Coming to an End

For several weeks now, a notion has been flitting around in my brain, one that made me a little sad and a little glad. This morning I awoke to find that the notion had become a solid conviction. After nearly three years of blogging, it is time for Tundra Medicine Dreams to end.

This blog has always been about life in Bethel, the Yupik Eskimo culture that enfolds it, and the practice of medicine in bush Alaska. It is not about Kenai and life on the road system, which is not so different from life in the rural Lower 48. Since I no longer live in Bethel, I find it difficult to continue writing blog posts in keeping with what Tundra Medicine Dreams has been about. And though Kenai is very much what people think of as classically beautiful Alaska, I am not inspired to write about it. Nor do I think that it is what TMD readers come here to read. Kenai is not the frontier of civilization that Bethel is.


I began writing this blog for two reasons: to create a portrait of a culture that is fascinating and very different from the one that most Americans and Western Europeans are familiar with; and to create within myself a discipline for writing. I believe that TMD has done that.

In three years I have written essays covering a wide range of topics on bush medicine and Yupik culture. These days, most visitors to the site arrive via searches on things I have written about: huffing, botulism, breast-feeding practices, Eskimo diet, dog mushing, kuspuks and many more. For that reason, the blog will remain open and available for people to learn what they can from it.


My occasional trips to Bethel and the villages may inspire a few more posts in the coming year; I certainly don’t rule it out. But my writing has taken a different direction, which is what I always ultimately intended. I am finally writing my novel.

For most of my life I have known that I had an ability to write in a way that people enjoyed reading; I simply never felt that I had a story to tell. Now I do. My life in Bethel has given me that story. It will be about a woman who is a physician assistant and a dog musher, who goes to live in a Yupik village to provide health care and to train an Iditarod-hopeful dog team. She will have many adventures, both medical and musherly, and she will learn much about the culture in which she lives and about herself. I am already many pages into it, and enjoying the process of creation thoroughly.


Perhaps when I think it is ready, I’ll post a preview here. I don’t have a literary agent, and don’t have a clue about how writers get one; I know publishers take a dim view of manuscripts sent to them without benefit of an agent. If Tundra Medicine Dreams can help me to open that door, it will have achieved far more than I ever dreamed.

To those few readers who have followed my progress here from early on, thank you. Your loyalty and support have meant the world to me as a fledgling writer. To those who took the time and care to comment, you have my deepest gratitude. As the author John D. MacDonald once wrote in a letter to my Dad, “writers drop feathers down wells and listen for an echo.” Comments on this blog have, for the most part, been positive and inspiring. And to those casual visitors who found this site through various search engines, welcome! I hope that the writing you find as a result of whatever search string you used peaks your interest to search through the archives and read more. A large volume of (I hope) interesting material awaits you there.



And so, for now, so long. May you each and every one go well.


Photos of Bethel by The Tundra PA:
1. My favorite trash dumpster
2. An old truck rusting into the earth in City Sub
3. Boats frozen into Brown Slough
4. Frozen Kuskokwim River just after sunrise in November
5. Sunset over tundra

I'm the Sixth Day of Christmas!

A blog I enjoy checking in with, Addicted to Medblogs, has been doing a series every so often called Calendar Docs. The Medblog Addict is an attorney who is fascinated by medical blogs and the portal into the world of health care that they provide. Last year she started interviewing different physician bloggers and posting the interviews along with sexy beefcake photos (most of the interviews were with male physicians).

This year for Christmas she decided to do one interview for each of the 12 days of Christmas. She chose 12 non-physician providers for this blogging bolus, and I am Day 6--the geese a-laying (is there significance to that?)!

She came up with some good questions, and I enjoyed writing answers. You can find my interview here. She has previous Calendar Doc interviews in a sidebar on the right. Enjoy!

Moving. Ugh.

Packing. It consumes every waking non-hospital minute of my life. I’ve been in full-on combat mode for over two weeks. If I had to make a list of things I most detest in life, very near the top would be moving, or moving house, as the British say. It is just such a huge amount of work.

Dutch and I have lived in this house for four years—one of my longest stints, five years is my record for one house. I’ve moved a lot. We’ve had four great years here; it’s a wonderful house, with a beautiful west-facing view of the tundra and a large deck that catches the afternoon sun.

Over the last two weeks I’ve watched the house slowly come apart, as pictures came down off the walls, bookcases were emptied into boxes for shipping (my precious few) or for donation to the library, shelves were emptied of their Yupik artwork. I’m about down to bare furniture, and the house is feeling empty.

Despite a good amount of heartless tossing of old things, there are still stacks and stacks of boxes to be picked up by Bob the mover guy on Monday for delivery to the city dock and loading on a barge to Seward. Leaving Bethel is not as simple as renting a U-Haul.

When I’m not actually packing boxes, I’m thinking about what needs to be packed, and when, and how to organize the great help I’ve been receiving. Breezy and Summer have been lifesavers of infusing energy and get-er-done attitude. And they’ve moved lots of heavy stuff, too. They brought their friend Liza along, and she’s been a big help. Joan and the boys came over last night for pizza, and they made short work of some big boxes full of camping gear. One shed now completely empty {dusting her hands and feeling satisfied}. Second shed nearly so. Third shed holds all the boxes packed so far. By the end of Labor Day weekend, the house should be nearly empty.

Three days later I leave for a spirituality festival in California, at which I have been invited to speak. So along with all the packing, I’ve also been putting together slide shows, scanning lots of old photographs I have going back more than thirty years. I will see old friends there that I haven’t seen for a very long time, including two young women that I love dearly, and had a hand in raising for about five years when they were children. I think of them as my nieces, but I love them more as my daughters. I haven’t seen them since 1991.

