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For the love of adventure
by Jennifer Morris PA-C
(published 2004 in a physician assistant journal) (c)
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"How do you
feel about going to Unalaska to work?" My husband Bob asks as he looks
up from his email and smiles like a cat with a feather stuck on his
chin.
"Where?" I ask
not looking up while folding clothes.
"Unalaska" He
repeats getting my attention. Now I see the sly smile. He is enjoying
messing with me.
" Unalaska? Ok, but where is Unalaska ?" mispronounced by us both as
oon-alaska instead of uhn-alaska..
"I don’t
know." He admits and we huddle over a computer map of Alaska. " Here is
Dutch Harbor" Bob points to Unalaska about half way down the Aleutian
chain on the island of Unalaska. Eight hundred miles from Anchorage and
several thousand miles from our home in Colorado.
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Bob has my
full attention now as I wonder aloud, " The scary fishing place?
Discovery Channel’s Most Dangerous Job in the World place? Remember
that program about the crab fishing in the Bering Sea?" My grin is now
matching his. We like living Discovery Channel. Our other job is
taking tourists places. One place is to Kenya on wildlife safaris.
Discovery Channel did a show about Africa and as our stomping grounds
were displayed on television we pointed in recognition at the familiar
places. "Oh, look that’s the view at Amboseli. See Mount Kilamajaro in
the back?" It’s a great show. So I think Alaska would be a super new
adventure. After all we are not going to fish, we are going to give
medical care to those who do.
I ask in
wonder, "How did you find this?" Bob amazes me.
"I answered an
ad that was looking for a full time physician and offered us as
locums." He slowly relates the offer in his Maine tinged accent.
Mainers tend to talk in gradual sentences. I speak Maine too having
grown up there to age forty and so I wait. Not patiently but buzzing
inside with anticipation. He adjusts a paper on the table, taps a
couple keys on what I call the ‘other woman’ his beloved computer and
continues. "They need both of us for a three month contract. Wanna
go? "
I look around
at our rental apartment in the city as my face breaks out into a wide
delighted grin. "Sure!" I get on the phone to tell my adult son we are
going to work in Alaska. My voice crackles with excitement as I tell
him of our new adventure. Greg is used to this sort of thing from us
and gives me his "you-go-Mom" support. I think of zillion things
needing to be done. My list making hand is already at work organizing
as I wonder if we need arctic gear.
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That first year
we were living in the city as our solar house in the mountains was on
hold for the winter months. After the summer of sweating some equity
into it we found the charm of hauling water, bathing outside, and
cooking on a camp stove pales rapidly with the brisk fall weather. We
had finished the stone chimney with rocks from our mountain range the
Sangre de Cristos plus a couple token stones that have stories of their
own from Africa and Massachusetts. It takes another post fishing
season to make the house ready to live in. Working in Alaska then home
to work on the house has become the norm. This season the sauna,
greenhouse and landscaping wait for us to get home in the spring. We
like having the time to put our backs into the project.
Lifestyle
Change for Life
When we
decided to stop our rat-race city life we had to commit to a major
change in lifestyle. It meant sell our city townhouse and quit our
nice secure benefited city jobs. Gone are the long hours of ER, family
practice and occupational medicine. Gone is the security of knowing we
get paid every two weeks. Gone are our bills paid off with proceeds
from the sale of the house and those final regular paychecks. Instead
of commuting to the office in Denver we went sailing in the Bahamas on
our thirty-six foot sailboat. It took a year before we came back to the
work world. For now we are done with on call and constantly being
pushed to ‘produce’. Produce should be fruits and vegetables not a
stick over a medical providers head to see more patients faster. The
decision to stop commuting and stop being mortgage poor became our
promise to each other. We keep the house modest at 1500 square feet
and do as much of the labor on our own as we can. No monthly debt
other than insurance, satellite television and computer. Now we focus
on temporary jobs in short bursts of work. Sometimes that means being
the provider twenty four seven for awhile. We have to be constantly
looking and available to work about three months of the year, maybe
four. Rarely do we find a job that needs us both at the same time.
