Summation of a month in the Arctic


The alk phos kept coming up high

And the local docs can’t tell me why

And the TSH low?

It’s just part of the show

Like the constantly cloudy sky.

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, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. I followed 3 years Community Health Center work with a return to traveling and adventures in temporary positions in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska. A month in the Arctic followed a month in Iowa followed 3 months in British Columbia.  Any identifiable patient information has been included with permission.

I finished in Arctic Alaska the Friday before Thanksgiving. I found the pace  leisurely, sometimes to the point of frustration.  I enjoyed my most productive days, 14 in 12 ER hours and 11 in 8 clinic hours, but the day 5 patients spread over 8 hours I filled the empty minutes with Continuing Medical Education (CME), email, Wikipedia, and naps.

I found 6 mildly low TSH (thyroid stimulating hormone) assays out of 9 that I ordered. Out of the 12 alkaline phosphatase (an enzyme found in liver and blood) tests I requisitioned, 10 came up mildly high. When asked, the clinical director confirmed that, yes, those two tests came back abnormal more often than not, but had no good explanation.

I covered the twelve-hour ER shift four times, coming into contact with 2 patients with dislocated fingers. I got to follow, from afar, the progress of the sickest patient I saw, sent out on a plane to a surgeon and hospitalized for the better part of two weeks.

I never worked more than 44 hours in a week.

I bought Rosetta Stone Inupiaq, the language of the Inuit, only to find it wouldn’t work on a computer using any software newer than Windows XP.

The major plus of the assignment: great leadership. The major minus: the housing (supposedly built from recycled cargo containers) which promoted isolation.

The rainy weather that greeted us promptly froze 4 days after our arrival, when the snow started. Cloudy skies prevented a good view of the Aurora Borealis, and the wind might have shifted direction a few times but never went under 20 mph.

During the month, a baby seal strayed through a breathing hole in the ice and appeared at the foot of an apartment house stairs. A week later, a caribou showed up at the hotel, looking lost.  Three days after we left, I got a video of a herd of caribou running on the sea ice outside the same hotel.

Inspired by the high cost of food, both Bethany and I lost weight.

I bought a hat made of beaver fur and a letter opener of mastodon ivory.

We never quite made it to the gym but we took lots of walks in the cold and the wind.

Bethany substitute taught Special Education, and found herself paid a good deal more than she’d expected.

Would we return? Absolutely!  But we would have to ask, When?

 

 

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