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 🍂.

The Rona

I am feeling burdened these days.  We've now had several cases of COVID-19 in our region.  Since we're the only medical option up here, we're the ones dealing with what this means and what to do.  So a lot of meetings and testing contacts to try and figure out if and where "The Rona" is spreading.  We've still been pretty lucky as everyone that's tested positive has been asymptomatic or just mildly sick (like with cold symptoms), so we haven't had to hospitalize anyone.  It's a constantly moving target.

What that means for me is that I'm doing a lot of phone visits and medical coordination without seeing patients in person.  And because we still have a lot of providers that are out (either out of state or just choosing not to work), I'm pretty much running both the outpatient department and long term care.  I don't mind, though there are certain patients that really need to see their usual provider.  But tag, I'm it!  Balancing both the patient's expectations and their usual provider's expectations can be tricky.

Since I'm working long term care (LTC), I'm being tested for COVID-19 every week.  That's not the most pleasant of tests.  But we want to keep the virus out of LTC since the residents are mostly elders that don't have the best immune systems.  So we're testing all staff and residents weekly.

One of my tie dye masks, a fun activity my hospital offered

When I'm not at work, I continue to walk a lot.  Berries are starting to ripen so I've been picking blueberries and salmonberries.  I hurt my back lifting some heavy totes in June, so bending over to pick berries then sounded horrendous.  But after some PT and a TENS unit, I'm on the up and up.  It's amazing how when you have pain, it seems like it'll never resolve and it's the worst thing ever.  But then when things lighten up, you're amazed and remember that our bodies are pretty incredible at recovering.

Arctic tundra for miles, with a few wild flowers and berries in the mix. 
But curiously, not a single tree.

I went to Fairbanks for a long weekend in June.  I was supposed to meet a college friend though she couldn't make it due to COVID.  So instead, I met up with a colleague that I had never met in person (a doc that does telemedicine for several Kotzebue villages).  I stayed in her guest cabin which was set up with a bed and mosquito net.  And boy were there mosquitos.  Aggressive little suckers.

The view from my bed.  So grateful for my mosquito net.

Fairbanks was a really refreshing experience.  I didn't do the best at social distancing as I was with my colleague much of the time, and she's surrounded by people.  Really nice people.  I had some amazing home cooked meals, the best berry pie I've ever tasted and a lot of laughs.  Besides some much needed socializing, I also got to explore Fairbanks a bit including soaking in the hot springs.  I want to go back in the winter when the aurora borealis is dancing through the sky- what a sight it'll be there!

The moose antler arch in Fairbanks

I've been walking the 8.5 mile loop through the Alaskan tundra many weekends.  The tundra is mostly flat and goes forever.  There are wild flowers blooming, berries popping up and there continue to be random animal parts around.  There's a well ridden loop road, so not much danger of bears or other predators.  If you venture off the road, you're on your own.  For the most part, we stay on the road, talk about all the things and breath in the fresh air.  It's been in the 50's with a few days in the 60's- excellent for walking.  

A nurse friend took me out to expore on an ATV, such fun!

It's still light 24 hours a day here though the sun will dip more and more in the coming weeks.  Then it will be "normal" for a little while with both day and night, then the darkness will set in for winter.  When I was interviewing for this job, I was told the light is a bigger problem than the darkness.  I guess it depends on what problem we're speaking of.  But for sleep, the infinite light definitely plays a role.  There's no cue that it's time for bed.  Many set an alarm.  Or just stay up much of the night, go to bed when the sun starts to dip (around 2-3am), then sleep until afternoon.  Since I'm due at work at 8am, I have to get myself into my bedroom with my blinds and dark curtains to get my brain producing some melatonin to aid in sleep.  Doesn't always work well and 8am often comes too soon.  But I try.

I'm an honorary Native Alaskan now

4th of July was fun.  We had a parade with every fire engine, police car and ambulance we have out here.  Also the coast guard helicopter took a pass and there were a few floats.  It was better than halloween for the kids, candy was thrown into the spectators from every vehicle.  There were no bands or singers, not sure if that was because of COVID or because we just don't do that here.  Everyone kept their distance on the sidewalks, some had masks and it all felt very festive.  Because of the no darkness here, there were no official fireworks.  Though I heard a few that evening.

