Well Man Dog Allergy

As the end of the work week (for some) is celebrated, I am pleased to have tomorrow 'off'. This will give me a chance to catch up on laundry, maybe some baking, perhaps even fit in a walk. Tonight I'm second on call and have made the trek up and down the stairs a couple of times already. 

I made my way over to the ATM at the COOP this afternoon, because there is no bank in Taloyoak, to get some cash out to pay for my kamiks as I had a call from the lady yesterday who sewed them, saying they were going to be ready. She called to say she has one put together but wanted to make sure they fit so came over for a fitting -  I was excited to try them on, they look great! They're black hide bottoms, sealskin legs and green duffle liners with embroidery. Feel like you're only wearing socks. She told me to wear them on alternate feet each time I put them on so there is no left or right and you don't get the big toe stretched out to make them wear that way. Maybe she'll have them done by tomorrow she thinks. I also this week managed to score a pair of earrings made of polar bear bone in the shape of drum dancers. Beautiful. 

This has been a full work week where I got to read an xray - no I didn't take it as it was during the day and the janitor did (pretty straight forward when you know the patient is non weight bearing and the pain is on the outer edge of the foot) as a fractured fifth metatarsal seen here in the picture I offered to email to the Dr. on call (we take a digital photo of the xray film) and put on a back slab. Not too complicated, better than some of those done by Docs if I do say so myself and I cleaned up my own mess too. This evening I learned to do a manual white blood cell count. Have seen the lab years ago sitting with the little counter clicking while peering into the microscope and although it's more of a challenge with bifocals, it's not a difficult skill to learn. We had a telehealth session on putting in IOs (yes I meant intra osseous) and several of the nurses in the region have done this already. We have the handy dandy EZ - IO drill and all the different size needles. Actually, less daunting than an IV in a wee baby I'm thinking. 

This week at work involved some Monty Python like moments where a fellow booked a 'well man' appointment through the front desk staff and my CHN coworker picked up the chart to find a pap smear cytology requisition (which is used for well women appointments) so questioned the staff "well man" they insisted. He sat in the hectic waiting room and finally left when it was clear he wasn't going to be seen before lunch. One of the staff said "he was really angry too because.......he wanted to know if he was allergic to dogs". Not clear how that or the pap smear form related to a well man appointment. Someone supervising a school dance was knocked down in the dark by a large student playing tag and although not seriously injured was really ticked and immediately shut down the dance. Saying"no one will own up to doing it" caused me to have an overwhelming urge to ask if "it was a hit and run?" however I restrained myself. One of the grocery stores had a customer faint there before supper and the excitement and calls for one of us to come pick this person up (no ground transport here) then sending someone to come pick one of us up, no we're not doing that, you bring her over etc. was a bit over the top. Especially finding out it was a prenatal who hadn't eaten since the evening before. I said to Nellie "what would they have done if it were a cardiac arrest?" and she said......"they have an AED there". I'm sure hoping I'm outta here before THAT gets used by such a crew. 

My roommate was attempting to go home today and the plane overflew Taloyoak (as well as another community) for something mechanical, and so tomorrow will be another chance. She now has to overnight in Yellowknife and won't be home to Moncton until midnight Sunday. Her job share contract   in NWT begins March 1st so she is supposed to fly out there on Wednesday. She is (understandably) not impressed. We watched The Town at the Top of the World which is a CBC documentary from about 2007 about Grise Fiord - interesting if you get a chance to see it - the most northerly non military settlement in Canada with about 150 people. And I thought here was small with about 20 - 25 vehicles in the community and no taxis - it's very unusual to have to wait at a stop sign for a truck, a skidoo perhaps.  I'm not likely to find myself there as it's a one nurse health centre and it's so much better to have someone to hang out with. 

Been a rough week at home with a fishing vessel lost in a storm with five young fellows on board. The search was called off on the fourth anniversary of the accident with the rogue wave. Hitting a bit too close to home when it's young fellows who played hockey with your son-in-law and you watch CBC with a father you went to school with talking about the search for his son. Sigh. Not one of those things as a fishing family that you want to think about but with the number of fishermen lost at sea memorials in our are it's clearly not something new to us. 

