The Life and Times of Michael C. McGoodwin
Indian Health Service Years in Alaska 1970 – 1972

Shine! shine! shine!
Pour down your warmth, great sun!
While we bask, we two together.
(Walt Whitman in "Out of the cradle endlessly rocking")



Grizzlies in Mt. McKinley (Denali) National Park July 1971 (photo MCM)
Grizzly Bears in Mt. McKinley (Denali) National Park July 1971


Topics Discussed On This Page

 

Journey to Alaska 1970

Driving Denver to Seattle:  We departed on our long drive to Alaska within a few days after I finished my internship on June 23, 1970.  The U.S. government provided shipping for our household goods, up to 11,000 pounds worth, along with travel expenses to drive ourselves to Anchorage in our own car.  We drove west in our 1969 blue Chevelle, visiting Dinosaur National Monument in Utah, Bonneville Salt Flats (UT), the Berkeley campus (including the Berkeley Botanical Garden), and the Lawrence Livermore National Laboratory physics museum (now called the Discovery Center).  We stayed with Rice friends Don and Jan Kirks in Mill Valley, California.  Heading north, we hiked and camped at Patrick's Point State Park, California.  At Crater Lake National Park, Oregon, an unexpected heavy snowfall prompted us to rent a cozy cabin with fireplace.  We passed through Mt. Rainier National Park, but true to form, rain and fog prevented our seeing much of it.  We also visited Olympic National Park and the Hoh Rain Forest.  In Seattle, we went to the old original downtown Eddie Bauer store—it was still very much an expedition outfitter in those days, selling all kinds of guns, fishing and other outdoor sporting gear, as well as expedition clothing.  We outfitted ourselves with new thick down Kara Koram parkas, heavy trousers, and other essential heavy winter clothing, and I recall the excitement, anticipation, and only a little trepidation that we two flatland Texans felt as we prepared in our imaginations to venture into the Alaskan wilderness.

Ferry from Seattle to Haines:  After a lunch at Ivar's (his original downtown walk-up fish and chips joint), we embarked on the Malaspina ferry in Seattle for the 3 to 4 day journey to Haines Alaska.  (This ferry, lengthened in 1972, is still plying this route, but now departs from Bellingham rather than Seattle.)  I'll always remember, as we sailed north of Bellingham, the mystical and lovely appearance of snowy Mt. Baker shrinking from view at the southern horizon—we were definitely leaving the "Lower 48".  The trip was foggy and rainy much of the time, and we were grateful to have a small windowless stateroom of our own, into which we sneaked our young dachshund Freude.  (Pets were not allowed in the rooms, and we had to keep her as quiet as possible with the help of tranquilizers from the vet.)  We enjoyed nice views of distant glaciers including the Mendenhall Glacier north of Juneau. 

Driving Haines to Anchorage:  We drove the remaining bone-jarring 700 miles on partly gravel road to Anchorage: the Haines Road (or Cutoff) connecting Haines to the Alaska Highway (formerly called the Alcan Highway), the Alaska Highway to Tok Junction, and the Glenn Highway on in to Anchorage. 

Life in Anchorage and Environs

In Anchorage, we were about 3275 air miles from our city of origin, Houston TX.

Anchorage Home:  We moved into a rental house in southeast Anchorage at 1603 E. 41st Court.  It was a plain but spacious newer home, with a large basement and gas heat but no fireplace.  The rent at $350/month was more than twice what we paid in Denver for slightly larger quarters, though this included utilities.  The roads in our neighborhood were oiled gravel, and there was virtually no landscaping around our house except for a lawn in front (merely a rough field in back, without trees).  While I was still interning in Colorado, we had assistance in finding this rental house from an acquaintance named Sue Johonnot who at the time was a University of Colorado medical student but had earlier worked doing medical research in an Eskimo village in Alaska. 

High Accident Rate in Alaska:  The rate of serious accidents in Alaska was and probably still is quite high, and nature can be quite unforgiving there.  During our two years there, we knew or knew of a number of other people who were in bad accidents: an Indian Health Service doctor whose small plane crashed; a medical family killed in a plane crash; a climber in the Mountaineering Club of Alaska who, along with his companion, was mauled by a grizzly bear; Congressmen Nick Begich of Alaska and Hale Boggs of Louisiana, who died in a plane crash in October 1972; and my friend Sue Johonnot, while later visiting in Alaska just prior to beginning her own internship, drowned in a tragic Hovercraft boating accident on a windswept lake.

Our neighbors across the street in Anchorage, Judy and Jerry Ware, had lost an infant girl in Seward.  She was carried away by the tsunami that was generated by the 1964 earthquake, and the parents had barely survived it themselves.  At moment magnitude 9.2, the massive 1964 Good Friday or Great Alaska earthquake was one of the largest earthquakes in recorded history.  Its epicenter was only 90 km east of Valdez, and 120 km east of Anchorage.  The tsunami had a wave height as high as 67 meters.

