If you aren't in over your head, how do you know how tall you are? T. S. Eliot

If anyone wants to complain about their "cold" and "gross" spring weather please know that this picture was take May 7th:

All kinds of snow!

Winter likes to hold on tight up here! Secretly I find it nice that the sun isn't blasting into my apartment until midnight on days like that. 

At work we have been having a rash of attempted suicides, lots of alcoholism, and many many pregnancy issues.  One of the days I worked was so incredibly hard for me. And it didn't really hit me until later that night after all was said and done. A young lady came in and she was so excited that she was pregnant. Her and her sister were both pregnant and they were only a few weeks apart. This was her first pregnancy; she was beaming. She came in because she had been bleeding, and was worried that something may have been wrong. She was in the very early stages of her pregnancy.  We tried to find fetal heart tones and there were none to be found.  Telling that girl that there were no heart sounds that were detectable and watching her face, it was like her soul was slowly fading from her.  I asked her if there was anyone she wanted to call, or wanted us to call, or if she wanted to talk to anyone, and she denied all of them.  It was all I could do to not crawl into that bed with her and hold her. No one should ever have to see the face that I saw that day.  After she left the ER I wondered if had done enough.  And you know I did. I did everything I could do for that girl.  There was nothing else I could have said or done.  And I find that comforting.  We also got a lot of people in for alcohol withdraw, and hangover symptoms.  I'm not gonna lie, I thought CU-Boulder and the like all had pretty solid drinking as a sport reputations... No no no. This place takes it to a WHOLE.new.level.  We have had people that were walking, talking, completely coherent come in for suicidal ideations (as a precaution we always take a breathalyzer) this person blew a .247.... umm i would be in a coma. It's actually kind of amazing, and I am kind of impressed (in a very perverse way) that this person wasn't even remotely acting drunk or tipsy.  Incredible.  Just another day. I know I post the sad stuff a lot, it's the stuff that affects me the most. I'm just letting it out.  We have lots of very run of the mill and normal ER things like headaches, chest pains, phantom abdominal pains, broken fingers and toes and the like.  But we also see a lot of stuff a lot places don't see.  Did you know my hospital services over 44,000 square MILES?! that's bigger than the entire state of West Virginia.  Holy cow!

We also ran a mock mass casualty drill.  I got to be the person that stickered and braceleted the incoming wounded.  I think I did pretty okay. Now I get to help with updating the current protocol.  That should look pretty nifty on my resume, helped to reform our Community Medical Emergency protocol! I think at least it will. 

  

I now have 3 days of rest until I get back to it! The weather is starting to break, and the sun should be back soon! I haven't heard when I will be heading to Anchorage for a month. Perhaps I will know as soon as next week... but I'm betting that I won't know until about 24-48 hours before I'm supposed to be on the plane out of town. Seems pretty par for the course ;) 

Here are some pictures from the last few days. The clouds here are pretty incredible. and the pictures just look like paintings. I also want to give a shout out to my wonderful Jack! Thank you for the HUGE puzzle and the typed letter! I also got a package from my mom and grandma! I opened it in front of my friend Emily and she said I was so lucky to get such a yummy care package!! Thank you all so much! Well I suppose I will go to the gym now and get that over with.  I love you all!

The headwall coming in from Russia Sunday evening. Snow showers the past few days.

A view of the Bering Sea from the hospital. The clouds are starting to roll away.  

Brought to you from the Bering Tea! Homemade cinnamon roll with homemade frosting! YUM!

Cause really, why not? 

Until next time lovelies!

I like this place and could willingly waste my time in it. - William Shakespeare

Here is what the absolute middle of nowhere looks like. There is absolutely zero cell phone service and not a tower, another car, or another group of people in sight.  These pictures were taken on the Nome-Teller Hwy out of Nome and towards the village of Teller.  We only drove about 22 miles outside of town, but the Teller Hwy is about 80 miles long.  Perhaps next weekend we will drive all the way there!  

The pavement ended at about mile 6.  This is looking back towards Nome

The water was so still when it froze it froze blue.  This is still a frozen creek, it is naturally this blue! STUNNING!

Mountains outside of town

My best gun show in front of frozen Cripple creek.

Me and Emily! Yet it was air temp of 33... but the sun is so intense that we weren't cold at all! (Yes we did have winter clothes with us... always be prepared!)

