Your Mouth is Not a Pocket

Where in the world are we?

Well we've left Nome.

We've left Maui.

But we're not at home in Atlanta.

No, we're back in the greater (and I use the term "greater" loosely) Portland area.

I really, really like Portland - after all what's not to like about a city that is home to Powell's Books (Think four stories of literary goodness)?

I do NOT, however, like Vancouver, WA.

Vancouver, WA is to Portland, OR what leprosy is to an intelligent beauty queen.

It detracts from the overall greatness.

Without the parasite of Vancouver, WA sucking the life out of it, Portland would be among the top cities in the world. With the greasy, grimy meth-heads of Vancouver defiling the greatness of Portland, Portland becomes that house you'd buy if you could just ignore the neighbour's dirty lawn fridge, cars on blocks and loud obnoxious parties.

I detest Vancouver.

A deep, almost primitive, hatred of the city of my wife's youth fills my very being. My soul cries when I enter Vancouver and rejoices with my departure.

I'd rather live in that God forsaken, rat trap of a so called city known as Bucuresti than Vancouver, Washington.

As you know we'll be moving from Atlanta as soon as absolutely possible and will, of course, probably end up in Vancouver.

Meh. As they say, in the instructions to that very silly game I am forced to play every freaking Christmas, "thems the berries".

We got into Portland yesterday morning after taking the red eye from Maui. Swell's Dad was kind enough to pick us up from the airport and drive us from the good side of the Colombia river to the wrong side and down past the stink that is Camas to the isolation that is Washougal, WA.

Let me tell you a thing or two about Washougal.

When Swell's folks first took us out to their new homestead the foundation for their home hadn't even been poured.

It was a desolate land.

Filled to the brim with deer and frogs.

Now five years later?

It is an overdeveloped wasteland that seems to be the epicenter for all that was wrong with mortgage lenders over the past few years.

Empty lots unable to be sold.

Homes that were built and purchased? Back up for sale.

More for sale than lived in.

The across the street neighbours from Swell's folks just up and left one day.

Bank notices are plastered on their front door.

They say something along the lines of "Ummmm.... would you pretty please drop by the bank to make arrangements to pay your missed mortgage payments. We fully realize that we shouldn't have qualified you for this overpriced home but we did and we'd really like our money."

The owners response?

Well like I said they left and took everything with them.

We wandered around Washoughal yesterday looking at all, the many, many, homes for sale.

1) Ugly
2) IN WASHOUGAL!!!
3) Poorly constructed.
4) Ugly and in Washougal.

Sorry folks-in-law not a chance.

Now that I've said all these bad things about Washougal let me assure you that Swell's parents have a very, very nice home.

With a great view.

And it suits them.

But not me.

But it is better than Vancouver.

Because its not Vancouver.

We have problems.

Big, big potentially life changing problems.

(Yes that means its new problems not my very many old problems - like living with the trauma of getting a pink bracelet when I was born, or having a grandmother who thought I was retarded for much of my childhood, or having to go to skating lessons rather than bowling lessons as an impressionable young lad.)

What problems could such fortunate people such as ourselves have?

How about we were told that we should return to Nome on April 14th?

How is that a problem?

Well we were told that before we left Nome. We were also told that we would know for how long we would return to Nome before our departure.

We were not told the length of our second trip prior to our departure.

That was over 3 weeks ago.

Since then we have heard nothing.

Zero.

Nada.

Not a thing.

At least the person we've been contracted through has finally been paid meaning we can finally get paid (as of yesterday).

Ummm... if we're supposed to go back in two weeks it would be very nice to:
A) Have a ticket
2) Know for how long we're staying and
iii) If this will be our last trip.

How is this life altering?

1) We don't have enough money to survive more than a couple of months (especially since April 15 is fast approaching and we have to write two five figure cheques)
2) We need to be able to buy our tickets to Romania this summer but don't know when we can leave making scheduling somewhat difficult.

Bastards.

In case anyone who has decision making power for our return is reading this - we are looking forward to coming back and working very, very hard. Please bring us back. I'll be nice. I'll even smile once in awhile. I'll try hard not to bite anyone again. And you get Swell if we come back. How is that not an incentive to hurry up and finalize things?

So Swell has finally clued in that I have An annoying habit. I hold things in my mouth. Driving through a toll booth or state park if I give someone money and they give me paper change I put it in my mouth and continue driving. Give me a pen - I'll hold it in my mouth. Give me a piece of paper and I need my hands, I'll use my mouth to carry the paper.

She has come up with a new slogan for me.

When she sees me do this she thinks its important and appropriate to shout: "YOUR MOUTH IS NOT A POCKET!"

Lame.

I fully intend to do a Maui post that is about how nice and fun it was rather than how nice and depressing it was.

I'll do it. Soon.

When I download my pictures.

One thing that needs to be told about Maui is that we learned a great lesson. When someone is nice and lets you stay with them, and plans things and gives you surprises and is very kind and fun to be around - DON'T TRUST THEM!

They are just doing it to take something that belongs to you.

G did the above things. She gave us a bed. She let us take over her home. She planned nice outings and surprises. She showed us all the cool things in Maui we wouldn't have done otherwise (1/2 price sushi, lavender farm, winery, swinging bridge and red-rocks-in-your-sandals hikes). She didn't even yell when Swell left the sugar out which bred millions of tiny little ants in her kitchen.

Why did she do and not do these things?

Solely to steal something.

Let it be known from this day forward that G in Maui is a thief.

Furthermore let it be known that we will not stand for this thievery.

We ask all of you to stand in solidarity with us while we fight for the return of who is rightfully ours. Do not talk, email, facebook, myspace or otherwise communicate with G until she renounces her evil and returns our property. If you are not with us you are against us and will face a similar, as yet to be determined, fate as G.

WE DEMAND THE RETURN OF THE HOSTAGE KNOWN AS SHEEPIE.



Return her safely or suffer our wrath G.


We know where Sticky lives.



We love you Sheepie we will not rest until your return.

One week

So we've been here in Maui for a week.

We have four more days to go.

We like it here.

We like the sun (although it often gives me a headache).

We like the beach (although I'm not much of a swimmer).

We like the atmosphere (although at times it is a little too laid back).

We don't much care for the guilt.

We're in a strange stage of life right now.

We're really unsure of what our next step should be. We know that we want to sell our Condo ASAP.

We know that we no longer want to live in Atlanta.