We still
commute
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I tell people
who ask what we do that we live in Colorado and work in Alaska.
Instead of fighting traffic every day we commute once or twice a year.
It is a bit of a commute to the island.
Unalaska
where the town of Dutch Harbor rests has a population of about 3000
local people, made up of an interesting ethnic mix of Caucasians,
Filipinos, Aleuts a smattering of other Asians and a few Mexicans. This
number swells to approximately 10,000 people of all races during the
height of the fishing season. It is a United Nations mostly of the
third world. Most of our patients speak some English, but in one day I
heard Arabic, Somali, Spanish, Tagalog, Russian, Japanese, Chinese,
Hungarian, and a few I’ve no idea what they were speaking. This makes
language issues a constant challenge. Even the best English-speaking
buddy who translates has trouble with medical terms like ‘surgery’ or
‘immunizations’. Every English word for things related to fishing is
known, but not the ones for medicine. Somehow it seems to work out. We
have bilingual books in many languages. Often it is a case of a
local-that-has-a-friend-and-knows-a-person that will come to the clinic
to translate in a pinch. We find the willingness to help is never
stingy.
The Iliuliuk
(Ill loo lee uk )Family and Health Services Clinic in Dutch Harbor is
not a hospital but well equipped. In the Aleutian Islands this clinic
is the biggest most well equipped facility. I am pleasantly surprised
to see x-ray, lab, nurses, pharmacy, exam rooms, a four bed ER and a
reasonable trauma room. Everything is clean and stocked. I also notice
the smell of fish permeates the clinic as patients gather and I am
reminded of a friend once describing the smell of manure on her Nebraska
farm as "the smell of money." The fish odor is too. Without this
industry many of Alaska’s communities would turn into ghost towns.
A Conjugal
Visit Maybe?
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Bob and I try
to keep our time apart down to a month or six weeks. This trip out it
will be three months unless I can finagle a visit on my days off. Bob
is on the Aleutian Island of Akutan and the only provider while I’m in
Unalaska with three other providers. We are now in A-Season, the
busiest winter fishing season. Although Bob and I are a mere thirty
miles apart over deep icy arctic waters it takes five rough hours by
boat or a noisy but more efficient flight by amphibious plane called the
Goose. I will
try my best to get over and visit at least once.
In the
evening we talk by phone and share the day’s stories. I tell him about
the crowd of hacking and coughing patients at the processor dispensary
that morning. This is free clinic and a service to the employees by
one of Unalaska’s biggest processor plants. I triage and treat the
illnesses that are fast and simple. The rest I send to our regular
clinic for work up. It is not free at our clinic, but grant money helps
with a sliding fee scale. Bob and I are both seeing patients with nasty
upper respiratory infections. Some look like some flu too with harsh
dry coughs, aching bodies and high fevers. The exhausted workers who
process the crab know time is of the essence as the crab sitting in the
ship holds must be alive to keep or it will spoil. Tons of crab. The
crab processors work eighteen-hour days, seven days a week and make more
money on overtime than they could make in a lifetime at home. When the
crab is finished they move onto pollack or cod and the hours are cut
back. A cushy twelve or sixteen hours with one day off a week. This
work is not for the wimpy. There is a sigh of relief when the crab
season is done.
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Bob tells me
about a two am panicky call for ‘a man vomiting blood’. He crawls out
of his warm bed as he does most nights to see the patient. We chuckle
that the blood was cherry pie with a bit of Spanish rice. I tell him
about a medevac that day of a critical patient from a real GI bleed, not
cherry pie. An emergency medevac runs in the tens of thousands of
dollars. Bob has been there, done that too. We talk about the overuse
of ibuprofen and alcohol by the fishing industry population.
We discuss
work comp issues and the silly ones that aren’t very good actors and we
talk about our family. We chat about our first grandchild due in April
with soft smiles in our voices. I look out my apartment window at the
continual drizzle. "I miss you."