For every dark night, there’s a brighter day. - Tupac Shakur

Clouds, the horizon and the sea ice

So sorry for the long delay in checking in! If I wasn't working on the floor I was in class renewing my Pediatric Advanced Life Support certification.  I was pretty glad I retook the course because we got one VERY sick kiddo soon after my class had ended.  2 months old and working REAL hard to breathe. We didn't have to intubate the little one, but it came real close.  After you intubate someone you have pretty much run out of ventilation options, so we hung real tight and watched this little ones sats real close and waited to see if the nebulizer treatments and humidified air going through the nasal cannula would be enough until the flight team from Anchorage could get to Nome.  This little kiddo came from a village and wasn't handling altitude well so they stopped in Nome to re-stabilize and have the flight crew from Anchorage with their nifty kiddo carrier (helps with keeping them oxygenated at altitude) come to Nome to pick him up and take him back to the big city.  Don't know if the kiddo made it to Anchorage, but I would like to think they did and that our little ER helped to save a life. Other than the sick kiddo we had LOTS of drunk ladies, and good old abdominal pain.

When I'm working and going to training classes I feel very comfortable here. It's the 3 days off in a row that I have a hard time with.  My life seems to be on pause/slow-motion whilst I watch everyone else getting married, starting new relationships, ending old ones, having kids, first stages of pregnancy, all these big life events. I'm just hangin tough at the edge of nowhere watching from the outside. Pros and cons to everything though.

This was yesterday (5/3), and the moon was all pink!

Let's see today we are at 17 hours and 21 minutes for the length of our day... we have 19 hours and 57 minutes of visible daylight... SOON there will be 24 hours of visible light.  This should be cool. Especially because I have finally given in and blacked out the windows in my bedroom.  You call them black hefty trash bags... I call them make shift curtains. And they are AWESOME at making my room dark.  I'm now actually sleeping soundly again.  The sun doesn't go down until around midnight and it rises around 5 in the morning. And I get to see this out my kitchen window when I wake up early for work:

Thursday morning over the still
frozen Bering Sea

 I got back to the Post Office this week.  Got another awesome package from my favorite uncle and aunt! I will have plenty of puzzles and sodoku for weeks now! THANK YOU!! I also got in a whole bunch of boxes that I had forgotten I was going to be getting.  You see in bush AK we don't have 2-day shipping all shipping is roughly 3-4 weeks.  So I bought my shampoo and conditioner body wash, etc. and promptly forgot about all the cool lady stuff I had gotten.  UNTIL TUESDAY:

It's like Christmas!!!! 

 I also received snail mail from my wonderful friend Lindy! I needed this card more than ever. I totally teared up when I got it. I love you Lindy-loo!  

I am headed to the rec center for some much needed gym time, and then off for a drive with Emily! Going to see how far the road is open in any direction we choose!  Then to the "Soup-er" Bowl... It's like a chili cook off only with soup.. here's hoping I don't get food poisoning.. and if I do at least I got an in at the hospital ;) If I get any cool pictures from my drive today I will be sure to post them! Take care everyone! 

Thank you all for your emails, texts, and facebook messages sending me your well wishes after my homesick post. It's incredible to know that I have so many souls to hold me up when my wings get wet. Thank you all so much! I love you all! 

I get homesick - Larry Bird

Mt. McKinley

Somewhere NW of Anchorage. I LOVE this picture

While I am making some pretty incredible friends here in Nome and continuing my awesome friendship with my original Nomie I was so so overcome with wanting to go back to Denver today I almost couldn't get on the plane to come back to Nome. I cried in the airport and on the plane.  I miss all the luxuries in life that cities have to offer, I miss driving a car and cranking the music and singing at the top of my lungs, or how much a place of refuge it can be. I wanted to see my friends in Denver again.. desperately.  I wanted to play in the sunshine and climb mountains, and be warm with my friends! I called my friend Emily who is in Nome and she talked me down. She wisely pointed out that I haven't been in Nome long enough to experience the charms that make people stay for years, and raise kids here. I haven't been able to see open water from the shore yet, or the midnight sun, or going 4-wheeling at 2am when it's still bright outside. While Nome doesn't have big city luxuries it does have some serious small town charm.  Getting on a plane where everyone knows everyone, the flight attendants know regulars by name. Walking down front street you know people! Emily and I were in the post office and between the two of us we knew everyone there! That doesn't happen in big cities usually.  Our ER docs bring shotguns to work because they want to show it off to everyone... this DEFINITELY  doesn't happen anywhere else! The best analogy I have heard is Nome is like a neighborhood you just can't physically leave unless you get on a plane.  And hey.. neighborhoods can be pretty nice :)  Here are some pictures from the plane ride to and from Anchorage.  It's like they are paintings. The landscape here is absolutely breathtaking.

