Holidays

I made it through the holidays in this cold, dark place.  The Arctic is like a whole other world.  Though I still go to work, the darkness seems to slow everything down.  We hardly see any patients before noon.  Then the sun starts peeking over the horizon, it's like people just aren't willing/ready to start the day without some light.  I wonder how it will be during the summer when the sun never leaves- maybe terrible insomnia??

A little Christmas cheer at the Arctic Heritage Center

I've been continuing to enjoy exploring this region by foot.  My neighbors and I have been going out on long treks every weekend, more with our days off during the holidays.  Depending on the day, it can be clear and gorgeous or so windy you can hardly put one foot in front of the other.  Though it's cold, it hasn't snowed much this season.  However, snow is still several feet deep and when you're off of a trail, you often find yourself sinking or dropping through the upper crust, sometimes thigh deep.  That can make for a difficult journey.

View of Kotzebue from across the lagoon on a Christmas Eve hike

We've taken to walking on top of bodies of water.  I really like walking across the lagoon that's just outside my window.  Sometimes you'll hear a crack when walking, a bit nerve wracking but we've been assured the ice is 2+ feet thick, so the cracking is really just settling of the layers, not the ice giving way.
We also walk on the sound, which is salt water.  Because of the current, the ice there is thinner.  And there are deep cracks/crevices, especially close to shore.  However, the ice is still a couple feet thick and feels very sturdy to walk on.  There is a lot of travel by snow machine across this ice to get to surrounding villages.  They mark the direction with sticks that go for miles.  I saw a couple of SUVs out on the sound the other day- that made me nervous.  But they must trust that the ice will hold.

One of the many large cracks in the ice.  We still walked on it and it felt solid and sturdy.

We spoke with some ice fishermen the other day.  They had drilled small holes through the ice and were using strings on a short stick with hooks and bate.  The one guy was pulling up a new fish every 30 seconds, it was amazing.  The fish are called sheefish and they're relatively small.  The natives eat them whole, just fry then up and eat.  With the temperature being so cold, I can't imagine being outside and sedentary, fishing over an uncovered hole for hours at a time.  But that's what people do.
Speaking of cold, it's gotten down to -35F (-37C)- now that's cold.  With the wind chill, it was in the -50's.  I've been bundling, not with more layers, but making sure every part of me is covered and protected.  I remember when I hiked Mt. Kilimanjaro and the temperature dropped low at night.  Our guide told us the smartest thing to do is wear minimal clothing inside our sleeping bag but sleep with hot water bottles, that way you heat the bag up and it forms a cacoon of warmth around you.  Too many layers actually made things worse.  So I'm working on believing and living that principle here in the Arctic.

My neighbors are hard core and go out in any weather.  I've been declining to join them when it's below -15.  I still go to and from the hospital for work.  But that's enough on the cold cold days.
My saga with the mail system also continues.  I had a FedEx package "delivered" according to the website, only it was no-where to be found.  When I finally got a human on the phone, I discovered that they only deliver on Mondays but mark packages "delivered" when they arrive at the airport.  However, Monday came and went and still no package.  Then on Tuesday, a man from the airport called saying I had a package waiting for me.  I asked if it could be delivered, he said they don't really do that (???) but then said he could drop it by the hospital.  Remember, everything here is within a 5 minute drive of the airport.  So I waited and waited, no package.  Then the next day, 2 men showed up at my clinic with my package.  It was quite something, however hit or miss the system is.
I went back to my village, Point Hope.  Once again, flights were affected by wind.  I was supposed to go Monday but both flights out were cancelled due to blizzard warnings so I stayed put until Tuesday.  Then on Thursday, flights were cancelled due to high winds so I stayed a bonus night and got out Friday.

My accomodations at the Point Hope clinic, a bed in the women's health exam room.

Clinic in Point Hope is so different than anywhere else.  I brought a list of patients that I wanted to see while I was there- mostly patients with chronic conditions that need to be monitored like diabetes or heart disease.  Only 4 of those patients were scheduled and just 3 of them actually came in to be seen.  However, I did see a lot of the mundane stuff like colds, rashes, joint sprains- the things the CHAPs (community health aids) are able to handle.  It would be nice to figure out how to get the patients that need to see a doctor to come in.

Dramatic colors with the sunrise in Point Hope

There is a small pharmacy in the village clinics.  There are over-the-counter medications (tylenol, mylanta, antibiotic ointment) as well as a handful of prescription medications in something called a pick point.  I order them through our electronic health record, the order goes to the pharmacist in Kotzebue to verify, then they release the medication to the pick point.  That's like a big vending machine that finds the medication requested and dispenses it.  Then I attach a label and hand it to the patient.  If a patient needs something not available in the village or a maintenance medication, that needs to be sent on the next plane (ideally the next day, limited by wind in Point Hope).
Same with the laboratory.  We collect blood, urine, swabs from wounds, etc in the clinic.  Then we have to print out labels, package and store them until the next flight comes so we can send the labs to Kotzebue to be processed.  Sometimes in Point Hope, you collect a sample and have to wait days just to get it sent to the lab, then wait another while for the result.  So not a super efficient system, but better than having to send the patient every time they needed labs done.  I'm quite enjoying drawing blood, something I haven't done since residency (and even then, we barely did it since our phlebotomists/nurses were on it).
I got to go to Anchorage for a long weekend.  AND my mom joined me, then came up to Kotzebue for a week.  We spent most of our time in Anchorage buying food and supplies to take back with me.  I even got cross country skiis and look forward to trying them out.  We went to the movies, ate delicious food and saw 2 moose just wandering around.  My mom was trying to get used to the cold (it was around zero on day one though warmed up to a balmy 20 degrees) in preparation for the even colder arctic.

Enjoyed this large polar bear

Anchorage was beautiful.  And so many trees!

My mom's visit was wonderful.  I don't get terribly lonely though there are moments where I just want something or someone familiar.  Phone calls are great, letters/packages are fabulous but an in-person visit, wow!  I don't expect many visitors since this is a pretty isolated place, but anyone who's curious about the arctic is welcome any time!