Well, plans to skype two out of three daughters tomorrow so I best crawl into bed and hope that the circus which was this evening on call has left town. 

Under the B....Bronchiolitis

Just checked the posts and realized that it's been a week since I updated the blog. The time does fly by up here. It's been a steady week and tonight for supper we hosted the staff dinner (which was supposed to be held at Christmas but didn't happen) with a roast turkey feast. I'm too stuffed to settle down to sleep yet. So to recap the week just ended....

Arctic char for supper yum

My roommate and I had arctic char for supper last Sunday as someone came to the door selling it, offered to filet it and so and we baked it. Yum. It's sort of like salmon, or sea trout but a better milder flavour. Have some more to take home and some left from my last trip so will have to have friends over for supper (you know who you are) when I'm back. Last weekend while we were enjoying our fish here, in Nova Scotia it was a wild ride of blizzard, wind and power outages. The shore captain wrote a cryptic email saying that he'd had four hours of broken sleep in his office chair in the previous 39 hours as he babysat $200,000 worth of lobsters in the tank house. He moved those from his satellite office to world headquarters as that meant only one generator to keep running. All this with his main employee on the way back from Disney World so doing it solo. There was also the incident of having the fishing boat break down and 28 hours later arriving with the Coast Guard towing them to the fairway buoy and then the boy captain bringing them to the wharf from there with the lobster boat, although it's a short distance it took over an hour and was described as towing a transport with a half ton truck with the transport putting the brakes on occasionally, which was the equivalent of a wave hitting them periodically. So, although call shifts have been busy here, he wins for the busiest weekend award.

I have this past week though, learned to do an X-ray and could likely stumble through it with the manual by myself if I had to now. We only do chests and appendages. The most difficult part was feeling in the complete darkness (there was no red light) of the dark room to open the plate and get the film out and into the machine and then a new film into the plate for the next one. I kept worrying I was going to lose a finger to the machine when it inhaled the film to process. We send the x-rayed person home on crutches and this involves a very small, stubborn grandma attempting to piggyback a child taller than her down the steps to the snow machine although I clearly instructed her to use the ramp. When they came precipitously close a second time to both tumbling down the stairs I headed out in my uniform on to the steps at -53c and read them the riot act. She finally relented and they headed down the ramp with me waving my arms like a traffic cop and yelling over the skidoo. Nothing like putting someone in a car in front of the hospital in the rain, nothing. It turns out my roommate was watching horrified from the upstairs window, unable to do anything as the window was stuck shut and when she sees me appear on the scene was relieved. I get to bed after midnight.

Although I'd been hoping for a quiet night after that, it was not to be as I was awakened at 0245 hrs by someone with an allergic reaction that had been going on for several days, been back and forth a few times for benadryl and it had worn off again, so I gave her another injection, told her to stop scratching and crawled back into bed. At quarter to five I have another phone call this is from the C.A.R.S. (Community Aerodrome Radio) operator who deal with the airport who tells me "your medevac flight will be here within the hour". I assure them that we don't have a medevac going out as there is no one here at the health centre and try to fall back asleep. The next call says "your medevac will be here in 20 minutes" which I again dispute as we are not evacuating anyone, "well it's Discovery Air the fuel truck operator told me and they do your medevacs". I can't help it, no medevac here - do you want me to call Nellie? "This offer is declined. Well, I'm going to have to call the pilot then" to which I reply "you do that and if it's not for me, don't call back". By six a.m. I am still awake and hear the loud roar of the plane land as it can be heard all over the hamlet in the stillness, usually we're really busy and don't hear it. Apparently it was a plane chartered for the Rangers as they'd hoped to go overland to Cambridge Bay on a winter training mission but the current is keeping the sea ice open in some areas so needed to do a fly over to see if the route would work - it won't - so they're going to Gjoa Haven instead. I just dozed off when a grandmother brings in a croupy three year old who we fix with dexamethasone and he's recovered within the hour. By then my work day has started. It passes in a busy blur as I am fried. Mind you I do remember that I see children named Lazarus and Samson in the same day - rather biblical eh?

