Home Sweet Home

After the storm

I arrived safely home on the evening of the 4^th of July; Cole picked me up at the airport where I dropped off the rental car from Walla Walla, and we had a nice drive home together. I was too tired for the fireworks, and since I got to see the Canada Day fireworks on the ferry at Campbell River, I didn’t feel deprived. Happy birthday America!

I had the next day off and spent it cleaning house, as the dogs had created havoc and chaos and one hell of a lot of dirt and dust that was just too much for my house sitter to combat alone. And way too much for me to put up with. Welcome home, Teresa!

View across the road

Jumped right back into work the next day and have gone like the proverbial bat out of the proverbial hot place since then, and it all seems like kind of blur—and now tomorrow is the first day of August. How does that happen? I started my clinical in orthopedics and then my doc tore his rotator cuff overcoming gravity when he jumped off the cliffs at Laclede into the river and flung his arms up and out to clear the cliff edge (he is built kind of like a 747). So he had to have surgery after I only got two days with him. Ironic—the orthopedic surgeon has to have orthopedic surgery. So I’m taking an incomplete for that clinical and will schedule the rest of the days sometime in October, hopefully.

I start my last big class, Family and Pediatrics, in August, and will be with an NP preceptor at Sandpoint Pediatrics, and do the family portion at my family doc’s clinic here in Priest River. Then I have a Women’s Health clinical scheduled in August, have to do all my literature research and write up my professional paper, and try to schedule three more internship credits for the spring semester (Emergency and Mental Health), present my project and theoretically I’m done and ready to take my boards.

I could have graduated in December, but I realized during my time in Alaska that I really need to have some time in the ER and to get ACLS (advanced cardiac lifesaving) in order to work in the bush in Alaska. Not to mention that I’m rapidly going broke working as few hours as I have been, and if there is any hope of keeping even a shred of sanity (I suppose that implies that I actually started with any…) and of studying for my boards, I need more time. Not to mention that it’s a lot easier to move to Alaska in the summer than the middle of winter. I plan to rent out my house and be working somewhere in Alaska for some tribal organization by this time next summer. The Aleutians were amazing in many ways, but that weather would NOT make the Aleutians my first choice in places in AK to live. I will, however, go wherever I get the best offer.

Poppy


So I’ve been gardening and slowly beginning to run again, using good shoes and arch supports and walking more than running and so far the plantar fasciitis has not reoccurred. Today I entered the fun run at Timber Days and just did the one mile to see how it felt.


Front yard, July edition


Front yard, last day of July



My niece, Samantha, at the Timber Days parade

I ran the first ½ mile, no aches or pains, then walked three short bits on the last ½ mile and it all went well. My time was a blazing 27:64—and I didn’t even place in my age class, but I finished it and didn’t hurt myself, so that’s all I asked for today. But next year I plan to win my age class! Or maybe I’ll tackle the 5 mile run and see how that goes.

This concludes the first chapter of Teresa’s Alaskan Adventure, but the sequel is in the works even now. So long Alaska, I’ll be seeing you next year!

Sleeping with strangers...

Mendenhall Glacier in Juneau

My last day in Juneau I hooked up with my roommate at the hostel, also named Teresa with no “h”, and we went out to the Mendenhall Glacier. Pretty impressive! It even calved a small iceberg while were there but because we were standing next to the giant waterfall coming off the side of the glacier at the time, we didn’t hear it. I was faced the other way but saw that all of a sudden the water rushed up onto shore and there were little waves lapping in, so I turned around and could see where it looked like a new spot of intense blue on the face. They confirmed that at the visitor’s center when we got back, and said that they could hear it from there, almost ¾ mile away.

