Posts Tagged ‘Messenger Feast’

Highlights of six weeks in Barrow

March 1, 2011

You might say it flew far like a sparrow

Or fast and straight like an arrow.

     But either way time

     Like a vacation sublime

Went fast while we were in Barrow

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I just finished an assignment at the hospital in Barrow, Alaska, the northernmost point in the United States, and I’m in Anchorage for two days.

Six weeks in Barrow, Alaska, has flown by.  We arrived at the end of the two-month Arctic night.  We went out in -75 degree F temperatures, and we stayed inside while the worst blizzard in four years raged outside.

Gone!

Blizzard in Barrow

I worked 360 hours while here, but the other doctors worked more hours than I did.  I received the lightest load on the call schedule.  I didn’t work any nights.

I saw a lot of broken ankles, from snow machine accidents and falls on the ice.  I picked up two cases of vitamin B12 deficiency, nine cases of vitamin D deficiency, two cases of hypothyroidism, and not one case of frostbite. 

I took care of people from all over Alaska, including Barrow.  I also saw those from Tonga, the Philippines, Hawaii, Korea, California, Tennessee, Kentucky, Mexico, Canada, Puerto Rico, Florida, England, South Africa, Colombia, and Ireland.

I met people who had survived plane crashes and gunshot wounds.  I made personal acquaintance with more than a dozen whaling captains, and more than two dozen who had personally killed whales.

A lot of the men had taken polar bears, most at close range with low-powered rifles, many in self-defense.  One had killed a polar bear without a firearm at all.  

I talked to women who sew the seal skins onto umiak frames, and the men who hunted the seals.

When a white-out shut the town down for four days, I suited up and went outside.  Twenty paces from the building I thought better of the venture and turned back.

I didn't have to go out in a blizzard to ice up.

We watched the first dawn after sixty-three days of darkness on the afternoon of January 24, and watched it set less than two hours later.

First sunset and first sunrise in 63 days, at the point. January 23 2011

The medical community viewed the Superbowl in the Commons room, farther north than any other medical staff activity in the country.

I talked to other hunters who shot caribou, wolf, goose, duck, wolverine, seal, and walrus.  Several people had been hunted by polar bears, but lived.

We saw the Northern Lights, I for the first time and Bethany for the second.

We attended Kiviuk, the Messenger Feast that happens every two years.  I saw dancers passionately portray heroic stories with their dances.

Afterwards, while the Northern Lights swept mutely across the sky, we watched the best fireworks display I’ve seen.

While we were here we saw pressure ridges form in the ice on the Arctic Ocean.

For every active drunk I took care of I met two in recovery.

Bethany taught sign, Inupiak, Special Ed, third grade and fifth grade.  She made a lot of new friends, one of whom she started into knitting.  She got a lot of exercise.

I drove twice, a total of less than fifteen miles.

We had the best Kung Pao chicken and Mongolian beef we’ve ever had.

Both of us lost a few pounds.

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Overheated, Inuit Country and Western, Inuit dancers, Qivgik, Northern Lights, and fireworks

February 13, 2011

We went out to watch, not to dance,

We went out to walk, not to prance

     To outdo Northern Lights

     We were watching last night

You would need some federal grants.

 Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I’m on assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

Qivgik, the Messenger Feast, started Wednesday.

A hundred years ago, one village would send a messenger to another village to invite them to a feast.  In the depths of the winter, most of the village would brave the cold and the snow to cross the tundra.  The party would last four days, with gifts from the host village at the end.  After recovery of a year or two, the invited village would return the favor.

Bethany I have had the luck to witness Barrow hosting Qivgik this year.  In the 21st century, most arrivals came by plane, few came by snow machine, and no one came by dog sled.  They flew in from Canada, Siberia, and Greenland.

Of course, most of the time I worked so late I was too tired to attend.

Yesterday the clinic’s heating system outdid itself as beastly hot; I suspect the department couldn’t have gotten hotter without installing microwave equipment.  With the extra population of Qivgik comes extra illness and injury, and my work day went late, without time to stop to drink water.  I finished sweaty, tired, overheated, on the brink of dehydration.

As hot as I was I didn’t suit up all the way, and we walked into a still night at 20 below Fahrenheit (30 below Celsius).  The fresh cold air, sharp on my cheeks and ears, came as a soothing relief. 

The snow squeaked under our boots, high-pitched as tortured Styrofoam .  Three blocks later, I was still too hot when we arrived at the Roller Rink to listen to the Bethel Fiddlers.

We brought no expectations to the listening.  Two guitarists, a bass player, and a drummer stood around the fiddler/singer who occupied center stage.  They played Country and Western, the same genre that dominated Casper, Wyoming when Bethany and I courted each other.

