Practicing medicine in Antarctica? Yes! Watch to learn more!

so today i have another great interview i have a guy who is a pa who has spent this winter doing something very unusual he was working at a research station down in antarctica and today he's going to tell us all about that experience so please help me welcome joe hornerman [Music] okay well so that you know brings us to the not i wouldn't say the highlight of your career because there's a lot of cool stuff i'm sure you've you've done it no it's definitely the highlight of my career yeah it's definitely a unique experience that not a whole lot of people can say that they have done for sure so um tell us at what research station you were at and briefly kind of just a general overview of your duties i was at the amundsen scott south pole station in antarctica which is located at the earth's geographic south pole and i was part of the medical support team it was myself and a doctor we were there over the winter the polar winter which lasts about nine months six of those months the sun is down and it is dark 24 hours a day for that time so it was that was an interesting experience but basically we are there as medical support for the station so during the winter there especially there is no um traffic in or out of the station there's no ground traffic there's no flying traffic we're basically stuck there for nine months left to our own devices and so it's a doctor and i and we are the sole medical support for everybody on station which is including us 39 people this year in case of whatever happens a broken bone you know hopefully nothing more serious like a stroke or a heart attack but that's what we're there for and uh anything else that can come up medically you know it's kind of like you're uh you're on mars you know you got to have a medical team ready to respond to things especially any kind of trauma there is some heavy equipment there heavy loads that need to be moved around so accidents can happen luckily we didn't have anything bad happen this year but that's basically what we're down there for so i guess like with astronauts the the people who actually work in the research station they must get screened pretty well for for health and psychological fitness yes so um we go through with the pq process or physical qualification process and basically you send in this pretty complete medical records form and that's to the university of texas medical branch in galveston they run the center for polar medical operations which oversees all of antarctica's stations not just the south pole they staff the medical people there they're my employer how many stations are in antarctica do you know the u.s stations there are three total stations in antarctica i'm not sure it's got to be upwards of 40. wow uh if you include every country's station as far as the winter rover stations i believe there's 22 or 23 that are actually staffed during the winter a lot of them are only staffed during the summer or just buttoned up and um closed up for winter and then they come back in the summer yeah see i mean that's something that i would you know i think most people would say if you ask how many stations down in antarctica people would be like one one the antarctic station yeah now there's a ton most of them are on the coast because it's just such a rich area for antarctic wildlife there are very few stations on the interior the south pole station is one of them what type of research is that station mainly focused on most of the research that happens at the south pole station is astronomical in physics we have the south pole telescope as well as a couple of other telescope arrays that are looking at the cosmic microwave background radiation there are some climate some climate science the national oceanic and atmospheric association noaa runs a observatory there so it's a it's an array of it's an array of uh of experiments the most prominent ones are the astronomy and the physics ones though and i imagine i mean you may not know about this but i would imagine each one of these stations have to have their own medical personnel all the u.s stations do for sure so there's mcmurdo there's south pole and there is palmer station the biggest station on the continent is mcmurdo station which is a u.s station and it's where a lot of people come through even other stations other countries before they go to their station uh and that has can't have upwards of a thousand people during the summer maybe even 1500 1800 people at max capacity and there is usually two doctors um i think two nurses a pa like they got they got a pretty decent uh size staff for that clinic uh there is uh for south pole like i said there's a pa or np and a dock so two of them and then palmer just has a doctor because it's the smallest station it usually has only like 20 to 30 people there and that's on the coast that does some biological research so how does the licensing work it's just any state license similar actually to the indian health services where i work in south dakota they take any state license as well because they're a federal program during that like nine month span when you're there shut in over the winter how much how many providers work there two of us so there's a doctor station doctor and then there's either a pa or np as the secondary position position that physician and that's another thing that's surprising to me just like when i just interviewed um somebody who was a pa working with the president the vice president um not to put down our profession or anything but i guess a lot of times he just would assume that it would just be physicians did anyone ever talk about what the reasoning is of that having a doctor and a pa or an mp the navy station was established back in 57 and since that point up into i believe it was around 2000 early 2000s maybe 2004 i'm not sure exactly when there's just a doctor