Initial Thoughts

I've been here a few weeks now- can hardly believe it.  Many of you have asked what it's like, so this is my attempt at giving you an idea.
I flew in via Anchorage.  I purposely had a several-hour layover in Anchorage so I could go to Costco and pick up some perishable and cold items.  Things like eggs, yogurt, frozen veggies, bread.  As an Alaska resident, I can check 3 bags for free (2 bags if coming from outside AK). When I got back to the airport (thanks Uber), my food box was 65 lbs.  Limit is 50 lbs, so the lady gave me the option of splitting it into 2 boxes.  After doing that, I was told I was checking in 1 item over the limit, $100.  Ugh!  Thankfully she was nice and waived the fee just this one time.  So off I went on the 1.5 hour flight to Kotzebue.

My apartment is a short walk to the hospital where I'll be working most of the time.

Typically, doctors stay in hospital housing (right behind the hospital), but there's an 18 month waiting list for those apartments, so I was put in teacher housing.  It's a bit further away, but not too shabby.  Plus, it's right on the water.  Not the ocean, on a large lagoon (I called it a lake for the longest time) where the airport runway is.  There wasn't enough space to build the runway on solid land, so they built it right over the lagoon.

The city of Kotzebue.  Population ~4000.

I have a wonderful view of the water and get to watch planes take off and land right from my living room.

View from my couch

The sound of the planes isn't terrible and has never woken me up (maybe because they don't routinely fly at night).  There are 2 commercial flights from Anchorage every day, then daily flights to each of the 11 surrounding villages.  Flights for medical emergencies also go when needed.

The Inupiat villages surrounding Kotz

The water in the lagoon froze over in the middle of last week.  One day, there were waves from the wind.  The next morning, there was a sheet of ice that has only grown thicker since then.  Just a few days ago, I saw people cutting their holes for ice fishing.  I fear they'll fall through, but hopefully they know that it only takes a few days to be strong enough (?).
I have a 3 bedroom apartment all to myself (I was expecting a 1BR).  So anyone who wants to visit the arctic, I have a place for you to stay!
I started work on October 1st.  Though it was light until close to 9pm, the sun didn't rise until 9am, so I walked to the hospital in the dark at 8am.  The temp was 30-40's, not too terrible, though nothing like the 90+ temps I was having in Houston.  So after a few days, I figured out how to dress better for the weather.  It's gotten down into the teens now, those are bitterly cold walks.  I have to give myself pep talks, "Just a few more steps, you can do it".
Thankfully, the heat works well both in my apartment and the hospital.  So as soon as I get to work, I peel off all my layers.  I wore a sweater one day and was way too hot.  So I've learned, a short-sleeved shirt with a cardigan or a long-sleeved shirt is enough for work.

I have yet to see an igloo, not sure they exist anymore??

The days have already gotten shorter in the few weeks I've been here.  Now it's dark until 10am and gets dark again before 7pm.  The days will keep shortening until there's hardly light at all in Dec/Jan.  My biggest worry about this is getting around town.  Right now, I walk and I feel relatively safe.  But when it's dark, I don't want to be wandering around, not knowing quite where I am.  I've already chosen not to go places in the evening because of this.
I've thought about getting a vehicle.  The options are a snow mobile (called snow machines here), ATV or an SUV/truck.  So far, I haven't felt I needed one.  But as the snow and ice intensifies, it might not be a bad idea.  There's no protection against the elements with the snow machine/ATV option, though they seem to be most popular around here.  I guess you just bundle up and go.  My concern is the cost and availability of maintenance for these vehicles- I've heard it's not great.  So we'll see.

The coolest ambulance I've ever seen

I have both a PO Box and a physical address.  What I've learned is for USPS (normal mail), everything goes to the PO Box.  The post office is across town, maybe a 15 minute walk, so not terribly far.  Though I don't go often, it's cold and I don't have much mail to pick up anyway.  Then on-line orders (like Amazon) use my physical address.  I got my first Amazon order last week, it was so exciting.  My neighbor texted me, told me Christmas had arrived.  We get excited about mail around here :)

Yay, packages!

I have explored town and some of the surrounding area a bit.  The first weekend, my neighbors invited me to go cranberry picking.  They are really lingonberries, but they call them cranberries here.  We walked 20 minutes or so out of town and picked for a couple hours.  No bears to see, though I heard someone spotted a grizzly with 2 cubs just the week before.  I made cranberry jam which I've been mixing in my yogurt- yum!

