GMA team sporting Carhartt gear that was gifted to us

I got to take a trip to the lower 48 to visit my family and bestie in February.  It was nice to have access to any food I wanted, fast internet and to love on these sweet twin girls.

Ava and Emma, they are the best!

I've been skiing a lot.  That's what you can do up here, so I do it with gusto.  Skiing season is almost over, the temperature is right up around freezing now so snow is melting and the conditions just aren't ideal.  I'm sad because I don't anticipate being in Alaska another winter which means my "ski in, ski out" location will no longer be a thing.  

Out exploring the tundra.  Spied a white wolf this day.

I also do a lot of walking, up and around.  Lots of slipping and sliding, I don't like wearing my crampons as they cause blisters so choose to risk it with just my snow boots.  We can't really walk on the tundra- in the winter, you'd need snow shoes otherwise you sink and in the summer, it's too wet and soggy.  But for berry picking, it's worth the wet.  With all the COVID hoopla, getting out of my lonely refuge is oh so needed.  A chance to breathe in the fresh air, chat with a friend without worrying about masks.  Since there aren't fancier options, walking the same path is what we do and it's refreshing to the soul.

The crazy piles of snow that formed this winter

That's me for now.

Here are a couple press links just for fun:

https://abcnews.go.com/US/video/alaska-female-vaccination-team-75620891

https://www.cbsnews.com/news/covid-19-vaccines-alaska/

Famous

I became famous in January- who knew??

It all began by me posting this picture on Facebook:

It was taken while my team was out on a whirlwind trip to 3 villages in one day to vaccinate community members with the COVID-19 vaccine.  It was a great picture and I wanted to share it.

I'm part of a group on Facebook for Woman Physicians in Alaska.  One of the members is Dr. Anne Zink, the Chief Medical Officer of the state of Alaska.  She asked if she could share the picture on her page.  That was seen by a reporter for NPR radio who asked her to ask me if I'd be willing to do a radio interview.  I said sure, and a week or so later, I was featured on NPR.

https://www.alaskapublic.org/2021/01/08/in-rural-alaska-covid-19-vaccines-hitch-a-ride-on-planes-sleds-and-water-taxi/

That was fun, I didn't think much of it.

But then a reporter from ABC heard the NPR story and reached out to me.  We chatted for a bit and a day or so later, she said her producer wanted my whole team to go live on GMA (Good Morning America) that Friday.  With the COVID-19 pandemic in full swing, it would be by Zoom rather than us traveling to NYC.  But still, wowzah.  I reached out to my other team members, they were all on board and we said yes.  A day or so later, I found out Maniilaq (my work) needed to be involved (why that never occurred to me, I don't know).  Thankfully, they said OK and we went live at 3am Alaska Time on GMA.  Here's the clip:

https://www.goodmorningamerica.com/wellness/story/female-team-delivers-covid-19-vaccines-snowmobile-harshest-75229506

That was a fun experience.  We all met by Zoom with the producers the day before to talk about what to expect, we were told what questions would be asked, in what order, etc.  I happened to be in Fairbanks visiting a friend during the actual interview, so that made having reliable internet a lot easier.  But making sure I had proper lighting, sound, etc was tricky since I couldn't do a check until I got there.  My colleagues that were also featured were all in Kotzebue and managed to get their checks with the producers done a day before so we could all be on together.  I was really glad it wasn't just me and that we got to tell at least some of our story, convey the craziness of practicing medicine in the arctic and all that that entails.

The following days and weeks were even crazier.  We were all bombarded with requests for additional press interviews, especially myself and our pharmacist Meredith.  I wasn't particularly interested in being on TV again, so tried finding others who would be willing as I thought it would be nice to feature Maniilaq and the work being done here.  But alas, no-one else stepped up.   All reporters got directed to our Public Communications Coordinator and a few managed to squeak by for an interview.  But most were denied.  Even really cool requests like the BBC and The Washington Post.  I had to let it go and realize that I am not in charge.