I was able to share a taxi to the ferry early the next morning with Steven and Elspeth from England, which was a great help. They have proven to be very congenial and enjoyable travel companions! We set up our little camp in the center front edge of the solarium and have our stuff piled around us. I haven’t used the lockers, and it seems pretty safe to leave things around here. I don’t think I’d feel safe leaving my stuff in the other areas of the ship, but up in the solarium not many people wander through except for those who are living up there, and I think we all watch out for each other. It’s really nice to have so much unstructured time and such beautiful surroundings to float by, and no matter how rainy and blowy the weather, the solarium is heated from above and blocks the wind very well. It’s an interesting way to travel, looking backward at where we came from; maybe a good metaphor for life and what we need to do from time to time. I could really tell how far south we’ve come when I went to bed about midnight and realized that it was DARK. Kind of a shock…

Mendenhall Glacier and bergs floating in Mendenhall Lake


Teresa squared, Mendenhall Glacier visitor center



Alaska Marine Highway's ferry The Columbia in Juneau (Auke Bay) Harbor



Leaving Juneau Harbor



Leaving Juneau Harbor

I haven’t slept with this many people in years, certainly not bare like this with no illusory nylon walls between us! The solarium, on the back top deck of the ferry, has proven to be a wonderful place to sleep and hang out. We’ve most of us gotten fairly cozy up here, and I find myself casting a jaundiced eye on the “cabin” passengers who wander up here from time to time. “Hey, what are you doing in my bedroom?” One of the nice things about traveling alone is that it’s much more likely that you’ll make contact with other kindred souls, and here on this long ferry voyage there’s plenty of time to hear a whole lot of life stories and exchange philosophies with no time table to keep track of or appointments to rush off to. Today, the last day, we don’t even stop in any ports at all, and are scheduled to arrive at Bellingham tomorrow morning at 0800. The first day we were kept occupied by running back and forth from port to starboard (now I know which one is left and which one is right…) to look at (or for) whales. I saw a fair number, but didn’t even try to take pictures, since most of the time what you see is a spout or a brief set of flukes in the air—just the kind of thing that leads to pictures of open water where you say to people, “There was a whale breaching RIGHT there just a second before!”.

Yesterday I hooked up with several people who have guitars (my solarium people) and we sat around and played music for hours (I have my dulcimer with me.) I’m working on my calluses on my finger tips again, and have almost learned one new tune that I’ve been wanting to learn for a long time. One guy, Tim, has a nice triple ought size Martin, and the two other guys have Martins as well, one a baby backpacker, and one the little elongated triangle shaped one. All three are pretty good guitar players, and Tim has written a host of pretty nice songs. Its so interesting to hear what everyone’s story is, where they’ve been, why they’re in Alaska, where they’re going. I even met an older couple from Sandpoint, Idaho, and he has the same hat I do (Idaho State Forestry Contest).

On Tuesday we stopped at Sitka for a couple of hours and took a bus to town proper for a look around. It seemed like a nice town but a little too big for me. Yesterday we stopped at Petersburg in the middle of the night (I sat up, put on my glasses, looked at the view and went back to sleep);

Sitka



Sitka Harbor



St. Michaels Russian Orthodox church in Sitka



My home for three days--The Solarium

Night before last I had just dropped off into a deep sleep when over the loudspeaker came a blaring voice asking any medical personnel to report to the purser’s desk immediately. So I staggered around getting on my shoes and digging my stethoscope out of my bag, thinking, “Chest pain, ABCs, I hope someone didn’t cut themselves badly, I didn’t get to sew up any live flesh in the Aleutians…” Turns out it was a little boy who had tripped on the way into the bathroom and smacked his forehead on the toilet rim. He had a nice goose egg and was pretty resistant to being checked over, but from what the other two nurses who also responded (one a pediatric ICU nurse) and I could see, his pupils were fine and he was going to be fine. He was still fine the next morning. So we were given dinner vouchers by the purser for being willing to come down and help. Yesterday a German doctor boarded the ferry at Ketchikan—but it turns out he’s a former urologist, turned psychiatrist, so he probably won’t be of much use in an emergency unless it’s a mental health problem or a blocked urethra (and even then, he probably can’t put in a Foley catheter). I just found out that one of the new people in my solarium bedroom is a nurse practitioner from Ketchikan, so we’re probably well-covered in the event of something going on. We even have a crash cart with all the supplies, not that I’m qualified in ACLS, but hopefully the NP and the doc are.

