A busy morning on my final day in Sitka. I woke up early, ate breakfast, and spent a few hours in the dental clinic saying goodbye to those who were so nice and accommodating during my few days in Sitka. I also got a bit of work done since I can now compile all of the data from OB interviews in Sitka. Tomorrow is my last full day of surveying and interviewing. It's been a fun and interesting few weeks, but I am definitely ready to move on and put all of my information and data to good use.
I caught the Community Ride to the ferry terminal and headed back to Juneau. The ferry was just pulling away as the Cardinals were batting in the bottom on the ninth inning, trailing by 2 runs. Matt Holliday has just singled, bringing the tying run to the plate when, suddenly, I lost cell service. I spent the entire 4 hour ferry ride on edge until my phone finally regained cell coverage a few miles from Juneau and I could check the final score.
Of my 45 days in Alaska, today was by far the worst weather I have experienced. When I left Sitka it was raining sideways, so I was relieved when the ferry docked in Juneau and the rain had slowed to a slight drizzle. Unfortunately, the temperature had also dropped to the mid 40's which is not something my body is used to on June 30th.
I got back to the dorm and ate before quickly crashing into bed. Some days I have no problems staying up until 10 or 11 PM, but days like today it is hard to stay up past 7:30 or 8 (even with the sun still shining brightly!). Traveling takes a lot out of you, so I am glad that I will be in Juneau for the duration. It will also be nice to spend some time on the UAS campus. Tonight will only be the 7th night I have spent in the dorm since June 1st. I think that speaks to the amount of exploring and traveling I have been able to do and how that traveling has made my experience in Alaska much more rich and diverse. This trip has been a real lesson in independence, commitment, and learning. I couldn't have asked for a better experience up to this point...
Wednesday, June 30, 2010
Tuesday, June 29, 2010
Day 44 - Sitka, AK v.2.0
Spent my second day in the OB clinic in Sitka today. But, before that, I spent the morning in the dental clinic talking with Colleen, the receptionist, and a few of the dental assistants - explaining my surveying and how I thought it could help the SEARHC organization better serve their patients. It is always interesting to hear the perspective of someone like Colleen who has been at SEARHC for many years because those people have insight into the evolution of the organization and what has worked in the past and what ideas were not quite as effective.
This morning I also had a run-in with a patient. I was walking through the clinic when I suddenly I saw a woman pointing at me an Colleen responding, "Yep, that's him." After the patient left, I asked Colleen why the patient had wanted to know who I was. Apparently, I called her during my phone survey and she was none too happy to receive my call. She felt scolded and disrespected by my call. It is funny to think of the different ways people interpret things. From a provider standpoint, I think that the phone calls are a great opportunity for patients to offer some feedback to dentists and administrators and explain why they weren't at an appointment. Further, the information the patients provide will eventually make their health care experience much more seamless and accessible. The patients do not appear to be having the same interpretation. Intriguing and interesting.
I also had the opportunity to make a few phone calls since one of the Sitka dentists was not in the office today. My numbers are climbing and the trends and reasons for missed appointments are becoming very clear. Dr. West, one of the dentists from Juneau, was in Sitka helping out in the orthodontics clinic so it was nice to see a familiar face and have someone to eat lunch with today.
I spent the afternoon in the OB clinic interviewing the patients who had an appointment. Last week, Valerie convinced 15 women to take my survey so that made up for the fact that there were only 8 patients the last time I was in Sitka. The afternoon got off to a good start as I interviewed the first round of women without a hitch. About an hour into the afternoon the women suddenly stopped coming over to speak with me. About that time, I overheard a patient talking angrily to the front desk worker. She was apparently furious about having an extra person in the exam room while she was interacting with the OBGYN.
She stormed over to the area where I was sitting and sat with her arms crossed. Valerie motioned over that I should avoid her at all costs so, what did I do?, went over and spoke with her. Before I could get a word out she said to me, "I don't understand. You are working for the dental clinic, why do you have to come into the exam room and observe?" Needless to say, I was a bit taken aback and confused. After explaining to her that I had absolutely no interest in being a part of her examination and that I only had a few questions her stance softened and we laughed about the misunderstanding.
One of the front office workers had gotten her signals crossed and did not completely understand the premise of my surveying. She thought that I was going to have to be in the exam room with the women during their invasive procedures. When the front desk worker was asking these women if I could be in the room with them she was offending them and, in turn, allowing them to opt out of my survey. Once I figured this out I explained that I, without a doubt, had no interest in shadowing during the actual physical and that I wanted no part of the inside of the examination room. Once we wrinkled out this small detail I had no problem getting plenty of interviews completed.
After that excitement, the rest of the day was pretty uneventful. I watched the Cardinals game (I'm not a machine, OK. I'm just Albert...) and took advantage of the free access to the weight room. Just finished packing my bag because I am heading back to Juneau tomorrow morning.
Hard to believe I have less than 20 days left in Alaska...
This morning I also had a run-in with a patient. I was walking through the clinic when I suddenly I saw a woman pointing at me an Colleen responding, "Yep, that's him." After the patient left, I asked Colleen why the patient had wanted to know who I was. Apparently, I called her during my phone survey and she was none too happy to receive my call. She felt scolded and disrespected by my call. It is funny to think of the different ways people interpret things. From a provider standpoint, I think that the phone calls are a great opportunity for patients to offer some feedback to dentists and administrators and explain why they weren't at an appointment. Further, the information the patients provide will eventually make their health care experience much more seamless and accessible. The patients do not appear to be having the same interpretation. Intriguing and interesting.
I also had the opportunity to make a few phone calls since one of the Sitka dentists was not in the office today. My numbers are climbing and the trends and reasons for missed appointments are becoming very clear. Dr. West, one of the dentists from Juneau, was in Sitka helping out in the orthodontics clinic so it was nice to see a familiar face and have someone to eat lunch with today.
I spent the afternoon in the OB clinic interviewing the patients who had an appointment. Last week, Valerie convinced 15 women to take my survey so that made up for the fact that there were only 8 patients the last time I was in Sitka. The afternoon got off to a good start as I interviewed the first round of women without a hitch. About an hour into the afternoon the women suddenly stopped coming over to speak with me. About that time, I overheard a patient talking angrily to the front desk worker. She was apparently furious about having an extra person in the exam room while she was interacting with the OBGYN.
She stormed over to the area where I was sitting and sat with her arms crossed. Valerie motioned over that I should avoid her at all costs so, what did I do?, went over and spoke with her. Before I could get a word out she said to me, "I don't understand. You are working for the dental clinic, why do you have to come into the exam room and observe?" Needless to say, I was a bit taken aback and confused. After explaining to her that I had absolutely no interest in being a part of her examination and that I only had a few questions her stance softened and we laughed about the misunderstanding.
One of the front office workers had gotten her signals crossed and did not completely understand the premise of my surveying. She thought that I was going to have to be in the exam room with the women during their invasive procedures. When the front desk worker was asking these women if I could be in the room with them she was offending them and, in turn, allowing them to opt out of my survey. Once I figured this out I explained that I, without a doubt, had no interest in shadowing during the actual physical and that I wanted no part of the inside of the examination room. Once we wrinkled out this small detail I had no problem getting plenty of interviews completed.
After that excitement, the rest of the day was pretty uneventful. I watched the Cardinals game (I'm not a machine, OK. I'm just Albert...) and took advantage of the free access to the weight room. Just finished packing my bag because I am heading back to Juneau tomorrow morning.
Hard to believe I have less than 20 days left in Alaska...
Monday, June 28, 2010
Day 43 - Back to Sitka, AK
Today I sailed on the ferry to Sitka, AK for the second time. This will be my fourth and final trip of the summer. On one hand, I am really glad I got to see lots of the Southeastern part of the state but, on the other hand, it will be nice to settle down and spend the last 2 and a half weeks in Juneau - sleeping in the same bed every night, interacting with people I know, and falling back into a routine. Of the 30 days in June I probably spent only 4 or 5 in my UAS housing. In addition to getting to settle back into a routine, I also won't have to hear my alarm go off at 6 AM to catch another ferry or plane until I head back home July 18th!
The ferry ride was pretty neat today. For some reason, the were a whole bunch of humpback whales the surrounded the vessel the entire ride. It was neat to see them shoot off spouts of water and breach. The ferry vessel has a naturalist aboard who comes over the intercom every time he sees wildlife in the water or on the nearby shorelines. Since there were so many whales today he came on every 5 minutes, "Whales starboard" or "Whales port side". His messages were followed by the boat's passengers running from one side of the ferry to another, crawling over each other hoping to catch a two second glimpse of a whale 500 yards away. It was like a 4 hour track meet from one side of the boat to another. Definitely not an environment conducive to sleeping.
I learned from my mistake last time and avoided a costly taxi from the ferry terminal to Mt. Edgecumbe Hospital. Instead, I utilized the Community Ride to get around town and get to my housing. The housing staff was prepared for my arrival this time - no surprises - and they even had a couple of extra perks that I did not have the last time. I now get access to the short term housing weight room and I was given the security password for the wireless internet connection in my room.
I spent just a few hours in the clinic today collecting phone numbers and gearing up for the final few days of surveying. Last time I was in Sitka the weather was really cold and rainy, but today was sunny and warm so I decided to see some parts of the city I didn't get to see the last time I was here. I took the Community Ride to Whale Park (since I didn't get enough whale viewing on the ferry). The park was really nice. There were boardwalks that went down to the coastline and there were binoculars that you could use to look out into the water to try and spot whales, sea lions, seals, or anything else that lives in the ocean. I was going to try and walk to the nearby Bear Fortress, a bear rehabilitation center, but as soon as I started to head in that direction it began to rain.
Instead, I went back into downtown Sitka and ate dinner. I ate at a Mexican place called Agave. Most of their food is cooked with Agave nectar, a honey like substance, and it was pretty good. Even though I get the meals from the diet office I felt I could let loose on a well-deserved, good meal after 6 weeks of hard work. On my way back to the hospital I stopped at historic Castle Hill. Initially, Castle Hill was an important spot for the Tlingit natives. Since it is elevated, the Tlingits built many of their most important buildings atop this hill. Eventually, the Russians invaded Sitka and overtook the hill, using it as an important epicenter for their enormous fur trade. In modern history, Castle Hill holds a lot of importance to the statehooddd of Alaska. When the US government purchased Alaska from Russia, Castle Hill was the ceremonial location where the Russian flag was lowered and the US flag was raised for the first time. Also, once Alaska became the 49th state of the United States, the first flag with 49 stars flew at Castle Hill.
Other than that there wasn't much going on today. Tomorrow will be busy with phone calls and surveying in the morning and patient interviewing in the OB clinic all afternoon. I am excited to see how many OB patients filled out the surveys I left with Valerie last week. I also want to stop by and meet with Martha Pearson and Litia Garrison again to update them on the progression of ideas for my patient education material.
Early morning this morning so that means an early night tonight...
The ferry ride was pretty neat today. For some reason, the were a whole bunch of humpback whales the surrounded the vessel the entire ride. It was neat to see them shoot off spouts of water and breach. The ferry vessel has a naturalist aboard who comes over the intercom every time he sees wildlife in the water or on the nearby shorelines. Since there were so many whales today he came on every 5 minutes, "Whales starboard" or "Whales port side". His messages were followed by the boat's passengers running from one side of the ferry to another, crawling over each other hoping to catch a two second glimpse of a whale 500 yards away. It was like a 4 hour track meet from one side of the boat to another. Definitely not an environment conducive to sleeping.
I learned from my mistake last time and avoided a costly taxi from the ferry terminal to Mt. Edgecumbe Hospital. Instead, I utilized the Community Ride to get around town and get to my housing. The housing staff was prepared for my arrival this time - no surprises - and they even had a couple of extra perks that I did not have the last time. I now get access to the short term housing weight room and I was given the security password for the wireless internet connection in my room.
I spent just a few hours in the clinic today collecting phone numbers and gearing up for the final few days of surveying. Last time I was in Sitka the weather was really cold and rainy, but today was sunny and warm so I decided to see some parts of the city I didn't get to see the last time I was here. I took the Community Ride to Whale Park (since I didn't get enough whale viewing on the ferry). The park was really nice. There were boardwalks that went down to the coastline and there were binoculars that you could use to look out into the water to try and spot whales, sea lions, seals, or anything else that lives in the ocean. I was going to try and walk to the nearby Bear Fortress, a bear rehabilitation center, but as soon as I started to head in that direction it began to rain.
Instead, I went back into downtown Sitka and ate dinner. I ate at a Mexican place called Agave. Most of their food is cooked with Agave nectar, a honey like substance, and it was pretty good. Even though I get the meals from the diet office I felt I could let loose on a well-deserved, good meal after 6 weeks of hard work. On my way back to the hospital I stopped at historic Castle Hill. Initially, Castle Hill was an important spot for the Tlingit natives. Since it is elevated, the Tlingits built many of their most important buildings atop this hill. Eventually, the Russians invaded Sitka and overtook the hill, using it as an important epicenter for their enormous fur trade. In modern history, Castle Hill holds a lot of importance to the statehooddd of Alaska. When the US government purchased Alaska from Russia, Castle Hill was the ceremonial location where the Russian flag was lowered and the US flag was raised for the first time. Also, once Alaska became the 49th state of the United States, the first flag with 49 stars flew at Castle Hill.
Other than that there wasn't much going on today. Tomorrow will be busy with phone calls and surveying in the morning and patient interviewing in the OB clinic all afternoon. I am excited to see how many OB patients filled out the surveys I left with Valerie last week. I also want to stop by and meet with Martha Pearson and Litia Garrison again to update them on the progression of ideas for my patient education material.
Early morning this morning so that means an early night tonight...
Sunday, June 27, 2010
Day 42 - Juneau lumberjacks
There is a breakfast place that is about a 3 minute walk from my dorm room. People say it is pretty good and, after eating there today, my only question is - how did it take me six weeks to eat there for the first time? I met the Wilkinsons, Dr. Dee, and Dr. West for breakfast at Southeast Waffle Company. The food was pretty good and the conversation was even better.
After breakfast (if a meal eaten at noon can still be counted as breakfast), we all went over to Douglas Island to spend the day at Gold Rush Days. The Gold Rush Days are a two day festival that highlights the logging and mining history of Juneau and the rest of Southeast Alaska. Yesterday, there was an exhibition of mining skills and today there was a group of lumberjacks that showcased their talents.
There were lots of bleachers set up around a huge pit filled with various tools and piles of wood. There were lots of neat skills showcases all throughout the day. We saw women throwing axes above their heads towards a target about 15 feet away. There was also a man who made a chair out of stump of wood using only a chainsaw. In addition, we saw the two person saw competition (where two people move a handsaw back and forth to saw of a slice of wood from a tree) and the tree climbing competition (you have to look at the pictures I posted to completely comprehend how cool it was). Each exhibition was pretty neat, but I think that everyone can agree that the highlight of the day was the log roll.
The was a huge tree trunk in the middle of a 4 foot deep pit of freezing cold water. The lumberjacks took turns competing against each other in a 2 out of 3 contest to see who could stay on the log the longest. Even though there were winners and losers, the crowd won every time because we got to see big, strong men and women flailing face first into the ice cold swimming pool. The looks on their faces and their accidentally audible curse words from sheer shock of hitting the water kept the crowds thoroughly entertained for a good hour. Besides the lumberjack competition, there was also the traditional fair staple - food on a stick - which kept us busy during the downtime in between events.
For dinner we all went to the Island Pub for pizza. All in all, between the weather and the company, it was a pretty fun Sunday. Tomorrow I leave for Sitka for my final few days of travel. Let's hope that Karen has my room ready so that my arrival will be much more seamless than the last time I showed up a few weeks ago...
**New pictures added**
After breakfast (if a meal eaten at noon can still be counted as breakfast), we all went over to Douglas Island to spend the day at Gold Rush Days. The Gold Rush Days are a two day festival that highlights the logging and mining history of Juneau and the rest of Southeast Alaska. Yesterday, there was an exhibition of mining skills and today there was a group of lumberjacks that showcased their talents.
There were lots of bleachers set up around a huge pit filled with various tools and piles of wood. There were lots of neat skills showcases all throughout the day. We saw women throwing axes above their heads towards a target about 15 feet away. There was also a man who made a chair out of stump of wood using only a chainsaw. In addition, we saw the two person saw competition (where two people move a handsaw back and forth to saw of a slice of wood from a tree) and the tree climbing competition (you have to look at the pictures I posted to completely comprehend how cool it was). Each exhibition was pretty neat, but I think that everyone can agree that the highlight of the day was the log roll.
The was a huge tree trunk in the middle of a 4 foot deep pit of freezing cold water. The lumberjacks took turns competing against each other in a 2 out of 3 contest to see who could stay on the log the longest. Even though there were winners and losers, the crowd won every time because we got to see big, strong men and women flailing face first into the ice cold swimming pool. The looks on their faces and their accidentally audible curse words from sheer shock of hitting the water kept the crowds thoroughly entertained for a good hour. Besides the lumberjack competition, there was also the traditional fair staple - food on a stick - which kept us busy during the downtime in between events.
For dinner we all went to the Island Pub for pizza. All in all, between the weather and the company, it was a pretty fun Sunday. Tomorrow I leave for Sitka for my final few days of travel. Let's hope that Karen has my room ready so that my arrival will be much more seamless than the last time I showed up a few weeks ago...
**New pictures added**
Day 41 - Only Fools Run at Midnight
I took the ferry back to Juneau this morning, but instead of taking the fast Fairweather vessel I took the slower, bigger Malaspina. The Malaspina moves at about 15 knots as compared to the 30 or 32 knots at which the Fairweather travels. Also, the Malaspina is much bigger with more space and amenities on the ship. There is a huge movie theater, a bigger cafeteria, and berths to spend time in or sleep in if you are going to be on the ferry overnight. I spent most of the ride on the top deck under the solarium. It's pretty neat because it is either a great place to sit when the sun is out and also when it isn't so sunny because there are large heaters that are fairly warm. I got cell service on the top deck so I sat up there and listened to the Cardinals game and tracked the World Cup on my phone.