Electric power plant

We have had large numbers of children, especially small babies, premies and those with other illnesses in with bronchiolitis from RSV. Those who are struggling more are usually the bottle fed ones in homes with smokers, or those who smoke with babies in the amauti. We've had a few parents who smelled so strongly of weed that I insisted they remove their jackets and wash their hands. I asked about grow ops here as pot smoking is not uncommon and was told that this isn't possible as the electricity is produced locally by burning fuel and so the offenders would be easily caught. Hmmm. The bronchiolitis requires frequent aerosols or inhalers and reassessments at the health centre for many days and the cough stays often for weeks. One of the grandmothers who brings her adopted baby for a recheck on Saturday evening says she doesn't trust to leave her bingo cards with her husband as he's so deaf. I tell Nellie "under the I - 24 and she says "B is for baby or bronchiolitis not for bingo" as she's very displeased. Nellie often has sayings that are in different order than I'm used to - perhaps her Jamaican roots - and when we are discussing writing the no shows on the charts for parents who haven't returned as requested with their children for rechecks, especially one very difficult family she says "that one will come back with teeth on it" as opposed to 'that'll come back to bite you'. But the sentiment is the same.

First Air in from Gjoa Haven

I took the dental team to the airport on Saturday and the dentist was asking me about the treatment for bronchiolitis as he'd been hearing all the yelling from the exams and treatments the past week. I explained the aerosols and commented that if they yelled the medicine got into their lungs better although the parents weren't pleased with it and that was likely why they didn't give the aerosols as often as they should at home with the machine. He said that it wasn't uncommon for them to be discussing doing a dental extraction for a two year old and the parents to ask the child if he wanted it done. More often than not the kid refuses so they say "he doesn't want it" and take him home. "Yeah, to come back some night to see the nurse at 4 a.m. with a dental abscess" I say. I headed out to the airport a second time to pick up the ultrasound tech who was flying over from Gjoa Haven and snapped this photo of the plane landing, can't you just see how cold it was?

It's been a good weekend though all in all. Heard from my buddy at home who is awaiting her first grandbaby and all the emotion that will bring. The lady who is making my kamiks came to do a personal fitting this evening - they're going to be black leather bottoms, sealskin sides and green duffel liners - anxiously waiting for them to be done. Had a chat with the life partner and can't believe I turned down a chance to travel to Boston as he is planning to take in the Boston Seafood Expo but...it's the first weekend I am home so I'm taking a rain check and he'll head along with some industry counterparts. My roommate is getting ready to desert me as she's shipping out on Friday and moving on to a job share in Aklavik which is a community in NWT. I shall miss her as we share a twisted sense of humour and she likes to eat my cooking (cranberry scones being her personal favourite although the blueberry and chocolate chip weren't bad) which is  helpful as I like to bake but don't want to eat it all so I can get into my jeans to wear home. I am pleased that she has found some security in her work life though. This quote is the advice I've given her as she begins her new career as a CHN. I shall need to remind myself of it as well as we head into a new workweek.

Urban hares and beaver trim

So to resume the story from.......gotta go there's the phone and I'm second on call....well that was quite a benign beginning to another rather long night. The 10 p.m call was from the first on call co-worker and I heard a commotion and hoarse crying babies in the background when I answered the phone - this could've been any house in Taloyoak this month. She must've been a bit rattled as she says "who am I speaking to?" so I say "who am I speaking to?" in return until she finally manages to call me by name and says "oh, it didn't sound like you" which was likely because I was trying to get into my pyjamas when the phone rang and was probably trying to disguise my voice as I'd had a late night on call the evening before. We establish that I'll come down and reassess the little ones downstairs that she's worried about - a seven month old who has been sick for a few days at home with what is clearly bronchiolitis, likely RSV the cause. We send the four month baby home with a maxi mist machine to come back in the morning, or sooner if needed (he has a ventricular septal defect and is on lasix) and the other we try to sort out. 