on station one doctor and then there started to be some issues that where the doctor themselves were getting sick or had some problems um there's a famous case uh i can't remember her name off the top of my head yeah i was just thinking about her yeah i read her book and now i can't remember her name but she wrote icebound um the book where she she was a physician at the south pole station and she got breast cancer which was very unfortunate timing basically it started growing right after she arrived and right after they closed the station and she was just hoping and praying it wasn't cancer and it turned out to be so yeah that was just a series of unfortunate events actually that wasn't the one i was thinking about wasn't there someone that had like an appendix and they had to operate on themselves or was that a movie yes yeah no no that's true that's true that was a russian that was a russian doctor in the 70s actually that that happened to was at a russian station but yeah the early i think it was actually 2000 1999 or 2000 was when this doctor she had a breast cancer and actually they airdropped chemotherapy drugs midwinter to the station besides going through the polar night there which is not easy on the body itself and the brain and the mind she had to also start like chemotherapy there i believe and then all of a sudden you're kind of without a fully functioning doctor as soon as something like that happens and oh yeah there was another case where um not the doctor but uh some one of the staff had a pretty serious medical condition that required like 24 7 monitoring for weeks like they weren't even able to fully perform their job you know because that one patient was taking their entire attention all the time you know you're the only person there you're the only person there you don't have any help you got to establish all the ivs you got to take all the x-rays you got to call the consults you know you got to administer all the medications you've got to pull everything out of the pharmacy yourself like you're it plus if any other patients need to be seen exactly but they're probably just shelved off the back burner at that point unless you're unless you're also about to die you can move along it's almost like a mass casualty incident at that point you know because like mci is usually termed like whatever whatever amount of patience or severity overwhelms your capacity to treat and that basically is that like one bad patient overwhelms one doctor and so around that point usap was like in usap is united states antarctic program okay usap said um you know what how much would it cost for us to put a second provider there like another doctor that's too expensive what about a pa or np yeah that's cheaper let's do that there's an argument to be made that i am the most useless person on station you know as far as how essential i am because i'm basically there as a backup to the doctor obviously since we're both there we both split responsibilities we split our hours and stuff like that um and we take on equal loads but you know the real purpose of me being there is if he gets a patient he can't handle if it's serious or uh you know he himself gets sick or he or she obviously you're there for any like major you know critical things that happen but on a day-to-day basis what kind of conditions were you seeing how often were you seeing them and then what were your other duties or responsibilities if any our duties are fairly light as far as see actually seeing patients because like i said our we do go through the physical qualification process which weeds out anybody who's really high risk and then on top of that there's only 40 of you so the chances of something really going wrong is very very low which so you end up not really treating a whole lot you know maybe somebody's allergies flare up when we go trimming stuff in the greenhouse but other than that there's really no allergens around there there's nothing growing except what's in the greenhouse you know so we deal with a lot of like low-key trauma like people break their toes break a finger maybe or get a little frostbite maybe get even worse frostbite where they lose a little bit of tissue something like that but you don't do a whole lot of extreme patient care as far as what you do the rest of the time there's a fair amount to do because you're the only two people there everything has a maintenance schedule whether it's the x-ray machine or the three ventilators you have or all the defibrillators you have around station you know everything has to be checked periodically so we had you have a whole spreadsheet schedule on how you're going to verify everything is working properly beginning of winter we do a pharmacy inventory where every single pill in the pharmacy is counted that was my project for the first couple weeks and we actually have a pretty comprehensive pharmacy for how remote and how small the clinic is it's now as far as the depth of how many medication how many bottles or vials of a medication we have isn't that deep but we have a pretty big variety so utmb from what i know of the process they order all the medications from all the different vendors to utmb and then package it up in their own packaging and then send it through new zealand has to clear new zealand customs and then it finally gets shipped down to mcmurdo and then from there to the poll so they try to get a jump on things as early as possible um when we came in in february we our medications were like on one of the last flights in and when you say last flight for people who don't know there's um there's a window where flights can come into the south pole but then once the winter kicks in there you were as you said earlier you're literally cut off there's no flights coming in there's no way to get to the station so anything that's going to get there has to get there before that window closes