 There is no need to worry. I am just adjusting (slowly... but it's forward progress).  It's just going to take some time. Until then I'm gonna ride my ATV and take pictures of cool stuff.  I'm getting together with a group from the hospital that skis in the mountains outside of town and will hopefully be skiing again Saturday!

Me and Jesse going for a ride! 

Ha! Happy Nurse Sara! 

Tomorrow is a new day, and a new day brings new beginnings, and a better outlook than today.  I am excited to be in Nome, and I will make the best of it. Homesickness be damned!

Take care lovelies! Talk again soon!

  

With the new day comes new strength and thoughts - Eleanor Roosevelt

YUMMERS!

I just wanted to give a shout out to my FAVORITE uncle (my only uncle), for sending me two glorious care packages.  I will no doubt be on a sugar high for the next few weeks! Haha I am rounding through my third 12-hour shift in a row, and by tonight I will be completely exhausted. I head to Anchorage (The Big City!) tomorrow morning, and will ski one last day at Alyeska, the ski resort just outside of town (this is their closing weekend).  

Mail is here! Hehehe just bungee the boxes to the racks and I was ready to come home from the post office

I probably won't get back to update until Sunday.  The last few days have been interesting.  

The only thing I will say about the patients that I have seen so far this week is that domestic violence is terrible.  And even in a little town like Nome you will never escape the threat of it.  I just hope this person finds the means inside to stay away from the person hurting them. But being in such a small town there isn't anywhere to really run to.  I hope they heard me when I told them that the ER is a safe place to come should they find themselves in that situation again.  Big city problems? Sounds like people problems; and sometimes, people suck. 

Time to slam down some oatmeal and hot tea and run out the door! 9a-9p is the shift today! 

Take care lovelies!

If you get up one more time than you fall you will make it through - Chinese Proverb

So this happened since we all last met:

2007 Can-Am 650 (I went native with the color... CAMO!) with winch, mudding tires, front and back racks. It's pretty rad :)

I picked her up today, and it feels good to have wheels again! Because my bank is in Seattle, and I couldn't get a cashiers check ASAP, the family I bought this from held onto it until my check cleared.  Now I have exciting things to do for the next three days that I am off.  My schedule seems to be close to 2 days on 3 days off. Although next week I work 3 days on and then have 3 days off. So I guess I'm just at the mercy of the scheduling Gods.  Don't worry kids! I will be purchasing a full face helmet in the very near future! Until then it's sticking to the main roads in town.  I love that this is a 100% legit mode of transportation up here.

Nome is a town of some very interesting characters. Ha. Understatement of the century! I love my job  because I meet so many different people with so many different backgrounds. Everyone from Natives whose families have lived here for literally hundreds of thousands of years, to the town clerk who is a city boy from New York, hates his life here because he doesn't really like the outdoors (what on Gods white earth would possess someone like that to come out here?!). Hearing everyone's stories is fascinating.  Speaking of interesting characters. my friend and I were walking out of the post office and spotted this tremendous hood ornament:

Whale vertebrae. Because why not?

There is also a man in town who has a pet reindeer. He loads him into the bed of his truck and drives him around town.  I will get a picture of this sooner or later.

So Thursday we saw about 30 patients in the fast track, Friday we only saw about 10. (Fast track is where non-emergent cases go, it's open from 9a-7p, and those working there will see anything from a follow up, to re-bandaging, cleaning wounds, headaches, RSV and flu testing, etc.  It's like a cross between a primary care doc and urgent care... Yes this crowd doesn't necessarily know how to use an ER in the sense of how big cities would use an ER.  What is cool is that you never really know what is going to come walking through the door.) So not a lot of excitement this week. Just got too see what happens when you don't treat a strep rash on the hands... an entire family will get it, and a poor soul will have to have their hands wrapped up in mittens of kerlex to keep all the pustules from bursting EVERYWHERE. It was so gross. I gave away the pen I used to document that case right to the trash can gods and never thought twice about it.

Here is a palate cleaner after that mental image: http://www.youtube.com/watch?v=J11uu8L8FTY
(You are welcome)

So the sun is shining and I'm going to go gallivanting around the tundra side, and perhaps see how far the road is open to the east.  High today is 36.... 36!!!!!!!!!!!!!! So I may as well enjoy the warmest day of the year! After I go to the gym and run my intervals and make my arms hurt from lifting those weights.  Just because I live around bears doesn't mean I need to look like one :)

Oh I forgot one more picture.  This is of the flight schedule for the the docs and what villages they are going to.  Diomede is a teeny tiny island about 20 miles from Russia .. you can most certainly see it from your backyard there. Anyways the runway there is on the ocean. So when the ice gets gross and cracks, there is no longer a runway... meaning no more plane access until the ocean freezes up next fall/winter.  There is a blackhawk helo that makes runs there once a week when the runway goes away.