After we docked in Juneau, Lisa Cone took me back to UAS. I spent the afternoon doing laundry and picking upa few groceries. It was really cold and rainy yesterday so it was not a good day to go out and do anything. Around 8 o'clock I went out to dinner with some people from the office and then I went off for the highlight of my day.
Tonight was the Only Fools Run at Midnight 5K. The race benefits SAIL (Southeast Alaska Independent Living) which is an organization that helps adults with special needs find independent living arrangements and job opportunities so that the can be a bigger part of mainstream society. There were about 10 or 12 people from the office who ran so we all met early to hang out and take pictures (the less dedicated runners/walkers also wandered over to a nearby bar to "carbo-load").
One of the coolest features of the race is that nearly everybody dresses up and attaches themselves to a giant rope to run as centipedes. There were some pretty elaborate costumes. The best costumes won prizes like whale watching trips, plane tickets to Glacier Bay, and signed items from the pride and joy of Juneau, AK - Carlos Boozer. If only I knew the prizes were so good I would have tried something a bit more creative that the dental theme.
Of course, even neater than the costumes, was the fact that we got to start the race at 11:59 PM and run through the streets of Juneau at midnight. Everyone dresses themselves in glow sticks so all you can see during the race are streaks of neon. It was a really neat experience and the t-shirt is definitely a great souvenir.
Off to bed since it's really, really late. Not much going on tomorrow. I'm hoping for good weather so I can spend some time outside...
After we docked in Juneau, Lisa Cone took me back to UAS. I spent the afternoon doing laundry and picking upa few groceries. It was really cold and rainy yesterday so it was not a good day to go out and do anything. Around 8 o'clock I went out to dinner with some people from the office and then I went off for the highlight of my day.
Tonight was the Only Fools Run at Midnight 5K. The race benefits SAIL (Southeast Alaska Independent Living) which is an organization that helps adults with special needs find independent living arrangements and job opportunities so that the can be a bigger part of mainstream society. There were about 10 or 12 people from the office who ran so we all met early to hang out and take pictures (the less dedicated runners/walkers also wandered over to a nearby bar to "carbo-load").
One of the coolest features of the race is that nearly everybody dresses up and attaches themselves to a giant rope to run as centipedes. There were some pretty elaborate costumes. The best costumes won prizes like whale watching trips, plane tickets to Glacier Bay, and signed items from the pride and joy of Juneau, AK - Carlos Boozer. If only I knew the prizes were so good I would have tried something a bit more creative that the dental theme.
Of course, even neater than the costumes, was the fact that we got to start the race at 11:59 PM and run through the streets of Juneau at midnight. Everyone dresses themselves in glow sticks so all you can see during the race are streaks of neon. It was a really neat experience and the t-shirt is definitely a great souvenir.
Off to bed since it's really, really late. Not much going on tomorrow. I'm hoping for good weather so I can spend some time outside...
Friday, June 25, 2010
Day 40 - Haines, AK Day 6
Hard to believe I've been in Haines for 6 days now, even harder to believe that this is my 40th day in Alaska! I went into the clinic in the morning to do my standard Friday phone calls, but the dentists in the Haines clinic do not work on Friday afternoons so I left around noon.
I met up with Sean Cone and we decided to go fishing since the rain finally stopped. I had to go and buy a fishing license because the fish and gaming commission is very strict on who can fish, how many fish you can keep, and the size and length of those fish.
There are a lot of neat intricacies to fishing in Alaska, but none more interesting than the arrangement with Canadian residents in Alaska. Residents of Canada can come to Alaska and purchase a fishing license at the in-state rate (the price difference is equivalent to going to a state university and not being from that state, albeit not on that scale!) and bring fish back across the border. It's a great deal because salmon fishing in Alaska is much better than in British Columbia or the Yukon so residents of those parts of Canada can make the easy day trip into Haines or another Southeast community, clean up on fish, and then drive back home and have a sockeye filet for dinner.
Unfortunately, the Canadian government does not extend the same luxuries to American citizens that hunt and fish in Canadian provinces. Canada, specifically the parts mentioned above, has a much higher population of deer, caribou, and moose than does Alaska. Despite the fact that the Alaskan state government allows Canadians to come and take their fish at the local rate, Alaskans cannot travel to Canada and hunt these animals at any type of reduced cost. This is a huge loss for a lot of the population in the Southeast of the state because many still rely on game meat to survive and feed their large families. It's a very interesting situation and makes you wonder why there isn't more give and take, or why the American government doesn't simply start charging Canadians the out-of-state rate.
Sean and I went to the Chilkoot River hoping to catch some sockeye salmon which are just now beginning to make their run through the fresh water rivers and lakes. On the way out to the river we saw a grizzly bear who had the same idea we did - he wanted to fish. Fortunately, we fished on the opposite side of the river. My first few casts were a little difficult because I am not used to fishing with such a strong current. You cast the reel upstream and let it flow downstream as you reel it back in. The problem is that every time the current tugs at the line it feels like a fish is biting. I was very jumpy and excited until I realized that I was simply dealing with current and rocks, not a 50 pound king salmon.
We fished upstream from an area of the river where they count the salmon that run through each day. The fishing commission directs fish through certain parts of the river and then counts them by sonar. They keep track of the numbers so they can set appropriate limits for the private and commercial fisherman to ensure that they are not depleting the salmon population. Yesterday over 400 sockeye salmon ran under the sonar whereas today only 30 or so swam through.
Today was also a beautiful day whereas yesterday was cold and rainy - a perfect day for fishing. If I had gone to Skagway today and fished yesterday I would have definitely been able to both dog sled and catch a salmon. But, naturally, I did the activities in the opposite order. Oh well, such is life!
Sean and I left the Chilkoot River and drove towards the Canadian border to fish on the Chilkat River although we had similar luck there. It is still a bit early for the salmon to be running in large enough quantities to catch them easily. In another month or so people will be catching so much salmon that they won't even be able to give it away. Even though we didn't catch any fish I still had a great time talking with Sean and spending the day out in the sun - sure beats work.
I came back from fishing and watched the Cardinals game. Almost as frustrating as not being able to catch a fish was the fact that nobody on the team can get a clutch hit or any hit for that matter. The Cardinals apparently do not play well on Alaskan time. For dinner we ate salmon that someone else caught, not as fun, but still good nonetheless. After dinner I finished packing and just relaxed. I convinced Lisa and Zach to come with me to Juneau tomorrow to run in the midnight race (more on that tomorrow...) tomorrow night. Not only will it be fun to spend an extra day with them, but Lisa is bringing her car so I won't have to walk from the Juneau ferry terminal back to the dorm, instead, I'll have a ride...
I met up with Sean Cone and we decided to go fishing since the rain finally stopped. I had to go and buy a fishing license because the fish and gaming commission is very strict on who can fish, how many fish you can keep, and the size and length of those fish.
There are a lot of neat intricacies to fishing in Alaska, but none more interesting than the arrangement with Canadian residents in Alaska. Residents of Canada can come to Alaska and purchase a fishing license at the in-state rate (the price difference is equivalent to going to a state university and not being from that state, albeit not on that scale!) and bring fish back across the border. It's a great deal because salmon fishing in Alaska is much better than in British Columbia or the Yukon so residents of those parts of Canada can make the easy day trip into Haines or another Southeast community, clean up on fish, and then drive back home and have a sockeye filet for dinner.
Unfortunately, the Canadian government does not extend the same luxuries to American citizens that hunt and fish in Canadian provinces. Canada, specifically the parts mentioned above, has a much higher population of deer, caribou, and moose than does Alaska. Despite the fact that the Alaskan state government allows Canadians to come and take their fish at the local rate, Alaskans cannot travel to Canada and hunt these animals at any type of reduced cost. This is a huge loss for a lot of the population in the Southeast of the state because many still rely on game meat to survive and feed their large families. It's a very interesting situation and makes you wonder why there isn't more give and take, or why the American government doesn't simply start charging Canadians the out-of-state rate.
Sean and I went to the Chilkoot River hoping to catch some sockeye salmon which are just now beginning to make their run through the fresh water rivers and lakes. On the way out to the river we saw a grizzly bear who had the same idea we did - he wanted to fish. Fortunately, we fished on the opposite side of the river. My first few casts were a little difficult because I am not used to fishing with such a strong current. You cast the reel upstream and let it flow downstream as you reel it back in. The problem is that every time the current tugs at the line it feels like a fish is biting. I was very jumpy and excited until I realized that I was simply dealing with current and rocks, not a 50 pound king salmon.
We fished upstream from an area of the river where they count the salmon that run through each day. The fishing commission directs fish through certain parts of the river and then counts them by sonar. They keep track of the numbers so they can set appropriate limits for the private and commercial fisherman to ensure that they are not depleting the salmon population. Yesterday over 400 sockeye salmon ran under the sonar whereas today only 30 or so swam through.
Today was also a beautiful day whereas yesterday was cold and rainy - a perfect day for fishing. If I had gone to Skagway today and fished yesterday I would have definitely been able to both dog sled and catch a salmon. But, naturally, I did the activities in the opposite order. Oh well, such is life!
Sean and I left the Chilkoot River and drove towards the Canadian border to fish on the Chilkat River although we had similar luck there. It is still a bit early for the salmon to be running in large enough quantities to catch them easily. In another month or so people will be catching so much salmon that they won't even be able to give it away. Even though we didn't catch any fish I still had a great time talking with Sean and spending the day out in the sun - sure beats work.
I came back from fishing and watched the Cardinals game. Almost as frustrating as not being able to catch a fish was the fact that nobody on the team can get a clutch hit or any hit for that matter. The Cardinals apparently do not play well on Alaskan time. For dinner we ate salmon that someone else caught, not as fun, but still good nonetheless. After dinner I finished packing and just relaxed. I convinced Lisa and Zach to come with me to Juneau tomorrow to run in the midnight race (more on that tomorrow...) tomorrow night. Not only will it be fun to spend an extra day with them, but Lisa is bringing her car so I won't have to walk from the Juneau ferry terminal back to the dorm, instead, I'll have a ride...
Thursday, June 24, 2010
Day 39 - Day trip to Skagway, AK
The majority of my summer has been centered around my project with SEARHC - identifying reasons for missed appointments, recognizing shortcomings and lapses between the administrative and clinical staffs at SEARHC, and working with patients to develop new education material - but I have also spent a fair amount of time exploring the culture and geography of Alaska. To me, one of the most unique aspects of the summer project is that it not allows gives you an intensive, hands-on opportunity in your field of interest, but the stipend also provides you with an opportunity to explore parts of the world that you may have never had a chance to travel to otherwise. Keeping this in mind, I have taken a few days over the past 6 weeks to forget about work and see something new or experience part of a culture that is different than mine.
All of my travels have been in Southeast Alaska which is a unique part of the state. First, the climate here is not what you would expect in Alaska. It is rainy, not snowy, and many places are covered with green Sitka Spruce trees and not hundreds of feet of snow. Southeast Alaska is also unique in that there are no roads, well, unless you count the large series of highways and byways that are in the water. The only methods of travel around the Southeast are boat or plane. Some of these villages are literally 20 or 30 miles from each other, however, your car or SUV is useless unless you load it onto the Alaska Marine Highway System. I am currently in Haines, AK which is just a 45 minute ferry ride from Skagway, AK. Since I will not be this close to Skagway again, I decided it would be a fun day trip to go and see what the city had to offer.
Skagway is a very interesting place. If not for the tourists off of the cruise ships in the summer, the city would not be a viable place to live. Between October and April only about 800 people live in the city. Come summer though, about two or three hundred extra people migrate to Skagway and work in the local jewelry or gift shops. Skagway is a big port for the major cruise lines so on some of the busiest days in the summer there may be 5 or 6 ships docked in the harbor. It is funny to think that the tourist population dwarfs the actual population of the city nearly 3 or 4 times over.
Initially, Skagway was a starting off point for the gold miners heading to the Klondike River during the gold rush of the early 1900's. People would travel from the continental United States, stop in Skagway, and then take the White Pass Trail into Canada towards Klondike. The city developed a reputation as a trade town, a last chance for hopeful miners to stock up with any necessary supplies. Skagway also competed with a nearby city called Dyea, which was also a starting off point for some of the gold miners. Dyea is the start of the Chilkoot Trail, another trail that lead into the Yukon and towards Klondike. Skagway eventually overtook Dyea because the city was able to build a railroad that eliminated the need to carry thousands of pounds of supplies over steep mountains during freezing cold winters. That railroad is still in service today and provides tourists with unmatched views of the expansive Yukon region. In addition to the railroad, other feature of the current town pay homage to its storied past. All of the storefronts are set up like they were over 100 years ago, and the entire city is designed to make tourists feel like they are about to embark on a difficult, dangerous journey in search of gold.
I took the 6 AM ferry to Skgagway so I arrived a little before 7. I had spoken with a women in the Haines dental clinic who lives in Skagway so she recommended a few things to see and do. Her first recommendation was a breakfast place called the Sweet Tooth Cafe. I sat and ate while the cruise ships unloaded and the stores opened. I then took a walk around the town (all 7 blocks of it!) to see what was there. Like I said, the town is completely geared towards tourists. Every store sells "unique Alaskan artifacts" or "the World's Best Fudge" or "High Quality Diamonds". It was still fun to walk around because in addition to those stores, there are a few buildings that are still in a historic state. I walked through the gold rush museum and watched a movie about the journey towards Klondike. Also, I walked through some old buildings that were still set up like there were in the early 1900's including the news depot and the saloon.
The highlight of my trip to Skagway was supposed to be a helicopter ride to a dog sled camp on the Denver Glacier. Once you got off of the helicopter you were supposed to get to walk around on the glacier and then drive the dog sled team through the snow. Unfortunately, the weather did not cooperate and I had to cancel my tour. I was scheduled to ride in a helicopter with a woman named Terri. She is a third grade teacher and was so excited because one of the lessons that she teaches is on Alaska and the Iditarod. What better way to teach about dog racing than by having a picture of yourself leading a husky over a glacier? Not only did her tour get rained out today, but she also got rained out yesterday in Juneau. The weather is Southeast Alaska is pretty unpredictable so you can either come to Alaska and never get rained on or come and never see the sun. While I felt bad for her, I am lucky because the same tour that operates the helicopter tours in Skagway operates tours in Juneau so I will be sure to use my refund before I leave. We traded email addresses and I agreed to send her my pictures from my sledding experience.
I ate lunch at Starfire, a Thai resturant, that was also very good. Jenna really did a great job with her suggestions. Skagway is fun for an hour or two, but if you do not go on any sort of excursion the town gets very small, very quickly. I was banking on having the helicopter ride use up a few hours of my day but, when that fell through, I decided that there was no way I would last in Skagway until the 8 PM ferry.
I took the early ferry back to to Haines and met up with the Cones and Stefan. We went out to dinner at a pizza place called, ironically, Klondike. The restuarant is on the town fairgrounds. A few years ago, Disney filmed a movie called "White Fang" in Haines. Once production ended, they left the set standing and it has since become a focal point of the town.
That's about it for today. I'm about to crash because of the early ferry and excitement of walking around Skagway. Tomorrow is my last day in Haines so hopefully the weather clears...
**New pictures posted**
All of my travels have been in Southeast Alaska which is a unique part of the state. First, the climate here is not what you would expect in Alaska. It is rainy, not snowy, and many places are covered with green Sitka Spruce trees and not hundreds of feet of snow. Southeast Alaska is also unique in that there are no roads, well, unless you count the large series of highways and byways that are in the water. The only methods of travel around the Southeast are boat or plane. Some of these villages are literally 20 or 30 miles from each other, however, your car or SUV is useless unless you load it onto the Alaska Marine Highway System. I am currently in Haines, AK which is just a 45 minute ferry ride from Skagway, AK. Since I will not be this close to Skagway again, I decided it would be a fun day trip to go and see what the city had to offer.
Skagway is a very interesting place. If not for the tourists off of the cruise ships in the summer, the city would not be a viable place to live. Between October and April only about 800 people live in the city. Come summer though, about two or three hundred extra people migrate to Skagway and work in the local jewelry or gift shops. Skagway is a big port for the major cruise lines so on some of the busiest days in the summer there may be 5 or 6 ships docked in the harbor. It is funny to think that the tourist population dwarfs the actual population of the city nearly 3 or 4 times over.
Initially, Skagway was a starting off point for the gold miners heading to the Klondike River during the gold rush of the early 1900's. People would travel from the continental United States, stop in Skagway, and then take the White Pass Trail into Canada towards Klondike. The city developed a reputation as a trade town, a last chance for hopeful miners to stock up with any necessary supplies. Skagway also competed with a nearby city called Dyea, which was also a starting off point for some of the gold miners. Dyea is the start of the Chilkoot Trail, another trail that lead into the Yukon and towards Klondike. Skagway eventually overtook Dyea because the city was able to build a railroad that eliminated the need to carry thousands of pounds of supplies over steep mountains during freezing cold winters. That railroad is still in service today and provides tourists with unmatched views of the expansive Yukon region. In addition to the railroad, other feature of the current town pay homage to its storied past. All of the storefronts are set up like they were over 100 years ago, and the entire city is designed to make tourists feel like they are about to embark on a difficult, dangerous journey in search of gold.
I took the 6 AM ferry to Skgagway so I arrived a little before 7. I had spoken with a women in the Haines dental clinic who lives in Skagway so she recommended a few things to see and do. Her first recommendation was a breakfast place called the Sweet Tooth Cafe. I sat and ate while the cruise ships unloaded and the stores opened. I then took a walk around the town (all 7 blocks of it!) to see what was there. Like I said, the town is completely geared towards tourists. Every store sells "unique Alaskan artifacts" or "the World's Best Fudge" or "High Quality Diamonds". It was still fun to walk around because in addition to those stores, there are a few buildings that are still in a historic state. I walked through the gold rush museum and watched a movie about the journey towards Klondike. Also, I walked through some old buildings that were still set up like there were in the early 1900's including the news depot and the saloon.