On the way back from California I gave myself a short visit with Dutch in Kenai before flying to Bethel. Then it is a two-day turnaround (during which I have to go to the dentist and take both dogs to the vet for their health certificates) to fly out to Seattle to see Dad and Stepmom before driving with a friend to the Women’s Harvest Celebration in Montana. Whew. Then back to Bethel with my friend Jody (mentioned previously on the Arctic Adventure and the post Jody’s Trials) for five days to clean the house up completely, distribute the last of the wine collection to friends, and ship the dogs to Kenai. And have any more dental visits that are needed (there’s this one tooth…).

By October 1st Jody and I will be in Anchorage, hopefully picking up my new (to me) car, and then going to see the orthopedic surgeon about hopefully replacing my hip. Like the next day. The injury I wrote about in April of 2007 caused a rapid progression of arthritis, to the point that my hip is now bone-on-bone with no joint space left. For the last three months, it has been constantly painful, at times awful. So I’m thinking hot lights and cold steel. To cut is to cure. Everyone I’ve talked to who has had a hip replacement, and is more than a year out, says they are only sorry they waited so long to get it. Besides, I’m behind schedule. Both parents and my younger sister have had six hips replaced between them. It definitely runs in the family.


Stating the obvious here, but posts will be pretty sporadic for a while.

Online Again

After two full weeks without a computer in my house, I have a new appreciation for the roll of my laptop in my life. Every time I turned around, I was missing it for something.

The internet, of course. Couldn’t check my email accounts. Couldn’t make my airline reservations, hotel reservations, car reservations for two upcoming trips next month. Couldn’t shop for a new laptop backpack when my old one permanently popped its zipper. Couldn’t take a Google Earth tour of my niece’s new address to see what kind of neighborhood she’s moved herself into. Couldn’t do my online banking/bill paying. Couldn’t keep up with my favorite bloggers, Dr. Dinosaur, the Cranky Professor, MDOD, Ambulance Driver, and a few others. A dozen times a day I was reaching for my laptop to check something out, and coming up empty handed.

Of course I have a computer at my desk at the hospital, and was able to at least keep up minimally with my email. But doing anything more requires going in early or staying late, and neither of those am I inclined towards. As my friend Dr. H says, “the longer you are here, the longer you are here.” I certainly did not want to spend the kind of time there that I usually put into the writing of posts for this blog. And I can’t post photos from there.

Separation from my laptop also allowed me a new appreciation of my non-internet dependence on technology. I will be a guest speaker at a festival next month and am currently going through hundreds of old photographs to put together three different Powerpoint presentations; without the computer I couldn’t start scanning and organizing the photos I want to use. Visitors in town from the lower 48 were over for dinner and wanted to see some old photos of Bethel I had scanned and saved before returning the originals to their owner. Nope, sorry.

But mostly the dependence is connected to writing. Without my laptop I have not written anything for the last two weeks. Zip. Zilch. It feels so…weird. Empty. I’ve had several pieces planned in my head and wanted to capture them before they drifted away. The right brain said “OK, so take a pad of paper and a pen and start writing. You remember how to do that, right?” And the left brain answered, “What?? Actually press pen to paper and leave a trail of ink? Do you know how SLOW that is? Whole sentences evaporate before I can capture them!”

The truth is that I can type about as fast as I can think, while gazing pensively at the tundra, which helps to transport me to that alternate mindspace in which my best writing happens. I don’t have to think about the process which transforms thoughts in my head to retrievable files which can be stored or printed. Handwriting with pen on paper requires far more focus on the process, and far more energy. Maybe I am just lazy, but I allow it to keep me from writing. I think back to those authors of the pre-technology era, like Jane Austin and Charles Dickens, and I wonder how they did it. As much as I would love to visit them during their times, it would have to be with my laptop and digital camera.

So it was with great joy and anticipation that I finally welcomed my laptop home last night. The wonderboy computer geek at Bethel Alaska PC managed to figure out the bizarre problem with my laptop, after disassembling the entire thing down to its component coils and wires.

As he explained it to me, the power button, in the top center of the keyboard face, is connected to a plug-in on the inside under the keys at the top right by a small wire. This plug-in is adjacent to the right hinge for the screen face. The wire is held in place by a piece of tape. Yeah. A piece of tape. Over time, the heat generated by the laptop in use made the piece of tape sticky on both sides instead of just one. When closed, the top of the tape was sticking to something above it; opening the laptop was pulling the wire out of its connection. So I couldn’t turn it on.

While Rich had the computer broken down he cleaned it all up, used some kind of silver compound to dissipate heat from heat sensitive parts, and secured that troublesome wire in a more reliable fashion. Final result: computer is working beautifully again. And I am so glad to have it back. What’s more, it didn’t cost an arm and a leg. Rich doesn’t charge for diagnostic time, even though he spent nearly two weeks trying to track down the problem. Final bill: $116. Way better than the two grand I was anticipating having to spend to buy a new computer.

I am ready for a lighter and more streamlined model than this seven-pound clunker (Dell Latitude D800), primarily so it is easier to carry in a backpack when I am traveling. But when I am sitting at home, this one works fine and has given good service for the last two years. Dutch just had Rich put a brand new hard drive in it a few months ago with a basket load of gigabytes, so baring other bizarre hardware problems, it should last me a few years yet. Maybe I just need more upper body strength.

