Welcome to Naknek

Naknek Week 1 I traveled uneventfully through Spokane, Seattle, and Anchorage airports, arriving at King Salmon around 7 PM on Wednesday the 22nd of January. I was met by the gracious and thoughtful Kat, our executive assistant at the clinic, who had also cleaned my cabin, washed bedding and towels and put fresh sheets on the bed, and bought me some breakfast makings for the morning. My guitar and dulcimer and my giant suitcase all arrived unscathed, and I pretty much went right to bed by the time we got to my new home in Naknek. Now picture a solid, homey little log cabin in a remote clearing, surrounded by trees. Now wipe that out of your head, because my cabin doesn’t look anything like that. It’s in a group of rental cabins owned by the local tribal corporation, right off the Alaska Peninsula Highway that runs between King Salmon and Naknek. It is very clean and quite comfortable, and as the director of the clinic, Steve, describes it is “a little lower quality than Motel 6.” But really it’s fine, nice and warm and only 2 miles from the clinic. The walls in most of the place are painted an interesting color, somewhere between salmon, coral, orange and pumpkin, depending on the light. It has most of the things I need, and will be just fine as soon as the 6 more boxes of my stuff arrive.

The vehicle I am driving is a 1998 Nissan pickup with a canopy on the back. It’s interesting to see as many really nice rigs here as I’ve seen, since most rigs get the stuffing beat out of them on these roads in a short time. If I decide to purchase a vehicle, I’ll be looking for a beater. It costs about $2500 to barge a vehicle here in the summer from Seattle or Anchorage, so everything is worth at least $2500. I am already in love with this place! I can’t describe why or how much I already feel at home, except for maybe it has a lot to do with how welcoming and friendly everyone has been so far. I met the mayor at the high school basketball tournament this weekend and got the skinny on all kinds of things. On Saturday I drove out to the cliffs just above the Bering Sea (about 1.5 miles from town) and noticed another pickup there with a guy sitting in it who waved me over. Turns out he was the Fish and Game wildlife biologist here for about 40 years, and he invited me to use his binoculars and spotting scope to look at the Beluga whales that were feeding out in Kvichak (kwee-jack) Bay. All I could see was the occasional brief flash of back as they fed on the smelt that were being pulled by the tide out toward them. Apparently the whales actually come quite a way up the Naknek river, which is about the size of the Pend Oreille. Then he gave me a copy of Sibley’s Birds of North America, saying that he gives away 10 or 15 of them every year! The beach was littered with chunks of ice, most of which were covered with sand and pebbles and were in some pretty unusual shapes. The weather has been ridiculously warm for January—in the ‘40s, and the snow is pretty much gone. Hopefully there will be more snow so that the sled dog races can still proceed this year.

Later that day Ann Shankel picked me up to go to her house and go for a walk with 3 of her 4 sled dogs out in the tundra. Ann is the local Rolfer and apparently the only one who still has sled dogs in the area. She is also a very successful cold weather gardener and fills many other roles in the community, including swim team coach (yes, Naknek has an indoor swimming pool!). Her dogs are mostly Inuit Huskies, who are the aboriginal sled dogs, still found in Greenland as well. They are HUGE, and amazingly friendly and playful.

Today I was invited out to Linda’s house that she shares with our director’s daughter and her husband and kids for lattes. Linda is one of our two Medical Assistants, and according to the other providers I’ve talked to, makes us all look good in her quiet way. They have chickens and will be my much-appreciated source of fresh, homegrown eggs. It is so beautiful here, even in the winter with tundra brown and gold!

I will have to figure out how to make peace with the wind; I have never liked wind and it’s windy pretty much all the time, I think. At least that ought to help keep the mosquitoes off in the summer! Stay tuned for more of the Rolling Tundra Review (you probably have to be a certain age to get that)!

Just to catch up any of my readers who have been out of touch for the last 3.5 years: I graduated, passed my boards and immediately went to work for a 3-clinic non-profit community health care organization, assigned to the clinic in my home town of Priest River, Idaho. It's been a huge learning experience, and I'm happy to say that I had a great mentor in the physician there, JB Fowler, and the best nursing and front office staff around. I wish I could say the same about the corporation's management...so here I am off to work in Alaska, where I've longed to return since I left in 2010. I fly to King Salmon on January 22 and then will be driven the 15 miles to Naknek, which is just about all the road there is. Unless you fly or come by boat in the summer, you can't get here. Well, you could theoretically come by snow machine or dog sled, but most people travel by air. I was planning to take my golden retriever and my malamute with me this first trip in, but then started thinking a little more seriously about schlepping two big shipping kennels, two big dogs, a big suitcase, my skis, and a guitar and decided that I should probably get settled in and get set up before I bring in the dogs. So I'm busy deciding what I really must have up there right away, packing those things into large plastic totes, drilling holes in the edges and securing the lids with wire tires and sending them via the US Postal Service. Not cheap, but the only way. UPS and Fed Ex don't seem to deliver up there. It's kind of hard to leave my patients here, most of whom are also friends, and it's hard to leave my mom who is in assisted living up here, and it's hard to leave my niece. But it's time for me to do this! I will be there at least two years, and who knows? Maybe forever. Everyone I've talked to who has worked and lived there has only good things to say. Stay tuned!

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.