Lingonberries, AKA cranberries.

I've also walked a bit through the town.  There isn't a ton to see.  Lots of run down houses, a few abandoned buildings.  The hospital is the biggest and most pleasing building.  Most structures are on stilts due to permafrost- ground that stays frozen year round.  Global warming is threating these structures, as we rely on the ground staying frozen to keep our buildings up.  But it seems we're pretty safe for now.  Because of the stilts, houses/buildings sway.  When I first felt the sway in my apartment, it reminded me of being on a boat.  My neighbor said the first time she felt it, she thought it was an earthquake.  Now, I'm more used to it and I know it will pass.

Maniilaq Hospital, on stilts.

The only wildlife I've seen so far are birds and seals.  The seals are fun, their heads bob just at the surface in the Sound, sometimes they splash and play.  There are boats with guns waiting to get them, so that's not as great.  I guess seal skin makes great hats and boots.  Also something called seal oil which is used both in cooking and as a home remedy for colds.  I went on a walk over the weekend and saw moose droppings, so I know they're around.  Also caribou and bears, though I've yet to see either of them.  I suppose we won't see much in town.  And I don't wander too far out of town, not alone anyway.  So maybe I'll see them when I'm at the villages?
The places of note here in Kotzebue are the hospital, the airport, the post office, the grocery store and the cable/internet company.  There's also a shipping port on the other end of town, only active in the summer.  The grocery store is overpriced but has everything you might need in a pinch.  There are also 4 restaurants in town.  One is in the hospital (the cafeteria), one in the hotel and a couple others.  I bought soup at the cafeteria yesterday for $7, bought a side salad for the same (full salad was ~$15) at one of the restaurants.  There is pizza for $20 medium/$30 large.  Something to splurge on from time to time.

I've mostly managed my food from the things I sent up.  Besides my Anchorage Costco run, I sent up 3 bins full of non-perishable items.  I feel like I have most of what I need.  I don't have a salad or fresh fruit/veggies as often as I'd like, but I have things like raisins and dried peaches to get me by as a snack.  I've bought a weekend flight to Anchorage in a couple weeks, so I'll pick up the food things I'm missing then and replenish what I'm going through.

Then there's work.  Once again, I'm learning a new EMR (Electronic Medical Record), this one is called Cerner.  No fun and in my opinion, not a great system.  But it's what we've got, so I'm trying.  I've started seeing patients, many run-of-the-mill, some not as much.  The difference here is we see both people here in Kotz (90% native) and from the villages (100% native).  Patients from the village come by plane and are triaged by a PA/NP before they come, so we have an idea of why we're seeing them.  But it's dependent on the flight coming on time, and making sure they are done in time to get back on the plane to return home.  So if we order medication, labs and/or an x-ray, we have to try and get all that done before their flight back.  Or if they're sick enough, we keep them here.  Either in the hospital or put them in the hotel.  Or fly them down to Anchorage or elsewhere is it's really bad.  So I have to determine their severity and make decisions in a timely manner to make sure they get the medical care that they need.
Interestingly, there is a high no-show rate here.  Meaning people schedule an appointment to be seen in the clinic, but never come.  This happens even with village patients.  It's hard to know if it's because they missed the plane, or if they came just for a free trip to Kotz and didn't bother getting their medical need addressed.  There's no consequence for no-shows, so we just carry on.
I've been assigned to a village- Point Hope.  It's a relatively wealthy village due to whaling and actually is technically in a different region than Kotzebue.  However, we are paid to see their people.  I will be going there in a couple weeks from Monday-Thursday, seeing everyone I can that need to be seen.  Mostly chronic medical conditions that need to be monitored periodically or other conditions that can wait.  We're short-staffed, so even though it's my first time, I'll be going alone.  I have no idea what that will be like- I'll let you know!

That's it for now.  I'm sure there will be more revelations as I learn and experience more up here.  I feel like I'm leading a fairly boring life here so far.  Not really lonely (yet), but boring.  Just work, hunkering down in my apartment at night and doing some exploring on the weekends (while it's still light).  Time will tell.

Alaska is BIG!

P.S.  For anyone wondering, here is my address.  I love mail, especially chocolate ;)
        Katrine Bengaard
        PO Box 1427
        483B 9th Ave, Apt 9 (only need this line if NOT using USPS)
        Kotzebue, AK 99752