One interview I did on my own was for my Alma Mater, St. Olaf College.  I figured it would just be seen by my fellow alumni, no need to get permission.  Here's a link to that:

https://wp.stolaf.edu/news/alumna-cares-for-rural-patients-in-the-arctic

So there you have it.  Famous.  The fame has come and gone, I'm back to being a regular old primary care physician now.  But it was a fun month or two of feeling extra special.  Kinda a big deal ;)

 

Village fun

November was uneventful. It snowed a fair amount, I voted, tried my hand in some ice fishing and did a lot of cross-country skiing. The days got shorter so any light was welcome. Because of social distancing, I didn't attend any Thanksgiving gatherings and didn't even take a little bite of turkey (as is my custom despite being vegetarian). Low-key, nice to have a break from work.

"I voted" sticker in Inupiaq

My friend Peggy trying out some ice fishing.

My amazing view, can't get enough.

 We saw some Aurora/Northern Lights in town on Nov 21st. I have an app on my phone that tells me when/where the aurora is most active and luckily that coincided with a clear night. It lasted all night, the lights were most active around 4am- I serendipitously got up around then so enjoyed the show from my living room window.

Pictures don't do the Aurora justice

I celebrated a birthday Dec 12. Last year I was still so new and hadn't really told anyone it was my birthday, so the day went by without much fanfare. This year I got a bit more attention including a little lunch party with cake and presents from the Long Term Care staff. It's nice to feel celebrated and come home with a big banner to commemorate another year.

I planned a trip to Anchorage in December since I needed to see a dentist. I found out the ski resort Alyeska was opening on Dec 18 so I made sure to be there for opening day. I brought my snowboard along and had a good day. Also a day that made me feel my age. My body doesn't like all the sitting, buckling and twisting that snowboarding requires. So though I enjoyed myself, I decided to sell my snowboard and off it went to a new owner. I will continue down-hill skiing whenever the opportunity arises, but I don't anticipate more snowboarding (though you never know...).

My new friend Triin and I at a park in Anchorage

On the lift for my last snowboarding adventure

Christmas was fun. My friend Melanie (Nurse Case Manager at the hospital) dressed up like Santa and visited some kids in my complex. Somehow I weaseled into her plans and we ended up spending an hour driving around town on an ATV surprising people with Santa. She was fun to watch, dancing outside people's windows and giving big waves and "Ho, Ho, Ho"s. It was a mild night, so we didn't get too cold as we drove around and tried to make people smile. It's dark most of the time here in December, so being outside at night was something fun & different.

Melanie in her awesome Santa suit

The absolute highlight of my whole experience up here in the Alaskan Arctic happened this Tuesday, Dec 29th. I was asked to go with a team to a few villages to vaccinate against COVID-19. These teams are typically not staffed with physicians since we're needed at the hospital. But with so many employees out on vacation for the holidays, they got desperate and asked me. I said yes immediately and was up early Tuesday morning, ready for an adventure. 

My team consisted of me, 2 nurses and a pharmacist. We met at the airport, we started on a larger plane (10 seater) along with a couple other passengers and headed to Ambler. We were picked up on the runway by the village clinic staff, they brought a couple of snow machines and a sled. We piled on and headed on a 5 minute ride to the clinic. 

Getting there :)

 

There were several patients already waiting at the clinic for the vaccine when we arrived, the staff had been announcing by VHF radio that we were coming all morning. We stayed a couple of hours and even made a home visit to a 92-year-old elder who couldn't travel. The thing that struck me the most was how grateful the villagers were. Grateful that we came, grateful that they were getting this vaccine and that they weren't forgotten. The flu of 1918 hit the Alaskan Arctic hard, wiping out whole villages. The stories of that pandemic has endured and when COVID-19 hit, the fear of another devastating pandemic and them being so isolated was pervasive. Of course, our system to provide medical care to these remote villages has come a long way since then. But being able to make this vaccine available to these citizens was very satisfying.