She can't hold her oxygen sats above 90% without 2L/min of O2 and is getting tired so.....we attempt to locate the Dr. who covers our community and happens to be in the hamlet this week - who is at this moment blissfully unaware at the Boothia Inn. We ring multiple times and finally let the boss know, she advises that we call the physician on call in the region. The next morning when I ask the Doc if he paid the clerk not to switch the phone over so we couldn't reach him, he denies this and says it's happened before. And it most likely has.  As he says "no, I had a great night's sleep last night". My colleague and I had quickly decided though - the Doc in the Box was the better option as the physician on call in another community a few hours away (or in this case another region and two time zones away) cannot set eyes upon this baby - in this case you are the eyes, ears and hands of this professional so….they cannot really 'make you' do anything you are resistant to. As in "do you think this baby needs an IV?" "NO! she drank 20 oz of fluid in the four hours she's been here". Where as our community Doc was singing the tune of "these baby's do really well with a bolus of fluid" and the response to that is "yeah, she did really well with the 20 oz of fluid" but he wasn't convinced - this certainly confirmed that we had indeed been dealing with an easier sell. As is "can you do a chest X-ray?" "NO, I haven't done one before" which really means - and what is the purpose of that ? the treatment is probably the same and if an antibiotic does need to be started a few hours wait isn't going to change plans after a few days of this cough, the quality of the film won't likely be great, we're not wonderful at reading these and the films will go out with the patient anyway (where they will do a better one and laugh at ours) as we both know the direction this is heading, not to mention what you put a seven month old with compromised respirations through to get it. On one of my first days here when I had someone who (in a more resource rich location) would be sent for a chest X-ray and I pondered calling the janitor, I asked Nellie if she would do a chest X-ray and she says "will it change your plan of treatment?" Slight pause…."um, no" and that's settled. So after asking for a transfer, calling the medevac and giving some dexamethasone as requested by the Dr (it's in vogue again for RSV bronchiolitis) we wait for the call as to who the receiving Dr. is to get the paperwork in order. 

Thankfully (for us) the medevac is out of Cambridge Bay and they're just heading in there to refuel after a transfer so will be over in less than two hours - much better than the option of waiting for one that just left some northern community and has to get down to Yellowknife and back as in the previous all nighter - but it's going to be a short night. The baby settles a bit and we check periodically as she sleeps - yes this is important therapy for a tired baby fighting to breathe - while we get the documentation in order, eat trail mix, drink mint tea and find ourselves sleep deprived and somewhat giddy as if we're doing a night shift. The first on call is responsible for the patient and stays at the health centre, the second on call is the chauffeur so we finally get the call with the ETA of 3 a.m. I suit up (snow pants, dickie, parka, hat, scarf, mitts, boots with grippers) and grab the garage door opener and keys to to the SUV and motor out to the airport to wait for them so there is a quick transition and we get to see our pillows. Let me see if I can recreate the situation for you:

I arrive at the tiny building which serves as Taloyoak Airport  sitting unaccompanied on the edge of a gravel airstrip, not even a vehicle waits outside in the inky black, eyeball numbing, frigid, stillness. I leave the SUV running as at -54c it is the routine, and step away to the edge of the parking lot and the absolute aloneness of an arctic night (with the memorial to Judy Hill et al from that 1972 story) where NOTHING can be heard - no trees to crack in the cold, no bushes to rattle, not even any animals moving in these conditions. Every star and constellation in the northern sky is twinkling just for me in my solitary situation. Within a few moments a tiny star drops out of the night, touches smoothly down on the icy airstrip and stops before the flashing orange strobe on the roof of the SUV. Two men children (who are most certainly younger than my youngest offspring of almost 24) in parkas leap from the small King Air with blankets and grunts of acknowledgement to me as I introduce myself - just another nurse on another airstrip to them - and start covering the engines and wings with insulated blankets. These are to keep the engines somewhat warm, reduce wing icing and hopefully mean a quick take off. The clock is ticking. The tall, lanky flight paramedic who is known to me, pops out of the side door with the flight bags and unfolds himself down the stairs. As he gets closer I see his bleary eyed, Miami vice growth look. He tells me that they've been flying since 3 p.m. yesterday having just transported someone with premature rupture of membranes from a neighbouring community. He tells me they've done 29 transfers in the past 30 days. I sense that he shares our "let's get this party started" approach and this will be a quick turn around. Out through the gate, past the waiting fuel truck which has appeared to service the plane. Back to the health centre and Mom, baby and suitcase are ready to go. Quick check of the baby by the receiving paramedic, he calls Stanton Territorial Emerg to tell them they're on their way, mom pops baby in the pack and pulls the cords for monitor etc out the side, pops on her parka and we're out the door while I manage the O2 and monitor attached to baby. Dad carries the suitcase which I throw in the hatchback with the flight bags while he kisses mom and baby in the back seat goodbye, hops on his skidoo and heads home. We make a quick trip back to the plane and I drive up to the back door. Paramedic heads out to get the plane ready and calls back over his shoulder "I'll come back and get you mom, sit in the warm vehicle" while I help him drag the gear back. As I stumble up the flimsy steps and stand on the top one to peer into the dark, very narrow, about 5 ft. high crawl space looking like a submarine filled with equipment from stretchers to bags - I again confirm to myself that 'nope, never gonna work under these conditions, not interested in this being my workplace' and back out and down to the ground. The paramedic appears shortly behind me wearing a head lamp, assists mom and baby from the back seat - I wish them well, then they're up the steps and I drive around the plane while heaving a huge sigh of relief, out through the gate and back to put the vehicle away. The coworker and I are up the stairs in a flash as there's only three hours of sleep before the work day starts again. Am I whining? Not on your life, not a moment I regret walking away from a full time down south job. As I stood in the bone chilling dark watching those two young lads put that plane down in front of me to take a sick baby who I had helped to assess, treat and transfer out for advanced care I thought……'will someone please pinch me, I can't believe that I am really doing this, something that I have wanted to do for over 35 years since I saw it in Labrador'. I can't imagine doing anything else now and this is only my second contract. 

Tis the season - RSV Season that is

Clearly the poster the CHR (Community Health Representative) laboured over for the waiting room is not doing it's job. The situation has more to do with a large population under age 15, living in crowded conditions, in a harsh environment, most are anemic due to poor junk food vs traditional diet and so.....they pick up a virus and pass it around. The older kids get a harsh cough and wheeze but it's the little babies, especially the premies, bottle fed, living with smokers who are the one we worry about.....We've been doing our best to do influenza immunizations but the uptake isn't great. Now, when that wave hits maybe I'll be heading to warmer climes. 

This is life in the fast lane Nunavut style. I offer it as a bit of explanation to those who ask "what do you do with all your space time to amuse yourself up there?" I could say that I read - don't you just love this graphic on the left? But I have turned the Kindle on about three times in the past month and fallen asleep before I turned more than four pages.  

9 am sunrise a few days ago

The days are getting longer (and this happens more quickly here as closer to the top of the world) the sunshine is stronger, it's light from 8:30 am to 2:30 pm now. Here is a shot of sunrise about 9 a.m. I looked out the window the other morning as I made breakfast and realized that the white on white which I saw moving down over the hill was a huge arctic hare. Not only are they large, at - 54c they are tough. Hadn't seen one since I'd been here so I assumed they weren't that common, which my roommate confirmed. She says this guy takes the same route when she sees him as well heading around the hamlet. 