so it's possible to to fly in the middle of winter to pole but it's very very uh it's dangerous a it's not something you'd want to do routinely and it has to be for a really good reason generally a life-saving medevac or something like that and it's not just that you know the pilots are sitting with their planes at mcmurdo and they could fly over but they just don't want to because it's dangerous actually once winter starts all the pilots and planes leave the continent and go back to wherever they're from our main contractor is ken boric air or kba in canada and so if we want to rescue or we won't need a medevac or anything like that they've got to come all the way down from canada to retrieve whatever we need them to retrieve you know a patient or whatever so it's not just dangerous but it's a logistical nightmare so yeah it generally does not happen um at all in the winter once station closes that's it and then at that point you're on your own uh which is a funny feeling um definitely a little bit of anxiety as you see the last plane leave but then it's i felt mostly excitement i thought it was pretty cool are you able to like perform surgery if you need to not really no um now if it was something life-threatening surgery-wise i mean like you know the doc and i know how to do a cranial burr hole if we really had to but do we want to no we have to be pretty like we'd have to be pretty convinced that this is like it's like this or death right before we're gonna do surgery and our our policy on appendectomy is so everybody that goes down doesn't need their appendix out that's uh it used to be the case it's not the case oh really um yep and that's just because uh antibiotic therapy has progressed right even in the regular ers they're being managed a lot more just non-surgically right exactly so it sometimes it's curative but even if it's not curative it's a great temporizing measure so our our policy is for usap at least at the south pole is just load them up with antibiotics stabilize them and then call it medevac immediately and see how quickly we can get them out so we do not have an or we do have sterile instruments but i would not want to have to try to do surgery there it'd be have to be a last-ditch attempt for sure but we have ultrasound we have an x-ray and uh the whole computer set up for reading x-rays digitally we can do dental x-rays too we have a whole dental suite with dental tools we have a lab with you know all your basic labs like uh cbc cmp we can do uh lipase all the cardiac enzymes you know d-dimer all the stuff that you know you frequently order in an er we can do striker stretcher right here of course with our go bag is there power 24 7 or does the do they cycle through power there are three generators each one of those generators can could run the station so it's extremely reliable just in general like kind of how big is the station and what were what was your like sleeping quarters like so the station is much bigger than most people realize i'm not sure what people imagine maybe they're imagining like the space station or something like that but it's it's pretty big the inside livable space i think it's about 60 000 square feet which is about the square footage of a football field if you imagine that um if you add in all the utility space it's even more than that but that's the elevated station so it's pretty big um it can house up to 150 people the rooms you get aren't that big they're pretty small eight by ten i believe maybe seven by ten it's pretty tiny it's enough for a twin bed and that's about it but they are your own rooms you don't have to share rooms now at mcmurdo station on the coast they can have a lot of people during the summer and then everybody's sharing a room so you don't get your own room there and uh communal bathrooms i assume are shared yes definitely communal bathrooms um and like i said you can see how the tour i've all had on my youtube or my tick tocks as well but um it's very livable space it's a little bit like uh a little bit like college you know you're in your own little dorm and you have to share a bathroom and then you go to the cafeteria where everybody eats you know it's it's very much a shared space kind of environment well that's so cool that there's a greenhouse because that would be really hard just eating you know pre-packaged food all the time not having anything fresh for nine months that's a long time yeah basically all our food is um if it didn't come out of the greenhouse it has to be able to be frozen or powdered yeah the greenhouse is amazing to be able to have that now they don't they can't it's not huge it's not like we have a big old orchard of orange trees in there or something mostly it's it's things that grow on a vine or tomatoes or cucumbers or leafy greens like spinach and lettuce things like that but we're able to get probably a fist-sized salad every day which doesn't sound like much except it's like life-saving right that's all the green thing you have and it's either that or nothing it means a whole lot i assume that there are some researchers that are going out of the station but did you were you pretty much indoors the entire time or did you get to go out as well so i loved going outdoors and um being medical we kind of have free reign to do what we want and i took that as a license to accompany scientists all the time whenever they're going outside to their stations or doing rounds on their science equipment just to make sure it's working properly still and while i was out at the out buildings i was usually checking the medical equipment out there or the aeds making sure they were functioning properly that was my excuse for going out there does the south pole have anything like the northern lights absolutely we got them very frequently this year actually it was it was really cool just about any time a day or night you could walk outside