Our transportation outside of an elder home, school in the background

Next we went to Shungnak. We were taken back to the runway on sleds, then met a small charter plane that barely had room enough for the 4 of us and our pilot. Off we went. The sun was just coming up near the horizon then (around noon), so we got to see pretty colors as we flew in to Shungnak.

 We were again met with fun transportation and got this awesome picture snapped.

My awesome team

After Shungnak, we went to Kobuk (just a few minutes by plane away). The clinic staff laughed and said we should have called and they could have picked us up by snow machine. We had less of a turnout in Kobuk (unclear why), but it was nice to spend time chatting with the villagers that came and doing another home visit to 2 married elders. The village staff know their people and when we said we had enough for 1 more vaccine, they got on the radio and got someone in before we packed up.

View from Kobuk clinic.  They have trees and mountains, a nice change from Kotzebue

Our pharmacist was responsible for keeping the vials frozen during transport, then de-thawing the right amount to be able to vaccinate whoever came. We didn't want to waste any doses and she did a great job of gauging how much we would need and making provisions when necessary. Our 2 nurses were awesome, they did all the vaccinating and made sure patients filled out the correct paperwork and got appropriate handouts about the vaccine. And then there was me. My role was to make sure patients were medically appropriate to get the vaccine and to observe them afterward to make sure there were no adverse reactions. Everything went so smoothly making my job super easy. My presence was necessary but I ended up spending most of my time enjoying the recipients' stories and making sure they stuck around for 15 minutes.

Our flight back to Kotzebue in our tiny charter was long and loud, but we made it back by 6pm. It was amazing how much we were able to accomplish all in 1 day. And how enjoyable the whole experience was. When I first signed up for this job, I imagined all of the traveling and unusual assignments I'd be taking on while I was here. With COVID, travel to villages has been so limited that my expectations weren't being met. There has been a lot of monotony and I was feeling a bit burned out. Now that I've had this adventure (and hopefully a few more with COVID restrictions lightening up), I feel a new sense of purpose and vigor. It makes me smile just thinking about it.

View of a village (maybe Noorvik) from the air with a winding river and full moon rising

 Here's to a better 2021!

Travel

I finally got to travel to a village after we shut down routine trips due to COVID-19.  Not my assigned village (Noatak), but Kivalina which was having trouble with staffing.  I was originally told I would be the only provider, so would be on-call 24 hours a day for the week I was there.  Thankfully, a CHA (Community Health Aid) agreed to stay M-F, so I only had to do night call every other day until the weekend when it was all mine.

Kivalina is on a barrier reef, not connected to the mainland though they are building a bridge/road that will connect.  The village is eroding from harsh storms and rising water from global warming.  Eventually they will need to move the village inland though there's been some resistance from the people.  A new school is being built 5 miles inland and the road will connect the village to the school.  The hope is that people will start moving inland near the school and make the permanent relocation easier.  Meanwhile, the whole village gets evacuated periodically for weeks at a time when storms come and ravage the structures here.

My plane getting unloaded.

I landed in Kivalina by propeller plane on a Monday morning.  I was picked up by the health aid trainee and taken on an ATV to the clinic.  I brought along food for a week in a cooler and a small suitcase.  I dropped my things in a small bedroom behind the little kitchen in the clinic.  Before I knew it, I hopped back on the ATV to see an elder at her home.  I saw a few more patients back at the clinic, then was asked to hold the night phone.  The challenge at night is to decide if the patient is OK to wait until morning or has to be seen right away.  Sure enough, I had someone that I tried to keep home but she kept calling, so in she came.  She left at 11pm feeling much better and I got in bed to try and rest up for the next day.  A couple days later, a middle aged man was found dead in his home so I had to go pronounce him and call the troopers to fly in for an investigation- that was a learning experience for sure.