The highlight of my trip to Skagway was supposed to be a helicopter ride to a dog sled camp on the Denver Glacier. Once you got off of the helicopter you were supposed to get to walk around on the glacier and then drive the dog sled team through the snow. Unfortunately, the weather did not cooperate and I had to cancel my tour. I was scheduled to ride in a helicopter with a woman named Terri. She is a third grade teacher and was so excited because one of the lessons that she teaches is on Alaska and the Iditarod. What better way to teach about dog racing than by having a picture of yourself leading a husky over a glacier? Not only did her tour get rained out today, but she also got rained out yesterday in Juneau. The weather is Southeast Alaska is pretty unpredictable so you can either come to Alaska and never get rained on or come and never see the sun. While I felt bad for her, I am lucky because the same tour that operates the helicopter tours in Skagway operates tours in Juneau so I will be sure to use my refund before I leave. We traded email addresses and I agreed to send her my pictures from my sledding experience.
I ate lunch at Starfire, a Thai resturant, that was also very good. Jenna really did a great job with her suggestions. Skagway is fun for an hour or two, but if you do not go on any sort of excursion the town gets very small, very quickly. I was banking on having the helicopter ride use up a few hours of my day but, when that fell through, I decided that there was no way I would last in Skagway until the 8 PM ferry.
I took the early ferry back to to Haines and met up with the Cones and Stefan. We went out to dinner at a pizza place called, ironically, Klondike. The restuarant is on the town fairgrounds. A few years ago, Disney filmed a movie called "White Fang" in Haines. Once production ended, they left the set standing and it has since become a focal point of the town.
That's about it for today. I'm about to crash because of the early ferry and excitement of walking around Skagway. Tomorrow is my last day in Haines so hopefully the weather clears...
**New pictures posted**
Wednesday, June 23, 2010
Day 37 - Haines, AK Day 3
Woke up early and headed to the clinic today. I spent the morning making the usual phone calls and patient interviews. Nothing really exciting or out of the ordinary. I am getting close to 80 phone interviews and hopefully I can push to about 140 or 150 before I wrap things up. It's tiring work but I think that the report I submit at the end will make it all worth it.
On my way to work I stopped by Mountain Market to have that "best cup of coffee in Haines". It was pretty good, but I'm not much of taste critic anyway. I ate lunch at Fireweed, a small bakery right near the dental clinic.
In the afternoon I took off and watched the Cardinals game. After the game, I went running again with Marnie and Leslie. The three of us ran out to Battery Point which overlooks the Lynn Canal and back towards downtown Haines.
I came back to the Cone's home and helped prepare dinner - steaks, salads, and potatoes. It was nice to sit and have a home-cooked meal while sitting around an actual kitchen table. It's funny to think of the little things that you miss when you are away from home.
After dinner we went out onto the boat to pick up our crab pots. It would have been fun, except it was pouring down rain. I guess I take the warm weather in the Midwest for granted, but if the people of Southeast Alaska took a day off every single time it rained nobody would ever get to spend time outside. We did catch a couple of crabs but decided to throw them back. There is an illness called PSP, Paralytic Shellfish Poisoning, that people can get if they eat certain bottom feeders which can trab certain algae in their systems that are toxic to humans. A man from Haines recently died from a suspected case of PSP, so people are not supposed to be eating crabs from the Lynn Canal until further notice. Since I am not a huge seafood fan anyway, that was all I needed to hear to sway me from even considering trying crab or other shellfish.
Tomorrow will be another early morning since Team USA plays at 6 AM. Stefan and I are going to get up and watch in the morning. A win and the team advances to the round of 16. Should be fun...
On my way to work I stopped by Mountain Market to have that "best cup of coffee in Haines". It was pretty good, but I'm not much of taste critic anyway. I ate lunch at Fireweed, a small bakery right near the dental clinic.
In the afternoon I took off and watched the Cardinals game. After the game, I went running again with Marnie and Leslie. The three of us ran out to Battery Point which overlooks the Lynn Canal and back towards downtown Haines.
I came back to the Cone's home and helped prepare dinner - steaks, salads, and potatoes. It was nice to sit and have a home-cooked meal while sitting around an actual kitchen table. It's funny to think of the little things that you miss when you are away from home.
After dinner we went out onto the boat to pick up our crab pots. It would have been fun, except it was pouring down rain. I guess I take the warm weather in the Midwest for granted, but if the people of Southeast Alaska took a day off every single time it rained nobody would ever get to spend time outside. We did catch a couple of crabs but decided to throw them back. There is an illness called PSP, Paralytic Shellfish Poisoning, that people can get if they eat certain bottom feeders which can trab certain algae in their systems that are toxic to humans. A man from Haines recently died from a suspected case of PSP, so people are not supposed to be eating crabs from the Lynn Canal until further notice. Since I am not a huge seafood fan anyway, that was all I needed to hear to sway me from even considering trying crab or other shellfish.
Tomorrow will be another early morning since Team USA plays at 6 AM. Stefan and I are going to get up and watch in the morning. A win and the team advances to the round of 16. Should be fun...
Monday, June 21, 2010
Day 36 - Haines, AK Day 2
The best part about being in Haines is the two-minute walk to work in the morning. In Juneau, I have to leave myself time for a 35 minute commute when planning my morning routine, but here I can just roll out of bed. I started early and got a few interviews out of the way. There are only two chairs in the Haines clinic (one hygienist and one dentist) so it isn’t difficult to complete the interviews. During the actual appointments I can use the empty desks to make my phone calls to the patients who missed their appointments.
The Haines clinic is unique because it is the only SEARHC clinic that serves patients that are not Native Alaskans. Since the population of Haines is 80% non-Native Alaskan the clinic sees the other patients on a sliding scale fee based on income. It’s a great service for the residents of the village and also leads to a smaller missed appointment rate. It’s interesting to note how the missed appointment rate declines when a percentage of your patient population is held fiscally responsible for their dental treatments…
For lunch, I went to the Mountain Market. The Mountain Market is an organic food store that is known for having the best cup of coffee in all of Haines. The also have great lunch sandwiches which is why I went this afternoon. The weather was great again today so I sat outside and enjoyed my lunch along with several eager crows.
After lunch I went back to the clinic to continue my phone calls. I met the physical therapist, Marnie, and got to talking to her about her job and life in Haines. It turns out she is a runner and so we decided to go for a trail run after work. I left a little early and walked back to the Cone’s home to hang out with Stefan. I helped him edit a powerpoint presentation that is a timeline of his time in Alaska. He is going to surprise the Cone’s by presenting them with all of his thoughts and pictures as a giant thank you for hosting him for the past six months.
Marnie picked me up and the two of us, along with her friend Leslie, went running up Racer Trail. The trail is named because it is host to a 4th of July race that starts at the bottom of the mountain, goes all the way to the top, and then goes right back down into town. The three of us ran the same route as the race – up and then back down. Marnie and Leslie were eager to run on the trails because they have just now dried up from the melted snow. Since Haines gets a lot of snowfall runners are reduced to street running during the winter months. In Haines running the streets is no fun since there is only one street and to do any kind of distance run you have to run in circles for hours. It took us about one hour and fifteen minutes to complete the loop.
After the run we went to the hotel in town to get dinner. Marnie’s boyfriend is the bartender and waiter at the restaurant so everything was on the house. Hopefully I’ll get to run with these two a few more times before I go back to Juneau.
I headed back to the Cone’s and decided to relax in their hot tub for a few minutes. I’ll post a picture of the view from the hot tub because it is impossible to describe how beautiful it is. It must be even more spectacular in the winter when everything around you is blanketed in snow.
That’s about it for today, but I don’t want to go to sleep because it is the summer solstice. Like I mentioned yesterday the sun rose around 3:15 this morning so I want to see how late it sets.
Until tomorrow…
The Haines clinic is unique because it is the only SEARHC clinic that serves patients that are not Native Alaskans. Since the population of Haines is 80% non-Native Alaskan the clinic sees the other patients on a sliding scale fee based on income. It’s a great service for the residents of the village and also leads to a smaller missed appointment rate. It’s interesting to note how the missed appointment rate declines when a percentage of your patient population is held fiscally responsible for their dental treatments…
For lunch, I went to the Mountain Market. The Mountain Market is an organic food store that is known for having the best cup of coffee in all of Haines. The also have great lunch sandwiches which is why I went this afternoon. The weather was great again today so I sat outside and enjoyed my lunch along with several eager crows.
After lunch I went back to the clinic to continue my phone calls. I met the physical therapist, Marnie, and got to talking to her about her job and life in Haines. It turns out she is a runner and so we decided to go for a trail run after work. I left a little early and walked back to the Cone’s home to hang out with Stefan. I helped him edit a powerpoint presentation that is a timeline of his time in Alaska. He is going to surprise the Cone’s by presenting them with all of his thoughts and pictures as a giant thank you for hosting him for the past six months.
Marnie picked me up and the two of us, along with her friend Leslie, went running up Racer Trail. The trail is named because it is host to a 4th of July race that starts at the bottom of the mountain, goes all the way to the top, and then goes right back down into town. The three of us ran the same route as the race – up and then back down. Marnie and Leslie were eager to run on the trails because they have just now dried up from the melted snow. Since Haines gets a lot of snowfall runners are reduced to street running during the winter months. In Haines running the streets is no fun since there is only one street and to do any kind of distance run you have to run in circles for hours. It took us about one hour and fifteen minutes to complete the loop.
After the run we went to the hotel in town to get dinner. Marnie’s boyfriend is the bartender and waiter at the restaurant so everything was on the house. Hopefully I’ll get to run with these two a few more times before I go back to Juneau.
I headed back to the Cone’s and decided to relax in their hot tub for a few minutes. I’ll post a picture of the view from the hot tub because it is impossible to describe how beautiful it is. It must be even more spectacular in the winter when everything around you is blanketed in snow.
That’s about it for today, but I don’t want to go to sleep because it is the summer solstice. Like I mentioned yesterday the sun rose around 3:15 this morning so I want to see how late it sets.
Until tomorrow…
Day 35 - Haines, AK Day 1
As I sit here and type, it’s hard to believe that I have already completed more than half of my summer project experience. It’s amazing how quickly I have progressed from “Day 1” to “Day 35”. Each day is still new, fun, and exciting and often brings a nice element of surprise.
Today I boarded the 8 AM Fairweather vessel to Haines. I knew that I would be staying with Lisa Cone and her husband, Sean, but I did not know what an incredibly open, sharing family they would turn out to be. Lisa met me at the ferry terminal and drove me around Haines before we headed to her home. The tour of Haines took about 6 minutes as I saw the grocery store, the school, the library, the restaurant, the bar, and, of course, the SEARHC clinic. There are no stoplights in Haines, and only one street through the middle of town. The population is right around 1,000, just like Hoonah. Even though the populations are similar, Haines is a bit more developed than Hoonah because of the Haines Junction.
The junction is a road in and out of Haines and is the only way you can drive from Southeast Alaska to the interior of the state (Anchorage and Fairbanks). You can also drive into Canada towards the Yukon Territory and see areas such as Whitehorse. Haines is a beautiful town. It sits right on the Lynn Canal and it surrounded by huge mountains covered with snow. Haines gets about 30 feet of snow each year so there is much more snow on the mountains here than in Juneau. Haines is known for its large population of bald eagles that come during the early part of September to feed on the late spawning pink salmon.
We pulled up to the Cone’s home around 10:30. Her husband was out and she had some errands to run so she left me alone to get settled. As promised, I found their big screen TV and sat down to watch baseball and golf. The Cone’s are hosting an exchange student who in from Vienna, Austria. His name is Stefan and he is part of a program that brings foreign high school students to the United States to see what it’s like to live here. I’m not sure how the program decided that Haines, Alaska was an accurate portrayal of life in the United States, but that’s another story.
Stefan and I watched golf together. He loves to speak English because he is still learning and sorting out certain areas of speech so he just goes on and on about anything and everything. He is a really nice kid and will be fun to have around for the next few days. Eventually, Sean came back home and asked if Stefan and I wanted to go out crabbing on the Lynn Canal. Of course, the one time I get invited to go out fishing or crabbing over the past few weeks would coincide with the final round of the U.S. Open, but in the end going crabbing turned out to the better choice.
I borrowed Lisa’s Extra-Tuffs (knee high rubber boots that are as much of a fashion staple in Alaska as Nikes or Reeboks are in the continental United States) and headed off to the canal. We took the boat out towards Battery Point and then dropped the crabbing buckets into the water. I guess in my mind crabbing sounded a little more involved that dropping a metal rectangle into the ocean but, nonetheless, it was fun to spend a few hours out on the water. There were whales, sea lions, and bald eagles all along the coastline and there were also lots of beaches and residences along the water. We took the boat as far as Mud Bay and then turned around and headed back to the crab pots.
Unfortunately, we only caught a misguided flounder and a female crab (you don’t keep the females so that they can reproduce and make more crabs) so we decided to do the next best thing – go to the grocery store and buy our crabs. There is a huge debate going on between the locals and the commercial fishing companies about who can place crab pots where. The locals are upset that the commercial fishing companies are placing their crab pots in the easily accessible places even though they have the means to reach coves and inlets that the locals cannot. Before we headed back to shore we dropped the pots in a different location so that they could sit in the water overnight and hopefully bring us some better luck.
Stefan and I grabbed a quick sandwich and then went up to the school soccer fields to play soccer with some of his friends from the high school. The weather was really nice and, since it was the day before the summer solstice, we had plenty of sunlight well past 10 PM. After soccer I walked back to the Cone’s house and took a quick shower. I was downstairs surfing the internet when Zach, Lisa and Sean’s 6 year old son, decided that it was time to play.
He was intrigued by the widgets on my MacBook and was particularly fond of the English to Spanish translator. He laughed for a good 10 minutes after we translated the word “butt”. He told me that he was at an advanced reading level for his grade so I decided to test him out. I always read the sports page from the Post Dispatch online so I sat back and relaxed while he read me articles by Bernie Miklasz and Bryan Burwell. After he finished reading me the paper, I collapsed into bed. It was a long, but fun, day.
Tomorrow I will be in the Haines clinic doing patient interviews and phone interviews. There are only another couple of work days until I have to wrap up my surveying and begin on my education materials so these next few days I’ll be working long, hard hours. Tomorrow is also the solstice, which is an unofficial holiday in the state. The sun is supposed to rise at 3:15 AM so I better remember to close the blinds…
Finally... Happy Father's Day!
Today I boarded the 8 AM Fairweather vessel to Haines. I knew that I would be staying with Lisa Cone and her husband, Sean, but I did not know what an incredibly open, sharing family they would turn out to be. Lisa met me at the ferry terminal and drove me around Haines before we headed to her home. The tour of Haines took about 6 minutes as I saw the grocery store, the school, the library, the restaurant, the bar, and, of course, the SEARHC clinic. There are no stoplights in Haines, and only one street through the middle of town. The population is right around 1,000, just like Hoonah. Even though the populations are similar, Haines is a bit more developed than Hoonah because of the Haines Junction.
The junction is a road in and out of Haines and is the only way you can drive from Southeast Alaska to the interior of the state (Anchorage and Fairbanks). You can also drive into Canada towards the Yukon Territory and see areas such as Whitehorse. Haines is a beautiful town. It sits right on the Lynn Canal and it surrounded by huge mountains covered with snow. Haines gets about 30 feet of snow each year so there is much more snow on the mountains here than in Juneau. Haines is known for its large population of bald eagles that come during the early part of September to feed on the late spawning pink salmon.
We pulled up to the Cone’s home around 10:30. Her husband was out and she had some errands to run so she left me alone to get settled. As promised, I found their big screen TV and sat down to watch baseball and golf. The Cone’s are hosting an exchange student who in from Vienna, Austria. His name is Stefan and he is part of a program that brings foreign high school students to the United States to see what it’s like to live here. I’m not sure how the program decided that Haines, Alaska was an accurate portrayal of life in the United States, but that’s another story.
Stefan and I watched golf together. He loves to speak English because he is still learning and sorting out certain areas of speech so he just goes on and on about anything and everything. He is a really nice kid and will be fun to have around for the next few days. Eventually, Sean came back home and asked if Stefan and I wanted to go out crabbing on the Lynn Canal. Of course, the one time I get invited to go out fishing or crabbing over the past few weeks would coincide with the final round of the U.S. Open, but in the end going crabbing turned out to the better choice.
I borrowed Lisa’s Extra-Tuffs (knee high rubber boots that are as much of a fashion staple in Alaska as Nikes or Reeboks are in the continental United States) and headed off to the canal. We took the boat out towards Battery Point and then dropped the crabbing buckets into the water. I guess in my mind crabbing sounded a little more involved that dropping a metal rectangle into the ocean but, nonetheless, it was fun to spend a few hours out on the water. There were whales, sea lions, and bald eagles all along the coastline and there were also lots of beaches and residences along the water. We took the boat as far as Mud Bay and then turned around and headed back to the crab pots.
Unfortunately, we only caught a misguided flounder and a female crab (you don’t keep the females so that they can reproduce and make more crabs) so we decided to do the next best thing – go to the grocery store and buy our crabs. There is a huge debate going on between the locals and the commercial fishing companies about who can place crab pots where. The locals are upset that the commercial fishing companies are placing their crab pots in the easily accessible places even though they have the means to reach coves and inlets that the locals cannot. Before we headed back to shore we dropped the pots in a different location so that they could sit in the water overnight and hopefully bring us some better luck.