Life in Anchorage and Environs:  Anchorage, located at the head of the Cook Inlet and nestled between Turnagain and Knik Arms, was then a fairly plain, utilitarian, rough-and-tumble town.  The Anchorage Borough surrounding Anchorage had about 120,000 inhabitants, including Elmendorf Air Force Base and Fort Richardson Army Post (this borough in 2010 had by census 291,826).  It had recovered well from the 1964 earthquake, but still bore some scars from that tragic event.  On the rare occasions when we ate out, we could get a good meal at the Nikko Gardens, but otherwise it was pretty much steaks and hamburgers as I recall.  We felt a little off the beaten path culturally in Anchorage.  The television evening news, specifically our favorite, Walter Cronkite on CBS, had to be flown in daily on videotape, and we ended up seeing it delayed to the next day.  We added a subscription to the Sunday New York Times to our usual news magazines to enjoy its great writing and to try to stay connected with the larger world.  Symphony concerts were infrequent, but I tried my hand at playing in a local community training orchestra (see music).  City life included a nice college campus where we cross-country skied (Alaska Methodist University, renamed Alaska Pacific University in 1978), a film series that we subscribed to, and a few downtown attractions such as the Native Arts Festival and the Fur Rendezvous.  The latter was a winter festival which included sled dog races.  (The Iditarod Trail sled dog race going the full 1050 miles from Anchorage to Nome apparently did not begin until 1973).  Summer had very long daylight (as few as 4 1/2 hours of darkness).  Even though we bought curtain liners to block out the night sunlight, the effect of prolonged daylight was to keep us and neighborhood children awake and unable to quiet down.  The weather in general tended to be cloudy and rainy, but fall was beautifully crisp and cool, and winter tended to be tolerable with temperatures usually in the teens or at least above 0° F.  The coldest temperature during our two years in Anchorage was minus 26 °F.  During this cold spell, the main underground water pipe leading to our house froze up solid, and had to be thawed out by a professional using a special electrical heating process.  I managed to play only a few games of tennis, and outdoor swimming was not readily available or tolerable.  We attended the Alaska State Fair in Palmer in August 1970—major attractions included huge cabbages and pumpkins.

The most appealing attractions about Anchorage were the nearby hiking, skiing, and touring destinations: Russian Jack Springs Park (a nice urban park for walking and XC skiing); the Biathlon Trail (near Arctic Valley and Fort Richardson, good for XC skiing); the Chugach mountains and Chugach State Park (in which we hiked to the summit of Rendezvous and Ptarmigan Peaks, and XC skied); the Campbell Creek Valley (with XC skiing, including a trip to the summit of Wolverine Peak in February 1972); the Matanuska valley (including the Matanuska Glacier; Eklutna Lake and Glacier); the Eagle River area; Potter Marsh (visited in season by rare trumpeter swans); the Alyeska downhill ski resort (where one morning I witnessed a huge avalanche take out parts of the ski lift as we were waiting for the lifts to open); Portage Lake and Glacier and nearby Byron Glacier; the hike to Crow Creek Pass and Raven Glacier; Turnagain Pass (for XC skiing); and many other excellent nearby recreational destinations. 

Plant and Animal Life:  The trees in the Anchorage area, particularly black spruce (Picea mariana), were fairly short and scruffy compared to the lush forests we saw in the Pacific Northwest and Southeast Alaska.  One Christmas, Becky and I harvested a small spruce tree near Hope for use as a Christmas tree.  However, it was unhappy in our warm house and quickly lost most of its needles long before Christmas even arrived.  Despite the unimpressive trees and forests, the mountains and glaciers were spectacular.

The regional animal life was also quite impressive and included moose, caribou, Dall sheep, mountain goats, loons, and trumpeter swans.  I recall with amusement one encounter with a motorist suffering from a kind of Alaskan fever, akin to the "buck fever" endemic in Texan hunters.  He had pulled off the highway along the Kenai and was intently glassing the nearby mountain slopes, exclaiming excitedly that he was seeing white Dall sheep or mountain goats moving high overhead.  We of course eagerly tried to make them out with our own binoculars, but as he kept repeating that he saw movement, I gradually became aware that he was hallucinating, viewing only snow patches that were very much stationary but that might with enough imagination be seen to have the shape of a sheep or goat.  Such is the madness that Alaska can engender in the unconditioned cheechako.  Despite all the horror stories recounting bear attacks, I never saw a grizzly bear in Alaska except in Mt. McKinley National Park. 