Whale bones.  They get some beluga whales here, not often the big bowhead whales.

And so it went.  Since this isn't my village, I didn't come with a list of patients I was hoping to see.  Instead, I saw whoever called in with a concern.  Similar to when I was in Point Hope, I also saw the health aid, administrator and the janitor as patients- they all seem to come up with health concerns when a provider comes to town.  

Waking the beach, black sand and rocks.

After clinic closed at 5pm, I tried to get out and walk around.  The beach was nice though a little difficult to walk on.  It was chilly (in the 30's), so I'd walk along with my winter coat and hood up.  There were big jellyfish and crabs washed up by the waves- who knew?

One of many jellyfish washed up on shore.

One day, I walked back through town.  I saw a group of people gathered, several kids playing in the street.  As I got closer, one of the kids asked my name.  Then he pointed and said "There's a drunk over there".  A lady was lying on the street surrounded by 2 other adults talking to her and trying to get her up.  I felt sad for her.  Also sad for the children that were watching, observing.  Alcoholism is so pervasive and destructive in this people group.  There's no alcohol available to buy in the villages so they have to be strategic to get it here.  But they manage and their daemons follow them.

It was nice to get away, nice to break up some of the monotony of life in Kotzebue.  I do hope I get to go to Noatak one day soon.  We're waiting on the tribal councils to agree to allow routine visits to villages by providers again, this was halted due to COVID-19.  Though we continue to get COVID-19 cases, symptoms are mild and it's a struggle to enforce social distancing in a culture that doesn't not embrace this concept.

I also got to take a vacation to the lower 48.  I met my family in North Carolina, then drove with my parents to Nashville before flying down to Orlando to visit my bestie and her new twins.  Then back to Houston with my parents to do some on-line CME (Continuing Medical Education) before heading back to Kotzebue.  

Back to the frozen tundra.  That lagoon was not frozen over before I left, now people are ice fishing every day.  They are catching Tom Cods.

I'm in radio room today- not my favorite assignment.  I have to field all the notes from the CHAs (community health aids) in the villages.  It can be as easy as prescribing tylenol, but sometimes it involves flying them in for evaluation in Kotzebue or planning to have them seen by a specialist.  If someone is in serious trouble, we try and pull them up on the screen and walk the CHAs through things like CPR or splinting a fracture.  I much prefer to manage patients in person but with villages, that's just not possible so we rely on the CHAs to relay information to us the best they can and try and to make the best decisions to get patients timely care.  

In the radio room "dungeon" with my Halloween mask.  This is where all the magic happens.

We sometimes have patients threatening suicide in the villages- that's a hard one.  We do have behavioral health practitioners that can get on the phone with the patient.  If the patient is not in the clinic, we utilize the VPSO (Village Public Safety Officer- volunteers in the community) to go to the home for a welfare check and sometimes physically restrain them.  I wish I could understand why suicide was so prevalent up here, why we haven't managed to make strides in preventing this terrible statistic from rising.

There's a blizzard outside at the moment, planes aren't landing so village patients are on their own.  I still wonder how I ended up here sometimes...  Looking forward to getting my cross country skis out and being all bundled up.  I saw a fox yesterday, maybe there will be other critters to discover.  Always an adventure up here!

Change

I'm amazed at the change of season that is upon us.  Summer here was glorious.  It was warm, mostly dry and the light was incredible.  We were also lucky to have hardly any bugs this year, couldn't get much better.  

However, the weather has shifted.  There's suddenly a cold bite in the air, it's wet, it's windy.  I can no longer head out the door with my coat open and not much thought about feeling cold.  Now I find myself wishing I had remembered gloves and a hat.  It's dark when I wake up (still light into the evening).  Just like that, it's fall and headed towards winter fast.

