Thursday May 27

After the DU dinner (10 PM!) and Unga Island from the airport (right)

Thursday May 27, 2010

Wow, so much to tell! I have been busy, and right now am in HEAVEN after receiving my Full Circle Farm CSA box (fresh, organic produce and groceries shipped from Seattle) and making a wonderful dinner of FRESH VEGETABLES (did I mention how expensive and not-fresh the vegetables in the local store are??) and left over prime rib (from the DU dinner on Sat.) stir fry!

To continue the tale of the DU dinner…it was a lot of fun and I met a bunch of local people and the not-local doctor who was in from Anchorage’s Alaska Native Medical Center for his bi-annual visit to the island. I also saw my seat mate from the Penn Air flight in, the one with the bird. He also, I forgot to say, boarded the plane with a big honking knife on his belt, but hey, no problem. Terrorists don’t come to Sand Point, AK; there is plenty of home grown terror right here just starting bonfires. More on that later…Much money was spent on raffle tickets and the auction to support waterfowl habitat conservation, and many people went home well armed, since much of what was up for bid was fire arms.

After dinner we went to the beach just next to the airport—my preceptor, Laura, the diabetic educator Louise, the traveling PA Thai Verzone, the doc, and my next door neighbors Evan (21 and going fishing for the first time—I mean working on a commercial boat) and his roommate, the one local cop, Shane, 22. The weather was incredibly lovely, probably in the low 50s, very calm and of course light for a long time. The pictures were taken around 10 PM, and some of our group was out until after midnight with a bonfire in the twilight of 12 AM. The doc, Louise, and I (whose body was saying it was really 1130 PM) decided we just couldn’t stay up for the bonfire, so we were given a ride home in the back of the patrol car. We didn’t get handcuffed, but we did have to put on our seatbelts. The doc sensibly decided at the outset of the bonfire planning that bad decisions were about to be made, and that he should probably go back and wait at the clinic for the inevitable burn injuries, given that the entire rest of the health care providers were now at the bonfire except for one of the Community Health Aids. Apparently when Shane returned to the beach, he felt that the fire was not progressing sufficiently so he added several cups of gasoline and used a flare on it. He was on duty in full uniform, mind you. But Laura saved the day when she told Shane that if he didn’t put down the gasoline and back away she was going to walk home. And never take his dog for a walk again. She lives above me in the upstairs apartment and Shane and Evan and Casanova live next to me. So we had no emergency calls that night.

The next day I went on a long, gorgeous hike with Laura. See pictures below:

Monday morning started the clinic day and I shadowed Laura with a few patients, got to know where everything was and got to know some of the other staff there. I thought Laura was the only health care provider there, but actually there is usually one other midlevel (Nurse Practitioner or Physician Assistant) there. They have an NP who works on contract with 5 months on, then 1 month off, so while she and her family are in Montana, I’m staying in her apartment, and Thai is taking her place for a couple of weeks. Thai works throughout the Aleutians, Pribilofs and in Anchorage and even in Antarctica. He is really great and has been very patient with me and good at teaching. He is one good looking guy, too! Half Italian and half Vietnamese, 36 and single. I’m trying to match make him with one of my younger friends because he’s just too good to be going to waste and I want to be able to stay in touch with him. My preceptor is stellar, and I feel so lucky to be with someone who is so proficient, so good at teaching and so much fun to hang out with! We have a lot in common, and I am learning a lot from her. She’s made me feel very welcome. I don’t think they have had a lot of students here, so I hope that I can make a good impression and pave the way for more students.

The clinic also has two Community Health Aids, which is a program that I think is still unique to AK but probably will be exported to other Tribal health entities in the lower 48. They are community members who go through a very rigorous training program and function as health care providers under the supervision of a physician or mid level. But often the “supervision” is via phone, and they have a very detailed book that leads them step by step through physical exam, history taking, what to do next, etc. There are two of them here, and they see patients just like the mid levels, but have to consult with us if they need to prescribe medications or have a condition that needs higher level evaluation. They are amazing! All the providers here have to do their own lab draws and tests, own x-rays, own EKGs, plus we are the staff for the ER in the clinic. There is also a local Ambulance service and EMTs.

About half the island’s year round population has some native blood, but there are almost no full blooded Aleuts left anywhere. Many people here I would not have guessed had native blood and consider themselves native, but they have a distinctive style of speech that clues you in even if they don’t appear particularly native.

We had a tundra fire on Tuesday, when someone decided it would be fun to set off some flares down on the beach near one of the areas where there are a lot of houses just above. It really took off for a few hours, and we ended up with an ER patient with smoke inhalation, dehydration and exhaustion. The tide was too far out for the fireboat to be effective, and digging line through tundra is a losing battle. They put some hose lays out and finally got a couple of coast guard planes with retardant and did some drops. The next day it started raining and hasn’t quit, so it probably won’t hold over. We all walked down and watched the fire. One of our elderly patients lives down there, and her pug (Mr. Beefy—with a pink collar) tagged along and apparently felt it was his duty to supervise the hose lays. According to Mary, he returned quite late, very dirty, and smelling of smoke.

Tomorrow we’re having a luau at lunchtime, and I still have studying to do, so I will close for now. I have internet at the apartment but it’s pretty slow, so I probably won’t do much from there. The connection is faster at the clinic, so I have to go over there to do all my homework. I miss home but I’m still feeling the high adventure here! Send good coffee, whole grain granola bars and dark chocolate!