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 ;)