Take care lovelies! Adventure waits for no one!

Time is the longest distance between two places - Tennessee Williams

I took this picture right after the last real post I wrote about it being a snowy day.  It's all sunshine and severe clear here today

Today marks the last of my three day weekend.  I have found that my one puzzle I brought lasted for about 2 hours, I go to the gym a lot, and walk around town a lot.  I don't have much to do. So I think a lot about what I left behind, and what awaits me when I return.  It was weird to watch the TV and see what had happened in Boston.  It sounds weird and feels horrible to say but being so far away it was  as if it happened in another country, on another planet! It was and is a horrible tragedy in every way, but up here people didn't much talk about it.  They talked about hunting and kiddos and life... their blissful small town lives.  There is a lot to be learned from that I think. It wasn't that the community ignored the news, they acknowledged that something terrible had happened, but in the next breath it was on to the next thing. It is kind of refreshing.  I am sitting here drinking my tea and watching the Today Show and all they can talk about is this tragedy, how these pressure cooker bombs were made... if nothing else the people in Nome are probably more worried about the government taking away their crock pots than anything else.  Life runs at a much different pace here. After 10 days or so at this pace I find it very hard to relate. I see everything that is happening on facebook, and the news, and from talking to my friends in the lower 48 and I feel like my life is just standing still. I am in this weird time warp; and the rest of the world is just whipping around at a million miles an hour.  My god I need a hobby stat because I'm thinking like this and it's been only 10 days!

The good news is today I am going to look at an ATV that is for sale!  Perhaps by the weekend I will have a mode of transportation that isn't just my feet!  I will be sure to post a pic of my sweet new ride! (Yes it will probably be camo.... when in Nome!).  They are starting to clear the roads outside of town.  Yes they are dirt.  I met an awesome girl from VA here. She is a new ER nurse like me, and will also be here for 2 years.  Seems like a lot of people either run away from things up here or just wanted an adventure.   So my friend and I are going to be studying how to properly triage folks at the Bering Tea... it's like Starbucks, except that it's not at all.  But they have hot soups, and home made baked goods (Which all of those things would make Starbucks just SOOO much better!)

My god that blue sky! It's not like Starbucks because it's closed on Sundays, and after 2pm all the other days of the week. But what if I want Reindeer Vegetable soup on a Sunday?!?!? (That is what they are serving today. Don't mind if I do!)

 I went to dinner with one of my original Nomies Monday and we enjoyed our $35 pizza (yeah this meal doesn't happen all that often, and this was a cheaper pizza on the menu!). We then went on a drive to the other side of the mountain into a little teeny town of Dexter (note this was a 5-10 minute drive outside of town).  This is what we saw when we came around the corner:

Taken at 1045pm

If that face was fully covered in snow I would probably ski right on down it... Next winter! And don't worry there are numerous insane people like me here that like to skin up the sides of mountains and slide down them and then repeat :)  So I won't be doing this alone by any means.

On our way out of town we stopped at another friends place, this guy was a riot! I met his two little girls, and also go to see his very impressive gun rack:

There is a third rifle hanging from the left antler.  He said this was the biggest moose he had ever seen.

I want this to be known about this community, and about most of the native villages and bush towns in Alaska.  People don't hunt animals here just for a nice rack to mount, or skins to make a rug out of.  These people rely on these kills to give them food for the entire year.  A village called Savoonga on St. Lawrence Island off the coast of Nome just harpooned a Bow Whale, and the entire village will be get meat from this kill.  It is extremely important to know that every single piece of every animal that is killed is used. From the fur, to the meat, to the bones. Nothing goes to waste. ::::::: steps off soap box :::::::::

So fingers crossed this ATV works out this evening!  Also I was just voicing my feelings earlier, I'm doing great, I'm making friends, just have to get used to the speed of life here. It takes time, and soon enough I will be running on bush AK time just like the rest of them ;)

I leave you with the receipt from me purchasing a HALF a gallon of milk yesterday.  Yup that is most certainly $5.99.  Makes your milk seem pretty cheap eh?

I work the next two days so perhaps I will check in on Saturday or Sunday! Until then lovelies!