That stage of our lives is over.

It is time to move on but to where?

Seven years ago Swell was a beautiful fourth year optometry student. Being the very serious student she was she chose one of her practicum/externships in Maui.

Not because it was to be a terribly challenging externship. Not because she was dying to be an optometrist at the location she was to work at.

No she chose Maui for two reasons:
i) It is after all Maui and
b) She knew a girl.

Swell met a wonderful young woman at Pacific University who was from Maui. Her family was still there and this girl was going to return for summer break. Swell took advantage of this and soon had a free place to stay.

Optometry school has certain rules about how many hours who needed to work per week to receive academic credit for the externship.

Swell flirted heavily with the minimum.

While she was in Maui I was slaving away in the bustling metropolis of Chattanooga, Tennessee.

Now that is a long distance relationship.

We saw each other for a week that summer - at which time I proposed before leaving for another four months far, far apart.

All of that is an aside.

The important part of this story is that while apart from the love of her life Swell found two new loves.
A) Maui - it is after all Maui and
ii) The L family.

Swell lived with the L's that entire summer. K - the Dad - is a pastor at a church here on Maui. S - the Mum - owns a cleaning business. M - the daughter - was at that time an undergrad student at Pacific University and is now an optometric colleague of Swell and I. MK - the son - was then a young punk kid and is now married and in college in Oregon.

Swell was treated as a daughter. She ate with them, was included in their big family events of the summer and was loved on by this family.

It was arguably the best summer of her life.

After her departure from Maui we finished school and got married. The L's attended our graduation (despite having had a very early morning attending M's graduation from Undergrad). They also attended our wedding in which K played a role (one of three pastors at our wedding), M was a bridesmaid, and S made a beautiful flower arrangement under which we stood.

Life move on for both us and the L's.

Swell's other friend, G, was attending OT school in Tacoma, WA and happened to be renting a place from a Hawaiian Airlines pilot. She got a couple of guest passes from said Pilot and took Swell back to Maui for a week or so in the winter of 2003.

G. eventually did an externship of her own on Maui and then transitioned that into a full time job.

We visited her - and I made my first trip to the Island - after my first semester of public health school.

We had the privilege of doing a bunch of stuff while here and also spending a small amount of time with K and S at MK's wrestling tournament.

It was toward the end of that trip that I received a phone call from my Pa telling me that my Grandpa had passed away. A rotten way to end the trip but it was still a very nice trip and I began to realize just why and how much Swell loved the Island.

We continued to live life.

M was enrolled in optometry school in California and MK began undergrad in Oregon.

As a family the L's decided to take a once in a lifetime family trip following MK's first year at Undergrad and M's completion of optometry school.

They went to England, France, Italy and Greece.

We just happened to be doing our big Romania, Italy trip around the same time as there trip.

We just happened to be on the same no-name street as them at the same time as them in Florence.

A one-in-a-million happenstance.

We were able to coordinate schedules and spend an amazing few days with them in Rome and the Vatican.

It was great. They were kind to us. They were inviting. And importantly, for me - as someone who is disillusioned with the church -, they were real with us.

It was a great/beyond words time and we were blessed to have had that "coincidental meeting".

M found her way back to Maui and is now working various jobs as an optometrist here on the Island.

We came here to Maui this time to spend time with G and M and any of the other L's who had time for us.

We came expecting nothing from our trip other than time with people we care about and rest.

G made quite the schedule of activities for us.

One was a surprise.

It was a really great surprise.

On our first Saturday here we got to live as if we were rich.

G took us to the Grand Wailea - an extremely expensive resort where the rich and famous stay - where we sat in lounge chairs, swam in their cool pool and ocean, and ordered pool side food service.

It isn't that G is rich (at least in money - she is rich for knowing us) its that she knows people who can get us a day pass at the pool. It was a great time, although I came to learn that the new "spray on sunblock" sucks.

It was while on this "live like the rich" adventure that I began to read my book.

I purchased a no-brains-required novel that I finished on the flight to Maui but now I only had "The Irresistible Revolution" by Shane Claiborne to read.

Irony at its finest.

Here I was sitting in the lap of luxury with arguably some of the wealthiest people in the world reading about "living as an ordinary radical".

Shane writes about his life and his journey as a Christian. He is part of the "emerging church" - the Christian who doesn't identify with the Republican party. The Christian who doesn't find solace in large church buildings and material things.

I was reading about Shane and some friends packing their things up and heading to Calcutta to work with Mother Theresa.

The night before we had attended K's church.

We were beyond disappointed.

Huge.

New building.

Showy.

A let down.

Seeing that and then going to the Grand Wailea while both Swell and I are struggling to find our place in this world was difficult.

While we had great fun at the resort it created a little sense of guilt.

What were we doing here when we've done so little to improve the lives of others? We were again confronted with our opposition to but complete involvement in the materialism, over consumption of the Western world.

Our trip continued and as Swell and I hung out watching sunsets and seeing the beauty of the Island we began to be tempted by the idea of moving here. The oversupply of optometrists isn't as bad here as it is in the Pacific Northwest. There is a distinct lack of optometrists in certain parts of the Island.

We were also tempted because it is an easy thing to do.

Move to paradise.

Forget the troubles of the world.

We are isolated here.

Far from starvation and lack of clean water.

Far from the needy.

To ease the fears of those who want us closer to them I'll jump ahead.

Maui is not for us.

Swell still loves it here. I love that she loves it but we cannot live our lives surrounded by wealth. There is, of course, poverty here but to open a practice among the million dollar houses we would need to pursue wealth daily.

Our lives would become very limited. The Practice would become the end all and be all of our lives.

We're not ready for that.

So where does this leave us?

Back at the beginning.

Uncertain.

Confused.

Lost.

The L's invited us over for a really nice dinner. It was a delicious Bar-B-Que complete with chicken and steak.

K was feeling under the weather that day. He had been informed earlier that he was anemic and he was having some fun with his family.

"I've never been anything before! Now on those forms you have to fill out I can say Anemic? Why yes I was!"

"You better be nice to me, I'm anemic you never know how much time I have left."

Two days later he was diagnosed with an aggressive form of leukemia.

He starts 3 months of chemo on Monday.

He preached on Good Friday.

Swell and G after crying their way through the sermon (I was a rock...) came home and drank - heavily (well, put some alcohol on their ice cream - as a celebration of life).

I won't go into the sermon but it was good and meaningful.