Stefan and I grabbed a quick sandwich and then went up to the school soccer fields to play soccer with some of his friends from the high school. The weather was really nice and, since it was the day before the summer solstice, we had plenty of sunlight well past 10 PM. After soccer I walked back to the Cone’s house and took a quick shower. I was downstairs surfing the internet when Zach, Lisa and Sean’s 6 year old son, decided that it was time to play.
He was intrigued by the widgets on my MacBook and was particularly fond of the English to Spanish translator. He laughed for a good 10 minutes after we translated the word “butt”. He told me that he was at an advanced reading level for his grade so I decided to test him out. I always read the sports page from the Post Dispatch online so I sat back and relaxed while he read me articles by Bernie Miklasz and Bryan Burwell. After he finished reading me the paper, I collapsed into bed. It was a long, but fun, day.
Tomorrow I will be in the Haines clinic doing patient interviews and phone interviews. There are only another couple of work days until I have to wrap up my surveying and begin on my education materials so these next few days I’ll be working long, hard hours. Tomorrow is also the solstice, which is an unofficial holiday in the state. The sun is supposed to rise at 3:15 AM so I better remember to close the blinds…
Finally... Happy Father's Day!
Sunday, June 20, 2010
Day 34 - Bunko
There is a running club in Juneau called the Southeast Road Runners and they put on races all the time throughout Juneau. It costs $5 to enter each race, and that $5 buys you an official time, a bottle of water, and some nice running company on Saturday or Sunday morning. I was supposed to run in the Ben Blackgoat Memorial Race this morning on the Perseverance Trail but I missed the early bus downtown. I was pretty mad at myself because I had been looking forward to the race all week and was excited to race on the trails. Unfortunately, I missed out on all of the excitement and ended up having to create my own version of the race.
I decided to meet Dr. Nasicmento and Dr. Dee for breakfast at a little diner called the Valley Restaurant. It is run by Philippine women who speak about six words of English – coffee, bacon, pancakes, eggs, orange juice, and toast. Despite the language barrier for verbal words, they can still cook a damn good breakfast. The food there is really good and cheap and the women never let your cup of coffee get below half full. Instead of taking the bus or getting picked up, I ran from my dorm to the restaurant. I ended up going over 8 miles and feeling a little better about missing out on the race earlier in the morning.
I spent some time outside watching the US Open and the Cardinals in the afternoon. Since my TV connection off of the computer isn’t always clear and consistent, I have gotten really into listening to the Cardinals on the big 550, KTRS. There is nothing better than a sunny afternoon and an exciting home run call from Mike Shannon or John Rooney that leads to a Cardinals victory.
The Wilkinsons had an office party at their house tonight. Everyone brought food and drinks and we grilled and ate out on the Wilkinson’s large deck. We watched the bald eagles soar overhead and saw the seals playing in the channel. Not a bad way to spend an evening in and of itself, but the food and the scenery were merely a warm-up for the intense Bunko game that came after.
Bunko simply consists of rolling three dice to try and get a certain number, but I have never seen anything so intense in my life. There were married women fighting young residents on the floor for a pair of dice that had fallen off the table, there was so much screaming and yelling that I’m surprised the neighbors didn’t come over and complain, and there was enough trash talking to make an NFL middle linebacker blush. Who knew that three dice could raise such a commotion? I’m not sure if the intense competition was a result of the drinks people brought over or the true desire to win but, either way, it was an awesome way to spend a Saturday night.
I just finished packing for Haines since I am heading there in the morning. I’m getting back on the fast ferry for a two hour ride through the channel. It’s supposed to be nice again tomorrow so I’ll get some more great scenery off the back of the boat.
I’m staying with Lisa Cone, a hygienist from Haines, and her husband for the next few days. They are coming to pick me up from the ferry terminal and taking me to their home where I will promptly plant myself on the couch to watch the final round of the US Open and some afternoon baseball.
Off to bed dreading another 6:15 AM alarm…
I decided to meet Dr. Nasicmento and Dr. Dee for breakfast at a little diner called the Valley Restaurant. It is run by Philippine women who speak about six words of English – coffee, bacon, pancakes, eggs, orange juice, and toast. Despite the language barrier for verbal words, they can still cook a damn good breakfast. The food there is really good and cheap and the women never let your cup of coffee get below half full. Instead of taking the bus or getting picked up, I ran from my dorm to the restaurant. I ended up going over 8 miles and feeling a little better about missing out on the race earlier in the morning.
I spent some time outside watching the US Open and the Cardinals in the afternoon. Since my TV connection off of the computer isn’t always clear and consistent, I have gotten really into listening to the Cardinals on the big 550, KTRS. There is nothing better than a sunny afternoon and an exciting home run call from Mike Shannon or John Rooney that leads to a Cardinals victory.
The Wilkinsons had an office party at their house tonight. Everyone brought food and drinks and we grilled and ate out on the Wilkinson’s large deck. We watched the bald eagles soar overhead and saw the seals playing in the channel. Not a bad way to spend an evening in and of itself, but the food and the scenery were merely a warm-up for the intense Bunko game that came after.
Bunko simply consists of rolling three dice to try and get a certain number, but I have never seen anything so intense in my life. There were married women fighting young residents on the floor for a pair of dice that had fallen off the table, there was so much screaming and yelling that I’m surprised the neighbors didn’t come over and complain, and there was enough trash talking to make an NFL middle linebacker blush. Who knew that three dice could raise such a commotion? I’m not sure if the intense competition was a result of the drinks people brought over or the true desire to win but, either way, it was an awesome way to spend a Saturday night.
I just finished packing for Haines since I am heading there in the morning. I’m getting back on the fast ferry for a two hour ride through the channel. It’s supposed to be nice again tomorrow so I’ll get some more great scenery off the back of the boat.
I’m staying with Lisa Cone, a hygienist from Haines, and her husband for the next few days. They are coming to pick me up from the ferry terminal and taking me to their home where I will promptly plant myself on the couch to watch the final round of the US Open and some afternoon baseball.
Off to bed dreading another 6:15 AM alarm…
Friday, June 18, 2010
Day 33 - Friday
I woke up at 6 AM today to watch Team USA in the World Cup. I went up to the lodge with Will to watch on the big screen TV. We were up there with 15 other people, all crammed onto small couches and cheering on USA. It turned out to be a pretty exciting game.
I headed to work in the late morning and began making my phone calls. My telephone survey is really progressing along quite nicely. I am starting to build my numbers and it still amazes me to hear the perspectives of many of these Native Alaskans. Dr. Hort told me that she brought some of the suggestions I made about patient contact information to the office manager's meeting and they are going to look into making some changes. Glad to see my work is paying off!
I went out to dinner at the Twisted Fish with some people from the office. I had Halibut tacos which were pretty good. I have never been much of a seafood fan, but I guess I've never had it this fresh. There was a free concert on the harbor so we stopped and listened for a bit. We went and got some ice cream and then headed back to the Mendenhall Valley. I crashed early since I had gotten up so early to watch the soccer game.
Everything is going pretty well still. I am hoping for some nice weather this weekend so that I can get out and run and continue to explore.
All for now...
I headed to work in the late morning and began making my phone calls. My telephone survey is really progressing along quite nicely. I am starting to build my numbers and it still amazes me to hear the perspectives of many of these Native Alaskans. Dr. Hort told me that she brought some of the suggestions I made about patient contact information to the office manager's meeting and they are going to look into making some changes. Glad to see my work is paying off!
I went out to dinner at the Twisted Fish with some people from the office. I had Halibut tacos which were pretty good. I have never been much of a seafood fan, but I guess I've never had it this fresh. There was a free concert on the harbor so we stopped and listened for a bit. We went and got some ice cream and then headed back to the Mendenhall Valley. I crashed early since I had gotten up so early to watch the soccer game.
Everything is going pretty well still. I am hoping for some nice weather this weekend so that I can get out and run and continue to explore.
All for now...
Thursday, June 17, 2010
Day 32 - Doh!
I met my fourth roommate today. I think I can do any accurate job of portraying how well we will get along based on the following story. I was sitting eating dinner watching Game 7 of the NBA Finals between the Lakers and the Celtics. Even in Alaska, where they have no professional sports, there were people on the bus betting whether Kobe Bryant or Paul Pierce would have a better stat line. So that kind of sets the tone for how big of a game it was.
Ian, the new roommate, sits down next to me and asks who is playing. I said, "Lakers and Celtics. Game 7. NBA Finals." Nothing. Not even a trace of recognition. I guess I shouldn't be quick to judge, but anybody that knows me knows that the quickest way to get me started is talking sports. There could be some long awkward breakfasts and dinners upcoming if Ian doesn't learn about the importance of the double switch or the sacrifice fly pretty quickly. Besides his lack of sports acumen, he seems like a pretty nice guy. He goes to Western Kentucky University and wants to be a meteorologist. He is working as an intern for the National Weather Service as part of a program that guarantees jobs to those who work a certain number of hours in the same city. Essentially, it is the equivalent to Vanderbilt's early acceptance program to their medical school. As long as he works this summer and next, he is guaranteed a job after he graduates.
Other than the roommate excitement, today was pretty similar to last Thursday. I spent the day in the OB clinic interviewing and surveying patients for my education material. I also spent some time compiling the long list of phone numbers from patients who missed appointments who I'm going to have to call all day tomorrow.
Also, after about a week of hiding, the sun reappeared today. I took advantage and went on my first really good run in a long time. There is a race on Saturday morning that I am thinking about running in if I can find a ride to the starting line. I think that summer classes have begun at UAS because there is a lot more activity on campus than before. I see more kids hanging out in the lodge and around the other dorm buildings. I met a girl from Kansas City today who is a full-time UAS student. And I think it's a hassle to get from Nashville to St. Louis for Thanksgiving...
Tomorrow I am waking up early with another one of my roommates to watch Team USA in the World Cup. I know nothing about soccer, but for some reason the World Cup feels like something you shouldn't miss (even if you have to wake up at 6 AM!).
One more day until the weekend.
Ian, the new roommate, sits down next to me and asks who is playing. I said, "Lakers and Celtics. Game 7. NBA Finals." Nothing. Not even a trace of recognition. I guess I shouldn't be quick to judge, but anybody that knows me knows that the quickest way to get me started is talking sports. There could be some long awkward breakfasts and dinners upcoming if Ian doesn't learn about the importance of the double switch or the sacrifice fly pretty quickly. Besides his lack of sports acumen, he seems like a pretty nice guy. He goes to Western Kentucky University and wants to be a meteorologist. He is working as an intern for the National Weather Service as part of a program that guarantees jobs to those who work a certain number of hours in the same city. Essentially, it is the equivalent to Vanderbilt's early acceptance program to their medical school. As long as he works this summer and next, he is guaranteed a job after he graduates.
Other than the roommate excitement, today was pretty similar to last Thursday. I spent the day in the OB clinic interviewing and surveying patients for my education material. I also spent some time compiling the long list of phone numbers from patients who missed appointments who I'm going to have to call all day tomorrow.
Also, after about a week of hiding, the sun reappeared today. I took advantage and went on my first really good run in a long time. There is a race on Saturday morning that I am thinking about running in if I can find a ride to the starting line. I think that summer classes have begun at UAS because there is a lot more activity on campus than before. I see more kids hanging out in the lodge and around the other dorm buildings. I met a girl from Kansas City today who is a full-time UAS student. And I think it's a hassle to get from Nashville to St. Louis for Thanksgiving...
Tomorrow I am waking up early with another one of my roommates to watch Team USA in the World Cup. I know nothing about soccer, but for some reason the World Cup feels like something you shouldn't miss (even if you have to wake up at 6 AM!).
One more day until the weekend.
Wednesday, June 16, 2010
Day 31 - Sitka, AK Day 3/Moving back to UAS
Today was my last day in Sitka - well, at least for a couple of weeks. I woke up early and took advantage of the free breakfast from the diet office. Unfortunately, the weather was cold and rainy today so I had to scrap my sightseeing plan and instead went into the dental clinic for about an hour. I spent some more time in the clinic and lab observing the prosthodontists crank out dentures for thankful patients.
I took the Sitka bus to the ferry terminal. The bus isn't really a bus though, it's more like a tiny little shuttle van. At while there is a set route, bus drivers are friendly and willing to take you anywhere you want to go. For $2 you can ride for as long as you would like. I miscalculated how far it was to the ferry terminal and ended up arriving very early. This turned out to be even more of a problem as the ferry coming from Juneau was late. Not a good combination.
I did meet another Americorps volunteer who is in Juneau working on HIV prevention. She works in the hostel in Juneau and in return the hostel is housing her for free. All she has to do is spend a couple of nights at the front desk. It was nice to have someone to talk to on the ferry. We met a group from Europe who were backpacking all throughout Alaska. They had these huge 30 pound packs, tons of pictures, and lots of stories. It helped the time pass quickly on the ferry.
Dr. Hort and her daughter were waiting for me when I got off of the ferry in Juneau and took me over to the Ray's house to pick up my stuff. When I walked in the door Mrs. Ray dropped everything and gave me a huge hug. Apparently the last time they had gone out of town the house-sitter had left a bit of a mess. I had run the dishwasher, vacuumed the floor, and washed my linens before leaving to Sitka so it was a nice surprise for her to come home to a nice, clean house. As my friends and roommate can attest to, I am pretty good at keeping things neat and clean. I said my final goodbye to Sky and then headed back to the dorm.
On the way back to the dorm Dr. Hort's six year old daughter was explaining to me how she was scared of how fast the pitching machine pitched the softball and that she was afraid to stand in the batter's box. I told her about the time I faced a pitcher who threw in the mid 90's and suddenly her pitching machine didn't seem so bad. She laughed at me when I told her that I play softball because in her mind softball is just for girls.
When I walked back into my apartment there were two guys hanging around the kitchen table. It appears as if my days of having the dorm room to myself are over. As it turns out, the guys I will be living with are really nice. The are both doing an internship with U.S. Forest Services and will be here through the middle of September. One, Dan, is a student at Humboldt State University in California, and the other, Will, had graduated from the University of Minnesota. They are both around my age and really into fishing, hiking, and biking (I guess you have to be to do an internship with the Forest Services) so I'm thinking we'll get along pretty well. We have a fourth roommate coming tomorrow. He is from Knoxville, TN so it'll be nice to have a fellow country music fan in the house.
It's been a long day and I have to get up early tomorrow to get to the OB clinic by 8 to continue my interviewing. Off to bed...
**New pictures of the ferry added**
I took the Sitka bus to the ferry terminal. The bus isn't really a bus though, it's more like a tiny little shuttle van. At while there is a set route, bus drivers are friendly and willing to take you anywhere you want to go. For $2 you can ride for as long as you would like. I miscalculated how far it was to the ferry terminal and ended up arriving very early. This turned out to be even more of a problem as the ferry coming from Juneau was late. Not a good combination.
I did meet another Americorps volunteer who is in Juneau working on HIV prevention. She works in the hostel in Juneau and in return the hostel is housing her for free. All she has to do is spend a couple of nights at the front desk. It was nice to have someone to talk to on the ferry. We met a group from Europe who were backpacking all throughout Alaska. They had these huge 30 pound packs, tons of pictures, and lots of stories. It helped the time pass quickly on the ferry.
Dr. Hort and her daughter were waiting for me when I got off of the ferry in Juneau and took me over to the Ray's house to pick up my stuff. When I walked in the door Mrs. Ray dropped everything and gave me a huge hug. Apparently the last time they had gone out of town the house-sitter had left a bit of a mess. I had run the dishwasher, vacuumed the floor, and washed my linens before leaving to Sitka so it was a nice surprise for her to come home to a nice, clean house. As my friends and roommate can attest to, I am pretty good at keeping things neat and clean. I said my final goodbye to Sky and then headed back to the dorm.
On the way back to the dorm Dr. Hort's six year old daughter was explaining to me how she was scared of how fast the pitching machine pitched the softball and that she was afraid to stand in the batter's box. I told her about the time I faced a pitcher who threw in the mid 90's and suddenly her pitching machine didn't seem so bad. She laughed at me when I told her that I play softball because in her mind softball is just for girls.
When I walked back into my apartment there were two guys hanging around the kitchen table. It appears as if my days of having the dorm room to myself are over. As it turns out, the guys I will be living with are really nice. The are both doing an internship with U.S. Forest Services and will be here through the middle of September. One, Dan, is a student at Humboldt State University in California, and the other, Will, had graduated from the University of Minnesota. They are both around my age and really into fishing, hiking, and biking (I guess you have to be to do an internship with the Forest Services) so I'm thinking we'll get along pretty well. We have a fourth roommate coming tomorrow. He is from Knoxville, TN so it'll be nice to have a fellow country music fan in the house.
It's been a long day and I have to get up early tomorrow to get to the OB clinic by 8 to continue my interviewing. Off to bed...
**New pictures of the ferry added**
Tuesday, June 15, 2010
Day 30 - Sitka, AK Day 2
After yesterday’s travels and the stressful housing predicament I decided to sleep in late today. I woke up and went for a run around the hospital complex. The diet office has free coffee and tea all morning so I took advantage of that to go along with my free breakfast. I showered and watched a little bit of the World Cup and then headed to the hospital to meet with the OB nurse.
The OB nurse in Sitka is named Valerie and she was incredibly nice and accommodating. She showed me around the clinic and agreed to send patients my way after they checked in at the nurse’s station. I was a bit disappointed to learn that today was going to be a slow day in the OB clinic with only 8-10 patients. On a normal Tuesday there are anywhere from 20-25 patients seen, so I got a bit unlucky in this regard. I spoke with Valerie and she agreed to distribute the survey to patients next week when the schedule is back to normal. This will be extremely helpful as it will allow me to increase the number of people who get to add their input. This was very nice of Valerie and I am extremely appreciative that she has agreed to do this. I’ll pick up the completed surveys when I return to Sitka in two weeks.