One of the floats, "Catch fish, not COVID"

We'll see what these next weeks and months bring.  Feels a bit like Groundhog's Day, like we're just playing out the same day over and over.  Maybe because of The Rona.  Maybe because it's Kotzebue.  But I try to find little things to mix things up, break up the monotany.  Hearing from friends and family is the best, please reach out or use snail mail :)

Self Isolation

What a drag this COVID-19 is.
We've been lucky enough not to have a case (yet) here in Kotzebue.  Since the only way in is by plane, we have public health nurses stationed at the airport offering COVID-19 screening right then and there.  Only 70-80% of passengers take advantage of this, though all are advised to self-quarantine x 14 days once they reach their final destination (Kotzebue or one of the villages).

One of many handmade masks that have been donated

There's been a lot of fear up here.  Though we have no cases, there are a lot of questions.  The Spanish Flu in 1918 hit hard up here, wiping out large numbers of people in the Arctic.  This has been on people's minds, lots of worry and fear.  Therefore, we're seeing a lot fewer patients both in the village clinics and at the hospital in Kotzebue.  Even when we recommend they come in, some have refused, choosing to suffer it out.  That's been hard for us, trying to properly care for our patients that won't show up.  Of course we're delaying elective visits and procedures.  But we still need to check in and address the acute issues that come along.
There's also a lot of uncertainty for our medical staff.  We are just a small community hospital without an ICU.  We do have a couple ventilators that we've dusted off, though few of us are fully comfortable using them if/when needed.  When COVID-19 first hit the US in mid-March, we jumped into high gear and came up with trainings and protocols.  We transformed rooms, preparing for pandemic numbers to flood through our doors.  Those plans are still in place, though we've become much more relaxed.  That doesn't mean we don't expect the virus to come, because we absolutely do.  But we have so few cases in Alaska that now, if we get a really sick patient, there's more of a chance we can fly them down to Anchorage safely so they can get all the care they need.

One of our planes that go to the villages

I've been enjoying the outdoors whenever I can.  It's now light from 5am - 1am, so there's plenty of opportunity to be out, even after work.  My neighbors were kind enough to come over and put up some blinds on my bedroom window so I can block out the sun to sleep.  I'm still not shutting down very efficiently and often find myself wide awake well after 10pm, making 6am seem awefully early to have to get up.

Warmer and longer days

The lagoon outside my window still has a solid ice cover, though the overlying snow is mostly melted.  And the snow piled up all over the sides of the roads is now producing impressive puddles that are challenging to traverse.  I've had to find a new route to work to avoid getting my feet soaked on the way.  And some days, the puddles in town have been so deep that vehicles have to redirect for fear of ruining their engines by submersion.

These puddles are intense

We have an 8.5 mile loop outside of town that I've been enjoying.  My neighbors are very ambitious and have been taking me along for the hike.  

It's so pretty here

We've heard rumors of a moose sighting though have yet to spot it ourself.  But there are tons of birds that have seemingly appeared out of no-where.  Even ducks, suddenly here and bustling about.  We have big black crows that hang around through the winter, they are tough.

The crows are resilient

Some caribous parts discovered on a loop hike

We should be getting berries soon, that will be fun.  Bears also enjoy the berries, so I'll stick with my neighbors who have both bear spray and a gun.
One wonderful thing my hospital has started offering is fruit and veggie boxes.  There are 4 different options that can be ordered once a week and are delivered right to the hospital.  I got my first box a couple weeks ago and get my next one this week.  What a treat to have lettuce, snap peas, fingerling potatoes- I could go on and on.  Having something to prepare that's not frozen or canned is fabulous!

Fresh fruits and veggies- so yum!

I'm anxious to be able to take another trip to civilization, even within Alaska.  I don't want to have to self-quarantine x 14 days when I come back, so am holding off for now.  But there's something about being able to grocery shop and eat food prepared by someone else that is so intruiging.

A new shelf I procured to use as a pantry.  I still have a decent sized stash.

Until then, I will continue exploring this northern land and soak up all the Vitamin D that the extended sunlight has to offer.

Spring and COVID

Hello again.
Things have certainly changed since I last wrote.  This new and novel coronavirus has been throwing us all for a loop.  I left for a medical conference on March 10th and the very next day, my hospital mandated all permanent employees stay in the region.  Since I was already gone, I attended my conference in Colorado Springs.