K and the whole L family have a long road ahead of them. K will be on Oahu for the next 3 months and then in California for the 3 after that.

We have a few more days left here on our own and with the guilt we've (I've) been feeling and the witness the L's have been to us over the past 7 or 8years and K's sermon we have a lot to think about and a lot to decide.

Prayer from those who pray would be helpful both for K and for us.

Here's to bad news in Maui!

And to moving ahead with life while "sowing into other's lives".

Off again

So we're on our way.

Sitting in an airport once again.

This time we have 11 days of doing nothing to look forward to.

We're excited. In about 6 hours we'll land in Maui pick up our car and then we'll do whatever we want, whenever we want.

Not much has happened since we left Nome. We took care of some long overdue errands. We introduced Swell's parents to the Wii. I ran into my first love and gave her a hug.




We had difficulty connecting with people.

Swell got her hair did.

We slept well.

Swell ate a lot (Its interesting how everyone loves their Mum's cooking.)

A lot happened in our last week in Nome that we've neglected to write about. We'll get to it eventually. It was nothing groundbreaking it was just a week of work and hanging out.

Well we're on our way soon so I'll sign off with a Congratulations Lance Mackey! (Look it up)

Happy Happy

Happy Birthday BL The best oldest sis and sis-in-law a guy and gal could have.

Emphasis on oldest.

Shishmaref and beyond

I forgot to mention that when in Wales one can see mainland Russia off in the distance. The international date line is also very nearby.

After the long cold walk to the airport. We were soon on our way to the next village - Shishmaref.

This village was larger than Wales and we knew we were in for some busy times.

We flew on the same plane with the same pilot as took us to Wales.

The plane was still cold.

After a short flight we landed in Shishmaref and were soon on a much shorter walk to the clinic.

This time our clinic was located in the health center. It was a largish building with three exam rooms, a pharmacy, a front office and two - for lack of a better descriptor - storage rooms.

The health center is staffed solely by health aides. These are lay people trained to diagnose and treat basic conditions and refer up the chain for extra help. They basically follow algorithms to come up with diagnoses and treatment plans but have physicians, optometrists, pharmacists, dentists, audiologists, etc. available for consultation via fax, telephone, and tele-medicine.

The communities seem to love and trust their health aides.

Upon arrival we grabbed a quick bite to eat and were soon setting up.

The question was where could we set up? We had quite a bit of stuff and the clinic would still be seeing regular patients while we were there.

I asked where we could set up our main exam area and was told to set up in the room "to the left of the kitchen".

Now here is where Swell and I began to get a little angry.

Looking in the room "to the left of the kitchen" I soon realized that there was no way in the world that we could do anything in that room.

To put it bluntly I could barely fit in the room by myself let alone with equipment and a patient. This room was packed to the rafters with a combination of junk, dental equipment and supplies. (Dentists being who they are, are able to leave some of their big equipment in each village rather than lug it around - I'm talking patient chairs, exam chairs, lights, and the like). In addition to all of the stuff there were also file cabinets, a desk and a couple of book shelves.

No way, no how.

We decided forget it we'll set up wherever we like.

We set up in exam room 2, the main hall and a little hall off to the side.

It was not ideal.

Not ideal at all.

The optician set up in a little room to the right of the kitchen - and she wasn't happy about it.

We did the best we could to clear it out but she ended up using our big Tupperware boxes as tables and sitting in an office chair with a drug dispensing table as a desk. Not only was she cramped and uncomfortable she was way in the back of the building with no phone. This meant that patients we unsure of what to do and where to go and she was running back and forth between the office (where she was calling people to set up appointments) and the optical where she would help people with their glasses.

This really didn't work well so the next morning I, without asking, moved her to the front reception area of the building. It worked out much better and we didn't seem to be in the way of the clinic staff.

Swell and I had it tough. I did half of my part of the exam in a little hallway beside her room and the other half in the same room as her. She did her first bit in the main hallway and then the rest of it in the exam room.

It was crowded and unfortunate.

I was finding prescriptions in a way too short hallway with a chart that was a bit out of focus. It was not fun.

When we asked where they usually set up nobody really seemed to know or care. Eventually a patient indicated that they thought in the past that they eye exams occurred completely in the room Swell was in.

I really can't see how that worked but we made do.

And hopefully people's glasses work.

We dealt with a lot of minor disease issues and made a number of referrals both to Anchorage and to ourselves when we come back - we need to so some special testing on some kids and adults that we couldn't do while there.

Here are some pictures of our wonderful examination areas:

The Big E - for the optometrists out there, yes it was only 10 feet away. Yes it was out of focus. Yes I should be killed in my sleep.




New and improved glasses area:


We worked until 9:30 that night. We were happy that they had a TV in the clinic and we watched a little bit while having a midnight snack and unwinding then it was off to the least comfortable sleep ever.

Swell had an air mattress, the optician/assistant had a pull out bed, I had a little mat that they use for medi-vac patients. I was basically sleeping on the floor.

Ouch my back.

The next morning we were up and working by 8:30 and would end a little after 9 pm. It was on this day that we learned that the itineraries we were given were not, shall we say, accurate.

We would not be leaving Friday afternoon, rather we would be working a full day on Friday and leaving "sometime" on Saturday.

Great. Just great.

We were happy that there was a fairly big grocery store in the village although things were extremely expensive. Beyond expensive. We thought Nome was expensive this stuff was nearly twice as much as it is there. I guess thats what happens when you need to fly stuff in.



It was a neat village. Very hilly. Very snowy. Not terribly cold most days.




Beautiful sunrises.


Cute kids wearing wolverine jackets


Dogsleds




Antler Roofs


Rusty Gas Pumps (???)


We worked hard that day and all day Friday - from 8 am until 10 pm on Friday.

We were tired.


I think we did alright work. That will remain to be seen when others look at our charts though. It was hard. It was tiring. My back will never be the same both because of the sleeping arrangements and the awkward position I stood in for a week doing eye exams.

We eventually left not getting back to Nome until Saturday afternoon around 3 pm.

We flew to Nome via three other villages in the wind and ice. It was scary.

Icy Runways




Beautiful views


All in all a good trip.

What's going on?

In the last two days I've examined two patients who were wearing handcuffs and accompanied by an armed guard. I get to see one of them again today.