Wrangell—sprinted through the mostly-sleeping town in the 40 minutes we had there at about 0745; and then docked in Ketchikan for our last stop of the journey and had about 2.5 hours there. Of the three towns, I much preferred sleepy little Wrangell with its (maybe) 800 residents. Most of the other towns have planet-sized, alternate-universe cruise ships docking right downtown just about every day, sometimes as many as 6 in a day! I am just SO DONE with cruise ship tourist waterfronts! I spent my time in Ketchikan in the old, historic hotel dining room having a lovely spinach salad with a big hunk of grilled salmon on top. I wanted one more fresh fish dinner before leaving Alaska.

Wifi access is too expensive on board ship, so this won’t be posted until I get into Seattle most likely. I have had some cell access, but not for very long. I did get another message from Blake, reiterating that I need to change my voice mail message, and letting me know that his crew is no longer in Colorado, but now in Wyoming doing project work on standby. Right now we’re rocking along in the open waters of Queen Charlotte Sound, swaying gently under partly cloudy skies and a stiff breeze. It’s Canada Day and we saw fireworks as we passed Campbell River. I’m looking forward to seeing my Seattle classmates tomorrow and heading for Walla Walla for Megan’s wedding on Saturday. If all goes as planned (and there are a lot of junctions where things could get snagged up) I’ll be back home the evening of 4^th of July.

Net floats in Wrangell



Wrangell



Steven at the starboard



They aren't kidding



My boudoir (note the trashcan nightstand)



Jeff's peace offering to his girlfriend in Seattle for his 3 mos at Denali


The world's largest cruise ships also dock here



Elspeth, my next door neighbor

So I made all my tenuous connections from the ferry to the Amtrak to my friend Samantha’s car and off to Walla Walla with Jenny and Ben. It feels very surreal…it’s hard to describe the little world that was created on the back of the ferry, and how poignant it feels to leave the people I grew so close to behind. So here’s to you Tim, Elspeth and Steven, Neville, Dennis, Jeff and all the rest…I’ll miss you! And I hope I’ll see you again someday.

Now it’s Saturday July 3, and I’m in this palatial vacation rental house in Walla Walla Washington with my former classmates Yancy, Erin, Jenny and Samantha, and another midwife and her husband, Sara and Sam. This place has a pool, hot tub, wi-fi, fully equipped kitchen, a 1.5 hectare television set…I still feel like I’m swaying much of the time. I don’t know if three days on the ferry has gotten into my blood or it’s just a congested inner ear. This morning most of the wedding guests, along with the bride and groom, had a 5K fun run along a creek at one of the parks (I fun-walked…), and then the wedding will commence at 5 PM at a different park-like place tonight. I picked up a rental car, that being the cheapest and fastest way back to Idaho of all my options, and will head to Spokane tomorrow after the farewell brunch at Megan and Malcom’s tomorrow. Cole is scheduled to pick me up sometime early enough to get home for fireworks. Home soon!

The groom and race official, Malcolm Dunn


The bride and fun-runner, Megan Lillis


Erin (pediatric NP) and Samantha (Nurse midwife), wedding fun-runners

Juneau day 1

Juneau Hostel

Juneau hostel—check. Heritage coffee company—check. Juneau library (on top of a parking garage, with the most fabulous view out the front windows except when the damn behemoth cruise ship is parked in the way…)—check! Mt. Roberts trail up, tram down—check. Twisted Fish restaurant for blackened salmon Caesar salad—triple check, two thumbs way up! I’m working my way down Molly Dutton’s must-see list in Juneau, and tomorrow I’ll take on the glacier.

I had to take an expensive taxi to the hostel, but at $10/night there you can afford a couple taxi rides. It is very clean, well run and congenial, although having to vacate the place between 9 AM and 5 PM makes me feel a little bit homeless.



