The sun on the snow gets so bright
Reflecting the light off the white
The stuff new to me
Is wonderful, see,
And Aurora brightens the night.
Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record (EMR) I can get along with. Right now I’m on temporary detail to Brevig Mission from the hospital in Nome, Alaska.
I make house calls. I enjoy them. I don’t do them very often.
When I worked in Navajoland, the war between the bureaucracies resulted in the demolition of a perfectly good clinic with the empty promise of a quick replacement; I got mean after two weeks of pay with no work and talked the Public Health Nurse into driving to hogans. I treasure those memories of the community I got that way.
Sometimes at home “housecall” means the patient comes to my house.
Here in Brevig I made three house calls on foot today. The Community Health Aide (CHA) and I walked together, through the blinding bright sun-on-snow, in bitter cold and wind.
Confidentiality precludes discussion of patients and problems in any but the most general terms. All three patients would have had difficulty getting to the clinic.
But I can talk about the context.
All the houses had portico closed on three sides, protecting the outside door and a space between the inner and outer doors. Two had firearms casually stacked in that space; I noted .22s, .223s, 12 gauges shotguns, all with outer finishes roughened by prolonged use in hard conditions. Each home had a first-class wood stove in the living area; no trees grow here but lots of wood drifts on the beach.
I saw frozen pizza boxes and traditionally dried salmon. Tabasco sauce bottles sat next to peanut butter jars. A single gleaming spark plug sat on a washing machine next to a rusty box/open end wrench. People sewed furs from sheep, beaver, seal, and wolf with waxed dental floss.
I commented to the CHA how the smallest, most mundane details of someone’s daily life fascinate people from other places; for me a flock of wild turkeys or a doe and her fawns in my backyard rate a yawn but would bring her wonder, while Northern Lights every night and a nearby island good for hunting seal knock my sox off.
During the visits people talked about bingo. I don’t gamble, but bingo on the Bering shore promised a unique experience, and at 7:00PM, my clinic documentation done, I suited up and walked out into the brightness.
I did not find the bingo game.
In a village this small and this isolated, the children play as freely as I played in the 50’s. Two, who recognized me from clinic, came up to show me their puppy while I wandered.
Back inside, my glasses frosted over, rendering me sightless till the ice sublimated and the temporary darkening relaxed.
I napped and read until a patient came in with a CHA at 9:00PM.
Not sick enough to warrant a Medevac, but definitely in need of an IV and a few 21st century pills, they left in the dark an hour and half later.