"I miss you,"
Bob answers looking at the fog out his own window.
In a way we
enjoy our time apart. It makes the heart grow even fonder.
I have heard
a story and ask Bob, "Did you know a few years ago there was a murder on
Akutan when some guy had his throat cut? He bled to death because they
couldn’t medevac him out in time." I shiver at the thought of this
happening on my watch. Bob gets very quiet thinking the same thing as I
continue, "I was asked by someone here if that could happen on this
island. I assume the question referred to bleeding to death not
getting murdered."
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"Did you set
them straight?" Bob asks. We both are amazed at how innocent the public
is to their risk of being so far from a hospital. " I did." There is
no hospital, no blood to give, no CAT scan, no surgeon, and no
anesthesia on this remote island. Amazingly there are a lot of saves.
The good outcomes depend on our skills but mostly on the weather.
Weather
Report- wind 10 to 100 knots, rain, drizzle, more fog and of course
snow.
Coming into the
island I look out the plane window at nothing. Snow swirls around the
window blurring the sky so that even the wing has vanished into the
storm. It seems like night at two PM when the plane descends.
Visibility has gone from blue sky at higher altitude to zero in the last
thirty minutes. The pilot is hoping for a peek at the runway, just
enough to set us down, here on the shortest jet runway in the world.
Special training is needed to land at this airport. Only visual
approaches are made, there are no instrument landings. Pilots love the
challenge. Passengers pray. We get lower and lower until I feel the
jet go full throttle as the landing is aborted and we ascend in a steep
climb for the return to Anchorage. The day has been six hours of travel
without making our destination. Tomorrow we will try again, and the day
after that, until the weather breaks and we get in. Those of us waiting
are getting to be buddies.
One fisherman
regales us with a tale of trying to get to Unalaska for fourteen days.
"This is better than being stuck on the island trying to get off" he
laughs. "Out there we had to sleep on the airport floor it got so
crowded." We perversely enjoy these hardships and the tales they
create. The men swap grim stories about whose job is more dangerous,
the crabbers or the cod fishers. Everyone has tales of narrow escapes
and near drowning. I look the crowd over and wonder how many I will see
as patients over the next few months. I hope the bad weather days
don’t fall on the times I need to send out a seriously ill patient.
The weak sun
in the Aleutians rarely shines for a full day. High volcanic mountains,
pristine white in the winter and bright green in the summer, skirt the
bays before they drop into the sea. A blanket of cloud covers their
tops. The island is like a fishbowl with a cover. Clouds congeal into
gray sponges constantly dripping when not being wrung out by wind
blasting the island in a gale of rain. Winter sunrise is a soft blur
as it circles just above the horizon for six or seven hours and then
settles down again for another long night. Summers are soft days that
are gloriously long. Winter is never bitter cold, nor is the summer
warm. It is desolate and exquisite.
On and off
time
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The North
Slope is hiring for itinerant physician assistants and we apply.
Native and town clinics recruiting full timers need fill-in help. Full
timers often come and then go. There is a pool of us out here working
the holes left by resignations, vacations or illness vacancies. There
isn’t a line up of qualified applicants for these remote sites reachable
by air only. If the need is in Aleutians we are happy to return.
On off time we
work on our house and travel. We are not sailing now; we fly. In the
spring our plan is to fly across country in our company Cessna 172 to do
research in Plymouth for my book about the Pilgrims, and also visit the
new grandbaby and proud parents. I am a student pilot. Bob is an
experienced pilot. Then a six week visit to the British Isles and
Ireland to continue research on the other side of the ocean, where the
Pilgrims came from. We will look it over for OTG Adventures, formerly OTG Adventures Inc., our
small personal travel company too. Our trips with tourists to Kenya for
wildlife safaris have slowed down since the terrorists have sped up.
Instead of Africa for guided trips, perhaps Maine our original stomping
grounds or Alaska or perhaps Italy. It is a big beautiful world.
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