I just had a little 3 year old girl who I could not examine. Remember I used to teach how to examine kids. I've examined severely retarded individuals, autistic kids, I've been hit and kicked. I've sat on the floor to examine kids. I've sung, jumped up and down, whistled and made silly faces. Never before have I had a problem.

This kid from the moment she walked into the room until the moment I told her Ma that we'd have to reschedule clenched her eyes shut or covered them with her hands. She yelled and screamed. In the fleeting seconds that she wasn't doing this I was able to do about half of the exam. The other half? There was no way.

I hate kids.

Its not a town. Its a village.

Preamble: This is attempt two at this post. This time with functioning pictures?

The week that was, was the week that was.

Difficult.

Professionally.

Personally.

Psychologically.

Physically.

The best way to explain these difficulties is to simply tell you our week. Our week in rural Alaska.

But before we discuss our week in the villages I should go back and post some long promised pictures from our first week in Nome.

This is the entrance we use every morning we are in Nome to get to our offices:


Swell meets a friend named Velvet. (What’s with us seeing animals in the backs of cars?)


One of our views. (Ignore the shadow on the right corner. Somehow I jacked my camera up. I’ll need to get that fixed when we’re in Washington).


Our gourmet kitchen.



Eskimo Dancing



Sunset over the Bering Sea





The most beautiful girl in the world




Late last week we received our travel itinerary for village week. We were to leave via Bering Air on Monday around 10 in the morning and return on Friday February 29 in the late afternoon. Being the ignorant Southern 48ers we are we packed according to this itinerary.

When we flew up here from Atlanta we packed in two large suitcases and a duffel bag. I didn’t think that the large suitcases would make for appropriate village travel luggage so we squeezed our weeks worth of clothes into the duffel bag and Swell’s small backpack. My backpack is suitable only for my camera and a computer so all of our belongings were relegated to the aforementioned duffel and backpack. We were also required to bring our sleeping bags and most importantly food and water for a week.

We were graciously lent the clinic’s cooler for our food.

In case you didn’t realize – it was extremely difficult to accomplish this packing feat.

We were able to shove and squeeze everything into our allotted luggage but were forced to cut some clothes and shove some food into the duffel.

We were set.

But not prepared.

In the midst of our packing we were asked to go to one of the hospital’s big-wigs home for pizza.

A nice late welcome?

Nah, we were going to the “lets-convince-a-yet-to-be-graduated-OD-to-move-to-Nome” meet the staff dinner.

Funny enough only one of three staff members made it to the dinner but both Swell and I made it.

We actually left Nome and headed to the bustling Nome suburb of Icy View.

While I was packing a thought popped into my head, I thought; “Self the name of this optometrist they’re trying to convince to come here seems so familiar. Where do I know that name from?”

And then it dawned on me.

A number of years ago I wrote this person an unsolicited email.

Why would I do that?

Because I’m an ass.

This person wrote a plea on the internet for connections to plan a trip to Belize for an optometric mission. I had just done a case study on eye care in Belize in Public Health school so I wrote this person what I thought about eye care missions and that they should contact one of two groups – the Ministry of Health or a non-governmental organization working on eye care in Belize – if they decided to go forward with an inappropriate mission. (My email was worded nicely and there is good reason to discourage foreign eye care in Belize – the good reason is that optometry is developing along a very public health path in Belize and should be aided before foreigners run in and throw glasses at the people).

Surprisingly I never heard back from this person but learned later via other sources that they did contact and work with the NGO I suggested.

The pizza party was good. We visited with the potential OD and encouraged them to seriously consider coming up here all the while wondering why we were never given the sales pitch they were giving this person.

I suppose we weren’t given the sales pitch because we never expressed any interest in staying here more full time. On Monday and Tuesday while we were slaving away in the villages the potential employee was being interviewed, given tours, and told about the potential for loan forgiveness through Indian Health Services.

I could sure use some loan forgiveness.

Monday morning eventually rolled around and we were soon ready to head to the airport.

In order to save space in our luggage we both got dressed with long underwear, jeans, ski pants, boots, undershirts, thermal shirts, jackets, toques, gloves and anything else we could think of.

I called for a cab thinking that it would give us another 15 minutes or so to finish getting dressed. Upon calling the cab company I was told “We’re on the way.”

No lie 1 minute later the cab pulled up to our door.

We threw our boots on ran out and were soon on our way to the Nome “airport”.

“Airport” because it’s actually one runway and every airline has its own little terminal building.

The cab drivers act as their own dispatchers. We heard a funny exchange between the cabbie and a potential passenger.

Cabbie Checker Cab
Woman’s voice Can you come and get me at X hotel?
Cabbie Where to?
Woman’s voice The hospital
Cabbie Ok. I’ll be there soon.

Two minutes later
Cabbie Checker Cab
Woman’s voice Are you coming to get me from X hotel?
Cabbie I’m on my way. (by this time we were fully loaded with passengers – the cab is a van and it picks up multiple fares and makes up the most efficient route to pick up/drop off fares – and on our way to the airport which is a little way out of town).
Woman’s voice I’m having some chest pains and I need to get to the hospital
Cabbie I’m on my way to the airport so you should call the hospital and ask them to send the ambulance
Man’s voice – apparently another cabbie listening in Call 911
Woman’s voice I’ll be waiting outside
Cabbie – shaking head Ok. We’re on the way.

We arrived a little early and had to sit and wait to check-in. I suppose we didn’t have to wait but Swell wanted to wait until our optician/assistant arrived at the “airport” and all check in together.

We waited. And waited. And waited.

Eventually the front desk people told us we needed to check-in. As our concern grew that we were being stood up and wouldn’t be able to function on our own the optician/assistant arrived.
As part of the check in process you are required to give your weight and weigh every item that will be carried onto the plane.

That should tell you something about the size of the plane we flew on.




Soon some kid who looked about 12 years old with some five o’clock shadow walked into the waiting area and said “Brevig/Wales”. We followed him out the door onto the tarmac and onto the plane.



We were flying in a plane called a caravan. It seems to be a true bush plane. Being able to be transformed to carry people or goods or some combination of both.

Once on the plane both Swell and I were very grateful that our small luggage forced us to dress in all of our warm clothes. Soon after putting on my seatbelt I realized that not only was it chilly on the plane but I could see my breath.

I was slightly shocked when the 12 year old guy who walked us out to the plane got in the pilot’s seat and strapped in.

It was going to be a long plane ride.

We flew to Wales via another small village where we dropped some people and goods off. Soon we were approaching “windy Wales”.