Stay tuned for actual TMD blog posts with pictures coming your way soon, as I am able to squeeze them out between packing boxes. Forty-five days until my one-way trip from Bethel to Kenai. Of that, I’ll be traveling for 23 days. Not much time left for packing. I’d better get cracking…

Computer Blues

Last week my computer went belly up. One minute it was working fine; I put it in "sleep" mode, and when I came back it was frozen with the desktop being displayed. The cursor would move, but I could not click on any icons, and if I positioned the cursor on the bottom tool bar, the hour-glass appeared. The start icon did not work. Control-alt-delete did nothing. Holding down the on-off button did nothing. I literally could not turn it off. Dutch suggested unplugging it over night so the battery would run down and it would shut itself off automatically; then, hopefully, I could simply turn it back on. So that's what I did. By the next morning the battery had run down and it had turned itself off. So I plugged it back in and came back four hours later. Unfortunately the second half of the solution did not work. It would not turn on.

So I carried it (laptop, thank goodness) in to Bethel's computer geek and he is trying to resurrect it. At this point he is in the process of taking the entire thing apart. I should know by Friday whether there is any hope of continued life. If not I'll have to shop for a new computer, which wasn't really in the budget right now. My fingers are crossed.

Any insights out there as to why and/or how this happened? My computer guru is baffled by it.

And thanks to Joan for the loan of her computer so I could post this. I figured a few of you might be wondering what had happened to me.

Summer of Change

Long time readers of this blog have probably noticed that it has changed quite a bit since I first started writing it two years ago. It is less about bush medicine and more about bush culture. And, frankly, it is more about me than I originally intended. The first change has evolved out of a general concern for patient confidentiality. The hospital decided that I could not post any pictures taken in their facilities, and that made me less interested in writing the medical stories. There was so much to write about the culture that I hardly noticed the shift.

The second shift, to writing more about myself, came more gradually. As much as I thought the blog was not about me back in the beginning, it was to some degree. It is just a little more so now.

The biggest change of all is now happening, and I am not sure just how this blog will go on after it is done. This is my last summer in Bethel. And I am already spending it alone.

Dutch and I have been feeling for the last few months as though the time was coming when we would be ready to move on, to turn the page, to live our life someplace different than Bethel. In April he applied for a position with the City of Kenai; it was offered, he accepted, and a month ago he moved there to start his new job. I am required to give much more notice, and can’t leave here until the end of September. Four months apart until I can join him there. He started exactly five days after our wedding.

Kenai (KEEN eye) is a small town (population 7,400) in southcentral Alaska, about 60 air miles and 150 road miles south of Anchorage. It is on the Kenai Peninsula at the mouth of the Kenai River. It is on Alaska’s limited road system, therefore not “in the Bush”. And it is in the land of tall mountains, big trees and beautiful ocean—the “picturebook” part of Alaska.

We found a wonderful house through serendipitous good fortune: a friend here had a relative there who was looking for some reliable people to lease the house for a year. And dogs welcome! It was perfect. It is right on the Kenai River, has a great fenced dog yard, and moose wandering through the property on their trails down to the river. The deck on the back looks out over the tops of tall fir trees, eagles flying up the river, and the Alaska Range marching straight into the Pacific Ocean. I am so ready to put a hot tub on that deck.

One of the best things about this change is that I will get to keep part of my old job, one of the parts I like the best. I will continue to do Radio Medical Traffic with the health aides in the villages by fax/phone from Kenai. And I hope to be able to fly back for an occasional village trip as well.

Once fall comes, I will no longer live on the tundra, but I will always be The Tundra PA. The beauty of the tundra has taken up residence in my heart, and it will always be part of me. Tundra Medicine Dreams will continue but may be a completely different type of blog. My interest in writing and what I want to write about is shifting along with all of this. It is time to start writing my novel.

Leaving Bethel is a huge change in my life, along with the loss of my grandmother and the acute loneliness of being separated from Dutch. The second two are a deep ache in the heart, lessened a little by all the planning and details for the first. There is much work to do, sorting, packing, cleaning, and selling off the big things like the boat, the snowmachines, and my truck. I’m not a packrat, but I’ve managed to accumulate a fair amount of junk in my ten years here.

All three dogs have stayed in Bethel with me, but now that Dutch is somewhat settled in to his job and our new house, it is time for Bear to go and keep him company. I’m planning a trip over for the 3-day weekend of the 4^th of July, and he’ll go along as part of my checked luggage. After that it will be just us girls here in Bethel—me, Pepper and Princess.

And if I stay busy, the summer will go by quickly; there are fish to catch and berries to pick, as well as patients to see. It’s all good.

109 days until October 1^st. Not that I’m counting.

Photos of moose by Dutch: the first just outside his office at City Hall, the second about a block from our house. Isn't it just such a Cecely moment? Feels like Northern Exposure all over again.

Coming Home

No matter where I’ve lived in my adult life—including a few “iffey” spots in my younger days—I’ve always loved coming home. From a trip, or just from a day at work. Being greeted by dogs who are happy to see me, sitting in my comfortable chair with a hot or a cold beverage depending on the weather, sleeping in my own bed if I’ve been away overnight, I just love coming home. No where has that been more true than since my home has been in Alaska.

Trips to the lower 48 are a huge culture shock to me. I wrote about it last year after my trip to Alabama in this post. This year felt much the same. There is such an incredible density of people everywhere; parking lots are crowded, freeways are packed with (mostly new) cars, restaurants are full, and everyone seems to be in such a hurry. Billboards are everywhere, yelling consume! Consume! Consume! And people are rushing to do it at a breathtaking rate.

There is so little wilderness anywhere. Even driving through the countryside, the land is fenced, tilled, cultivated. Roads are paved, lawns are manicured, everything is just so. The evidence of human occupation is practically inescapable, and that is what feels so different from Alaska.

Here we have pockets of civilization amid a gazillion miles of untouched wilderness. Here I don’t feel constantly squeezed by the joint pressures of population and consumer culture. Life down there feels to me like living in a pressure cooker. If you’ve never known anything else, then it seems normal, but the longer you’re away from it, the harder it is to go back into it.