and see some and then very often they would flare up into like these really bright green bands across the sky and uh purple and reds and yellows is really cool yeah very cool one of the coolest things i've ever seen so the whole mental aspect did you have any challenges with that and what was it was it like what you thought it was going to be or was it claustrophobic at any time i was on a pretty good high just from being there um and kind of i've been wanting to get down to antarctica for for a long time you know since i was a little kid and so just being there was awesome and that that kind of carried me through a lot especially into the dark uh polar night but by the time it got to about mid-july and august i started to drag pretty hard um had a lot like a lot of symptoms of sad and seasonal affective disorder you know i was getting fatigued really easily i felt my sleep requirements just go way up just lack of motivation like i didn't want to go to the gym as much that's what i was going to ask earlier so there is a little gym there you can work out yeah actually pretty good size there's a weight room which has like all your treadmills rowing machines bikes exercise bikes and everything then uh there's one entire pod which is kind of like a wing of the station is dedicated to a sports gym um so like a basketball court basically which can also be converted into volleyball court badminton um indoor soccer if you wanted to do that you know street hockey whatever um so i thought that was really cool you're there all winter man you you just really look forward to like some of the things every week and one of the things i look forward to was volleyball which we played twice a week that can really get you through a lot you know it's good for bonding it's good for the community it's good for your mental health to have that exercise and kind of just the natural endorphins from exercise yeah exactly um exactly so i think it's really great that they have that so yeah i had a kind of a rough patch in late july i had just gotten done helping coordinate our south pole olympics which was like a big event for like a whole week we did all these events and that was kind of like a big high and then that was done and then all of a sudden i realized how like how many of these symptoms of sid i was i was struggling with you know it kind of crashed on me all at once at the end of july and then i didn't really kind of come out of my funk until uh september and i knew as soon as the light started coming back like i was gonna start feeling better and sure enough as soon as i started seeing some light on the horizon your brain starts resetting you're like oh yeah sunlight that exists and you're in physically physiologically your brain starts kind of getting back to normal for me at least that's how it was so yeah it can be tough and i know some people have a tough time as soon as the sun goes down and that's bad some people have no problems the entire winter so it really just depends on who you are do you end up putting people on antidepressants that's definitely an option we do it within consultation with psychiatry back at utmb okay which is really great that we have them available is there any problems with communication ever get disrupted our good internet satellite is about five hours a day while that's up we have great voice quality calling back to the states and then the rest of the time we have an iridium satellite phone which we can reach anywhere in the world any time a day but sometimes the quality is a little iffy so you're not totally cut off communications wise you always have the red phone option you know yeah call somebody which is which is pretty great so let's talk about how you how this opportunity came to you because we had talked a little bit earlier so i know you didn't quite go the traditional route so if you'll talk about usually how you know people do this and then what happened that you got to bypass some of that really i first learned about like the medical side of the u.s antarctic program when i was in the fellowship at uihc university iowa hospitals and clinics in iowa city i took a wilderness medicine course as one of my electives in the residency and the teacher for that his name is dr chuck huss he was the station winter over doctor at the south pole in 81 i believe and he gave us a whole presentation of what it was like to work at the south pole in the 80s in the old station before this nice shiny new station yeah i'm sure it was different and yeah and uh i was just fascinated by it and then so as soon as i graduated from the residency i applied at utmb's website you know for the position i applied then i applied the next year applied the next year i applied like every year and then finally last year um i just gotten back from traveling and uh a bunch of my other jobs just fell through the last second kind of frustrating you know right during the pandemic people weren't sure if they need you if they don't need you anyway i guess out of frustration i just emailed utmb the the hiring coordinator for them and i was like listen i was like you know as politely as possible but what i was thinking was listen like what are you guys looking for for this position like i have four years rule er experience i've done a residency i have the caq like what what are you guys looking for like what what could i do to make my resume look better i finally got a response from them was like actually we are looking for somebody like you and i was like great and i just went back and forth and it eventually landed this this job so always send follow-up emails i guess is the moral of the story for that right i mean if there's something that you want to do i've heard this so many times if there's you know any way that you can contact people and do follow-up you just you never know when you're going to make the call that's just at the right