My roomies and I for the conference

The conference was still really good (I love AAO Convocation) though many of the atendees had to cancel and we were trying to follow makeshift regulations during the program.  Because no more than 250 people were supposed to gather in one space, the conference center had to be opened up further and all of our chairs were placed 6 feet apart.  The regulations got stricter as the days passed and by the end of the week, there were concerns for travel restrictions to fly home.  I was planning to stay in Colorado to go skiing with my brother and sister-in-law but the resorts all closed.  So my choices were to fly back to Alaska early or go somewhere else.  I needed a break from Kotzebue so decided to fly to Washington DC to be with my brother for a few days.  It was a wonderful break despite having limited options and trying to adhere to social distancing.  The best part was the DC cherry blossoms were in full bloom, so we were able to walk outside and enjoy the beauty.

My nephew Dudley

Beautiful DC cherry blossoms

I returned to Kotzebue on 3/20/20.  I thought I would be mandated to quarantine at home x 14 days.  However, initially, my work let me back into the hospital with the caveat that I wear a mask and get my temperature checked twice daily x 14 days.  But as of today, I'm self-quarantining while working at home for the remainder of my 14 days.  So far, I'm feeling fine.

Following the rules with my mask on while at work

Thankfully, I live in the perfect place for this quarantine as I have plenty of food and supplies.  We have always stockpiled since there aren't affordable stores here- brilliant.  For now, social gatherings have been cancelled, including hanging out in the hospital lobby or cafeteria, which was the norm for many townspeople.  We now have people at the hospital entrance screening patients.  And if they don't meet criteria or don't have an appointment, they're sent away.  Patient appointments have been either converted to tele-visits or post-poned unless they are approved to be seen in person.  We've always done tele-visits for village patients, so it hasn't been too difficult to incorporate this for our local patients as well.  Of course, there are limitations when we don't get to see people in person or check their vital signs (temperature, blood pressure, etc).  But we do our best.
A permanent provider left at the end of February, so I have taken over her panel of patients.  What that means is I have been reassigned from my original village of Point Hope to Noatak.  I was supposed to go to Point Hope next week for the last time but that has been cancelled due to COVID.  So now I need to move on and figure out this new village of mine.  I've heard it's beautiful there, inland and right along a river.  With trees, oh how I've missed having trees!

Portrait taken for a mailing being sent to my new village, Noatak

The days are getting longer here in Kotzebue.  We currently have more than 12 hours of sunlight, and that will only increase.  It's just now starting to get light when I walk to work just before 8am.  But it's still light until after 9pm.  Pretty soon, I'll need to close the shades in my bedroom so I 'm not kept up all night.

Giant icicles- a result of warmer days

It's also started being warmer this month.  The winter was much colder than recent years, consistently in the negative degrees Fahrenheit.  However, it's been in the positives the last couple weeks.  Because of this, it's snowing more.  In the 2 weeks I was gone, it snowed several feet and the piles of snow on the sides of the road are impressive.

Snow piling 1/2 way up my windows, partially blocking my view of the beautiful lagoon

Walking to work is a bit more challenging with all this snow.  There's often several new inches overnight, so walking requires more effort to move my boots along.  However, I got some cross country skis in January and that's been great.  Unfortunately, I slipped on some ice while cross country skiing earlier this month and hurt my wrist.  It's a lot better now but has made me wary of skiing on the roads which tend to be more slick.  Instead, I prefer to ski on the water (lagoon, sound) where the snow is less compact and there's less to slip on.

My neighbor and I, heading out on a ski

A random caribou hoof we encountered on one of our walks

It's been fun to watch dog sled teams out on the lagoon.  The Ididerod (big dog sled race from Anchorage to Nome) was at the beginning of the month and it was all over the news.  The Kobuk 440 is a smaller race that starts and ends in Kotzebue.  It was supposed to happen in April though it's been officially cancelled due to COVID (http://www.thearcticsounder.com/article/2012kobuk_440_cancelled_in_light_of_covid-19).  So unfortunately I won't get to experience the excitement of the actual race, but I get a front row seat to watch some teams that are out for a run and it's fabulous.

A small dog team pulling both a sled and their cross country skiing leader- he took a big spill soon after this pic!

So, stay well!  I do hope this virus gets defeated soon though it's hard to know when.  I want to be able to get out when I need to, and the only way for that to happen is for COVID to take a hike.

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!