And then there is the climate. It was 97 degrees with moderate humidity in San Antonio, and 94 degrees with horrid humidity in Alabama. Without air conditioning, you sweat just sitting still. At night it gets darker (so early!) but not much cooler. And as hot as it was in early June, it will be so much hotter in July and August. It felt like full-on summer to me already. How did people live there before air conditioning?

Arriving home in Alaska was jumping back half a season. We are having early to mid spring; the temperature was in the mid-forties this morning, and the air is clear, dry and cool, even at midday. The snow and ice are gone and the tundra is a thick green carpet in the early surge of flowering. Trees have tender green leaves beginning to soften the hard lines of their branches, and birds of all sizes are everywhere. The air is alive with their songs. The golden plover pair has returned for their third summer and is nesting about 200 feet from the front deck. The previous two summers they successfully raised a pair of chicks, and I am so glad to see that they are back.

The Kuskokwim River is in full river mode with boats, skiffs and barges plying its waters. The first barge arrived about a week ago, bringing our new gasoline supply; gas prices went from $5/gallon to $6/gallon overnight. The king (Chinook) salmon run has started and I hear that a few people are catching them. I can’t wait for my first taste of fresh, yummy king! Such delectable fish…

The hospital’s incredibly hectic pace throughout the winter has started to slow a bit as people move out of town to go to their fish camps for a month to cut, dry and smoke the salmon that will sustain them through the coming winter. We generally get a breather for late June and early July, as the daily census in the outpatient clinics drops by nearly half. After the intensity of the past winter, the slow-down is sorely needed by the staff, and gladly welcomed.

So as always, it is good to be home, and even more than I previously remember. For the last three evenings I have sat on my front deck at midnight, watching the sun keep his date with the horizon, filling my eyes and gladdening my heart with the wide sweeping view of tundra that rolls out endlessly to meet it. I love Alaska. I love coming home to it.

Still Traveling

The long silence on this blog is an indication that I am still far from home and have very limited computer access. I have been in Alabama for a week now, staying at my grandmother's home with my mother. My wish for one more visit with Grand was not to be. She passed peacefully and without pain a few days before I arrived. I cut my conference time in San Antonio short in order to be present at the memorial and funeral in Franklin, Kentucky. My sense of loss at her death is so deep that I cannot begin to express it. In the week that I have been here, I have not felt at all like writing. Perhaps that will come.

I was here for her 94th birthday last July, and she was so vibrantly alive. The last photo I took of her was the one on this post and I just love it. It is so typical of how she lived life, with enthusiasm and laughter. Her final illness was swift and brief; she decided that it was time to go, and in five short days she simply withdrew her life force and was gone. She left us with wonderful memories that will never be forgotten.

I will be back in Bethel on Sunday night, after a brief stopover in Seattle to visit with Dad and Stepmom. New posts to come then...

New Blogger Welcome

We have a new blogger in the blogosphere, and I am very pleased that she has created this platform to share her thoughts and ideas. Those of us who are regular recipients of her letters are often inspired by them, and feel that a wider audience deserves to receive that inspiration as well.

Joyous Judy is a member of the Women's Harvest Circle whom I have never met. Last summer she was diagnosed with multiple myeloma, and due to health issues and treatment schedules, was unable to attend last fall's Harvest Celebration. A beautiful photo of her lived on the altar for those five days, and many women spoke of her so lovingly that I felt as if I knew her. She continues to face serious challenges with this disease, but her health has improved considerably, and we all hope she will be able to meet us in Montana this fall for the Celebration.

Her new blog is called Living Joyfully With What Is. She only has a few posts up so far, but I know her to be an excellent and prolific writer and fully expect that more will quickly follow. Her positive attitude glows through her words. Go. Read her. Be inspired.

Happy Birthday, TMD!

Today is the two year blogiversary of Tundra Medicine Dreams! It amazes me to think that I have been writing this blog for two full years; it just doesn't seem that long. This makes the 234th post, which is about one every three days. Just recently the 100,000th reader visited.

Of all the posts I've written, the one that enduringly gets the most visitors--through Google searches--is the one on huffing. The search strings vary a bit, from "how do I get high on Axe deodorant?" to "how can I tell if my child is huffing?" Probably the second most popular is the post on breastfeeding, landed on invariably from a search on "oldest breastfed child." Interesting how much people want to know that (my answer: the oldest I have personally found was seven years old). Coming in third would be the post on diet and obesity among the Yupik Eskimo people.

Controversy has not had a high profile here, and subsequently I have not garnered a lot of comments. Most posts get only three or four. The big winner was the one time I hosted Grand Rounds, in September of 2006, which got 32 comments--most of which were "thanks for including my post." That was also my all-time high number of visitors in a single day, nearly 700 as I recall. Second place in the comment division went to the post on a village funeral with 18 comments. Even though I feel like an old-time blogger after two years, I still get a thrill when people take the time to leave a comment.

I started this blog out of a desire to share with people the breathtaking and sometimes subtle beauty of the Yukon Kuskokwim Delta, and the stirring and generous warmth of the Yupik people. It has been an enriching experience for me, and one that has brought me much joy. To those who have become regular readers of Tundra Medicine Dreams, thank you for sharing this journey with me. And to those who have left comments, quyana cak nek!

Too Funny for Words

It was coffee spewing time this morning when I stopped in at Musings of a Dinosaur to see what Dr. Dino was up to. Dino and the Medblog Addict have an ongoing competition to see who can find the funniest You-Tube videos. Dino definitely won this round. If you want a big laugh, go check it out. I strongly encourage doing it beverage free. Don't say you weren't warned!

And FYI, the British generic name for Tylenol is paracetamol; the American generic name is acetaminophen.