I had a young fellow in having a pre-op assessment (we complete a basic checkup and fax it to the OR) for his orthopaedic surgery - having a wrist repaired which he injured caching his caribou in the great outdoor freezer last year when a boulder rolled on to his wrist. In the morning when I picked up his chart and called his name, he had left so when he reappeared in the afternoon  I made sure to snag him quickly "you were here this morning and you disappeared, where did you go?" I asked. "Had to do something about a caribou" he replies. We then have a hunting chat as I'm doing research for the life partner who makes noises about coming up to hunt/visit me one of these years. This hunter was telling me that he hunts for caribou and ringed seal, the caribou are about 12 km outside of the hamlet, usually better in the Oct/Nov when they're fatter than in Apr/May when they're thin after the winter. I asked "how many caribou do you get a year?" He ponders the question for a while and says "I don't count them" so I press for details "do you get one, ten, one hundred?" to which he replies "maybe 12". Pretty impressive with the one deer limit in NS. When I ask if he gets any arctic hare, he shakes his head no. I draw a picture of a rabbit snare and ask if this is how they catch them and he again shakes his head no and puts his two palms out flat then snaps them closed saying "trap".  Of course, there'd be no brush to hide those wire hoops in so they didn't show up in the moonlight would there? I ask why he doesn't hunt them and he tells me that they don't live out in the country causing me to say "so they're urban rabbits?" which after a bit of linguistic and cultural interpretation we agree is pretty funny. 

Ask for help and check expiry dates

Speaking of fur, it has become clear to me that although not shaving your legs is warmer and completely unnecessary up here as no one sees your legs anyway….it is important to put lots of moisturizer on those furry appendages. You look as if you have some kind of skin disease when you take your socks off due to the extreme lack of humidity as your skin flakes if not watered but more importantly your pants stick to you with static cling that makes it appear as if you're standing over a vacuum. Made worse by wearing those old lady stockings - support hose - and shuffling on carpet. I keep forgetting about the static and zapping folks I go to examine. 

Was tickled to hear from the student nurse daughter that she'd received an A- on her latest paper. My roommate and I had contributed some editing tips so we were pleased with that! She is into the stress of the last semester of studies, clinical which wasn't even one of her choices, graduating, writing RN exams and moving halfway across the country to start a new job. Not much stress there eh?

I have given my availability of April 21st - May 24th to the GN (Gov't Nunavut) and have chosen to go to Kugluktuk (used to be called Coppermine) for the five weeks. Always want to be looking forward to the next contract before I leave this one - that's the travelling motto. My resignation for the position at home was received and some kind words from those I'll miss but how would I go back to someone telling me what to do? My roommate has landed a CHN job share in Aklavik, NWT and is instigating to get me across the border. Hmmmm. 

Memorial to Judy Hill et al

After reading, watching all the news of the severe winter storm and damage in Nova Scotia this week I am amazed that we've had less threatening weather at 69 degrees north. I'm off to make some muffins for the roommate as she fed me last night when I was on call. Steady parade of sick kids all day - we're running out of aerosol machines to lend out - until about midnight so not much time to cook. Today as I was second on call, I took the mental health worker to catch her flight and I caught some photos which you see here, then decided with the beautiful sunny day that it was, I would walk to The Northern Store for supplies. So, there's all the news from Nunavut - tomorrow is a new work week. 

About 2 pm today

Engine warmer

Memo to self - be careful of the ulu

I had a busy Sunday on call as the weather was really cold on Saturday (even for here) for details please refer to previous blog post of Taloyoak Terrorist. So when the sun was shining and the temperature up from -56 c the population started moving. And everyone who had been unwell since Friday and found it too cold on Saturday made their way up over the hill to be seen. For an on call session this was my personal best to assess and treat ten sick kids in less than five hours. Now clearly if you're doing the math that's half an hour each but remember we're not doing sections of jobs as in physician tasks and nurse tasks. We are finding their chart, making a CHIMIS (paper which captures the visit for coding) head to toe assessing the patient, treating them, perhaps calculating and dispensing a medication (or a bag full by the time you add advil, tylenol, anbesol, an antibiotic etc. to the party bag) giving instructions, organizing a recheck and then fully documenting the encounter using SOAP notes. I had a nice chat with a grandmother (who has adopted one of her grandchildren - a common situation here) and she was telling me that it was terrible to be having menopausal hot flashes. Now I thought the north would be the best place for those - you know self heating but she told me that with the water and sewage being trucked it was really awful to have to shower twice a day and that you have to tear your outer wear off quickly when entering buildings as the moment you heat up it's game over. Never considered that, dear dear. Glad I've avoided that pestilence. I was pleased to make it upstairs to eat my leftovers before the evening sick clinic started. 