Doing It Yourself:  This was the first time in my life when I had the time, the incentive, the available funds, the work space, and the inclination to take up a variety of handyman projects.  (The trend to do-it-yourself seemed to have blossomed nationally in the 1950s and 1960s.)  Influenced by the pervasive and infectious Alaskan pioneer spirit, I tried to acquire various skills that would increase my capabilities and self-sufficiency.  (Of course, I was only partially successful at the latter, as I am really an urban person at heart.)  I bought hand tools and a number of power tools at the military commissary (at Fort Richardson Army Post or at Elmendorf AFB, where I had privileges through the PHS).  These included my first variable speed drill, radial arm saw, saber saw, sanders, etc.—and I read carpentry and cabinetmaking books to learn a little about woodworking.  (One of the PHS physicians who preceded me took this urge to the ultimate limit, building a house to live in from scratch.  As I recall the story, he endured a cold winter in his only partly finished basement, as he had not yet built the main floor.)  I contented myself with simple woodworking projects such as a work bench, a boxy house for Freude, a rocking seat in the shape of a hippopotamus and a toy box for Wendy, a tortilla press, and a car-top carrier.  I also took a beginner's course on investing, and Becky took a course in print making using blocks carved from linoleum.  (These Anchorage courses were the start of our lifelong pursuit of numerous self-improvement courses.) 

Cooking and Entertaining:  Becky acquired a wok and several ethnic cook books (such as Zane's Greek Cooking For The Gods and Julia Child's two volume Mastering the Art of French Cooking) and began for the first time trying out gourmet cooking, including a variety of ethnic recipes and techniques.  Friends and neighbors were unusually sociable and hospitable in Anchorage (making up for the relative paucity of canned urban-style entertainment), and we soon joined in a "gourmet" couples dinner group (including Tom and Lise Lawson, the Freenys, the Duncans, and the Boyces).  This was very enjoyable, and helped to start Becky on her lifetime avocation as a great cook. 

Food Gathering:  We made outings to the Chugach mountains, before the "termination dust" (first Fall snow) appeared, to gather low bush cranberries (lingonberries, Vaccinium vitis-idaea) which we used to make cranberry liqueur.  (It had a beautiful deep maroon color, but unfortunately tasted too much like the Robitussin cough syrup I frequently dispensed.)  We also gathered high bush cranberries (Viburnum trilobum), from which we made excellent red jelly. 

Hobbies:  Becky also took up candle making, macramé, knitting (sweaters and baby booties), and expanded on her sewing skills and projects.  She put together a number of Frostline kits (from Boulder CO) for us, including wind and rain parkas, a poncho, down booties, ski gaiters, a heavy down Tundra jacket, etc., as well as some dresses and baby clothes that she sewed from patterns.  (Stylistically, the era of elegant formal dances at Rice University seemed light-years away—my lovely princess now was sporting long straight hair and wearing homemade clothes, mukluks, and hiking or rubber boots to cope with the mud of "winter breakup".) 

Becky's Teaching:  After getting her Alaska teaching certificate, Becky also did a little substitute teaching in 1970, 1971, and 1972 in the Greater Anchorage Area Borough School District (mostly in the sciences).  She did not enjoy this type of teaching very much, and hung up teaching for good in 1972.  (She considered resuming teaching in the 1990s and 2000s, but decided against it.)

Hiking, Mountaineering, and Winter Survival Skills:  We bought more essentials for the summer and winter outdoor life: my first full size backpack (a Kelty BB5); a North Face 2-man backpacking tent; more day packs; a Svea stove; a .44 magnum Ruger pistol (optimistically intended to defend against marauding grizzlies on the trail—fortunately never used and eventually sold); spinning tackle and fly fishing gear; several sets of waxable XC skis, including metal-edged mountaineering-style Bonna skis with matching climbing skins, harscheisen (ski crampons), and the requisite palette of colorful ski waxes; wood snow shoes; crampons and ice axe; moon boots and other winter survival gear; etc.

I joined the Mountaineering Club of Alaska in 1970, and participated in a mid-December 1971 overnight trip to Fern Lake intended to teach winter survival skills.  While some of the group glided on XC skis, I laboriously snowshoed in about four miles in whiteout conditions.  We tried to erect an aging 4-man tent provided by the club, but to my dismay, it shredded to pieces in the high wind.  Those of us who thereby lacked a tent ended up retreating to an abandoned horizontal mine shaft as darkness descended (by about 3 or 4 PM).  One of the inexperienced fellow campers managed to convert a butane stove into a geyser of flaming liquid—we had to scramble to get out of its way.  (Lesson: Don't use butane in extreme winter temperatures below of its high boiling point of −0.5 °C, use propane, which boils at −42 °C, or gasoline.)  I learned then how to start my Svea gasoline stove in cold conditions (-10 F or so), and we grew to love the purring sound that trusty and much-loved stove made as it warmed our cooking water and our spirits. 