Life Rating

This Is My Life, Rated
Life:	8.2
Mind:	8.6
Body:	7.3
Spirit:	9.2
Friends/Family:	5.6
Love:	6.9
Finance:	8.4
Take the Rate My Life Quiz

Guess things aren't too bad, ah? 'Cept maybe I need a few more friends...
Thanks to Monkeygirl for the link.

And once started, I had to do the book quiz too. I'm really a sucker for these things...

You're The Mists of Avalon!

by Marion Zimmer Bradley

You're obsessed with Camelot in all its forms, from Arthurian legend
to the Kennedy administration. Your favorite movie from childhood was "The Sword in
the Stone". But more than tales of wizardry and Cuban missiles, you've focused on
women. You know that they truly hold all the power. You always wished you could meet
Jackie Kennedy.


Take the Book Quiz
at the Blue Pyramid.

The questions seemed odd and unrelated to anything, but I can't believe how accurately they pegged me. Scary! Even more than meeting Jackie Kennedy, I would like to meet the Lady of the Lake.

Now I wonder--which answers would make me The Clan of the Cave Bear?

Housekeeping

Perhaps it is because I am an Aries—you know, not a lot of patience with the details. Whatever the reason, housekeeping is just not my strongest suit, either in my actual house or on the blog. As long as things are reasonably tidy and mostly clean, I’m good with it. But some chores take me forever to get around to, despite my best intentions. Like repotting the plants. I’ve been promising them new dirt for a year now.

When it comes to blog housekeeping, the equivalent of repotting the plants is updating the blogroll. I want to do it. I need to do it. I just never get to it. Having more than a mild case of HTML-phobia doesn’t help.

For several weeks now (OK, months) I’ve been lurking at a half dozen new (to me) blogs and enjoying them thoroughly. I’ve planned to write a post encouraging TMD readers to check them out, and to add them to the blogroll. But my recent bout of blog ennui has seen me reading without mentioning them, or even commenting much on their blogs. Enough of that.

All of the following seven blogs came to my attention via my friend #1 Dinosaur at Musings of a Dinosaur, who I am proud to call my friend in Real Life as well as in the blogosphere. Dr. Dino definitely has a finger on the pulse of blogland (or would that be a toe?). Thanks, Dr. D!

I think it started with Ambulance Driver (AD) at A Day in the Life of an Ambulance Driver. He writes well, he handles volatile subjects gracefully, and he has a kick-ass sense of humor. When he posted the story of his daughter with cerebral palsy, he had my heart in his hands. Precious few blog posts can bring tears to my eyes, but this one did.

AD and Dr. Dino both had mentions of a nurse in Georgia named Babs, the blogger at Living Single in the Buckle of the Bible Belt, so I had to mosey over and check her out. Wow. A smart-and-sassy Southern blonde; I felt like I had found my blog sister (we share three out of four of those, but she is way sassier than I am). Her blog is now called Just Peachy, which is a lot easier to say than LSITBOTBB.

I am a sporadic reader of comments on other people’s blogs and hadn't been keeping up recently, so I was taken totally by surprise when AD and Babs made a Big Announcement last week. Read his version here and her version here. And congratulations to you both! I just love that Awwwwwwwww factor. I am so happy for you; you both deserve that finding-your-soul-mate joy. It is a wonderful thing to have.

AD also has frequent references to his friend Matt, who blogs at Better and Better. Matt is a small-town police officer in the Deep South who writes with compassion. Recently he and AD and Babs created a beautiful joint effort: each of them wrote a story from their individual perspectives—the responding officer, the ambulance driver, the ER nurse—about the events of a single night. They each posted their sections on their own blogs and pointed readers to the other two blogs to get the whole story. I was quite taken by the creativity of the idea and the beauty of its execution; and deeply touched by what they wrote. If you haven’t read it, do. Matt’s part. AD’s part. Babs’ part.

The two new ER nurse bloggers I am now reading and being highly entertained by are Monkeygirl at Musings of a Highly Trained Monkey and the eponymous blogger of ERnursery. Both are well-deserving recipients of the Thinking Blogger award. Both have the right balance of wit and snark to be amusing and thought-provoking at the same time. Both have many good posts, so rather than point to one, I’ll let you browse for yourself—and do!

Another friend of AD’s (that boy really gets around!) is the LawDog, blogger of The LawDog Files. Another small-town cop who writes well and tells a good story. And I love his hundred-year-old granny; she is five years older than mine, and cut from the same cloth. I’d love to meet her; even better, I’d love for my grandmother to meet her. It’s not so far from Alabama to Texas.

And finally, there is the Medblog Addict—a lawyer—at Addicted to Medblogs. I love her ever-changing lawyer-joke-of-the-day in the sidebar. And I was ROFLMAO when I read the August entry for her Doctor-of-the-Month Calendar. Yes, no other than the estimable Dr. Dinosaur! Both MA and Dr. D are in top form for this interview. And the revealing photo of Dr. D—what beefy cheesecake--breathtaking. I immediately wrote to the dinosaur and suggested an avatar change.

And speaking of the Thinking Blogger award, I was immensely pleased and very proud to have this sought-after crown bestowed upon my own head by Dr. Dino some months back. I did not mention it here at the time for two reasons. I mostly don’t blog about blogging, and I couldn’t figure out how to do the html-thing to get the TB icon in the sidebar. Pathetic, I know. But thanks, Dr. D! I was, and am, honored.

So there you have it. Next thing you know I’ll be posting my results on the Rate Your Life quiz that was all the rage five minutes ago. And house plants, look out! Your repotting is near.

Pulling Teeth

Writing has been like pulling teeth for me these last few weeks, as evidenced by the dearth of posts on this blog. Life is full and busy, I just haven’t been inspired to write about it. This is not so much writer’s block, as I have numerous ideas for topics I want to write about; it is more like lack of writer’s discipline—an inadequate supply of “bum glue”, as author Elizabeth George phrases it.