Had an interesting evening and managed to pull it together with my boss as my backup second on call. Then i get a call from a lady who I'd met earlier in the day with a grandchild and this time she tells me that she's cut her hand with her ulu (woman's knife) and can't get it to stop bleeding. I tell her to come up and I'll have a look at it (we both know which way this visit is going) and she tells me that it'll be about a ten minute walk. She arrives and of course has a deep slice which is about four cm on the palm of hand. If you were trying to convince yourself that glue and tape would work, you would just be fooling yourself as this is someone who will use the hand so…..I freeze it with 1% lidocaine and put in seven 3-0 prolene sutures. I am getting a bit faster but more importantly I am getting neater. Due to my slow speed we have a chance to get to know each other better. 

She had mentioned that she was teaching  Inuktitut at the school and was pleased to have work.  We talked about her life (she being about eight years older than me) and I thought of her growing up experiences versus mine. I told her that I had been amazed in my lifetime to find myself in the iglu which the elders built. She told me that her husband was one of the Canadian Rangers -here is a link to a blog which describes them a bit - they're really big here in Taloyoak:

http://watchersofthenorthblog.com

who had created the iglu and that they were limited by the building materials as the snow wasn't exactly as it used to be due to climate change. Here is a link to the local area with a bit of history:

http://www.nunavuttourism.com/taloyoak.aspx

My new friend told me that she was born in an iglu and that her family lived 'out on the land' not really belonging to any community in the nomadic lifestyle of the 1950s before flight opened up the north to southern ways. She remembers the first constructed house (Hudson Bay Co. housing) she was ever inside of, as it smelled different "like wood" when Spence Bay was only a few houses (it was only created in 1948) with the RCMP way over to the east and the Hudson Bay Co. and a few small places. There was no health centre until she was a teenager so before that the RCMP had medicine to distribute and even gave needles. Her mother died when she was really young and her father sent her to residential school in Inuvik before she was nine, as she had an older brother and sister and a younger brother so her sister had to sew the clothes for the family, they received family allowance if one child went to school and this made it easier. They were only allowed to speak English and she didn't speak the language so it was very difficult, she spent the first month just observing and not talking. Her English is very good now of course. In the 1960s there weren't many jobs here and people left to find work so she and her husband lived for a while in another community, there weren't many houses to live in and she 'adopted out' several of her children. Now one grandchild lives with her and another is visiting as her daughter attends school in Cambridge Bay to learn to be an underground miner as there is no work for her locally. They enjoy going out on the land and have two small camps which they visit in spring, summer and fall by four wheeler or skidoo. A tetanus booster, blood draw so she doesn't have to return for a routine visit which I centrifuge as she slips back into her parka and out into the frigid air for the walk home. Pinch me, am I really living like and doing all this?

Should you wonder if I'm learning the language I will tell you that I have picked up the terms for all the body fluids/functions as this is nurse language, some common terms such as "do you want to pack?" which is the term for carrying a young one (up to age five or six at times) on the back in the amauti or packing shirt (it sounds something like ayaiayi) and we have interpreters . If you'd like to try it out here is a link to a YouTube video on how to speak the language:

http://www.youtube.com/watch?v=NUSwXbz7CtE

Today was a busy beginning to the workweek and the Dr. who is responsible for this community is in doing his clinic. He had quite an adventure travelling up as his connecting flight 'went mechanical' out of Yellowknife and he hadn't thought he'd make it last night. However Canadian North put a charter on and after multiple stops and much later than planned, he was deposited at the airport. He called the health centre to announce proudly "we made it!" and I assured him that Nellie was there waiting for him - probably didn't want to get out of the vehicle until she had to. I told him today that he likely used the same enthusiasm when announcing the birth of his firstborn and he agreed.