Upon arrival we hopped off the plane and started the long walk to the village school where we would spend the next two days and nights. I carried my backpack, a sleeping bag, and Swell’s pillow while she carried her backpack and a sleeping bag.

It was cold and I’ve been cold before. I mean cold, cold not just regular cold. We walked, and walked, and walked. At one point the “snow machine” (aka snowmobile) that was our luggage cart came by with the second half of our luggage and picked up the optician. Swell and I continued to walk and walk. Eventually the snow machine picked us up. Swell sat behind the driver and I sat on the sled behind it hanging on for dear life with my backpack weighing me down and the sleeping bag slipping from my grasp.

Fun?

Ummmm…no.

We got to the school and immediately started to unpack and set up. The optician/assistant also began to man the phones phoning those who had signed up for an exam to set up an appointment for them.
We were a little shocked by the room we were given to work in. It was basically a large storage room. We did our best to set up in a way that would be at least somewhat functional while being clinically appropriate.

Our exam room




View through phoropter (prescription checker)


We began seeing patients at around 11:30 and finished for the night around 8pm.

We saw a lot of kids but also many adults. Everyone was very grateful that we were there and were very friendly. It had been a couple of years since a Norton Sound Health Corporation eye team had been to Wales but there are a couple of private outfits that fly to villages to do eye exam and sell glasses. The bad thing is that they don’t do follow up care or report to Norton sound. While it’s not necessary to share findings Norton sound provides the rest of these patient’s healthcare so it would be nice to have complete charts.

Just another little problem in the provision of care to those in rural areas.

Toward the end of the day I was met with the best of all news.

Every evening the school gym was open for people to play basketball.

For much of the evening a little store was also open that sold soda and candy.

Much to my excitement not only did they sell Dr. Pepper it was actually quite cheap – only 75 cents per can.

I was ecstatic.

The work was difficult. We were busy. Our equipment left much to be desired. Many of the folks had difficult problems that we were unable to completely deal with. We were not sure how to refer, where to refer, or when to refer.

Again, a manual – policies and procedures – would have come in handy.

The big excitement in town was that there was a Polar Bear spotted in town recently. We were told not to venture outside – not that we had time to – and the children were told to walk on the town side of the school rather than the water side.

Wales is a very small village with less than 200 inhabitants. The post office was closed while we were there as the post master was at a conference.

The school has five or six classes which are not grades per se; rather the children are grouped according to “level”. If you reach one level you’re geared for general life. If you want to go to college or trade school you have to reach the final level.

From the papers posted on various bulletin boards it seems that the kids are quite bright and well taught.

We met one teacher who is originally from Oklahoma and has been teaching in this little village for 10 years now. She mentioned that most of the staff had been at the school for years now.

Very impressive if you ask me. Important for the kids’ education as well. Continuity is important.

We met one girl who wants to go to optometry school – or not. It said in her chart under occupation “future optometrist” so we talked to her about it. Like most people she didn’t realize that it was a post-grad degree so we’re not sure if she’s in it for the long haul. We gave her Swell’s email address and have already communicated via email about optometry school.

As we prepared for bed we realized two things:
1) We would be sleeping in a classroom – the younger kindergarten age kids’ room and
2) There were others sleeping in other classrooms.

We’re not entirely sure how many people were spending the night in the school but I think there were three groups in total – us, some folks working on the schools plumbing issues (?? – An interesting plumbing side note in both villages we stayed in they had indoor washrooms for us but both contained signs bearing the clever albeit off colour saying If its yellow let it mellow. If its brown flush it down. In Wales the bathrooms also bore signs indicating that they were only to be used during school hours due to “freezing pipes”. That made for some long nights. Nah, we ignored that sign and some ignored the latter part of the first…if you get my drift.) The third group was a couple of young guys – Glaciologists – from the University of Alaska doing some research on the sea ice. I’m sure their conclusions will not bode well for humankind. They were nice although a little disappointed by our presence. Apparently the storage room/eye exam room is also the Glaciologist’s equipment cleaning room and we were in their space all day.

Our beds were grand.



But our sleep was not sound.

The next day started with a wonderful breakfast of water and a granola bar. We were both tired and my back was sore (and still is). Despite that we worked.

From 8:30 am until 9:00 pm.

Four patients an hour (with two ~45 minute breaks for lunch and dinner).

We each shared the patients and a routine that would carry through the week was developed. Swell would start the patients and I would finish with them. I think Swell had it harder, she thinks I had it harder. I guess that means we found a good balance.

Looking out the unfortunately placed (for an eye exam lane) window one could see why the village is called “Windy Wales”. It looked absolutely miserable out.


We were glad to be indoors in the too light exam room during the day and too dark exam room during the early morning and night. Swell was struck with the realization (and I’ll avoid using this opportunity to say I told you so) that she in fact did not need the heavy sweaters and pants that she packed as – surprise, surprise – they actually had good heat in the school. She was sweating like a pig. Ha!

The day was uneventful, although our last patient before dinner spent quite a bit of time talking to us about the changes he has seen in Wales. Mentioning that usually by this time of the year they have seen 8 or 9 Polar Bears but this year just one. He mentioned that the weather has changed drastically in the past number of years. He didn’t say why he thought these things have happened. Perhaps global warming we pondered, perhaps just a regular weather cycle. He didn’t know. We couldn’t offer an explanation but it was an interesting ten minutes learning about life in Wales.

Yet another life experience I couldn’t ever have imagined having: standing in a school hallway talking to an Eskimo about life in a tiny village in rural Alaska.

We went to bed that night knowing that this was our last night in Wales. We would wake up the next morning and work for a few hours and then pack up and fly out to Shishmaref.

That night Swell was shown the shower.

There was a shower (limited to a total of 2 minutes).

She states that it was so powerful that one couldn’t stay more than two minutes even if one wanted to.

I turned down the shower.

I’m a man’s man.

Stinky.

The next morning we woke up and started working again.

We worked.

We ate our PB and J for lunch.

I packed up the equipment while Swell walked to the only open store. It turned out to only be a grocery store. She was hoping for a hand made goods store.

We had opportunity to buy things made locally.

The first things one of the patients brought was beautiful. It was an Ivory carving of little Eskimo guys dancing.

It was $750.

We said no.

We also said no to the $150 crafts and the $85 ones. Well, we said no to everything.

Far too rich for our blood.

We decided that it would be fun to walk to the "airport" to take some pictures.