Tlingit dancer




Littlest Tlingit dancer





waterfront from the tram, halfway down

Juneau is really interesting; a capital city of 31,000 that feels like a small town. A small TOURIST town. I feel sorry for the year round residents. I can see what it must be like to have several hugemongous cruise ships a day tie up and disgorge hoards of tourists onto your streets. I know this is probably elitist, but I think I’d much prefer to snack on ground glass and poke both my eyes with lit sparklers than to go on one of those behemoth cruise ships…there’s just something distasteful about being a tourist anyway, and being associated with one of those stereotypical ugly American icons is just too much. Of course I AM a tourist right now, but I waste no time correcting people who ask what cruise ship I’m on and letting then know that I was here WORKING (sort of). Juneau reminds me a lot of Sandpoint, Idaho, but with a waterfront like a miniature Seattle or San Francisco. And glaciers, although you can’t quite see them from town proper. There is a narrow strip of land between the water of the Gastineau Channel and the almost vertical mountains, and the streets rise up like Seattle’s and turn into stairways without much warning.




Very old Russian Orthodox church just a block or 2 from the hostel




Tlingit (pronounced like "klinkit") totem pole





Another Tlingit totem pole




Capitol building






I just liked the building

But I have had a great day here, had a real bacon and eggs grease fest for breakfast in the Capitol Cafe, did a photographic walk-about of the downtown and waterfront, and then took these chubby little dachshund legs on a steep hike up to the Tram site way above the waterfront. It was so nice to hike along through lush huckle- and salmonberry vines, devil’s club (ok not so nice, but pretty from a distance) and other plants that forced my overly-health-care-saturated brain to go into the back filing cabinets and drag out the Latin names of the aforementioned plants. There’s something about knowing the plants and their Latin names that just feels like a big pile of treasure; not the kind you hoard but the kind that you just love giving away to whoever wants and needs it. The Latin just rolls off my tongue with a truly sensual pleasure—who couldn’t enjoy saying things like “Arctostaphylos uva-ursi”? OK, I know lots of people who enjoy it and their names are Molly, Laurie and I’m sure there’s someone else.

Anyway, I’m out of shape! As if I didn’t already know that! 5 weeks of eating stuff I NEVER eat at home, like French fries, deep fried egg rolls, CAKE for crying out loud! have added about 7 pounds to the 7 pounds I already accumulated last year when I quit Holy Family. I was sweating in the extreme 62 degree heat. There’s a new leaf that will be turned over when I get home, a new and improved leaf. I can’t STAND to be this out of shape and this fat!

View from the beginning of the Mt. Roberts trail; I started back of the hostel at the top of the 6th street stairs, and climbed up many switch backs to reach the top



View from the tram

The ravens are everywhere, whooping it up like a grade school classroom, but I haven’t seen as many eagles as in Sand Point. I do have a good picture of one perched on a tree outside the tram station up top. Stay tuned for day 2…

There's an eagle on the left; no really; its head is that white speck perched on the tree



From the tram, almost down


Tlingit drummer

Sand Point in the rearview mirror...

Dianna photographing the morel on the cliffs above the beach


FINALLY--the sun for a few hours after work--Zoe's point--just a small breeze by Aleutian standards...


my camera just doesn't capture the plethora of wildflowers in this grassy tundra above the beach
Laura and Dianna along the flats heading for Zoe's point

The time has come to change locations for this Alaskan adventure, and I will be sad to leave all my new friends and go off to Juneau tomorrow. I have had the privilege of working with some of the best folks in the world here! There are patients that I want to know the rest of the story on, and all those developments in the lives of the community here. There is no doubt in my mind that I'm meant to do primary care, not specialist work in some hospital.

So tonight I'm going to dinner at Dianna's--she's the Australian health aid who has been working in the Aleutians for 20+ years, was married to an Aleut and has a daughter with him, has helped write the CHAM (the bible of health aids in Alaska) and has been my delightful office mate for the last week or so here in the clinic. She's working as an itinerant right now, but also works and lives in Australia in the ICU as an RN (I don't think she actually LIVES in the ICU), and is a diabetic educator. Laura will join us and I'll hand off my food leftovers and pack and hopefully get on the plane around noon tomorrow.

