A Beginning

A Beginning

The Northward Pharmacist

A woman was inside. She said to her, "The bear will catch you soon! You have to go! But don't go through the entrance, go here!" And she had the little girl open an exit which had been covered up by a wall-hanging.

Then she came out into another world.

--- Nunivak Eskimo story

Each adventure story has a beginning. At the time the beginning is recorded, the ending may have not yet occurred. This is the case with this story.

As a pharmacy student nearly finished with academic rotations, I have had the opportunity to practice pharmacy in many locations, both traditional and nontraditional. When signing up for rotations, I had told the coordinators that I wanted to "get my hands dirty" and experience pharmacy outside of the traditionally thought-of roles. After all, I'd spent hours in retail pharmacies, taking calls from physicians, standing at drive-through windows, and counting out pills and putting them in amber-colored vials. Doubtless, it was an important part of pharmacy practice, and absolutely essential. But I looked at my academic rotations as an opportunity to push my comfort zone, practice medicine in some non-traditional yet essential areas, and to learn more about the world around me.

Therefore when I noticed the entry "Under served: Indian Health Service, Bethel, AK." on the list of available sites for rotations, I was immediately interested. I'd always felt at home "up North," doubtless stemming from my summers in Upper Michigan with my grandmother and two brothers, where wilderness was king, the sky was alight with stars, and the nearest walmart was held at bay by at least the span of 120 miles.

I was lucky. Most of the sites I was interested in were drawn by lottery. I remember feeling a rush of adrenaline when I read "Under served: Indian Health Service, Bethel, AK" on my list of confirmed rotations.

Of course, at the time, I had very little idea of what the Indian Health Service was, what sort of work the rotation would entail, or even where Bethel was in Alaska. Alaska is the largest of the 50 states, filled with many different ecosystems ranging from rainforest (of the subarctic, not tropical variety) jagged mountain ranges to flat, low-lying deltas.


I soon found that the Indian Health Service was a branch of the US Department of Health and Human Services designed for health care for Native American populations. The IHS provided all types of health care, including pharmacy. Bethel turned out to be located in central Alaska in the Yukon delta, near the Kuskokwim river. Bethel serves as a major hub between many outlying small villages, yet can hardly be called a metropolis. No roads lead in to Bethel--the only way to get there is either by plane or boat. The area is flat, pot marked by thousands upon thousands of lakes.

Once the excitement of getting the rotation site I wanted had washed over, I glanced at the time period I'd be visiting the town of Bethel. I looked over at the "date" column, and read:

February 2-27, 2009.

And so, on January 31st, I boarded my flight to Phoenix, Arizona. When I arrived there, the pilot announced it was 74 degrees Fahrenheit. I changed planes, and, six hours later, arrived in Anchorage Alaska, in the middle of the night, where the pilot happily chortled that the temperature was ten degrees below zero.

I had another flight leaving for Bethel, but it wasn't until noon the next day. So I picked up my baggage (since I was told it would be locked away until 5pm if I didn't) and found a bench next to the world record-holding Kodiak bear, his poised stance preserved forever in a taxidermied state. I piled my luggage next to me and lay down. The bench wasn't exactly the same softness as my mattress at home. What they say is true, I thought. Everything IS harder in Alaska. I slept on and off until 8AM. I then did something I'd never done before. I checked my bags and--left the airport.

I'd been warned that groceries were expensive in Bethel. A gallon of milk, I was told, was upwards of 8 dollars. In a land that was very unkind to farmers, all dairy and produce was extremely expensive. Everything had to be shipped in by plane or boat. So I had decided to go shopping in Anchorage, pack up a box of groceries, and take it with me. I took a car to a grocery store near the airport. I marveled at the view along the way. Mountains reached upwards, practically disappearing from view they were so high. Tall, thin conifers stretched skyward as well, blanketed in snow. It was truly a beautiful city. I managed to muscle all of my groceries in a box, taped it shut as if there was a wolverine inside desperate to escape, and headed back to the airport, where I checked the box to go with the rest of my luggage.

I soon found myself on Alaska Airlines flight 43, a 737 jet on the way to Bethel. It seemed half of the passengers knew each other. I felt as if I was at a family reunion of a friend. The group was diverse, bubbling, and happy. I watched the mountainous terrain outside slowly turn to barren tundra, filled with lakes and rivers. A plume of steam rose from Mt. Redoubt along the way. Soon, the plane made its way down and I soon found myself stepping on the snow-covered ground of Bethel, Alaska.

I met with a human resource representative, Tony. He said he "wasn't really with human resources...more employed by the clinical rotations department," and had been working there for a month. He collected myself and two optometry students from Quebec. He asked if we needed anything at the store and after we assured him we didn't, he drove us to our lodgings.

I met my housemate Erik, another pharmacy student, from North Carolina. His rotations were five weeks long, he explained, and would be leaving at the end of the week. "Remind me to give you the number to the phone here," he said. Indeed, when I had checked my mobile phone, there was absolutely no signal, nor would there be, for the next four weeks.

"If Mt. Redoubt doesn't put an end to my departure plans," he said. Mt. Redoubt, a volcanic site near Anchorage, had been blowing steam lately, and seismologists in the area expected an impending eruption--which would not put us in any danger, but would certainly cause problems flying.

"Yeah, they wouldn't fly through that," my friend and roommate at home in Indianapolis had said before I left. He had gotten his private pilot's license over half a year ago. "The ash turns to ceramic in the engines and will drop you like a rock." Erik was obviously concerned about this. I thought about the last roommate I had named Eric and wondered if this guy would be anything like him.

Superbowl Sunday reaches everywhere, Bethel, Alaska, was not an exception. The Pittsburgh Steelers were going to be playing The Arizona Cardinals. Erik had been invited to a Superbowl party with some of the other pharmacists and invited me to go with him. I agreed, and soon found myself in Beth and Gary's home, talking to them, their three kids (Lars, Ashley, and Caroline) and Amy and (Kevin?), another pharmacy couple. I ate some food and had a good time getting to know some people who lived in Bethel. After the game, and a particularly good episode of The Office, Gary took Erik and I down to what Amy and Beth referred to as the "man-shed." Gary taught trapping as part of subsistence education. And apparently, he had just caught a wolf.

Sure enough, when we descended under the house, a half-frozen Cannis lupus, or timber wolf, was waiting for us in room full of hides, a veritable PETA nightmare. Wolves, he explained, have always maintained a healthy population, sometimes too healthy, in most parts of Alaska. How much more I would have enjoyed seeing it alive! We helped him lift it so he could suspend it from a beam. Soon after, I found myself outside, waiting to be driven back to the housing IHS had provided us. It was very cold, but beautiful. It was dead silent and the stars filled the sky, in sharp contrast to Indianapolis. I was truly in another world.