We hadn’t expect that music to come so far north.

The entire band, and most of the audience, were Native (they prefer the term Inuit or Native to Eskimo).  One couple two-stepped on the dance floor.  After a while, Bethany and I got up to dance, and we could see the other couple, our age and Native, were very much in love and having a great time.

We fox-trotted and waltzed and fox-trotted some more, then we went back into the night to the Barrow High School gym.  Sort of like bar-hopping without the bars.

People dressed casually for the Arctic chill, and I commented to Bethany how well we’d acclimated to the low temperatures.

In the few short weeks we’ve been here we’ve met enough people that we were greeted by name.

In the gym we watched the Natives dancing for themselves, not for the tourists.  They danced with passion, power and skill; the motions telling epic stories of adventure, danger, and triumph, and I could only understand about a third.

At one point a well-costumed young man danced while the sixteen men and women behind him drummed and sang.  Smiling, a Native man my age dressed in the blue-collar uniform of jeans, t-shirt, and baseball cap walked on, looked at the younger man, bobbed twice to get the rhythm, and started dancing.  In twenty seconds he was joined, one by one, by four others of similar age and dress, all of them grinning.  They danced well, the motions describing canoeing, hunting, and caching meat.

We left before midnight, crunching through the snow back to the apartment.  I had cooled down to the point where I buttoned up my parka, but I left the hood down.

At the apartment we sat in the darkened room, pulled the shades up, and watched the action on the frozen lagoon in front of us.  Trucks drove in circles; snowmobiles zipped back and forth, cars parked on the levee.  We talked about what we’d done that day and the dances we’d seen at the Roller Rink and the gym, we agreed contrast ruled as the essence of meaning.  People clustered more and more around the Nalukataaq grounds two hundred yards away, Bethany fell asleep, while I watched a pale green glow in the sky above the Arctic Ocean.

I woke her up when the fireworks started.  The whistlers and fountains lit up the night while the Aurora Borealis intensified and swept silently back and forth across the sky.

It was the best non-federally funded display we’d seen.

Munchausen in the morning, narcotics seekers, and long distance snowmobile back pain.

February 10, 2011

Here’s an intelligence spark

To keep doctors out of the dark.

     The information we share

     In the hour we spare

About which patient is seeking which nark.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I’m on assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

The doctors’ mornings in Barrow start with an hour-long colloquium.  We discuss patients by name, talk about history, physical findings, and differential diagnosis (the list of possible diagnoses).  We talk about problem patients, consultations we’ve received, and interesting lab findings.  Every admission, delivery, and transfer gets discussed.

I keep my presentations short. 

When I worked in radio, and I could sell a commercial to a sponsor, I never got more than a minute to get the message across.  I learned to distill the communication to its essence, keep my sentences short and not repeat myself.  If you can’t say it in less than a minute, I used to lecture trainees, you’re not sure of what you want to say.

I named a patient and described an injury at morning rounds today, and how the patient copped an attitude when I refused a prescription for the requested narcotic.  As soon as I said the name the room erupted into spirited groaning.  A Munchausen, my colleagues said, who diverts the pills to a (named ) household member.  Then they told me about the self-inflicted injuries they’d seen.

Munchausen’s syndrome got its name from a fictional character in a 19th century play who went from doctor to doctor, making up symptoms to get attention and treatment.  In the 21st century, a patient with the diagnosis of Munchausen or Munchausen’s syndrome has demonstrated a willingness to injury him or herself, feign symptoms and alter lab findings.  Most of the pathology comes down to attention-getting and narcotics-seeking behavior.

I’ve had Munchausen patients in other places.  One’s (I won’t say where, I won’t say when) skills at feigning an abnormal neurologic exam were so good that a previous doctor ordered a seizure drug intravenously.  The drug went into an aberrant artery, instead of a vein, that ran on the inside of the elbow, and the patient lost a hand.  The tragic story unfolded over the course of a week, and as I used the telephone to close in on the truth the patient signed out of the hospital, against medical advice, never to be seen again. 

I talked about three other patients, I received advice on whom to call at Alaska Native Medical Center (ANMC), and learned some fine points about bush medicine.

The other docs with more experience here discussed what to expect during Qiviuk, the Messenger Feast that started today. 

Several hunters, who had been out for meat to provide for the feast, came in with medical problems related to their activities.  One had back pain from riding hundreds of miles on a snow machine in the pursuit and retrieval of a caribou, and gave me permission to write about it.  I’m sure if I’d been that long on a snowmobile I’d have the same physical findings.

I told him my thoughts on the importance of hunting to Barrow, how it sustains the people nutritionally and how it gives the men in particular and the town in general direction.