After meeting with Valerie I headed back down to the diet office to get my lunch. The food actually isn’t terrible and I feel like an elementary school student again – walking around with my carton of orange juice and cookie covered in saran wrap. Each meal has vegetables, fruit, an entrée, and dessert. Plus, I get unlimited juice, coffee, milk, and tea. There is a TV in the doctor’s lounge on the third floor of the hospital so I went up there and watched TV while I ate.
Following lunch I went down to the OB clinic and set up my table with brochures and my giveaways. Since there were so few patients today I got a chance to do a lot of reading on my Kindle. Even though it was a slow day, the information that I got from the patients is always meaningful. The age range of women seen in the OB clinic is very large in Sitka as well. I saw a girl younger than me all the way up to a women in her 40’s about to deliver her ninth baby. Large families for the Tlingit natives are normal as most begin having children in their teens and continue on through marriage. There is also not a large emphasis on any form of birth control and the idea of abortion is looked upon in a very negative light throughout the state. Plus, when it gets dark, cold, and rainy at 2 PM in the winter months, what else are you going to do?
I met with Martha Pearson and Litia Garrison in the afternoon for what turned out to be an extremely productive and helpful meeting. We discussed ways in which their organization, Wisewomen, has distributed patient education materials in the past few years. Essentially my project with OB patients is reaching the same demographic as Wisewomen so what they have found to be successful or unsuccessful should hold true for me as well. We talked about the need for strong local presence in our materials and how it is particularly important to not be at all condescending towards the Native Alaskans. It was also interesting to hear how their incentive based mailings only produced marginal results. Even with the incentive of a $25 gift certificate only about 30% of the patients responded to the Wisewomen surveys. They also showed me a series of postcard mailings that they are implementing in a few months that they hope will be more successful. The meeting gave me many great ideas for how to reach our patients in new, creative ways. I’m excited to share my new ideas with Dr. Hort to see what she thinks.
I went to grab dinner at the diet office. I have become friendly with the man who hands out the trays so he likes to throw extra dessert on my tray. I decided not to take the bike back into town today because it’s a bit cold and windy. I have never really been much of a bike rider, but riding a bike over a bridge could be the scariest thing I’ve ever done. As a result, I am going to take advantage of the internet and digital cable and just relax. It’s been a fun few days in Sitka and I’m excited to come back here in a few weeks. I now know my way around the town so I will be sure to explore the trail systems and fun, tourist areas next time I’m in town. If it’s nice tomorrow I would like to head to the Alaska Raptor Center where they rehabilitate birds and then set them off into the wild. There is also a bear fortress where you can see brown bears in a natural, but controlled, setting. If the weather is cold and rainy again I will head back to the dental clinic to check out some more bulk denture making.
That’s all for today…
The OB nurse in Sitka is named Valerie and she was incredibly nice and accommodating. She showed me around the clinic and agreed to send patients my way after they checked in at the nurse’s station. I was a bit disappointed to learn that today was going to be a slow day in the OB clinic with only 8-10 patients. On a normal Tuesday there are anywhere from 20-25 patients seen, so I got a bit unlucky in this regard. I spoke with Valerie and she agreed to distribute the survey to patients next week when the schedule is back to normal. This will be extremely helpful as it will allow me to increase the number of people who get to add their input. This was very nice of Valerie and I am extremely appreciative that she has agreed to do this. I’ll pick up the completed surveys when I return to Sitka in two weeks.
After meeting with Valerie I headed back down to the diet office to get my lunch. The food actually isn’t terrible and I feel like an elementary school student again – walking around with my carton of orange juice and cookie covered in saran wrap. Each meal has vegetables, fruit, an entrée, and dessert. Plus, I get unlimited juice, coffee, milk, and tea. There is a TV in the doctor’s lounge on the third floor of the hospital so I went up there and watched TV while I ate.
Following lunch I went down to the OB clinic and set up my table with brochures and my giveaways. Since there were so few patients today I got a chance to do a lot of reading on my Kindle. Even though it was a slow day, the information that I got from the patients is always meaningful. The age range of women seen in the OB clinic is very large in Sitka as well. I saw a girl younger than me all the way up to a women in her 40’s about to deliver her ninth baby. Large families for the Tlingit natives are normal as most begin having children in their teens and continue on through marriage. There is also not a large emphasis on any form of birth control and the idea of abortion is looked upon in a very negative light throughout the state. Plus, when it gets dark, cold, and rainy at 2 PM in the winter months, what else are you going to do?
I met with Martha Pearson and Litia Garrison in the afternoon for what turned out to be an extremely productive and helpful meeting. We discussed ways in which their organization, Wisewomen, has distributed patient education materials in the past few years. Essentially my project with OB patients is reaching the same demographic as Wisewomen so what they have found to be successful or unsuccessful should hold true for me as well. We talked about the need for strong local presence in our materials and how it is particularly important to not be at all condescending towards the Native Alaskans. It was also interesting to hear how their incentive based mailings only produced marginal results. Even with the incentive of a $25 gift certificate only about 30% of the patients responded to the Wisewomen surveys. They also showed me a series of postcard mailings that they are implementing in a few months that they hope will be more successful. The meeting gave me many great ideas for how to reach our patients in new, creative ways. I’m excited to share my new ideas with Dr. Hort to see what she thinks.
I went to grab dinner at the diet office. I have become friendly with the man who hands out the trays so he likes to throw extra dessert on my tray. I decided not to take the bike back into town today because it’s a bit cold and windy. I have never really been much of a bike rider, but riding a bike over a bridge could be the scariest thing I’ve ever done. As a result, I am going to take advantage of the internet and digital cable and just relax. It’s been a fun few days in Sitka and I’m excited to come back here in a few weeks. I now know my way around the town so I will be sure to explore the trail systems and fun, tourist areas next time I’m in town. If it’s nice tomorrow I would like to head to the Alaska Raptor Center where they rehabilitate birds and then set them off into the wild. There is also a bear fortress where you can see brown bears in a natural, but controlled, setting. If the weather is cold and rainy again I will head back to the dental clinic to check out some more bulk denture making.
That’s all for today…
Monday, June 14, 2010
Reflection at the halfway point
I am currently on a ferry halfway between Juneau and Sitka so I figured that it was an appropriate time to reflect on the halfway point of my summer project experience. So far, so good. I have been having such an enriching experience – not just through the stated goals of my summer project, but also through the social and cultural experience of Alaska. I have hiked 2,500 feet in elevation change to an alpine ridge where I saw bald eagles and blooming Shooting Stars. I have wandered 2.9 out of 3 miles to John Muir Cabin before turning around and sprinting back to the trailhead, terrified of brown bears every step of the way. I have seen traditional Tlingit dances and parades. I have seen “big” cities and small villages. Each experience has taught me something about the state of Alaska.
Alaska is such a unique and interesting place. The land mass of the state would cover 20% of the lower 48, however, the population of the state is so small. Every city in Alaska is like a small bubble – a tiny populated, developed area surrounded by thousands of square miles of vast forest. Even in cities like Juneau and Anchorage there is nothing beyond the city limits.
The people in Alaska all have interesting stories. There are the traditional people, the Tlingit, who spend their lives attempting to balance the Eagle and the Raven and continue storied family legacies that preserve their ancient culture and tradition. There are also many who have come to Alaska to find out something about themselves or to escape the fast pace of a big city. Either way, everyone that you meet offers a unique monologue on life and what it has brought them.
In regards to my summer project, I have learned some pretty incredible things. When I spoke to people before May 16th I told them, “Why Alaska? I’m going to Alaska because dentistry is done differently there and should offer me a unique perspective on the profession.” Differently? Until recently I’m not sure I even know what that meant, however, some recent experiences have helped to clarify.
Maybe it was the woman I spoke to who walked 60 miles through dense, bear-filled forest with her 75 year old mother and 8 year old son just to catch a ferry to come to Juneau to schedule a dental appointment. The woman was the only one of the three that came to Juneau for some dental work. The other two? They wanted to see what Wal-Mart and Costco were.
It could have been my experience in Hoonah, AK where SEARHC dentists visit the clinic once every two months. I did some math after my trip to Hoonah. There are ten appointment slots for four consecutive days for a total of 40 appointments. There are 800 dental patients in the village. If a dentist visits once every two months, that averages out to 20 dental appointments every month. By this math, it would take the dentists 40 months to see each patient once! 40 months. That’s enough time for a cavity to turn into a root canal and a root canal to turn into a nasty oral infection.
Or maybe it was just in Juneau, where I have continually spoken with patients who have simply told me they forgot their dental appointments or just didn’t feel like coming in that day. These people are offered an incredible service by the Indian Health Services – a service that provides them free dental and medical care for as long as they need it – yet they have found a way to abuse the system while others clamor for an opportunity to schedule a routine hygiene appointment because they feel the dentists are too young or the residents are simply there to experiment.
Different isn’t in the way a dentist preps a crown or crafts together a bridge – it’s in the people that make up the patient base. It’s in the mindset of patients who still don’t understand the basics of brushing and flossing. And it’s in the devotion of public health dentists who pass up a chance to join country clubs and drive BMWs to extract rotten teeth and fill cavities from the mouths of skeptical Native Alaskans. If nothing else the trip has offered a great opportunity for me to re-evaluate (not saying I’m quite ready to sacrifice the country club just yet!) the importance of dentistry and its impact on a population. Beyond that, I’ve been offered a chance to do more than just think – I’ve been offered a chance to make a real difference.
My telephone survey has helped identify whether or not patients are overcome with dental anxiety and fear and given the SEARHC dental staff a litany of reasons why their patients aren’t coming to their appointments 25% of the time. In addition, it has also helped to fix a broken scheduling system by identifying some disconnects in patient contact information. Hopefully, dentists will be given more access to Eaglesoft which will help provide the front desk with a more reliable way to confirm appointments and reach patients. There’s only so much you can learn over a telephone, though.
The waiting room survey has been equally effective. It has helped to identify that SEARHC’s approach to dental education information in the past wasn’t quite as strong as it could have been. It’s helped prove that, yes, these patients do generally care for their well-being and oral health – we just aren’t reaching them in the right way. Hopefully once the dust settles and the data is analyzed Dr. Hort and I will come up with something powerful and meaningful that will reach a new generation of patients and help break down the walls of skepticism and prejudice.
Even more than just the general knowledge of the state or the chance to make a difference, the trip has extended an opportunity to start over after two tough years - both personally and academically. I have always loved video games because you can always stop and hit the reset button. You get an endless amount of chances to do whatever it is you want – you simply cannot fail. In life, you can’t hit the reset button after getting a poor grade on a test you know you should have spent more time studying for or after reacting poorly to bad news. But for the first time in two years I feel lucky. At times over the past two years I have felt like I have been stuck in quicksand. Not only was I stuck but, the harder I tried to escape, the farther I got pulled down into a mess of personal and public anguish. This trip has taught me to appreciate the little things again and to create a stronger balance between working and playing. Not everyone gets a chance to live a video game life but, right now, I’m getting a chance to hit the reset button.
I’m not sure what the next four weeks will bring but I am excited for the possibilities. As my friendships with my co-workers continue to develop and I delve deeper into my patient interviews and surveys I’m hoping that I can leave a lasting mark on those around me and impact them as greatly as they’ve impacted me.
I’m off the to the back of the boat because for some reason I am really enjoying the cold, whipping wind and the spruce trees that line the sides of the ferry.
Alaska is such a unique and interesting place. The land mass of the state would cover 20% of the lower 48, however, the population of the state is so small. Every city in Alaska is like a small bubble – a tiny populated, developed area surrounded by thousands of square miles of vast forest. Even in cities like Juneau and Anchorage there is nothing beyond the city limits.
The people in Alaska all have interesting stories. There are the traditional people, the Tlingit, who spend their lives attempting to balance the Eagle and the Raven and continue storied family legacies that preserve their ancient culture and tradition. There are also many who have come to Alaska to find out something about themselves or to escape the fast pace of a big city. Either way, everyone that you meet offers a unique monologue on life and what it has brought them.
In regards to my summer project, I have learned some pretty incredible things. When I spoke to people before May 16th I told them, “Why Alaska? I’m going to Alaska because dentistry is done differently there and should offer me a unique perspective on the profession.” Differently? Until recently I’m not sure I even know what that meant, however, some recent experiences have helped to clarify.
Maybe it was the woman I spoke to who walked 60 miles through dense, bear-filled forest with her 75 year old mother and 8 year old son just to catch a ferry to come to Juneau to schedule a dental appointment. The woman was the only one of the three that came to Juneau for some dental work. The other two? They wanted to see what Wal-Mart and Costco were.
It could have been my experience in Hoonah, AK where SEARHC dentists visit the clinic once every two months. I did some math after my trip to Hoonah. There are ten appointment slots for four consecutive days for a total of 40 appointments. There are 800 dental patients in the village. If a dentist visits once every two months, that averages out to 20 dental appointments every month. By this math, it would take the dentists 40 months to see each patient once! 40 months. That’s enough time for a cavity to turn into a root canal and a root canal to turn into a nasty oral infection.
Or maybe it was just in Juneau, where I have continually spoken with patients who have simply told me they forgot their dental appointments or just didn’t feel like coming in that day. These people are offered an incredible service by the Indian Health Services – a service that provides them free dental and medical care for as long as they need it – yet they have found a way to abuse the system while others clamor for an opportunity to schedule a routine hygiene appointment because they feel the dentists are too young or the residents are simply there to experiment.
Different isn’t in the way a dentist preps a crown or crafts together a bridge – it’s in the people that make up the patient base. It’s in the mindset of patients who still don’t understand the basics of brushing and flossing. And it’s in the devotion of public health dentists who pass up a chance to join country clubs and drive BMWs to extract rotten teeth and fill cavities from the mouths of skeptical Native Alaskans. If nothing else the trip has offered a great opportunity for me to re-evaluate (not saying I’m quite ready to sacrifice the country club just yet!) the importance of dentistry and its impact on a population. Beyond that, I’ve been offered a chance to do more than just think – I’ve been offered a chance to make a real difference.
My telephone survey has helped identify whether or not patients are overcome with dental anxiety and fear and given the SEARHC dental staff a litany of reasons why their patients aren’t coming to their appointments 25% of the time. In addition, it has also helped to fix a broken scheduling system by identifying some disconnects in patient contact information. Hopefully, dentists will be given more access to Eaglesoft which will help provide the front desk with a more reliable way to confirm appointments and reach patients. There’s only so much you can learn over a telephone, though.
The waiting room survey has been equally effective. It has helped to identify that SEARHC’s approach to dental education information in the past wasn’t quite as strong as it could have been. It’s helped prove that, yes, these patients do generally care for their well-being and oral health – we just aren’t reaching them in the right way. Hopefully once the dust settles and the data is analyzed Dr. Hort and I will come up with something powerful and meaningful that will reach a new generation of patients and help break down the walls of skepticism and prejudice.
Even more than just the general knowledge of the state or the chance to make a difference, the trip has extended an opportunity to start over after two tough years - both personally and academically. I have always loved video games because you can always stop and hit the reset button. You get an endless amount of chances to do whatever it is you want – you simply cannot fail. In life, you can’t hit the reset button after getting a poor grade on a test you know you should have spent more time studying for or after reacting poorly to bad news. But for the first time in two years I feel lucky. At times over the past two years I have felt like I have been stuck in quicksand. Not only was I stuck but, the harder I tried to escape, the farther I got pulled down into a mess of personal and public anguish. This trip has taught me to appreciate the little things again and to create a stronger balance between working and playing. Not everyone gets a chance to live a video game life but, right now, I’m getting a chance to hit the reset button.
I’m not sure what the next four weeks will bring but I am excited for the possibilities. As my friendships with my co-workers continue to develop and I delve deeper into my patient interviews and surveys I’m hoping that I can leave a lasting mark on those around me and impact them as greatly as they’ve impacted me.
I’m off the to the back of the boat because for some reason I am really enjoying the cold, whipping wind and the spruce trees that line the sides of the ferry.
Day 29 - Sitka, AK Day 1
Early morning this morning as I had an 8 AM ferry ride to Sitka. Today was my lasy day house-sitting. I am going to miss the dog when I come home after work, but I am not going to miss the dog begging to walk at 6 AM. I drove to SEARHC to pick up my toothbrushes and toothpaste giveaways and pick up my bike from Dr. Hort.
I loaded onto the Fairweather vessel right before 8 AM. The Fairweather is a “fast ferry”. It goes directly from port to port at 35 knots so it takes less than half the time a normal ferry would take to get to Sitka. It doesn’t have any cabins because it is strictly for quick transportation. I grabbed breakfast and a seat near the window. I got lucky today as the weather was nice so I was able to spend some time out of the back deck. The view was great the entire time. We passed snow capped mountains and spruce trees along the shoreline. At times, whales swam alongside the ferry which was pretty neat. I spent most of the ride reading and writing. I am getting really into this book called The Bullpen Gospels. It’s about a career minor league pitcher and what it’s like to play in the minor leagues. If you are a baseball fan I would definitely look into it. The ferry ride took about 4 and a half hours until we arrived in Sitka.
I grabbed my bike from the bottom of the boat and hailed a taxi to Mount Edgecumbe Hospital. I was supposed to stay at the short-term housing facility, but when I arrived nobody had any record of my reservation. Talk about disconcerting. I stood stunned for a few minutes but eventually became friendly with the receptionist and got a hold of Karen Fredrickson, the housing director. She felt so bad about forgetting about my reservation that she set me up in a different housing unit right next to the hospital. The facility I am staying in now is a bit older than the short-term housing facility, but it has a T.V., cable, and internet so I was sold. Not to mention, Karen and SEARHC have agreed to take responsibility for all room charges. So that means two free nights in this room and free breakfast, lunch, and dinner from the hospital cafeteria. Even better, the Cardinals are playing the Mariners this week (Seattle is Juneau’s adopted sports city) so the Cardinals are on local cable all week.