My friend Molly has given me a list of things to do and see in Juneau that will take me at least 2 weeks to accomplish properly, so if I get time I'll post from there.

New Travel Plans

So, now that I've finalized my flight reservations (and spent $200 to do it...) to leave the island on Saturday instead of Monday, thus hoping to ensure that I CAN get off the island and beat the weather...it's sunny out for the first time in weeks!

I hope to be able to get into the hostel for $10 a night. It will be fun to spend some time in Alaska's capitol city...still on target to take the ferry, Alaska Marine Highway's The Columbia, to Bellingham, WA through the inside passage and then to Seattle and then to Walla Walla and then to Spokane and ultimately home by the 4th or 5th of July.

Summer Solstice Edition

Boats waiting to unload at the cannery on Sunday

Happy summer solstice! I actually was awake much of the shortest night of the year (as long as I’m not confused and it was the night of Sunday/Monday; otherwise I was awake for most of the next-to-shortest night of the year).

My fortune cookie today from the Aleutian China lunch I had was, “Your life will be peaceful and happy.” OK by me! Peaceful sounds good, probably for the first time in my life. But only if punctuated on a regular basis with adventures and challenges…

I’m still enjoying this adventure…and I’ll be ready to be home when I get there. I miss my family, my dogs and cat, my friends and my own bed. Sounds like I haven’t missed a thing, weather-wise, though, since summer still hasn’t started at home yet either.

The motel I moved down to is pretty clean and has all the basics, including a small kitchenette, and it is very generous of EAT to pay for it for me. And it does have some interesting features, mostly due to the difficulty in getting parts and things, all of which have to be flown or barged in. Apparently that includes tape measures, since the freestanding sink/cabinet was installed so that you can’t close the bedroom door because the door was open when the sink was put in and the sink overlaps the edge of the door. Hey, that’s better than having the door permanently closed…the mini blinds open and close via a flattened coat hanger, but it does match the blinds, colorwise…and I suppose it’s testimony to the cold, rainy weather that we’ve been having, that this morning I picked a mushroom out of the interface between the shower stall and the wall…minor things, and I’m glad to have a place where I can cook and not impose on anyone too much. Laura, bless her heart, was willing to put me in her spare bedroom when the other NP came back to the apartment I’d been living in, but I really didn’t think it was fair to her to impose on her for TWO weeks at home along with imposing on her at work too. So, since EAT was willing to put me up in the motel, I thought that was the better course.

So now I have access to TV, a real novelty for me. I saw Deadliest Catch for the first time last week and had a hard time sleeping after that! I kept wanting to tell them to get down off that slippery stack of crab pots! Watch out for that falling ice! Watch out for that 800 pound crab pot loose on the deck! I tell you it was nerve wracking. They are crabbing all around the Bering Sea and going into ports that are around here and many people here have met them. My new fisherman friends say it’s not an inaccurate portrayal of winter time crabbing, but of course the hair raising stuff and drama doesn’t go on non-stop like it appears to in the show. This new world of fishing is fascinating to me; there is so much to it. I’ve never been remotely interested in motorized boats for recreation, but have always been intrigued by working boats and the whole lifestyle that revolves around using the ocean and rivers for a livelihood and transportation. One lifetime is just not nearly enough to explore all the interesting things in the world!

The Canadian halibut research boat, the Free to Wander out of Pender Harbour, British Columbia


Skipper David Adams (center) (husband of our case manager), his son Marcus at right, and crew member at left of the Buldaro out of Sand Point, AK

Mending the net; a whale went through another net last week and tore a panel in half

The most exciting thing that happened last week was a medivac to Anchorage that we had to take care of in the ER for about 18 hours until the weather cooperated enough to get the jet in here. I can’t talk about what the condition was that required medivac, but I can say that things turned out well eventually. To add insult to injury (literally) the power went out on the whole island (except the cannery which has its own power generator) while the jet was circling, trying to get enough of a visual to be able to land. That meant no runway lights and no radios. Even though it only gets truly dark for an hour or so right now around 2:00 or 3:00 AM, the skies were so low and the fog so thick that the lights were really needed. So the jet had to return to ANC and try again later, and we turned the ER into a hospital room, kept IVs going and kept our patient stable. They came in again around midnight, and the visibility was much better—and a good thing too, since the power went out AGAIN about 2 minutes before they landed!

