I Need Ice Cleats, Stat!

Once again, I find myself practicing medicine in a wintry climate, this time in the small community of Bethel which is located near the mouth of the Kuskokwim River in southwestern Alaska.  The Yukon-Kuskokwim Delta region is populated by 56 tribes in remote villages spread all the way to the west coast of Alaska adjacent to the Bering Sea.  Admissions to the local hospital are divided by village, with one group comprised of villages clustered along the Yukon River and the other group consisting of villages scattered along the Kuskokwim River.

The Yup'ik name for Bethel is Mamterillirmuit ("smokehouse people") in reference to its origin as a trading post with a fish smokehouse in the late 19th century.  Although Bethel can only be reached by air or by river, it has the highest number of taxicabs per capita in the entire country; paved roads constitute a very modest 10 miles within the town itself.  I love how the hospital supplies its locum tenens providers with cab vouchers that resemble Monopoly money:

Temperatures have been in the single digits, but really more like -15 degrees with the wind chill factor.  I'm making good use of my gore tex goose-down L.L. Bean parka and insulated Sorel boots.  For those of us who enjoy ambulation, there's a shortcut to the hospital that involves walking across a teetery boardwalk hovering over a large snow-covered marsh.

  

The roads are super porcelain icy, and the main challenge in getting to work (other than the chill of the tundra) is trying not to get run over by a snow machine (a popular form of transportation, given the exorbitant cost of importing a car by barge or cargo jet).  The approach of a snow machine is heralded by a loud high-pitched buzzing remniscent of a giant mechanical mosquito.

I was warned about the high cost of food [thanks, Aurelie!] but I was still bowled over during a trip to the grocery store that revealed 6 oz of slightly moldy blueberries selling for $9.59 and a wilted head of cabbage for $6.99.  Half of my luggage was an experiment in food transport: I made pasta sauce with ground turkey & spinach, packed frozen in quart-sized ziplock bags tucked into gallon-sized ziplock bags wrapped in larger plastic bags to protect against leaking.  I also packed black beans, salsa, wild rice, shredded mozarella, and rotini.  I froze a loaf of whole grain bread to make almond butter sandwiches with dried mangos & dried cherries.  So far, the food supply seems to be holding up, but it's reassuring to know that if I do run short, I can always head to the hospital cafeteria for elk meatloaf.