After settling into the room I went to the dental clinic to meet some of the dentists and residents there. This week is a great week to be in Sitka because it is Prosthodontist Week. Every year the Sitka clinic brings in a prosthodontist, Dr. Tayler, and his residents from the University of Connecticut Dental School. They spend a week in the clinic making as many dentures as possible. They do everything in the clinic – from initial impressions to the final lab touch-ups. Sitka dental patients get dentures for a very minimal cost and the UConn prosthodontist residents get good practice making dentures and crowns. I spent the afternoon shadowing and watching the residents do lab work. They had quite the assembly line going in the lab with everybody working on varying stages of the dentures. Dr. Tayler is the head of the Prosthodontist Residency at UConn so he’s a good contact to have for the future.
Dinner is at 6 at the hospital and then I am going to take my bike into town to explore a bit. Tomorrow is a big day as I will be interviewing OB patients all day long. Off to dinner…
**New pictures in the album**
I loaded onto the Fairweather vessel right before 8 AM. The Fairweather is a “fast ferry”. It goes directly from port to port at 35 knots so it takes less than half the time a normal ferry would take to get to Sitka. It doesn’t have any cabins because it is strictly for quick transportation. I grabbed breakfast and a seat near the window. I got lucky today as the weather was nice so I was able to spend some time out of the back deck. The view was great the entire time. We passed snow capped mountains and spruce trees along the shoreline. At times, whales swam alongside the ferry which was pretty neat. I spent most of the ride reading and writing. I am getting really into this book called The Bullpen Gospels. It’s about a career minor league pitcher and what it’s like to play in the minor leagues. If you are a baseball fan I would definitely look into it. The ferry ride took about 4 and a half hours until we arrived in Sitka.
I grabbed my bike from the bottom of the boat and hailed a taxi to Mount Edgecumbe Hospital. I was supposed to stay at the short-term housing facility, but when I arrived nobody had any record of my reservation. Talk about disconcerting. I stood stunned for a few minutes but eventually became friendly with the receptionist and got a hold of Karen Fredrickson, the housing director. She felt so bad about forgetting about my reservation that she set me up in a different housing unit right next to the hospital. The facility I am staying in now is a bit older than the short-term housing facility, but it has a T.V., cable, and internet so I was sold. Not to mention, Karen and SEARHC have agreed to take responsibility for all room charges. So that means two free nights in this room and free breakfast, lunch, and dinner from the hospital cafeteria. Even better, the Cardinals are playing the Mariners this week (Seattle is Juneau’s adopted sports city) so the Cardinals are on local cable all week.
After settling into the room I went to the dental clinic to meet some of the dentists and residents there. This week is a great week to be in Sitka because it is Prosthodontist Week. Every year the Sitka clinic brings in a prosthodontist, Dr. Tayler, and his residents from the University of Connecticut Dental School. They spend a week in the clinic making as many dentures as possible. They do everything in the clinic – from initial impressions to the final lab touch-ups. Sitka dental patients get dentures for a very minimal cost and the UConn prosthodontist residents get good practice making dentures and crowns. I spent the afternoon shadowing and watching the residents do lab work. They had quite the assembly line going in the lab with everybody working on varying stages of the dentures. Dr. Tayler is the head of the Prosthodontist Residency at UConn so he’s a good contact to have for the future.
Dinner is at 6 at the hospital and then I am going to take my bike into town to explore a bit. Tomorrow is a big day as I will be interviewing OB patients all day long. Off to dinner…
**New pictures in the album**
Day 28 - Preparing for Sitka, AK
I am exhausted. Today was a very busy day. I had to do laundry, straighten up the Ray's house, get a haircut, go grocery shopping, pack for UAS, and pack for Sitka, AK. Fortunately for me, I have a car and my own washer and dryer this week. Not to mention, a dental assistant from the office works at a hair salon and agreed to cut my hair. Throughout the day I was able to accomplish each of these things. Keeping up with a house and a dog is harder than it looks.
Didn't do much of substance today. The weather cleared a bit so I was able to go on a run down near the Mendenhall Glacier. I also went over to Dr. Dee's house for some dinner and to watch the NBA finals.
Tomorrow I leave for Sitka and I am very excited. I will be taking the 8:00 AM ferry (I'm on the Fairweather) that arrives in Sitka around 12:30. Dr. Hort agreed to lend me her bicycle so I will carry that onto the ferry and use it to get around Sitka. Sitka has a lot of neat totem poles and musuems about the Tlingit culture. I'm going into the dental clinic in the afternoon and then after work I hope to explore the city. Tuesday I am going to interview OB patients at the hospital in Sitka and then I have a meeting in the afternoon with Martha Pearson and Litia Garrison. It should be a really fun and enjoyable trip.
Sorry for the short and rushed blog posts from the weekend, but I haven't had a lot of time to sit and reflect today. I'm going to take some time on the ferry tomorrow to collect some thoughts and post a nice, insightful article on Monday night.
Thanks for reading!
Didn't do much of substance today. The weather cleared a bit so I was able to go on a run down near the Mendenhall Glacier. I also went over to Dr. Dee's house for some dinner and to watch the NBA finals.
Tomorrow I leave for Sitka and I am very excited. I will be taking the 8:00 AM ferry (I'm on the Fairweather) that arrives in Sitka around 12:30. Dr. Hort agreed to lend me her bicycle so I will carry that onto the ferry and use it to get around Sitka. Sitka has a lot of neat totem poles and musuems about the Tlingit culture. I'm going into the dental clinic in the afternoon and then after work I hope to explore the city. Tuesday I am going to interview OB patients at the hospital in Sitka and then I have a meeting in the afternoon with Martha Pearson and Litia Garrison. It should be a really fun and enjoyable trip.
Sorry for the short and rushed blog posts from the weekend, but I haven't had a lot of time to sit and reflect today. I'm going to take some time on the ferry tomorrow to collect some thoughts and post a nice, insightful article on Monday night.
Thanks for reading!
Day 27 - Typical Juneau weather
It appears my stretch of good weather has officially ended. For the last three or four days it has been cold and rainy - quite the contrast to the weather I had during my first few weeks in Juneau. Everyone that I work with has been laughing at me as they all knew this stretch of rain and cold was coming while I was blindly optimistic. Oh well.
I woke up early this morning because the inspector came to look over the house. Of all the Saturdays to wake up early this was a good one because the World Cup was on early. I watched the first half amidst a series of fire alarms, smoke detectors, and lights flashing on and off as the inspector did his thing. At halftime, I met the Wilkinsons and Dr. Dee for dinner at Paradise Cafe in downtown Juneau. The restaurant was really, really good. It's a tiny little cafe with one cook. She asks you what you want and then makes it for you. Combined with the good company and the endless cup of coffee I'd say it was a pretty good morning.
The afternoon was a bit slow and lazy as the rain once again prevented me from going outside. It's a good thing I've got the dog to hang out with or else I might get a little stir crazy. Either way, it's nice to just have time to relax and not have to worry about an upcoming test or assignment.
I went over to Dr. Marcotte's house for dinner tonight. She and her husband made Indian food. They really like Indian food but since Juneau is not brimming with quality restaurants they have adapted and learned to cook it on their own. We played cards and hung out late into the night.
That's about it for today. Weekends have been very easygoing lately. Tomorrow I have to pack all of my things up as I will be moving out of the Ray's house and back to UAS early next week...
I woke up early this morning because the inspector came to look over the house. Of all the Saturdays to wake up early this was a good one because the World Cup was on early. I watched the first half amidst a series of fire alarms, smoke detectors, and lights flashing on and off as the inspector did his thing. At halftime, I met the Wilkinsons and Dr. Dee for dinner at Paradise Cafe in downtown Juneau. The restaurant was really, really good. It's a tiny little cafe with one cook. She asks you what you want and then makes it for you. Combined with the good company and the endless cup of coffee I'd say it was a pretty good morning.
The afternoon was a bit slow and lazy as the rain once again prevented me from going outside. It's a good thing I've got the dog to hang out with or else I might get a little stir crazy. Either way, it's nice to just have time to relax and not have to worry about an upcoming test or assignment.
I went over to Dr. Marcotte's house for dinner tonight. She and her husband made Indian food. They really like Indian food but since Juneau is not brimming with quality restaurants they have adapted and learned to cook it on their own. We played cards and hung out late into the night.
That's about it for today. Weekends have been very easygoing lately. Tomorrow I have to pack all of my things up as I will be moving out of the Ray's house and back to UAS early next week...
Saturday, June 12, 2010
Day 26 - Friday, the best day of the work week
Friday not only means the weekend right is around the corner, but it's also a day where I can sleep in and go to work a little later than usual. Today I woke up around 8 and took my time getting ready in the morning. It's great having a car because I am not bound by the Capital Transit bus schedule. I got into work around 9:45 ready to do some telephone surveys. Friday is the perfect day to do surveys because both Dr. Bornstein and Dr. Hort have Friday off. I can use their offices and telephones without disturbing anybody else. I have stopped counting the number of death stares I have gotten from the other dentists in my office as I repeat my survey script over and over and over.
The survey started pretty slowly initially, but I have found a bit of a rhythm. At first it was very disheartening when I would call and not get an answer or begin the survey only to be told that the person was not interested in participating or hung up in the middle of a question. I worked for a week to research past dental anxiety surveys and edit my questions. I also pretested with members of the dental staff so I felt I had prepared a very polished product. It's always discouraging to have someone not be interested in something you have spent a lot of time on. However, since the first few days, I have learned to shrug off these roadblocks and keep plowing through my growing list of phone numbers.
It's extremely rewarding to get some constructive feedback that I think will help the dental staff in the future. I have done so many surveys that I have kind of lost track of the trends, but I can't wait to compile all of the data in a few weeks and see what the patients are saying about their dental anxiety and why they are continually missing or breaking appointments. One positive thing that I know has come out of the survey is the discovery of many wrong or out of service phone numbers. To me, this is just as important to the dental staff as getting someone to take the full five minute survey. If the front office workers do not have working phone numbers they cannot call and confirm patient appointments. If they don't confirm appointments that lessens the chance that a patient will remember they were scheduled and actually show up to the clinic at the appropriate time.
After work I had to walk the dog in the rain. The typical Juneau weather has set in - cold with a constant rain. My rain jacket is my new favorite article of clothing and the windshield wipers on my car are permanently on the highest setting. I don't mind the rain while I am in the office, but it really affects my ability to go out and explore the city and the trail systems in Juneau.
Last night I went out to dinner and to the movies with some people from the clinic. We ate Chinese food (who would have thought I would eat Chinese just as much as I would eat seafood in Alaska?) and went to the movie theater downtown. It's a pretty neat theater. There are two screens - one on the lower level and one on the upper level. You walk up a few flights of stairs just to reach the theater.
Tomorrow I will be up early to watch the World Cup (USA! USA!) and to go out to breakfast with the Wilkinson's. We are going to Paradise Cafe downtown. I hope it's good...
The survey started pretty slowly initially, but I have found a bit of a rhythm. At first it was very disheartening when I would call and not get an answer or begin the survey only to be told that the person was not interested in participating or hung up in the middle of a question. I worked for a week to research past dental anxiety surveys and edit my questions. I also pretested with members of the dental staff so I felt I had prepared a very polished product. It's always discouraging to have someone not be interested in something you have spent a lot of time on. However, since the first few days, I have learned to shrug off these roadblocks and keep plowing through my growing list of phone numbers.
It's extremely rewarding to get some constructive feedback that I think will help the dental staff in the future. I have done so many surveys that I have kind of lost track of the trends, but I can't wait to compile all of the data in a few weeks and see what the patients are saying about their dental anxiety and why they are continually missing or breaking appointments. One positive thing that I know has come out of the survey is the discovery of many wrong or out of service phone numbers. To me, this is just as important to the dental staff as getting someone to take the full five minute survey. If the front office workers do not have working phone numbers they cannot call and confirm patient appointments. If they don't confirm appointments that lessens the chance that a patient will remember they were scheduled and actually show up to the clinic at the appropriate time.
After work I had to walk the dog in the rain. The typical Juneau weather has set in - cold with a constant rain. My rain jacket is my new favorite article of clothing and the windshield wipers on my car are permanently on the highest setting. I don't mind the rain while I am in the office, but it really affects my ability to go out and explore the city and the trail systems in Juneau.
Last night I went out to dinner and to the movies with some people from the clinic. We ate Chinese food (who would have thought I would eat Chinese just as much as I would eat seafood in Alaska?) and went to the movie theater downtown. It's a pretty neat theater. There are two screens - one on the lower level and one on the upper level. You walk up a few flights of stairs just to reach the theater.
Tomorrow I will be up early to watch the World Cup (USA! USA!) and to go out to breakfast with the Wilkinson's. We are going to Paradise Cafe downtown. I hope it's good...
Thursday, June 10, 2010
Day 25 - OB Clinic
Today was my first day in the OB clinic. I got to work early and met Chris to go set up our table in the waiting room. Chris has lots of dental posters and facts dedicated to newborn dental care that she lent to me today. It was very helpful as I not only had the chance to interview the women, but also to teach them a little bit about caring for their newborns. Once the patients started rolling in things got really fun and exciting. I had bags filled with toothbrushes, toothpaste, and dental floss that I handed to each person who took the survey. It was really interesting to take note of the ages of some of the women who were there in the OB clinic. Many were in their twenties or thirties, but I saw my fair share of teenage mothers. This just speaks to the mindset of the Native Alaskan and the cultural differences between some of those living in Alaska and the rest of the United States.
Each woman I interviewed was very thoughtful and helpful in filling out the survey. Some of the early trends that I am noticing between my surveys from Hoonah and my surveys today are that many people want two things: 1) To have access to dental information in a technologically savvy way, and 2) To have access to dental information in a way that does not require them to spend lots of extra effort outside of their scheduled appointments or visits to the dental clinic. Also, I am noticing that there is a huge push for more information on preventative care. This is great as it is already a goal of the SEARHC dental team to make dentistry a more preventative profession so this will give me the most support and backing as I begin to actually develop the patient education material.
I spent the day in the clinic and interviewed 17 women. It was a great experience and one that I am looking forward to repeating over the next two Thursdays. Before I went back to my home I spoke with Dr. Hort about Sitka. We booked my rooms in the Mount Edgecumbe Hospital Short-term Housing and I purchased a ticket for the ferry. I also got in contact with Martha Pearson and Litia Garrison to confirm that we would be meeting next Tuesday to discuss how they revamped their old patient education materials.
After such a beautiful day yesterday the weather today was a bit more typical of Juneau in early June. The clouds hung in the sky and a light drizzle fell throughout the day. Like I posted a few weeks ago, I don't feel bad skipping out on some work afternoons in early May as I will now be stuck in the office for the rest of June. I am still trying to shake my cold so I did not do much tonight. The Alaskan Time Zone is great as I am able to watch East coast sporting events (like the NBA finals) and still get to bed at a reasonable hour.
Tomorrow will be a pretty uneventful day as I will dedicate it entirely to calling my patients who missed an appointment over the past week. Since I was out of town and in the OB clinic today I have quite a few phone calls to make!
More to come tomorrow...
Each woman I interviewed was very thoughtful and helpful in filling out the survey. Some of the early trends that I am noticing between my surveys from Hoonah and my surveys today are that many people want two things: 1) To have access to dental information in a technologically savvy way, and 2) To have access to dental information in a way that does not require them to spend lots of extra effort outside of their scheduled appointments or visits to the dental clinic. Also, I am noticing that there is a huge push for more information on preventative care. This is great as it is already a goal of the SEARHC dental team to make dentistry a more preventative profession so this will give me the most support and backing as I begin to actually develop the patient education material.
I spent the day in the clinic and interviewed 17 women. It was a great experience and one that I am looking forward to repeating over the next two Thursdays. Before I went back to my home I spoke with Dr. Hort about Sitka. We booked my rooms in the Mount Edgecumbe Hospital Short-term Housing and I purchased a ticket for the ferry. I also got in contact with Martha Pearson and Litia Garrison to confirm that we would be meeting next Tuesday to discuss how they revamped their old patient education materials.
After such a beautiful day yesterday the weather today was a bit more typical of Juneau in early June. The clouds hung in the sky and a light drizzle fell throughout the day. Like I posted a few weeks ago, I don't feel bad skipping out on some work afternoons in early May as I will now be stuck in the office for the rest of June. I am still trying to shake my cold so I did not do much tonight. The Alaskan Time Zone is great as I am able to watch East coast sporting events (like the NBA finals) and still get to bed at a reasonable hour.
Tomorrow will be a pretty uneventful day as I will dedicate it entirely to calling my patients who missed an appointment over the past week. Since I was out of town and in the OB clinic today I have quite a few phone calls to make!
More to come tomorrow...
Wednesday, June 9, 2010
Pictures
I have added all pictures taken through June 9th. I am not sure if they all show up in the slideshow on the blog, however, if you click on the slideshow and go to the album they are all there.
Check them out and try not to get too jealous!
Check them out and try not to get too jealous!
Day 24 - Hoonah wrap-up
Today was my last day in Hoonah, AK. The day started off right as I finally got a chance to eat Pat’s famous french toast. She took extra good care of me and gave me a few slices for the road. Her reputation as Hoonah’s best cook is definitely well deserved.
Unfortunately, we had a few more cancellations in the morning. As each day passes I am starting to see the chasm between the front office workers in Hoonah (SEARHC employees, but not dental specific employees) and the dentists who make the village trips. The front office staff takes names from the patient list and places them on the appointment blocks, but then they do not call the patient until the day before their appointment. If you were going to be out of town on June 7th but you had a dental appointment on that day you wouldn’t know that you weren’t going to be able to make it until June 6th. This is despite the fact that you have likely been penciled into that June 7th appointment since the beginning of April. For those in a major city this is an inconvenience but may not be a huge problem as the dentist is always a quick car or bus ride away. But in Hoonah, AK, patients have access to a dentist only once every two months. The front office staff makes no effort to accommodate patient’s schedules or the dentist’s time. Yesterday the woman who works the front desk in the Hoonah clinic took the day off, however, she neglected to call any of the dental patients to remind them of their appointments today. What happened? We had no patients at 7 AM, 8 AM, or 9 AM until we realized that people were not skipping their appointments intentionally – they had no idea they even were on any sort of schedule.