It was sooooo cold. Colder than the first day. The coldest I've ever been.

Some pictures of our walk to the airport as taken by two frozen cameras.









Yes I'm stupid. Yes its on upside down. My excuse - I didn't put it on until outside and my fingers were freezing.



Next installment

Home

We're home in Nome. A day later than expected. Will post more (a lot?) later.

Miss us?

We're in Wales.

Look it up on a map.

We're exhausted but have much more to do today.

Have sporadic contact with my three loves:

Swell
Dr. Pepper
Internet

Leave tomorrow.

Will probably lose contact with two of my three loves.

We'll see.

Back in Nome on Saturday (Friday night actually).

Will write more then.

Haven't missed us I see.

The Bread is Fresh...

So we're at the endish of our first week. It has been extremely challenging on many fronts.

First the good:
It has been awesome to be here with Swell. We don't see a tonne of each other during work but its nice to get home at a decent time 5:30-6:00 and sit and watch TV or DVDs together.

On Wednesday we were invited to go to the local Catholic Church where some Eskimo folks were "practicing their dancing". We weren't entirely sure what that meant but after arrving realized that we were experiencing one of the coolest things I've experienced in my life. It ranks up their with sitting on a roof top in Palestine listening to some locals play music (in '99). It also ranks with when I was sitting in the back of a truck in rural Honduras zipping along listening to the frogs croaking. On Wednesday we sat in this Catholic church and listened to three men play traditonal drums and sing. Whenever anyone felt like it they would jump up and do a dance associated with the song being played. What I found most interesting is that there were many young people there (12-14 years old) and would at times be the only person dancing. It was actually (for this bleeding heart) a very moving experience and one that I won't soon forget. I'll try to put some pictures up but that will require going to the pizza place and spending a bunch of money on lunch or dinner (this Sunday or tomorrow for dinner).

The patients here are very challenging. They people are beyond nice but they are a sick/old population (the ones we're seeing this week any way - remember that they are all diabetics this week). The previous optometrist was meticulous in her note taking and I would argue extremely conservative in her treatment plans. Swell and I, having worked in the worst of all situations, are far less likely to call something a problem. It makes it difficult to reconcile our findings with the previous optometrists. We were astounded by how much the previous optometrist did but have come to find out she was really only doing one exam an hour. We will be doing at least 2 an hour each.

The negatives are just things we have to learn to live with.

A lack of communication is a big one. There is no one "in charge" of optometry here. No one really seems to know how things work. There is no policy and procedures manual. We are going out to villages all next week and were told to make sure we had all the necessary equipment ready. Most of it was already packed away but we really don't know what we need as we've never done this before. If I were ruler of the world I would make a manual that states bring this and that for every village trip. No such manual exists. This wouldn't normally be a problem because there were two optometrists here but because both quit there is no senior OD here to guide the Jr. ODs (us).

In the villages we really only have enough equipment to be doing one exam at a time. We'll have to figure out a way around this.

We have to bring our own food and water to the villages. We only have one duffel bag and then a tourist style suitcase. We can bring as much luggage as we want but I don't think a four wheeled suitcase is going to work well in a small rural village.

Because they are without an optometrist we are pushing a lot of "special testing" off. Many of the charts have the notation to do a visual fields in a year, or photos, or someother non-regular testing. Well, a year is up but we can't really do this extra testing as we don't have the time. We tell them to come back in a couple of months and hopefully we will be here and able to do it or they will have hired someone.

A yet to graduate optometrist is coming by sometime this week or next to tour the facilities. They hope to hire this new grad. I couldn't have done this work right out of school but I hope that this new grad is willing because they really need someone.

Well thats that. We haven't been overwhelmingly busy because a couple of villages were snowed in and the folks couldn't make it into Nome.

I should explain that there are medics in many of the villages (these are well trained lay people who are able to prescribe some medications and take care of minor issues). They can also communicate with providers in the hospital and send pictures and questions for guidance. (Telemedicine at its finest).

Once in a while a specialist comes to Nome and all those requiring help from said specialist come into town to be seen. Physicians also travel to the villages on some set schedule.

It is a very public healthy set up and seems - albeit from the outside looking in - to be an efficient method of providing care to the local people.

We were in Safeway yesterday as a man took bread of the shelf he exclaimed: "The bread is fresh today!" He proceeded to thump it and explain how he knew it was fresh "Its still frozen!"

Thats Nome in a nutshell. Fresh bread is still frozen bread put out on the shelves.

Its been fun.

Day 1

I'm sitting in the smaller of our two offices here at the hospital. It is quickly approaching quitin' time.

The end of a hard day approaches.

Not hard because we were so busy. Not hard because the patients were so complicated.

Just hard because its always hard to start a new job.

Not knowing where things are. Not being familiar with policies and processes are always difficult.

They were especially difficult today simply because we are working in a hospital.

Mounds of paperwork.

No simple drawer full of new supplies, rather one must go to the pharmacy or supply room to obtain replacement drops or things.

New equipment is always a little difficult in the beginning. While it is true that everything works the same it just takes a little while to get used to where this knob is, and that button is.

My exam lane is the smaller of the two. Smaller simply because it is filled to the brim with extra equipment that isn't used regularly. I've really been struggling more than Swell I think.

I was getting more and more frustrated as I tried to figure out why it felt like I was moving in slow motion and everything just seemed really difficult.

It finally dawned on me.

I'm working in a left hand room.

Everything I'm using is on the opposite side of the room that I'm used to.

Not a big deal but its throwing me off. Physically and mentally. Just being in a weird room is causing everything to be just that much more difficult.

I'll get used to it but its going to take some time.

Nice weather today. Very warm, although we won't really experience it as we're here all day and then have a short walk home tonight.

There is no place like Nome

So we are sitting here in Airport Pizza just waiting for the waitress to bring Swell's Latte.

Needless to say Swell is ecstatic that she has the availability of Lattes, Cappuccinos, and Espressos.

Airport Pizza is one of many restaurants in Nome. It is, however, the only one we've tried thus far. We've now eaten here twice.

Our first meal here was a lunch where we got a very expensive, yet yummy, pizza. Believe it or not we had Reindeer sausage pizza.

It was quite good. We felt like doofus tourists ordering it but I've come to find out that it is actually quite popular.

Today we each had a burger. I had a true beef burger whereas Swell had a Garden burger. Both were quite good but, again, expensive.