time like like you and then you get true yeah and yeah you never know like i i actually had emailed them right at the time that they had this opportunity come up and so they originally were thinking of me because of kovid and they were trying to add as much redundancy in their medical staff as possible they were worried about the single doctor at their palmer station which is the small the smallest station they're like maybe we need to add a pa over there and they're like we're considering adding this position um you know we'd love you to be that person i was like great i would love to go to palmer station that sounds awesome and then they got back to me uh about a month or two later and was like actually how would you like to go to the south pole instead because a person from the south pole just just said that they couldn't um they can't make it this year i was like that sounds pretty cool i'll do that i think a lot of people do some years or seasons at mcmurdo and then end up going to the polls so i feel very very lucky that i was able to go straight there so do you think that you are might in the future apply to to work at palmer or murdo just to experience something different down there i could see that for me i think if i could rank him in order i'd do a summer or winter at pole again um i would do either of those at palmer like a summer at palmer and then maybe if all those were exhausted i would do something in mcmurdo maybe a summer at mcmurdo is that how they're normally staffed is either like you do a summer or you do a winter so medical staff generally is only for a season either the short summer season which is three months or the long winter which is nine months one last note i guess if you're looking for other thoughts is that it is weird to work at a place where all your co-workers are also your roommates and also your potential patients i guess people who have done military time is not so different because it's probably the same thing but um you have to start building um some some boundaries in your mind over like what's personal what's professional and everything um because it's not like you go to work and okay now i'm in my work mindset okay now i'm home and i'm in my home mindset because there it's the same thing like your work is your home our clinic is right here in apod let me take you in so if you come in here through the vestibule and here is the lab with another door into the pharmacy and this is actually my office a little bit of a mess right now try to ignore it we're in the middle of trying to transition and clean things up for the next crew that's coming in here for how isolated we are i was actually impressed when i got here so coming further into the clinic we have our main patient treatment area through here and as our bed our crash cart over here our defibrillator ventilator our main ventilator we have several backup ventilators as well ultrasound all our equipment drawers here iv pumps etc and then we have our telemedicine station where often we'll call over to mcmurdo station where they might have a physical therapist which we don't have here and they can help us with the patient who might be having back pain or shoulder pain and help us do some rehab for them via telemedicine over here we have the dentist's area we rarely use this but we are trained in some very basic dental procedures and all our dental equipment over here we also have our portable x-ray machine right down here and our x-ray cartridges readers over here our 24 7 iridium phone line over here in case we need to call back to our medical support uh come through here if you're wondering we have the plastic up because of covid um we have not had a covered patient here at the south pole yet we're hoping to keep it that way but if we needed to take any isolation precautions because we have a covered patient there we could shut this we have not had to do that yet but again we can go through some more plastic over here to the inpatient area and here we have the inpatient bed mandy the man mannequin sitting over there right now i think this is probably the best view out of window at the station is from this room and that's because we get to look straight out at the ceremonial south pole basically right in line with it makes for great pictures great time lapses you can see all the way over to the atmospheric research observatory way out there and then the dark sector buildings way out there which are kind of just silhouettes right now we have not had to have an inpatient this year um i hope that continues we've had a very healthy year so far coming out of here we've got our stryker stretcher right here of course with our go bag nice acls medications and then through here is the station doctor's office uh dr lee who's not in here right now because it's three in the morning another exam table here and that's basically the entire clinic i'm so excited for you that you got to have this opportunity in life and thanks for sharing with us and um just thanks for being here joe and i wish you all the best thank you so much michelle it's a pleasure being here again don't forget if you want to see really cool videos and more about what it's like living in the south pole make sure that you check out joe's youtube and tick tock [Music] you

Channel: The Medicine Couch

Views: 9,582

Keywords: Working at the south pole, working in antarctica, PA jobs in antarctica, NP jobs in antarctica, cool pa jobs, cool np jobs, unique pa jobs, unique np jobs, south pole medicine, practicing medicine at the south pole, joespinstheglobe, how to get a job in antarctica, amundsen-scott south pole station antarctica, best emergency medicine jobs, wilderness medicine training, practicing medicine in antarctica, utmb center for polar medical operations, south pole medical emergencies

Id: _k4PcO4a4ts

Length: 28min 1sec (1681 seconds)

Published: Fri Jan 21 2022