Sun set from my living room window as the darkness sets in

I'm surprised at how surprised I am.  I moved here at the end of September last year.  So I arrived in this weather.  Yet somehow I thought it would stay summer a bit longer.  Probably more of a hope.

I joined the Maniilaq softball team.  The season was delayed and limited because of COVID precautions, but we had fun.  There were 4 teams in town and we came in 4th place...  But I really enjoyed the camaraderie, I liked getting back on the field and even got some good hits in.  Already looking forward to next year.

The Maniilaq co-ed softball team

On whim, I also participated in a 1/2 marathon last month.  I found out about it on Wednesday, then on Friday night, a friend said she wanted to do it and I decided to join her the next morning.  Options were walk, run or bike.  We were in the walking group.  And walk we did.  At first we though we were doing pretty well.  But as the other groups moved further and further ahead, we realized we were bringing up the rear.  There were a few that needed to forfeit along the way, so we weren't last-last.  But we were last to hopped on his ATV to fetch us a couple yoga mats and phone chargers that he had back at the office.  So we felt victorious and fulfilled after our 13.1 mile walk, averaging about 19 minute miles.

Thankfully there haven't been many mosquitos this year.
But clearly, there have been in the past to have this be our marathon theme.

I was originally scheduled to go to Norway in August, but those plans got cancelled due to COVID.  So I snuck out of town for a weekend.  We still only had flights Mon-Friday then, so I went to Anchorage Friday to Monday.  I enjoyed some sightseeing as well as hiking and of course shopping to restock my pantry and freezer.  It was a great break for me, I stayed in a sweet AirBNB and even got to see a moose!

Portage Glacier boat tour

I also finally took advantage of going kayaking.  The City of Kotzebue offered kayak, paddle boat and bike rentals.  We tried going kayaking the first weekend but they were sold out.  Then the weekends started passing by and we didn't get around to it.  So finally on one of the last weekends, we went.  We thought they opened at 10am, but no, not until 2pm.  So we went back at 2 and got our kayaks out on the water.  We kayaked out to the sound, then back and around the lagoon behind my apartment.  

One of the funnest things was to kayak around a bunch of jumping fish.  I'd seen them before from the shore (even from my window), but to be in the kayak and have them jump all around, how fun.  I don't know what makes them jump, someone said it's because there are bigger fish deeper down and they're trying to escape (?).  But jump they did.

I haven't been fishing up here.  But we had a SeaShare donation to Kotzebue.  Tons of frozen halibut were delivered in by the coast guard and given out one day.  I had asked for some since I couldn't make it to the distribution area while I was at work and got a whole box delivered.  Who knew I'd be sorting through frozen halibut at work.

SeaShare frozen halibut

There haven't been a ton of berries this summer.  I wasn't here for blueberries last year but I've been told this years' berries are smaller and sparse.  Also, we never got salmon berries because it didn't get warm enough.  Arctic cranberries are next, I've been told they'll be ready after the first frost.  I remember picking them the first couple weekends I was here last October, just before the snow came.  So I'm looking forward to some cranberry jam.

Sun rise over Swan Lake on my way to work

Work is still stressful.  Because of providers not working for various reasons, we're short staffed and it's making those of us that are working feel over-burdened.  Since we're such a remote place, it isn't easy to get replacements (temporary or permanent), so despite the amount of work being the same, we have to do more to keep our patients healthy and happy.  Happy is the tricky part as they have to wait longer and no one likes that.

COVID is still an issue too.  We have several new cases diagnosed weekly.  So our public health nurses are busy contact tracing and trying to enforce social distancing and quarantine.  That doesn't work so well up here since homes are often packed full of people and visiting is a part of the culture.  As before, we haven't had anyone particularly sick from the virus.  But we would prefer not to spread it to someone that might get really sick.  So we test a lot, limit interactions and hold our breath for what's to come.

I'm headed out to a village soon, more to come about that in the next blog.

Wishing you all a happy and healthy fall 🍂.