Everything is extremely expensive here. We were expecting expensive but were still a little shocked. Swell is going to write down the prices of some of the things at the grocery store to share our shock. To give you some idea I'm looking out the restaurant window at the nearby gas station - $4.29/gallon. And we're told that's very cheap for Alaska standards.

Our little apartment is warm. That's really all it is but we're not complaining. We are warmer indoors than we were this time last year.

Much, much warmer.

Outdoors is another story, though.

Anyway our apartment is a two bedroom one bath complete with washer and dryer - yippee - but is filthy.

Disgusting filthy but not the kind of filth that can be cleaned. Its just the type of place that has seen many different tenants - I believe its owned or rented solely for the use of the hospital. Stains of unknown origin on the carpets and walls.

Rickety furniture.

But its fine. We're treating it like a camping trip.

Scrounging for food.

Sleeping in sleeping bags.

We haven't done much the last few days. We're just trying to acclimatize and get used to the time change.

We've been watching TV (they have provided us with cable) and DVD's (on my computer). We did venture out a little bit each day.

It is a very small town. Population ~3500. Everything worth going to is in a short distance from our apartment. Front Street is the main drag - complete with bar after tavern after watering hole - and is right on the Bering Sea - which is, of course, completely frozen.

The temperature has been very bearable. We think it was actually much colder in Edmonton over Christmas. We, of course, also have much better/warmer clothing here.

We start work on Tuesday. This week, as we've already mentioned, is simply diabetic eye exams. No set schedule. Folks from around the Norton sound area will be coming in for their annual diabetic meetings with the nurse, physician, and dietitian. At some point they will drop by the eye clinic where we will check their eyes for any diabetic complications. So we'll be busy in spurts. No big deal. It should be fun.

We have internet at work and then here at the restaurant so we'll be in touch this week but out of touch next week.

Sorry for the rambling but it is difficult for me to write fast and entertainingly at the same time.

Some pictures to end the post.

Nome began due to Gold Rush



Front Street


Tourist Center


Iditarod finish line - They pull it out at the end of the race but it sits outside all year long


We could walk to Siberia - we could if we were crazy.

Nome Sweet Nome

Here.

Not that cold.

Apartment is...interesting.

Orientation half day tomorrow.

Long weekend due to Presidents Day on Monday. Start working on Tuesday.

Later.

Cold?

We are sitting in the Anchorage airport waiting to board our last flight of the day. We will fly to Nome via another town so we have two more takeoffs and two more landings to go, although it is only one flight.

Lots of snow outside. Doesn't look too cold here but we have a long journey North yet.

Uneventful day thus far if you discount the ticket lady in ATL, the big guy squishing me on the second flight and the SCREAMING kid sitting right behind me.

All those who read this and are sick you better get better immediatley. All those who read this and are being silly with your lives better cut it out immediatley.

Ok that's it. My thumbs hurt and I don't like not having a spell checker.

We're on our way

So we will be leaving our house via cab (or more accurately "luxury sedan" - same price as a cab and way more cooler) tomorrow morning at 6. Our flight is at 8:30 am and we arrive in Nome, via Seattle, via Anchorage at 8:30 pm. 16 hours of travel time (remember the time change people) and we'll be in Nome.

Here's hoping our flights are on time and without incident.

Swell is excited by the fact that there is a 100 degree Fahrenheit difference between Nome and our holiday location of Maui. That will be a shock to the system.

We've already been asked to make this a year long deal.

We'll see.

I don't know how much access we'll have to internet but I get all my emails pushed to my phone immediately so you can stay in touch that way.

I'll also try to update here via phone if the internet is not working.

Later Gators.

Put it out of its misery

Before I start this post I want to explicitly state that we love our car and are very grateful for it. It was a gift Swell's parents gave her for Optometry school graduation a number of years ago. Since then I have purchased it from her. (Click here for a reminder as to how this car became my property)

That said this car has become more trouble than its worth over the last few weeks.

As the car approached 115000 miles we figured it was oil change/tune up time. No problem. I could take it in on a Monday or Thursday. Mondays both Swell and I had off but we're often out and about doing errands, shopping,etc. Thursdays Swell worked but I had the day off and could drive her and then head back to the car place and they would drive me the mile or so back to our place where I could do my weekly cleaning. (Of the house, not of me. I clean myself monthly whether I need it or not.)

Hating talking on the phone I had Swell phone to make the appointment. She tried a couple of times but their phone just kept on ringing. After learning of this non-answered phone business I did what any sane individual would do.

Find a new garage?

No. Book an appointment on line.

The next Thursday.

Me: Bye Swell. Have a nice day. I'll see you later.
Swell: Let me know if they find anything wrong with the car.

Twenty minutes later.
Me - on phone: Ummmm...Swell... I don't think they're open anymore.
Swell: What! They're not open?
Me: Correct. They are not open anymore.
Swell: That's strange. I guess we'll have to do it another time.

Three days later
Swell: When are you going to take the car in?
Me: I don't know where to take it... I'll have to search on the internet for another Ford dealer.
Swell: Why don't you just take it into the dealer we always take it.
Me: FOR THE LOVE OF ALL THINGS HOLY, DO YOU NEVER LISTEN TO ME!
Swell: What?
Me: Remember? I was taking the car in last Thursday and I phoned you and said they weren't open?
Swell: Well, of course I remember that. What does that have to do with taking the car in this week?
Me: I DON'T KNOW WHERE TO TAKE IT! I'll have to look for a new dealer online or something.
Swell: I DON'T UNDERSTAND WHY YOU CAN'T JUST MAKE A NEW APPOINTMENT AND TAKE IT WHERE WE USUALLY TAKE IT.
Me: Oh my goodness! You really don't listen. I just told you that they were closed.
Swell: Its not like they're closed forever, stupid.
Me: It's exactly like they're closed forever. All the cars that were for sale are gone. Its just a big empty lot now.
Swell: Oh. I thought you meant they were just closed last Thursday.
Me: That doesn't really make sense does it?
Swell: I didn't think it made sense but you said it and most of what you say doesn't make sense.
Me: That's true.

So after that fateful misunderstanding I said something to someone once about not posting personal stuff (like fights) in a blog so I just want to reiterate that I exaggerate our disagreements although the underlying story is true. It is very true that we had a complete misunderstanding of what "They are closed" meant. It was quite funny. I searched and searched for another Ford dealer.