So, time to retrieve the laundry from the dryer - not that anyone would steal anything (even a duvet) from me here - apparently it's easy to apprehend anyone lifting stuff as there is no way to escape - well at least not far. Unless I guess it was small enough to get on a plane with. Oops gotta go, second on call and the phone is ringing. Later

Ee

A day off today to putter, connect with family and friends and bake. Ahh, life is good. I had a call from a buddy first thing this morning and we exchanged news from north of 60 and the balmy southwest. There is apparently a snowstorm forecast for the next two days at home. More winter this season there than for the past few years. I did a video chat known as Google Hangout with my summer neighbour from her sister's place in Vermont - she's hoping (weather permitting) to head up to see the sunroom that has been added to her summer home. And then I managed a skype date with the oldest daughter and her two beautiful fur babies - they are so cute - she showed me Mikey eating and you would think he was a leopard with the high speed chomping and mowing down. Must be because he was a foundling and has food security issues. He and his roommate Squeakers have sure landed in the right spot for love and attention. I had arranged (or thought I had) to have the life partner phone me (as him managing skype is highly unlikely) today - you know my day off - but received an email asking what time tomorrow (I'm first on call) he should phone? About right as in the almost 40 years I've worked shifts he has yet to figure out what my schedule is. He will have to take his chances with as busy as the call shifts have been. 

Sunset at 2:30 pm today

Taloyoak Terrorist

I decided that today was the day to head out for some fresh air and at -51 c with the wind chill, it could be described as brass monkey weather not just fresh. There was a bit of new snow as well as the original white stuff blowing around. I was sure glad to have my Canada Goose Expedition parka and all the remaining arctic survival gear on. I decided today was the day to break out the insulated bandana face mask which made me look as if I was on some sort of Jihad mission. I got my room mate to take my photo as I got geared up. It is amazing to be struggling up the hill, hunched over with these layers on, and meet a local female with a child in her amauti striding out across the snow with no face covering. I will be glad when the kamiks (mukluks) I have commissioned are finished - I had to draw my foot on a piece of paper, measure my ankle to knee and calf circumference and give my shoe size. They are going to be sealskin legs with black leather bottoms. Can't wait as I haven't had a pair since Labrador. Can only wear them north as it's too slushy at home for them.

Hardware/skidoo section at COOP

And just to prove that I did make it over to the grocery store I'm including a photo of the hardware section which is to the left of the produce. Speaking of which I bought broccoli today and the clerk asked me what it was as she was attempting to find the price. I think she didn't find the correct veggie as I was only charged $3.95 for the broccoli but I'm not telling. I did two nursing consultations in the aisles as I'm starting to be known here now as a nurse from the heath centre so felt really as if I were in Sobey's at home being asked health questions by the neighbours. 

Great news from the baby daughter yesterday who had done a job interview and was told by Battlefords Union Hospital in North Battleford, Saskatchewan that she had a full time position on the medical unit which she could start right after graduation. So I am posting this quote in her honour. I feel as if the last baby bird has climbed up on the edge of the nest and is getting ready for flight. She's been pretty independent for a while but is launching her new career. It's ironic that I recall this same area advertising for nurses 37 years ago when I was graduating from nursing school. It was a typewritten, photocopied posting but the very same location - no online posting or google map to help then - here check it out:

http://www.panoramio.com/photo/1283293

With my travels back and forth through Edmonton, I'll now be able to visit my two western daughters at once about six times per year. My advice to the soon to be graduate is.....

Never be afraid to try something new. Remember, amateurs built the ark; professionals built the Titanic. ~Author Unknown

Writing the term google map made me smile as my coworker asked me a question on Friday afternoon which I couldn't answer and I suggested she search online as in "google it" and then we concluded it would be quicker and more accurate to ask the boss so I told her to "google Nellie". She returned shortly with the answer stating "Nellie is sure a great search engine" which we thought was a funny inside joke to us. 

Speaking of health care, I found a great article in NEJM on the Cuban healthcare system which is for the most part accurate. I thought of our Cuban trip next month today during the white out walk. Enjoy:

http://nejm.org/doi/full/10.1056/NEJMp1215226

So this afternoon when I returned from my shopping expedition and got serious with the food preparation as I made chili and corn bread for supper then cranberry scones for dessert. Now it's an early bedtime as I was up during the night and looking at another 24 hour call tomorrow. Should you wish a bit of a language lesson I can tell you that yes in Inuktitut is pronounced simply ee as in bee.