Obviously, Alaska Girls are tough!


Community Health Aid Lou tends to a young fisherman with a swollen elbow

The plants are just JUMPING out of the ground and into flower with all the light, but since it’s been in the 40’s and below most of the last three weeks, the alders are still not leafed out all the way and the locals tell me that the wildflowers are slow in showing this spring. Some of the plants are very familiar species that we have at home, but many are completely new to me. I’ve been meaning to go up to the school library, which is open to the public in the evening, and look for books on plants and wildlife specific to the Aleutians, but haven’t made it yet. There is a bird that I haven’t been able to identify, that has a very unique call, but no one has been able to tell me what it is and none of the likely candidates on the bird ID sites on the web have the same call.

wooley lousewort

I mentioned last time that my advisor, Lorna Schumann, and her husband David were coming out so that Lorna could do my site visit, which consists of watching me see patients for a couple of days and talking with Laura to see how she thinks I’m doing. It was a good visit with Lorna, but unfortunately the weather wasn’t very cooperative so David didn’t get much fishing or 4-wheeling in. We did have a break in the weather on Saturday and walked out to the far breakwater where the ferry and the cargo barges dock and watched them load containers of fish onto a barge. Lorna and I asked the young men, who were dangling on cables above the containers with zero safety equipment, if their moms knew what they were doing! They laughed, said NO, and we don’t want them to! We told them that as both mothers and nurse practitioners, they were scaring us half to death and we hoped that we would NOT see them again at the clinic later. Laura also took us out to the end of the New Dump Road, to a rock formation reported to be an old volcano vent, which we climbed up on and got a view of Red Cove Lake and the other side of the island.

ancient volcano vent above Red Cove Lake (Laura's picture)



me, Lorna and David Schumann with Red Cove Lake and the ocean in the background on the other side of the island from town (Laura's picture)


Sand Point cemetery with some Russian Orthodox crosses


purple mystery plant

chocolate lily in bud


wild geranium



How far?


Eagle in the mast of the Dominator

All-weather patio


short cut

I’ve been mulling over what I said in the last post about it being tiring to be in an environment where everyone knows so much more than I do. And I realized that the thing that is stressful about walking away from a career that you’re good at is not the loss of status, or the tediousness of starting at the bottom again, or giving up the income, or even giving up the reputation and the colleagues; the hard part is no longer being able to do something that you’re good at. There’s a real satisfaction in doing something that you excel at, and it’s the same satisfaction that comes from playing a sport for the love of the game. It just feels GOOD to knock in that goal, stack a tight load of hay, or write a good forest management plan. I gave up just about everything I was good at to start over again and try to master a whole vast new body of information. I don’t regret it, but I’m seeing the subtle ways that it can take its toll, and I’m getting tired of being in the minimally-competent stage. Like just about everything else, the only way out is through, and I’m hanging in there.

I have one more weekend here, then if the weather cooperates I’ll be flying out to Juneau to get on the ferry early on the 29^th. But I’ve been looking at the weather forecasts for the next week, and I’m thinking seriously about hedging my bets and getting out to Juneau early, like on Sunday if possible, just because the weather promises to be cloudy and rainy forever. I guess that the only real downside of that is having to pay for a motel in Juneau, not cheap. Then it will be 3 days through the inside passage to Bellingham, then to Seattle, then to Walla Walla for a wedding, then home on the 4^th of July. There are a lot of places where the timing is very tight to pull off this itinerary, so it’s all subject to change, especially where the weather controls the flying. So stay tuned and I’ll see many of you in July.