This is not a new problem for me. Writing has always been something I have done in waves: big output followed by long periods of not writing at all. When I started the blog a little over a year ago, one of my reasons was to create a tool that would improve my discipline about writing. And it has definitely done that. In the first year, I pretty consistently posted two to three times per week. For the last month or two, though, I seem to have hit a trough.

Recently I read that there are now estimated to be over 77 million blogs on the internet. When I first started there were around 40 million. With such an explosion of blogs, there is plenty out there to read. Way more than most people have time for. To those of you who are loyal Tundra Medicine Dreams readers, thank you. You certainly have plenty to choose from, and I am honored that you choose to read my work. To those of you who are also commenters, thank you even more! Like all bloggers, I love comments. The great beauty of this format of publication is the ability of the writer to interact with his or her audience. That alone is a powerful motivator to keep writing.

I never intended to take a blog vacation, and that is not what I am calling this current phase. I’m thinking of it more like the trough before the next wave, which will come. In the meantime, my creative writing mind is traveling more often to the fantasyland where my first novel is gestating. It, too, is about life in Alaska.

More as it comes.

Blogger Woes

Does anyone know where my sidebars have gone? A few months ago, they simply ran away from home without provocation. Disappeared without leaving a note. One day they were there, the next day they were gone. And I had not been mucking about in the template. I kept hoping they'd come back, as the blog just doesn't look right without them, and I do like the functions they perform. I discovered that clicking on the timestamp for any given post will bring up that post and its comments as a single page, and the sidebars are intact there, except for the archives. There are no archives at all. I have gone back through the template and everything is there as it should be. So what's wrong?

When I look at the blog in Firefox instead of Internet Explorer, the sidebars are intact, including the archives. But the main page comes up showing the most recent post as over a month ago. If I type in the exact URL of the most recent post, that page will come up; but the main page is never current.

When I made the switch to Blogger Beta about two weeks ago, I hoped this problem would be corrected, but it was not. Any suggestions?

Six Month Anniversary

Tundra Medicine Dreams is six months old tomorrow. When I look back over how much I have written and posted since then, it seems so long ago. The blog, and my thinking about it, have evolved over that time, though that may be more evident to me than to TMD readers.

My initial intent was to be totally anonymous, to have no identifiable information about myself on the blog, to tell no one at the hospital about it (except my Clinical Director, for legal reasons). What was I thinking? I don’t live in a high-population area, marginally distinct from other high-population areas (i.e. urban Midwest) where anonymity is possible and even easily achieved. I live in a small community that is very different from most of the rest of the world. Word gets around here; anonymity in the hospital would be difficult to maintain.

And in the blogosphere? Probably there as well. When I hosted Grand Rounds in September, Nick Genes asked me in the pre-Rounds interview how important anonymity was to me. I had to admit that it had become less important than it initially seemed when I first started writing Tundra Medicine Dreams. He pointed out that a web-saavy clinician in the lower 48 could probably figure out who I am.

As a result of Nick’s interview with me on Medscape, Tundra Medicine Dreams and The Tundra PA came to the attention of The AAPA News, the twice-monthly news magazine of the American Academy of Physician Assistants. They wanted to run a story about me, but insisted that they must use my real name and identify me as a Fellow of the Academy. I took a few days to think about that, and to discuss it with Dutch. It meant “coming out” and I had to decide if I were ready for that. He felt that it was time, and he encouraged it. The News is distributed to the 60,000+ PAs who are members of the Academy, and once the story runs (possibly this month) any vestige of anonymity will be vaporized. I wonder if a tsunami is about to crash over me.

With these events as background, the six-month anniversary of TMD, and the start of winter, which is always a time of introspection for me, the blog has been much on my mind lately—even more than usual, if that is possible. Its voice (my voice), its direction, its presence as an entity in the medblogosphere, and where I want it to go in the next six months. The huge question is just how personal and self-revealing I want to be.

Several commenters have stated recently, both on the blog and in private email, that they want to know more about me, my background, my friends, my personal life. There has been a request for photos of me on the blog, which I have so far carefully avoided. The concept of fame is not one that I can apply to myself at this point in my life; but I recognize that, because of Tundra Medicine Dreams, I have become a personality that is known to people beyond the circle of individuals that I have actually met. Who I am and what I am doing is interesting to them, and some of them want to know more. What I have to decide is how much more I want to tell.

When I started writing TMD, my orientation to my own “voice” on the blog, as the narrator, was that I was creating a persona. The other characters I have introduced—Dutch, Henry, Joan, Michael and Luke, Betty, Andrea, numerous health aides and patients—are also personae. They are my creations, based on real people. I have thought of these creations as sort of a Sub-Arctic Lake Wobegone Tales, or Spoon River Anthology. My friend Traveling Doc (of Borneo Breezes) suggested in an email that if TMD is going to become a book—it might—then I should enlarge upon these characters, realize them more fully. I am thinking of doing a series posts, the TMD Kusko Anthology perhaps, that would do just that. Going in this direction means that I may be absent from Grand Rounds for a week or so (*sigh* I love what Tuesdays do to my sitemeter). Feel free to leave your thoughts in the comments. Reader input is always encouraged, considered, and appreciated.


Happy six month anniversary, Tundra Medicine Dreams! You have changed my life; you have allowed me to think of myself as a writer.