Not only is this a poor use of resources for SEARHC but, on a larger scale, the United States government. The federal government funds the Indian Health Services which then redirects the funds to SEARHC. So as Dr. Nascimento and Cindy sit and stare at the clock all morning they are being paid by the government for not doing any work. It’s very, very troubling and a hugely inefficient use of funding.
Once we called our patients to confirm their appointments they began to come in and visit the clinic. I got a chance to do some more waiting room interviews and am really learning a lot about the mindset of the Alaskan natives.
I went out to lunch with Cindy and Dr. Nascimento again today. Dr. Nascimento was so nice and picked up the tab for everyone. It’s great to be around genuinely nice people all the time. After lunch I said my goodbyes and headed back to the Hoonah airport for my flight to Juneau. There were only four people in the small Wings of Alaska plane when it took off. The flight was short again and the sky was blue and clear as far as the eye could see. We saw whales in the water below us and marveled at the beautiful spruce trees that are now almost entirely green and devoid of snow.
Once the plane landed I took the bus to the SEARHC clinic in Juneau. I met with Dr. Hort to debrief her on my experiences in Hoonah. I then spent some time talking to Chris, the DHAT, so we could plan for my first day in the OB clinic tomorrow. Things are really starting to get rolling now and I can’t wait to see what trends we start to see from our patients.
I had a nice treat for dinner tonight – a family friend was in town on a cruise ship and took me out to dinner. I ate with the Kwiatek family at The Twisted Fish for dinner right on the Juneau harbor. I had an awesome salmon filet served on a cedar plank. The Kwiateks told me all about the Alaskan cruise experience and where they were headed. Today the got to go dog sledding and said it was just an incredible experience. I have added it to my list of things to do before I leave Alaska. I took them back to the dock and then headed back to the Ray house. I’m thankful that Dr. Dee agreed to take care of the house and dog for me while I was gone. Again, just speaks to the quality of person I get to spend my summer with.
Big day tomorrow as I will finally put my OB survey into use. I am nervous and excited to hear what our patients have to say. Until tomorrow…
Unfortunately, we had a few more cancellations in the morning. As each day passes I am starting to see the chasm between the front office workers in Hoonah (SEARHC employees, but not dental specific employees) and the dentists who make the village trips. The front office staff takes names from the patient list and places them on the appointment blocks, but then they do not call the patient until the day before their appointment. If you were going to be out of town on June 7th but you had a dental appointment on that day you wouldn’t know that you weren’t going to be able to make it until June 6th. This is despite the fact that you have likely been penciled into that June 7th appointment since the beginning of April. For those in a major city this is an inconvenience but may not be a huge problem as the dentist is always a quick car or bus ride away. But in Hoonah, AK, patients have access to a dentist only once every two months. The front office staff makes no effort to accommodate patient’s schedules or the dentist’s time. Yesterday the woman who works the front desk in the Hoonah clinic took the day off, however, she neglected to call any of the dental patients to remind them of their appointments today. What happened? We had no patients at 7 AM, 8 AM, or 9 AM until we realized that people were not skipping their appointments intentionally – they had no idea they even were on any sort of schedule.
Not only is this a poor use of resources for SEARHC but, on a larger scale, the United States government. The federal government funds the Indian Health Services which then redirects the funds to SEARHC. So as Dr. Nascimento and Cindy sit and stare at the clock all morning they are being paid by the government for not doing any work. It’s very, very troubling and a hugely inefficient use of funding.
Once we called our patients to confirm their appointments they began to come in and visit the clinic. I got a chance to do some more waiting room interviews and am really learning a lot about the mindset of the Alaskan natives.
I went out to lunch with Cindy and Dr. Nascimento again today. Dr. Nascimento was so nice and picked up the tab for everyone. It’s great to be around genuinely nice people all the time. After lunch I said my goodbyes and headed back to the Hoonah airport for my flight to Juneau. There were only four people in the small Wings of Alaska plane when it took off. The flight was short again and the sky was blue and clear as far as the eye could see. We saw whales in the water below us and marveled at the beautiful spruce trees that are now almost entirely green and devoid of snow.
Once the plane landed I took the bus to the SEARHC clinic in Juneau. I met with Dr. Hort to debrief her on my experiences in Hoonah. I then spent some time talking to Chris, the DHAT, so we could plan for my first day in the OB clinic tomorrow. Things are really starting to get rolling now and I can’t wait to see what trends we start to see from our patients.
I had a nice treat for dinner tonight – a family friend was in town on a cruise ship and took me out to dinner. I ate with the Kwiatek family at The Twisted Fish for dinner right on the Juneau harbor. I had an awesome salmon filet served on a cedar plank. The Kwiateks told me all about the Alaskan cruise experience and where they were headed. Today the got to go dog sledding and said it was just an incredible experience. I have added it to my list of things to do before I leave Alaska. I took them back to the dock and then headed back to the Ray house. I’m thankful that Dr. Dee agreed to take care of the house and dog for me while I was gone. Again, just speaks to the quality of person I get to spend my summer with.
Big day tomorrow as I will finally put my OB survey into use. I am nervous and excited to hear what our patients have to say. Until tomorrow…
Day 23 - Hoonah, AK Day 2
I had an early wake-up call this morning because our first patient at the clinic was at 7 AM. Pat was upstairs bright and early cooking breakfast. She prepared eggs, sausage, and pancakes this morning. She loves to cook so, as long as you sit at the table, she’ll continually feed you juice, coffee, and breakfast. I told her I had been looking forward to the French toast so she promised that it would be on the menu tomorrow morning.
The walk to the clinic took about 5 minutes. I interviewed the first patient in the waiting room and then headed to my makeshift office to organize some things for the day. At the beginning of each day I have to update my list of people to call for my telephone survey. I go through Eaglesoft and look for patients with the 09130 code next to their names. I can then sort them by clinic and isolate the ones from the four clinics I am calling – Prince of Wales, Haines, Sitka, and Juneau. The list is growing quickly (25% missed appointment rate adds up!) and I am getting a bit behind because some of these patients are hard to get a hold of. I am in a precarious position because I don’t want to keep pestering patients who don’t answer, however, if not enough patients answer to take the survey the results will not be as meaningful. Good thing I am here for another month and a half.
The rest of the morning in the clinic ran really smoothly. I interviewed each patient as they came into the waiting room. I am getting some really great responses. One of the questions on the survey is an open-ended question that allows patients to tell me what dental information is most important to them. The responses have been quite surprising. Most don’t really care about anything more basic than how often to brush, when to make appointments, or whether or not flossing is important. Sometimes it’s hard to believe that this is the mindset of some patients in the United States in the 21st century.
Cindy, Dr. Nascimento, and I headed to a local restaurant for lunch. The restaurant is known for their halibut pizza so I tried a slice. It was actually pretty good. It must be hard to serve bad fish when it’s caught fewer than 50 feet away. During lunch I had an interesting conversation with Dr. Nascimento about the scheduling process for these clinic trips. Since the dentists obviously cannot see every patient every time they are in the clinic there is a bit of a rotating schedule. Ideally, the patients should rotate through the system to give everyone an equal opportunity to see the dentist at least once per year, however, it often does not work that way. The dentists are met with a lot of opposition from the full-time staff at some of the smaller clinics. There is a combative mindset between the dentists and the administrative employees in places like Angoon, Hoonah, and Haines. Many in these smaller villages appreciate what the dentists do for their communities, but others fell upstaged by the dental village trips. As a result, the front desk does a poor job of scheduling appointments for the most urgent patients. There is a lot of favoritism and discrimination by the administrative workers as they prepare the clinic schedules. This turns out to be unproductive for everyone as the most critical needs of patients are not met and the minimal time the dentists are spending in the clinics is not used efficiently.
I also learned about treatment planning today. There is simply no penalty for patients who skip out on appointments and that leads to a lack of commitment from the patients towards the dentists. There is little the dentists can do as the patient base is covered under the Indian Health Services and Medicaid programs, however, the one way in which dentists can fight back is through treatment planning. The dentists often start with the back teeth and work their way towards the front of the mouth. The patients, frustrated by the aesthetics of their front teeth that are visible when they smile, are forced to come back to get treatment on their back teeth. Dr. Nascimento agreed to fix a black decay spot on a front tooth for a patient only after the patient agreed to let her fix an infected tooth in the posterior of the mouth.
I just got back from the clinic and am about to go on a run. Cindy is going to meet me at the Historic Canner and we are going to grab a burger and watch the Zipriders from the beach. There are two cruise ships in port tonight so the area should be busy and fun.
Tomorrow is my last day in Hoonah and then it’s back to Juneau for the rest of the week. I have my first OB survey day on Thursday and a boatload of phone interviews waiting for me on Friday. Things are really starting to pick up and get exciting…
The walk to the clinic took about 5 minutes. I interviewed the first patient in the waiting room and then headed to my makeshift office to organize some things for the day. At the beginning of each day I have to update my list of people to call for my telephone survey. I go through Eaglesoft and look for patients with the 09130 code next to their names. I can then sort them by clinic and isolate the ones from the four clinics I am calling – Prince of Wales, Haines, Sitka, and Juneau. The list is growing quickly (25% missed appointment rate adds up!) and I am getting a bit behind because some of these patients are hard to get a hold of. I am in a precarious position because I don’t want to keep pestering patients who don’t answer, however, if not enough patients answer to take the survey the results will not be as meaningful. Good thing I am here for another month and a half.
The rest of the morning in the clinic ran really smoothly. I interviewed each patient as they came into the waiting room. I am getting some really great responses. One of the questions on the survey is an open-ended question that allows patients to tell me what dental information is most important to them. The responses have been quite surprising. Most don’t really care about anything more basic than how often to brush, when to make appointments, or whether or not flossing is important. Sometimes it’s hard to believe that this is the mindset of some patients in the United States in the 21st century.
Cindy, Dr. Nascimento, and I headed to a local restaurant for lunch. The restaurant is known for their halibut pizza so I tried a slice. It was actually pretty good. It must be hard to serve bad fish when it’s caught fewer than 50 feet away. During lunch I had an interesting conversation with Dr. Nascimento about the scheduling process for these clinic trips. Since the dentists obviously cannot see every patient every time they are in the clinic there is a bit of a rotating schedule. Ideally, the patients should rotate through the system to give everyone an equal opportunity to see the dentist at least once per year, however, it often does not work that way. The dentists are met with a lot of opposition from the full-time staff at some of the smaller clinics. There is a combative mindset between the dentists and the administrative employees in places like Angoon, Hoonah, and Haines. Many in these smaller villages appreciate what the dentists do for their communities, but others fell upstaged by the dental village trips. As a result, the front desk does a poor job of scheduling appointments for the most urgent patients. There is a lot of favoritism and discrimination by the administrative workers as they prepare the clinic schedules. This turns out to be unproductive for everyone as the most critical needs of patients are not met and the minimal time the dentists are spending in the clinics is not used efficiently.
I also learned about treatment planning today. There is simply no penalty for patients who skip out on appointments and that leads to a lack of commitment from the patients towards the dentists. There is little the dentists can do as the patient base is covered under the Indian Health Services and Medicaid programs, however, the one way in which dentists can fight back is through treatment planning. The dentists often start with the back teeth and work their way towards the front of the mouth. The patients, frustrated by the aesthetics of their front teeth that are visible when they smile, are forced to come back to get treatment on their back teeth. Dr. Nascimento agreed to fix a black decay spot on a front tooth for a patient only after the patient agreed to let her fix an infected tooth in the posterior of the mouth.
I just got back from the clinic and am about to go on a run. Cindy is going to meet me at the Historic Canner and we are going to grab a burger and watch the Zipriders from the beach. There are two cruise ships in port tonight so the area should be busy and fun.
Tomorrow is my last day in Hoonah and then it’s back to Juneau for the rest of the week. I have my first OB survey day on Thursday and a boatload of phone interviews waiting for me on Friday. Things are really starting to pick up and get exciting…
Day 22 - Hoonah, AK Day 1
I had a 7:20 AM flight to Hoonah this morning so I showed up about an hour early for my flight. When I told the check-in attendant that I was there for the 7:20 flight to Hoonah she started to laugh. Apparently, flying Wings of Alaska is much different than flying Delta or American Airlines. I approached the check-in counter and simply stated my name. The flight attendant looked on a piece of paper, saw my name, and told me to come back to the gate at 7:10. No photo ID, no boarding pass – nothing. I guess that’s why it was so funny that I had showed up an hour early for my flight. Apparently, most people come 10-15 minutes before the flight and walk right onto the plane. I learned the hard way as my mistake cost me about an hour of sleep this morning. When 7:10 rolled around I came back to the gate and a man wearing a t-shirt, jeans, and a baseball cap stood up and said, “I’m Justin, I’ll be the pilot for the 7:20 flight to Hoonah.” We followed him out onto the runway and boarded a small, 6-seat plane. One person sat next to the pilot and then there were two other rows with two seats each. We got on, the pilot started the engine, and the plane took off to Hoonah. Our luggage was neatly stacked behind the last row of seats and covered my a mesh net so it didn’t come into the seating area. The flight to Hoonah took an entire 18 minutes. I was on the ground by 7:40 and ready to head to my first village clinic.
I took a taxi from the “airport” (a small, wooden building with one room) to the dental clinic. The village of Hoonah is so small that any taxi ride is simply a $4 flat rate fee. Not a bad deal. I pulled into the clinic just as Cindy and Dr. Nascimento were walking in. We spent the morning setting up the clinic. Since no dentists work at the clinic full-time the dentists from Juneau are responsible for bringing basic supplies needed for oral surgery or other dental procedures. We spent the morning sorting and cleaning the clinic and making sure the chairs and x-ray machines functioned properly. We had cancellations at 9, 10, and 11 so I had some time in the morning to do more phone surveys. I have access to Eaglesoft from any SEARHC clinic so I simply found an empty office and started on my calls. I found it amazing that these patients did not make it into the clinic today. First off, at no point in Hoonah are you farther than about a 15 minute walk from the clinic. Also, the dentist coming to the clinic is a rare occasion so I find it strange that people would pass up the opportunity for care (especially since it’s free through the Indian Health Services!). Examples like these are what make dental care in Alaska such a challenge in comparison to the rest of the United States.
It was yet another great day outside today so we went down to the main attraction in Hoonah, AK for lunch – the Historic Salmon Cannery. Recently, an organization of private shareholders invested a bunch of money into the Cannery. They renovated the building to its original structure and turned it into a museum. In addition, they turned the area into a private port for cruise ships to come and visit during the summer. There are many great excursions that leave from the port – whale watching, ATV adventures, fishing, and Hoonah’s most famous attraction – the Zipride.
As soon as I saw the Zipride I knew that I had to find a way to get a ticket. It’s a zipline that starts from the top of a mountain and goes straight to the bottom. You travel 5,300 feet at 60 MPH while dropping 1,300 feet in elevation - in just 90 seconds. Normally the Zipride is reserved for cruise ship tourists, but occasionally they don’t sell all of the spots and today was one of those days! I got a ticket for the afternoon group so I hung around the Cannery and dock for an hour or so. There were lots of great restaurants and little gift shops. Not to mention a gorgeous beach on a backdrop of snow-capped mountains surrounded by miles of nature trails. Once my group was called I boarded a bus and headed straight up the mountain.
The bus ride in and of itself was a great experience. We had a Tlingit tour guide who explained the history of Hoonah. The Cannery used to be a huge source of income for the town. In the Icy Straits right near the dock there is an abundance of King salmon, Chum Salmon, Silver Salmon, and Halibut. When it was fully operational the Cannery produced millions of pounds of fish annually. It took all of 1 minute to drive through downtown Hoonah. There is one grocery store and one gas pump. Not one gas station, just one gas pump. Gas is currently $3.77 per gallon. Ace Hardware is the only chain store in the entire village. There is one school building for students K-12 and the Class of 2010 produced just 9 graduates. After we passed through downtown we continued to climb higher and higher into the mountains. There was lots of nature along the ride. We saw two bald eagles and some grizzly bear paw prints. At a couple of points along the route we stopped to look over the side of the mountain at the village. Off in the distance you could see an area that used to be a camp for loggers. The ride took about 45 minutes. We then had a 5 minute hike to the top of the Zipride.
They really know how to build the anticipation at the top of the mountain. You stand on a platform behind where people are put in their harness and sent down the zipline. You can see people disappear off of the side of the mountain and hear them screaming, but you can never actually see where they are going. Eventually I reached the front of the line and had a chance to look over the ledge. I now know why they don’t let people look over before it is their turn to go. Let’s just say they would probably have to have a bus waiting for people who would be sprinting back down the mountain in fear because 5,300 feet is a long way. You get strapped into you harness and place your feet on a door. You are in a seated position so you once again cannot see what is below you. Eventually, the door opened and for a split second, before I actually started falling, I was just staring straight down the face of the mountain. And then I was off. It was an amazing experience. After about the first 5 seconds you settle in and can enjoy being above the spruce trees and snow-caps on the mountain. They took some professional pictures so I will put those up when they become available online.
I headed back to the clinic in the afternoon. The afternoon patients made it to the clinic so I had a chance to do my waiting room survey for the first time. This is going to be the most important part of my summer project as it will help shape what form my patient education material eventually takes.