The nearest one wasn't really all that near. About 7 miles from our place, which is a long way in Atlanta.

So one fateful Thursday I dropped Swell off at work and made my way to the new Ford place.

Upon arriving I was impressed with the customer lounge, not so much with the neighbourhood.

After telling the garage dude that we needed i) an oil change ii) an inspection to look for any problems and iii) an explanation as to why the car was idling poorly at stop lights I went looking for a place to hang out.

Me - on phone: Swell, I'm a little bit a feared. This place is in the ghetto, and not the ironic cool ghetto I mean the actual ghetto and its freaking cold out today.
Swell: Don't care.
Me: Well ok then. I'll call you when the car is done.

I eventually found a place to eat. Who would have expected to find a Chik-Fil-A in the ghetto? (Ok that was crossing the line I know. It wasn't really a ghetto. It was just a rundown part of the city with a lot of shady people hanging around. And truth be told where isn't there a Chik-Fil-A in Atlanta?)

After my nutritious lunch I walked back to the garage and sat for five hours watching Scrubs on my computer.

Oil Change? Check!
Explanation for poor idling? Check!
Fix idling problem? Check?
Cheque? $600
Check the brakes? No. Although they were supposed to. Its on the sheet. The just marked. Didn't do.

Why would the brakes be important?

A few days later.
Swell on the phone: Ummmm, dear husband of mine. Remember when you took the car in. I told you to make sure they checked the brakes right?
Me: I know. They were supposed to. How am I to know that this new garage just ignores that part of the multi-point inspection?
Swell: BY TELLING THEM TO CHECK THE BRAKES!
Me: Sorry. Are they worse?
Swell: If you consider a combination of an ear splitting screeching and a headache inducing grinding worse, than yes they are worse.

The next Thursday I was on my way to yet another Ford Dealer.

My long walk this time led me to a Wendy's followed by 4 or 5 hours of The Office on my computer while waiting in the not as nice customer lounge.

Brakes fixed? Check!
Cheque? Another $600

One day later toward the end of a very long Friday.
Swell - on phone: I'm on 400 and the car doesn't sound right.
Me: What's wrong?
Swell: I don't know. It just doesn't sound right.
Me: I'm sorry. Drive slowly and try to get here. I can't really do anything else from here.
Swell: Ok.

Ten minutes later
Swell: It sounds even worse now and its not going very fast.
Me: Maybe you should pull over.
Swell: I'm on 400
Me: DON'T PULL OVER!!!!

Ten minutes later
Swell: I made it. I'm in the parking lot where should I go?
Me: Just find the nearest parking spot.
Swell: I think maybe the tire is flat.
Me: Just find the nearest parking spot.

Ten minutes later.
Me while looking at the huge piece of metal in the tire and the blown sidewall: Well, you're lucky you're not dead.
Swell: You're not supposed to drive on a flat tire?
Me: No dear.

20 minutes later.
Swell You'll stay open for us? We're almost there. We're just driving on a doughnut now and we work tomorrow so it would be great if we could get it fixed tonight.

2 hours later.

Tire fixed? Check!
All other tires ok? Check!
Cheque? $250.

Since then? So far so good.

Don't Phone Us

Well we got rid of Sprint. They hosed us a little and we weren't able to port our numbers. So don't call us. After living in Atlanta for over 3 years we finally have local numbers... just in time to move away.

If you don't hear from us in the next couple of days via email or phone and you want our new numbers drop us a line. For the next day or two we'll be going through our contacts and trying to figure out who needs our numbers.

I love Atlantans

Swell had the brilliant idea to weasel out of our cell phone contract by indicating that we were moving to a place that had no cell phone coverage.

We're not entirely unhappy with Sprint but would love to get out so that we could really weigh our options (particularly with phone availability - Sprint has the worst selection of phones in the world). We refuse to pay the cancellation fee so I thought I'd head over to a Sprint store during my overly slow work day, and ask if we could, in fact, get out of our contract without the exorbitant cancellation fee. I'd read that they are willing to forgive the fees if you can prove you are moving to a location without coverage.

Worker Welcome to Sprint. How can I help you?
Me Well, believe it or not my wife and I are moving to Nome, Alaska.
Worker Where's that?

Ok. Now I'm not the smartest person in the world. My intellect, unlike my stunning good looks, would probably fall smack dab in the middle of the intellect bell curve. Average at best.

That said, I know where Alaska is. I might not have been able to point to Nome on a map without a hint or two but if someone said I'm moving to Nome, Alaska I wouldn't say "where's that?". I had hoped that anyone in this country would have a vague idea where Nome, Alaska was.

The worker's response begged the question, did they not know where Alaska was? Did they know that Alaska was, in fact, part of the US?

Me - dazed and confused Ummmm... well... it's about as far north as you can get in the United States.
Worker - doubtful as to the veracity of my geographical knowledge and future habitat Yeah, let me check on that.

I tell 'ya the education system needs a good overhaul down here.

Any Americans who care to chime in. What cell service do you use and is it worth getting?

Cheers!

I'm gonna try out saying Cheers now. I don't know why. I just feel like doing it. By the way we applied for positions starting January '08... in New Zealand. They may or may not have openings at that time but have asked for two referees from us. Where can I find a referee? Do I just approach them after a hockey game or what?

Silly Girl Getting Ready

Silly Girls Wii-ing. (Long exposure with attempt to show movement. Kinda worked)

Now that's what I'm talking about

Hi Headhunter woman,

During SwellandSheepie's 3 week visit, we have schedule a village trip 2/25-2/29. They will travel together on one of our smaller airlines to two remote eskimo villages. 1 village is Wales, AK and one village is Shishmaref, AK. They will travel with the optician here and she will orientate them to the clinic and be there the entire time with them.

They will all stay in the village clinic overnight. It is safe there and there will be separate sleeping areas for Pearce's and the optician. However, if they have sleeping bags, they may want to bring them. Most clinics are equipped with cots.

I am writing to make sure they are up for the trip. We will pay for the airfare, etc. The lodging is taken care of and they can enjoy the experience.

Please let me know if there are any problems with this. Wales does not have "running" water. There is water and there is a local store, but no actual running water. There are showers available.

I think they will love it. The other two weeks will be spent in Nome. We have an annual diabetes clinic 2/19-2/22. The entire week will be used to see our diabetic patients. We usually have about 70 patients come to town for this clinic, so that week may be busy.

(emphasis mine)