A Response to California Medicine Man

Last night I was reading through the many excellent posts included in this week’s Grand Rounds (yes! It’s up at Health Care Law Blog). I clicked on a blog I had not visited before called California Medicine Man, written by Dr. John Ford, a physician in southern California who is on the faculty of the UCLA Medical School. I was stunned and amazed to see his post “Regarding Tundra Medicine Dreams”:

I have read extensively from the blog of this southwest Alaskan-based physician assistant. She is a incredibly authentic writer and has an amazing story to tell. Her descriptions of "tundra medicine" and her beautiful, evocative photographs are captivating.

Click on the link and read his entire post; he says even more nice things about my work. I read through his post several times, with my vision becoming blurred by the accumulating moisture. I was so deeply touched I was speechless. I wanted to respond and tell him how much I appreciated his kind words, but I wasn’t sure how to do so. Leave a comment on his post? Write him a private email? For several hours, all I could do was to hold his words like a beautiful crystal, turn them over and over, and feel the warm glow inside me that they generated.

This morning I decided to put up a post thanking him publicly, and that is what this is. I went to his blog to get the precise URL of his post, and found a new post entitled “Why I’m Not a Hunter”, inspired by my moose-hunting story from last month.

This post is an eloquent description of how many people in the lower 48 feel about hunting, and with good reason. Down there, hunting is not a necessity, it is purely recreational. Hunters quite often spend huge amounts of money on all the right gear, pay a knowledgeable guide to take them to just the right spot, kill whatever walks in range of their high-powered rifle scope, then pay a taxidermist lots of money to mount the animal’s head so they can hang it proudly in their home. If the hunter is responsible, he will pack the meat out and pay to have it processed by someone else; but he may or may not have had the knowledge and spent the time and energy to field-dress the meat properly. And when he gets the processed packages of meat back, he may or may not have much luck getting his family and friends to eat it. “Tastes too gamey,” they usually say; and they are usually right.

Hunting in southwest Alaska, at least by the people who live here, is not recreational. It is part of survival. It is necessary to a subsistence lifestyle; most families here would go hungry through the winter without a few successful hunts. Certainly, there is plenty of beef for sale in the meat department of the two grocery stores in Bethel. New York Strip steak sells for $10.79/lb. Most Yupik families in Bethel can’t afford to eat beef very often. In the villages there simply is no fresh meat for sale. The small village stores carry canned, boxed, and some frozen goods, all at prices even higher than Bethel’s. And let me say it right here: moose is fabulous! Sweet, tender, succulent, flavorful. I'll take moose over beef any time.

My friend and I are adequately compensated for our work as health care providers, and we can afford to buy fresh meat at the store. But part of one’s acceptance in this culture, and one's understanding of it, is governed by one’s participation in it. Yupik culture is entirely oriented around subsistence activities, and the people here appreciate that I participate in their activities. My credibility as a health care provider is markedly increased by the fact that I mush dogs, fish for salmon with a drift net, travel alone on the river, pick berries, and eat agutuk.

What I tried to convey in the story about my one-and-only moose hunting experience is that hunting has a completely different context here than it does in the lower 48 (or any other highly populated area of the world). Certainly, the trip I described was a tremendous experience that was a lot of fun, and a lot of hard work. There was respect, and a certain level of grace in our attitude towards the trip, the river, the people who helped us, and the moose whose life we took.

I left a very long comment to Dr. Ford’s post on hunting. I hope it did not come across as strident or defensive, as that was not my intent. It was passionate, however, which I hope did not override the context I was trying to present.

I think it is extremely difficult—if not nearly impossible—for people born and raised in urban American culture to understand just how vastly different life is here. The difference is not just about fancy houses and paved roads. It’s not just about wearing high-heeled shoes or dry-cleaned clothes. It’s not just about going to movies, plays, and nice restaurants. We don’t have all those things, and that constitutes an obvious difference; but it runs much deeper than that. Life here is about survival—in a cold, harsh, unforgiving and often cruel environment. The things that matter here are about taking care of each other and helping those around us. That is the most basic value in the Yupik tradition. Underneath all the noise, that is basically what life everywhere is about.

So, Medicine Man, thank you from the bottom of my heart for your beautiful tribute. It means more to me than you know. I think, underneath it all, we are not very different. I think our hearts are in the same place, it’s just the rest of our bodies that live in two different worlds. I hope, someday, you can make it up here for a visit.

On Music

Two bloggers have tagged me for the currently circulating music meme, The Dread Pirate Rob at Musings of a Distractible Mind and Traveling Doc at Borneo Breezes. For the dwindling few of you who don’t know what a meme is (hint: short for me-me-me-me-me), a meme is a question or set of questions to encourage (or force) self-revelation. The current music meme asks for seven songs you are listening to right now, and instructs you to pass the meme on to seven more bloggers.

This morning I read OncRN’s response to this meme, and I loved her description of her attitude about memes. I agree. I am very self-revealing, but in my own way and time. I never feel like I can answer the questions correctly or completely; in fact I tend to want to argue with the questions.

So my answer to this meme is that I can’t answer what is asked. I will get around to some self-revelation here in a minute, but some discussion has to come first.

Many bloggers who have answered this meme have responded that “the iPod doesn’t lie.” So they produce a quick list from iPod and there you have it. Well…I don’t own an iPod. Or an MP3 player. Or a personal CD player. The majority of my life is spent either at home, where I have a lovely sound system, or at work, where I have no time or brain space for music. The distance from one to the other is less than one mile and takes less than 5 minutes to “commute”. If I am anywhere else, it is likely to be on a boat or snowmachine where it is too loud to listen to music, or on a dogsled where the only music I want to hear is panting dogs and whispering sled runners. So this technology that provides music in your ears everywhere you go and up-to-the-minute access of all that’s new and hot on the cutting edge is simply not part of my life.