I took a run back to the Historic Cannery in the afternoon and then settled into Sportsman’s Bed and Breakfast. The place is actually really nice. Pat, the owner, is really nice and accommodating. She agreed to wake up early to make us breakfast tomorrow. I can already taste her “world famous” French Toast. Even though there is no internet in the B&B I do have DirectTV. I consider it a fair trade. Today was definitely a long day and tomorrow will be a long as well since I am working in the clinic from 7 AM – 6 PM. Off to bed…
I took a taxi from the “airport” (a small, wooden building with one room) to the dental clinic. The village of Hoonah is so small that any taxi ride is simply a $4 flat rate fee. Not a bad deal. I pulled into the clinic just as Cindy and Dr. Nascimento were walking in. We spent the morning setting up the clinic. Since no dentists work at the clinic full-time the dentists from Juneau are responsible for bringing basic supplies needed for oral surgery or other dental procedures. We spent the morning sorting and cleaning the clinic and making sure the chairs and x-ray machines functioned properly. We had cancellations at 9, 10, and 11 so I had some time in the morning to do more phone surveys. I have access to Eaglesoft from any SEARHC clinic so I simply found an empty office and started on my calls. I found it amazing that these patients did not make it into the clinic today. First off, at no point in Hoonah are you farther than about a 15 minute walk from the clinic. Also, the dentist coming to the clinic is a rare occasion so I find it strange that people would pass up the opportunity for care (especially since it’s free through the Indian Health Services!). Examples like these are what make dental care in Alaska such a challenge in comparison to the rest of the United States.
It was yet another great day outside today so we went down to the main attraction in Hoonah, AK for lunch – the Historic Salmon Cannery. Recently, an organization of private shareholders invested a bunch of money into the Cannery. They renovated the building to its original structure and turned it into a museum. In addition, they turned the area into a private port for cruise ships to come and visit during the summer. There are many great excursions that leave from the port – whale watching, ATV adventures, fishing, and Hoonah’s most famous attraction – the Zipride.
As soon as I saw the Zipride I knew that I had to find a way to get a ticket. It’s a zipline that starts from the top of a mountain and goes straight to the bottom. You travel 5,300 feet at 60 MPH while dropping 1,300 feet in elevation - in just 90 seconds. Normally the Zipride is reserved for cruise ship tourists, but occasionally they don’t sell all of the spots and today was one of those days! I got a ticket for the afternoon group so I hung around the Cannery and dock for an hour or so. There were lots of great restaurants and little gift shops. Not to mention a gorgeous beach on a backdrop of snow-capped mountains surrounded by miles of nature trails. Once my group was called I boarded a bus and headed straight up the mountain.
The bus ride in and of itself was a great experience. We had a Tlingit tour guide who explained the history of Hoonah. The Cannery used to be a huge source of income for the town. In the Icy Straits right near the dock there is an abundance of King salmon, Chum Salmon, Silver Salmon, and Halibut. When it was fully operational the Cannery produced millions of pounds of fish annually. It took all of 1 minute to drive through downtown Hoonah. There is one grocery store and one gas pump. Not one gas station, just one gas pump. Gas is currently $3.77 per gallon. Ace Hardware is the only chain store in the entire village. There is one school building for students K-12 and the Class of 2010 produced just 9 graduates. After we passed through downtown we continued to climb higher and higher into the mountains. There was lots of nature along the ride. We saw two bald eagles and some grizzly bear paw prints. At a couple of points along the route we stopped to look over the side of the mountain at the village. Off in the distance you could see an area that used to be a camp for loggers. The ride took about 45 minutes. We then had a 5 minute hike to the top of the Zipride.
They really know how to build the anticipation at the top of the mountain. You stand on a platform behind where people are put in their harness and sent down the zipline. You can see people disappear off of the side of the mountain and hear them screaming, but you can never actually see where they are going. Eventually I reached the front of the line and had a chance to look over the ledge. I now know why they don’t let people look over before it is their turn to go. Let’s just say they would probably have to have a bus waiting for people who would be sprinting back down the mountain in fear because 5,300 feet is a long way. You get strapped into you harness and place your feet on a door. You are in a seated position so you once again cannot see what is below you. Eventually, the door opened and for a split second, before I actually started falling, I was just staring straight down the face of the mountain. And then I was off. It was an amazing experience. After about the first 5 seconds you settle in and can enjoy being above the spruce trees and snow-caps on the mountain. They took some professional pictures so I will put those up when they become available online.
I headed back to the clinic in the afternoon. The afternoon patients made it to the clinic so I had a chance to do my waiting room survey for the first time. This is going to be the most important part of my summer project as it will help shape what form my patient education material eventually takes.
I took a run back to the Historic Cannery in the afternoon and then settled into Sportsman’s Bed and Breakfast. The place is actually really nice. Pat, the owner, is really nice and accommodating. She agreed to wake up early to make us breakfast tomorrow. I can already taste her “world famous” French Toast. Even though there is no internet in the B&B I do have DirectTV. I consider it a fair trade. Today was definitely a long day and tomorrow will be a long as well since I am working in the clinic from 7 AM – 6 PM. Off to bed…
Tuesday, June 8, 2010
Update from Hoonah, AK
I do not have internet in Hoonah so I will not be able to post my blogs for Monday and Tuesday until about 8:00 PM, Central time, on Wednesday. Check back then!
Sunday, June 6, 2010
Day 21 - Packing for Hoonah, AK
I enjoy having Sky during the past week. She is a faithful alarm clock - always by the side of my bed ready to go for a walk by 6:30 or 7:00. Unfortunately, she has no concept of the weekend. So this morning there she was, 6:30 AM, ready to go. Needless to say, I was not quite as eager to get out of bed that early on a Sunday morning.
I eventually did wake up and spent the morning packing for my trip to Hoonah. I had to make a trip to Fred Meyer to pick up microwavable lunches and dinners since food prices in the small village are apparently very, very expensive. I can see the price difference here in Juneau (the capital of the state!) so I can only imagine the price inflation in a small village town with a population of way less than 1,000. I am really excited to travel though. Not only will I get to see more of the state, but I will really get to see a different perspective on dentistry. I can definitely tell that the concept of dental care and oral disease prevention is a fairly novel concept in Juneau but, in the end, it is still a major U.S. city. Hoonah will be a completely different experience.
The clinic in Hoonah is staffed by a dental health aide therapist for most of the year. As I have mentioned before, these DHATs can perform only the most basic dental procedures so if you have a problem with the root of your tooth or a broken crown or bridge there is really nobody in the village who can help you. The dentists from the SEARHC clinic in Juneau take turns traveling to the smaller clinics throughout the course of the year. They usually stay for a week or two and see as many patients as possible. This is obviously not an ideal situation for those in live in Klawock or Hoonah or Haines and that is how the idea of dentistry has become so foreign in the state. I'm sure I'll have more to write about this topic after a few days in Hoonah.
I didn't do much this afternoon. It was a great day outside so I took a little hike around the Mendenhall Lake. It's a great trail system - very well marked and smooth and paved the entire way. Not to mention, there are many ponds and lakes that are clear and blue. Today was also a great day to be lazy because there were lots of sporting events on T.V. - the NBA finals, the Stanley Cup, and the Cardinals. Not only has the Alaskan experience been great because of the nature and atmosphere of the state, but I enjoy being in the United States so I don't miss out on Sportscenter and Baseball Tonight. I guess that's some advice for those planning a summer project for next year - remember to keep your priorities in check!
I went to Subway for dinner tonight. Apparently Alaska has a different slogan than the rest of the country. In Nashville or St. Louis it's the "$5 Foot Long", but in Juneau, Alaska it's the "8, 8 dollar, 8 dollar Foot Long".
I've come to find that I'm much more appreciative of the weekend when I know that I have to go to work on Monday morning. As bad as I think school is I guess I'm thankful that I have about 10 more years of structured school as opposed to having to jump right into a 40 hour work week after I graduate from Vanderbilt! Tomorrow will be an early morning because my flight is at 7:20. Looking forward to writing from Hoonah tomorrow night...
I eventually did wake up and spent the morning packing for my trip to Hoonah. I had to make a trip to Fred Meyer to pick up microwavable lunches and dinners since food prices in the small village are apparently very, very expensive. I can see the price difference here in Juneau (the capital of the state!) so I can only imagine the price inflation in a small village town with a population of way less than 1,000. I am really excited to travel though. Not only will I get to see more of the state, but I will really get to see a different perspective on dentistry. I can definitely tell that the concept of dental care and oral disease prevention is a fairly novel concept in Juneau but, in the end, it is still a major U.S. city. Hoonah will be a completely different experience.
The clinic in Hoonah is staffed by a dental health aide therapist for most of the year. As I have mentioned before, these DHATs can perform only the most basic dental procedures so if you have a problem with the root of your tooth or a broken crown or bridge there is really nobody in the village who can help you. The dentists from the SEARHC clinic in Juneau take turns traveling to the smaller clinics throughout the course of the year. They usually stay for a week or two and see as many patients as possible. This is obviously not an ideal situation for those in live in Klawock or Hoonah or Haines and that is how the idea of dentistry has become so foreign in the state. I'm sure I'll have more to write about this topic after a few days in Hoonah.
I didn't do much this afternoon. It was a great day outside so I took a little hike around the Mendenhall Lake. It's a great trail system - very well marked and smooth and paved the entire way. Not to mention, there are many ponds and lakes that are clear and blue. Today was also a great day to be lazy because there were lots of sporting events on T.V. - the NBA finals, the Stanley Cup, and the Cardinals. Not only has the Alaskan experience been great because of the nature and atmosphere of the state, but I enjoy being in the United States so I don't miss out on Sportscenter and Baseball Tonight. I guess that's some advice for those planning a summer project for next year - remember to keep your priorities in check!
I went to Subway for dinner tonight. Apparently Alaska has a different slogan than the rest of the country. In Nashville or St. Louis it's the "$5 Foot Long", but in Juneau, Alaska it's the "8, 8 dollar, 8 dollar Foot Long".
I've come to find that I'm much more appreciative of the weekend when I know that I have to go to work on Monday morning. As bad as I think school is I guess I'm thankful that I have about 10 more years of structured school as opposed to having to jump right into a 40 hour work week after I graduate from Vanderbilt! Tomorrow will be an early morning because my flight is at 7:20. Looking forward to writing from Hoonah tomorrow night...
Day 20 - Rain
Today was the first day since I've been in Juneau that the rain actually hindered my ability to go outside. If the weather stays sunny and warm the people I work with may not allow me to leave for fear that I may take the good weather with me.
I have been sick with a cold for the past few days. The drastic change in temperature each day has really messed with my system. It's cold and rainy in the morning, warm in the afternoon, and then cold again in the evening. Add in the constant sunlight and my body must be completely confused. It was nice to spend a day today to just relax. No running, no hiking - nothing strenuous at all. The Cardinals played this afternoon so that was another excuse to not go outside in the rain.
Tonight I went over to Dr. Wilkinson's house for dinner. Dr. Wilkinson and his wife, Cheryl, live right on Auke Bay which is about a three minute walk from my dorm at UAS. They live in Juneau about 8 months out of the year and spend the other 4 months on their two ranches - one in Colorado and one in Texas. If you get Dr. Wilkinson started on horses prepare yourself for a two hour monologue and picture slideshow of every horse he has ever seen or ridden. Needless to say, he is extremely passionate.
We had prime rib and potatoes for dinner. It's always great to have a home-cooked meal every once in a while. Between college and my summer project I haven't been home very much since August, so any time I get to spend in a family setting or in a house as opposed to a dorm is a nice treat. We played some card games late into the night before I headed back home. One of the amazing things about Juneau is how you can completely lose track of time. We were sitting playing cards and before we knew it it was about 11 PM. The sunlight gets confusing - not only in the morning, but also at night.
Tomorrow will be a busy day as I have to pack for my first trip. I'm off to sleep to hopefully get rid of this cold!
I have been sick with a cold for the past few days. The drastic change in temperature each day has really messed with my system. It's cold and rainy in the morning, warm in the afternoon, and then cold again in the evening. Add in the constant sunlight and my body must be completely confused. It was nice to spend a day today to just relax. No running, no hiking - nothing strenuous at all. The Cardinals played this afternoon so that was another excuse to not go outside in the rain.
Tonight I went over to Dr. Wilkinson's house for dinner. Dr. Wilkinson and his wife, Cheryl, live right on Auke Bay which is about a three minute walk from my dorm at UAS. They live in Juneau about 8 months out of the year and spend the other 4 months on their two ranches - one in Colorado and one in Texas. If you get Dr. Wilkinson started on horses prepare yourself for a two hour monologue and picture slideshow of every horse he has ever seen or ridden. Needless to say, he is extremely passionate.
We had prime rib and potatoes for dinner. It's always great to have a home-cooked meal every once in a while. Between college and my summer project I haven't been home very much since August, so any time I get to spend in a family setting or in a house as opposed to a dorm is a nice treat. We played some card games late into the night before I headed back home. One of the amazing things about Juneau is how you can completely lose track of time. We were sitting playing cards and before we knew it it was about 11 PM. The sunlight gets confusing - not only in the morning, but also at night.
Tomorrow will be a busy day as I have to pack for my first trip. I'm off to sleep to hopefully get rid of this cold!
Saturday, June 5, 2010
Day 19 - Happy Birthday, Dr. Dee
I got some good news this morning - the house I am staying in sold. Not only is this great news for the Ray family, but for me as well because I no longer have to vacuum daily, put away dishes immediately after using them, or make my bed every morning. In celebration, I slept in and didn't go into work until about 10. Since I now have access to a car, I stopped by a Heritage Coffee Company stand today. Heritage Coffee is to Juneau what Starbucks is to the rest of the United States. Just recently a Starbucks opened in the Fred Meyer and those who are seen with the familiar green and white cups are quickly scolded by the die-hard Heritage Coffee fans. I'm not sure if the coffee was any better or worse, but it was cheaper!
I spent most of the morning doing telephone surveys. I have gotten lots of great responses that should help the SEARHC dentists better understand how their patients are thinking when they are in the waiting room or in the dentist's chair. Public health dentistry is so different from private practice, especially when it comes to broken or missed appointments. A dentist in private practice would have no trouble telling a patient that missed a couple of appointments that it might be best if that patient found another provider, but in public health dentistry the providers have an obligation to their patients that they cannot break.
Organizations like SEARHC also have very large patients bases (something I wrote about previously) and want to maximize the number of productive patients that they have each day. If 25% of your patients are missing appointments - that is a very inefficient use of resources. This coincides with a nearly month long waiting list and creates a lot of patient unrest. SEARHC has tried to quell this problem in the past with Emergency Walk-In patients and a Quick Call list, but the system still isn't perfect or even close to it. I'm hoping these surveys will provide some insight into why patients are struggling to keep appointments and what the dentists can do to make sure that the missed appointment rate stays low. It will also be interesting to compare and contrast responses from larger cities like Sitka and Juneau to smaller, village clinics like Haines or Prince of Wales.
Since today was Dr. Dee's birthday everyone went to Twin Lakes Cafeteria for the once a month hamburger. This is a burger that you literally could not eat more than once a month for risk of immediate heart attack or permanent indigestion. The burger was about half a pound with tons of cheese, bacon, mustard, mayonaise, etc. Throw in a hot pile of fries and you have what the dentists like to call a "gut-bomb". I now know that is an incredibly accurate description.
I went to the storage unit in the afternoon to pick up toothbrushes, toothpaste, and floss to distribute to OB patients who take our survey. A little incentive never hurt and, while we may take something as simple as a toothbrush or some dental floss for granted, there are many here who overlook such items. I also continued to do telephone surveys through the afternoon. I am up to 25 completed surveys which is about 8/day. If I can continue that pace hopefully I can reach my goal of at least 200 surveys by the time I leave Juneau.
We are going out to dinner for Dr. Dee's birthday tonight at some Chinese restaurant downtown. I always like getting together with all of the dentists outside of the clinic setting because it is a really fun group to be around. Sky knows that about 5 PM is walk/dinner time so she is starting to move around and wag her tail. I'm off to walk the dog and then to dinner...
I spent most of the morning doing telephone surveys. I have gotten lots of great responses that should help the SEARHC dentists better understand how their patients are thinking when they are in the waiting room or in the dentist's chair. Public health dentistry is so different from private practice, especially when it comes to broken or missed appointments. A dentist in private practice would have no trouble telling a patient that missed a couple of appointments that it might be best if that patient found another provider, but in public health dentistry the providers have an obligation to their patients that they cannot break.
Organizations like SEARHC also have very large patients bases (something I wrote about previously) and want to maximize the number of productive patients that they have each day. If 25% of your patients are missing appointments - that is a very inefficient use of resources. This coincides with a nearly month long waiting list and creates a lot of patient unrest. SEARHC has tried to quell this problem in the past with Emergency Walk-In patients and a Quick Call list, but the system still isn't perfect or even close to it. I'm hoping these surveys will provide some insight into why patients are struggling to keep appointments and what the dentists can do to make sure that the missed appointment rate stays low. It will also be interesting to compare and contrast responses from larger cities like Sitka and Juneau to smaller, village clinics like Haines or Prince of Wales.
Since today was Dr. Dee's birthday everyone went to Twin Lakes Cafeteria for the once a month hamburger. This is a burger that you literally could not eat more than once a month for risk of immediate heart attack or permanent indigestion. The burger was about half a pound with tons of cheese, bacon, mustard, mayonaise, etc. Throw in a hot pile of fries and you have what the dentists like to call a "gut-bomb". I now know that is an incredibly accurate description.
I went to the storage unit in the afternoon to pick up toothbrushes, toothpaste, and floss to distribute to OB patients who take our survey. A little incentive never hurt and, while we may take something as simple as a toothbrush or some dental floss for granted, there are many here who overlook such items. I also continued to do telephone surveys through the afternoon. I am up to 25 completed surveys which is about 8/day. If I can continue that pace hopefully I can reach my goal of at least 200 surveys by the time I leave Juneau.
We are going out to dinner for Dr. Dee's birthday tonight at some Chinese restaurant downtown. I always like getting together with all of the dentists outside of the clinic setting because it is a really fun group to be around. Sky knows that about 5 PM is walk/dinner time so she is starting to move around and wag her tail. I'm off to walk the dog and then to dinner...
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