Snow machine excess, cold injury, and wolverines


Some people, they smoke and they drink,

Some trap the otter and mink

     But the story’s been told

     That Barrow’s so cold

You can’t open your eye if you wink.

Synopsis: I’m a family practitioner from Sioux City, Iowa.  To avoid burnout, I’m transitioning my career, and while my one-year non-compete clause expires, I’m working in exotic locations, traveling, having adventures, and visiting family and friends.  Currently I’m in Barrow, Alaska, the northernmost point in the United States.

I’ve been back on the job for less than twenty-four hours, here in Barrow.  I’ve seen several cases related to snow-machine use.

In Barrow, one avoids the terms sled or snowmobile in favor of snow machine.   The people here use them, not for recreation, but to do necessary work.  People hunt from snow machines, so that hunting injuries are almost synonymous with snow machine injuries.

Most, not all, caribou migrated south past the Brooks Range when the days grew too short.  Herds of up to five hundred remain, grazing on the tundra.  In temperatures so cold that alcohol freezes, in the Arctic night when the sun doesn’t rise and the moon doesn’t set, subsistence hunters go after them with firearms ranging from .22 magnum handguns to 7mm Remington Magnum rifles.

A lot of parkas here sport wolverine fur on the ruff. Unique in that breath frost won’t stick to its fur, hunters eagerly seek the “skunk bear.”  The creature has such a nasty disposition that it acts like a serial killer, slaughtering everything in its path for fun and eating for necessity. 

The government issued a wolverine fur-trimmed parka to a person I know (not a patient) during the cold war, for work done in the Arctic.  To this day, the nature of the work and the circumstances of issuance remain clouded in mystery.

Hunters also go after wolves; polar bears occur as targets of opportunity.

Most of my clinic load, whether in Iowa or Alaska, has to do with damage from alcohol and tobacco.  Respiratory infections, cough, asthma, depression, fatigue and malaise, hypertension, high cholesterol follow from those two substances.  Counseling people to quit, though a good idea, rarely works.

When the patients come in with fetal alcohol syndrome and fetal alcohol effect, it’s too late.  With irreparable damage I just make the best of the situation.

I won’t say where, but I attended a set of fraternal twins, one of whom had fetal alcohol syndrome and one of whom had much milder fetal alcohol effect.  Some people are more resistant to alcohol than others, and such resistance starts before birth.

If most of what I see in any clinic has to do with drinking and smoking, the majority of the remainder has to do with the unique factors of where the clinic stands.  Barrow’s air is so dry that eczema here runs an order of magnitude worse than any I’ve ever seen.  Yet most people know the cold so well that frostbite comes rarely.

The first case of frostbite here in Barrow came my way today, very shallow damage, but not to fingers or toes.

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