Dare I tell you? I don’t even own a cell phone. The service in Bethel is pretty Neanderthal; no digital is available, only analog. That means no caller ID, no different ring tones for different callers, no voice-mail messaging, no camera capability, and no use whatsoever more than five miles out of Bethel. It simply does not work if you’re up the river fishing or if you fly over to Anchorage. I do wear a beeper on work days and can always be reached by the hospital operator when anyone needs to page me. That is enough of a leash.

Back in the days when I lived in cities…Spokane, Seattle, Chapel Hill, Santa Monica…one of my favorite weekend pastimes was book store and record store browsing. I especially loved smaller, non-franchise type record stores with knowledgeable, helpful staff and listening booths where you could preview new stuff before you bought it. I’ve always had pretty widely varied and somewhat eclectic tastes in music.

Forget listening booths; Bethel doesn’t even have a record store. Or a book store. OK, there is a single stand-up, turn-around rack in the grocery store with some CDs on it—a selection that you might find at a truck stop in Montana. Not exactly the cutting edge of the music industry in any genre. And the helpful and knowledgeable guy who is ready to make suggestions for new stuff to listen to based on what he already knows you like? No, he doesn’t work there.

Well, what about radio, you ask. Radio is a reasonable way to keep up with what’s going on in the music world. But not in Bethel. We have two radio stations. Period. One is an FM religious station (no thanks). The other is an AM station that is the bag lady of radio. They broadcast a little bit of NPR (portions of Morning Edition and All Things Considered), local news (excellently done by Henry’s niece Andrea the news director), charmingly (!) local programming like the Birthday Call In show (thirty minutes of people calling in to wish someone a happy birthday, five days a week), and in-your-face political analysis/talk radio such as the weekly Talk Line (which Dutch refers to as the Dumb and Dumber Show). Every other Tuesday night, they broadcast gavel-to-gavel coverage of the full four to six hours long city council meeting for an evening of edge-of-your-chair excitement. Sprinkled in amongst these gems is some music programming, often chosen and hosted by local people who do not have careers in broadcasting or journalism or music, but just want to do an occasional radio DJ gig. You can actually do that in Bethel. Some of them are even pretty good. But as a source of information about the latest and greatest in popular music, our local radio station isn’t quite it.

OK, yes, there is the internet. Somehow I have not managed to get the whole streaming thing down yet. Maybe I haven’t tried hard enough. One thing that I have noticed in general is that aging has a tempering effect on that fire in the belly to always be on top of what’s newest and hottest in those areas of life that are strictly part of the Comfort Zone. Things like food, music, clothes, movies and probably lots more; familiar is comfortable to many of us fifty-somethings, and the search for new-and-hot is less urgent than it was twenty or thirty years ago.

Music has the ability to evoke memory almost as intensely as smell does. I can listen to classic rock of the late sixties (Chicago; Blood, Sweat and Tears; Earth, Wind and Fire) and be right back in high school. Let me hear early Beatles songs and I’m twelve years old again (yes, nephew, that was Paul McCartney’s group before Wings). And the Big Band sound of the forties brings back images of my parents jitterbugging in the living room when I was five. I love them all.

I studied piano from adolescence through college and love classical music. I played guitar in high school, and love folk music. I dated a fiddle player in graduate school and learned to love bluegrass and string band music. Jazz, blues, Motown, yeah…love ‘em. I majored in theatre in college, so—Broadway musicals! Right there! I can sing the lyrics to dozens (though with my voice, you don’t really want me to).

The one area of music I’ve never really liked is the loud and screeching category. Cacophony. Whether it is heavy metal or Bartok. I’ve never been fond of rap, though the ER Nurse Rap from the UAB Medical Center (thanks, Grunt Doc!) is truly great.

So, back to the music meme (finally!). All of the above is by way of explaining to you how it is that I am a retro-grouch in a technologically challenged environment. I don’t listen to single songs; at best I listen to entire CDs, which I still call albums, though I no longer have a record player.

Some of my favorite artists to listen to, in no particular order:
Tina Turner
James Taylor
Norah Jones
Josh Groban
Tingstad and Rumbel
The Pointer Sisters
Manhattan Transfer
k.d. lang
Tracy Chapman
Phoebe Snow
Elton John
Indigo Girls
Simon and Garfunkel
Cleo Laine
Mary Chapin Carpenter
Leo Kottke

And classical: just about anything by Chopin, Mozart, Handel, Tchaikovsky, Beethoven, Debussy, Rachmaninoff, Lizst. Any piano played by Van Cliburn or Rubenstein. Any violin played by Perlman. Any cello played by Yo-Yo Ma. Any flute played by Jean-Pierre Rampal.

So have I answered the meme? Essentially, no. Have I been compliant with the spirit of the meme and been self-revealing on the subject in question? Definitely, yes. And as for the seven others to pass it on too…Ob-Gyn Kenobi, Health Psych, Navel-gazing Midwife, TBTAM, Intueri, Wandering Visitor, and Tales from the Emergency Room.

Improving the Medical Blogosphere

Newcomers to any group often bring fresh ideas and insights to that group which are worthy of consideration and may even generate change. Traveling Doc, the blogger of Borneo Breezes, is such a newcomer, and has a new post up on her blog which deserves thoughtful consideration by medical bloggers. I won't try to synopsize her post, as it needs to be read in its entirety; go over and read what she has to say. Read the comments too, as she further elucidates her ideas there.

Moof also blogged about the post on Borneo Breezes, and--as usual--has additional food for thought. Her comment section also contains some good feedback.

As Traveling Doc suggests, diversity of opinion--politely discussed--is an essential component of growth and change, and is to be encouraged. Blogs are an ideal format for such discussion. The medical blogosphere can only benefit from more such critical thinking as she is offering.

Update

Home again, home again, jiggity jig!

Our fishing and camping adventure is safely concluded, with stories and photos to follow (and LOTS of salmon to eat!)...