Toksook Bay

What an adventure I had in Toksook Bay! I spent Tuesday - Thursday this week in this small village of about 500 located right on the Bering Sea. I couldn't see Russia, but it is pretty close! ... About 50% of the village still does not have running water or electricity. So, the natives go to a watering hole (a fresh spring) and carry large pales back to their home.


Local Catholic Church

Toksook also boasts some of the best halibut fishing in Alaska, and having had some, I agree! One of the local providers had me over for dinner Tuesday night and the halibut was absolutely delicious!  Believe it or not, the halibut here get up to 150 lbs!


In addition to their reliance on fish, muskox is another important substistence food for them. Right now there are two large muskox herds nearby that the locals have been hunting. To be honest, I didn't even know what a muskox was before I moved to Alaska. Basically, they look like a small ugly buffalo.


Toksook Ambulance Sled

Wednesday I got to do a home visit for a sick elder. One of the health aids (Alaskan version of a medical assistant/ nurse) took me on her snow machine to the elders house. Even though it was extremely cold (-30 with wind chill), snowing, and windy (around 40 mph) I found myself all smiles again. I really don't think there is a cooler job than mine. Here I am all bundled up in my parka, on a snow machine, headed into the middle of nowhere to help a sick Eskimo. After examining her at her home I found that she was actually very sick and would need to be transported back to the clinic for further testing and an EKG.  


A full parking lot at the clinic

 

The rest of Wednesday and Thursday was filled with sick children: pneumonia, dehydration, bronchiolitis, until I saw Mr. X (name has been changed for HIPPA privacy). He is a chronic alcoholic who apparently is homeless (not sure how that works in freezing Alaska). He was seen yesterday, diagnosed with scabies, and in today as a follow up. However, when I was talking with him I got the impression that something else was very wrong...my first clue was that he was as pale as snow!

As I began my exam, I also noticed that he had a new blowing systolic murmur. Not to my surprise his CBC revealed a hemoglobin and hematocrit of 5.5/18.2. For those of you not in the medical profession, that is extremely low. We actually transfuse people when they are around 7.  As you can imagine he was extremely short of breath and very fatigued. He also had an atypical scabie type rash on his entire body. I am not fully convinced that it is even scabies, though.  It may possibly be a secondary manifestation of another disseminated illness. As I was looking at his rash, I also noted that he looked extremely emaciated. When I asked him the last time he ate he said about 24 hrs ago.


View from plane, frozen Bering Sea with mountains in background.
You have to look very close!

 

This just broke my heart, so I gave him my dinner (I am not so emaciated that I couldn't go without a meal). Alcoholic or not, this man needed care! To start, he needed a blood transfusion. Unfortunately, this is unavailable in Toksook. So, I had to arrange for him to fly to Bethel on the next commercial flight (later that night). However, he didn't have anyone to take him there, so I decided to bring him myself. Around 5:00 pm we boarded the Cessna (seen below) and headed to Bethel. Once we landed I got us a cab, then personally escorted him to the ER. It actually worked out very well that I was able to take him myself, that way I could help in the transfer of his care. It also ensured that he would get in quickly and not spend hours waiting in the ER to be seen. Today it was really awesome to help someone who might have not made it otherwise, only in Alaska would this include taking your patient on a bush plane!



Our Plane - An 8 seater Cessna


Tomorrow I will be going to Emmonak, another small and traditional village. They are having a potlatch tomorrow night. This is a traditional Eskimo celebration and dance that is followed by a large meal. It should be really fun to watch and I will try to take lots of pictures to post.

After Emmonak, ANIAK! I will finally be able to go to my new home next Friday. Even though I have enjoyed my time here in Bethel and the other villages, I am very ready to get to my clinic.

Ian is still doing very well. He also got to go on a snow machine last week. He was able to join a family as they went to quarter a moose.....I will let him blog about that!  He has also been busy unpacking our apartment and says that it feels more like home now.  We have received everything we shipped except our ATV. So, Ian has been walking to and from work everyday, about 1 mile. Hopefully we will get it sometime next week.

That's all for now. Have a great weekend and check the blog next week sometime for more updates!

- Sarah