We greatly enjoyed the outdoors and hiking, but I was never really sold on becoming a mountaineer—it seemed to be a generally narcissistic or least an excessively foolhardy activity.  I especially recall being turned off by a leading member of the club, who made a statement to the effect that losing a finger or two was worth it in order to summit Mt. McKinley, and I noted in general the high accident rate among Alaskan mountaineers.  I decided that a man with a wife and a kid on the way had no business engaging in hard-core mountaineering, plus I just did not have the risk-loving personality or physical courage to willingly take on such hazardous recreation.

Fishing: Despite my earlier indifference to fishing, it was mandatory to at least give it a try in Alaska.  I had some success at fishing on the Kenai Peninsula (including so-called fly-fishing for salmon with fishermen packed elbow to elbow along the Russian River), as well as on some of my medical field trips to The Alaskan Bush (catching graylings at Nondalton, and rainbow trout on Lake Iliamna).  I made one fly-in leisure trip to a lake on the Kenai peninsula, Snag Lake, with friends Russ and Pam Shimizu in June 1971.  We enjoyed catching a number of dolly varden and rainbow trout, which we cooked up for supper at our rustic tents by the lake.  I also enjoyed harvesting razor clams in May 1972 on the west coast of the Kenai Peninsula.

Birdwatching and the Environmental Movement:  We continued to enjoy birdwatching in Alaska and had a general appreciation of the outdoors, and certainly by then also felt a rising interest in environmental conservation and preservation.  Our gradually emerging awareness and concern paralleled the rising societal awareness of the late 1960s, and was influenced by Rachel Carson's landmark 1962 book, Silent Spring, along with such public actions as the passage of the National Environmental Policy Act in 1969, the creation of the Environmental Protection Agency in 1969, the greatly expanded Clean Air Act of 1970, and the first Earth Day in 1970.  (The latter was a creation of Senator Gaylord Nelson which, in addition to reflecting urgent environmental concerns, tapped into rising anti-establishment anti-war sentiments, as well as the proliferation of demonstrations of all sorts as a form of expression.)  However, the prevailing atmosphere in Alaska while we were there seemed more like the 1950s in the Lower 48.  The long history of boom and bust cycles of exploitation of animal, forest, and mineral resources still overshadowed conservation concerns.  It would be several more years before the passage of the Alaska National Interest Lands Conservation Act of 1980, or the massive oil spill by the Exxon Valdez in 1989, events which apparently helped to galvanize a vigorous and more effective environmental movement in Alaska.

Our stay in Alaska preceded the era of the Trans Alaska Pipeline System (the Alyeska Pipeline, authorized in 1973 and built in 1975 – 1977), and the impact of the Alaska Native Land Claims Settlement Act of 1971 (which granted approximately one-ninth of the state's land plus $962.5 million in compensation to Alaskan natives).

Native Crafts:  We purchased a few souvenirs from Alaskan natives, including some soapstone carvings and attractive baskets, as well as "mukluks" (skin and fur boots, sometimes attractively ornamented).  Becky's mukluks were made by an Eskimo living in Anchorage, probably of spotted seal (Phoca largha) or of bearded seal (Erignathus barbatus, also called "oogruk", "ugruk", or "mukluk"), plus beaver trim and beadwork, and she wore these in Anchorage when temperatures were well below freezing.  My mukluks were more ruggedly masculine and utilitarian, being made by a villager in the Bush (Ruth Koktelash) predominantly of caribou fur and with a heavy sole of oogruk or of elephant seal (Mirounga leonina).  I am unsure what current limitations are imposed on Alaskan natives regarding harvesting seals of these species.  Although none of these seals currently seem to be considered "depleted" under the Marine Mammals Protection Act nor are they listed as "threatened" or "endangered" (see References), we would no longer be interested in contributing to their harvest by making such purchases.

Family Visits and Events:  While in Alaska, we were visited by Becky's mother (March 1971, prompted by Wendy's birth), Becky's step-grandfather Ben Morris (May 1971, also eager to see Wendy), her parents accompanied by her brother David (June 1971), and my mother Tina (August 1971).  We traveled to Texas to see our families in April 1970, and Becky went with Wendy to Texas in November 1971.  We also visited Texas in April and May 1972 in association with a trip to Europe.  We regretted being so far from our families, missing for instance the wedding of Becky's brother Charles to Linda Brown in August 1970, and the funeral in November 1970 of my grandfather, John Russell Wait, Sr. 

My mother earned her master's degree in Education at Trinity University in August 1970.  I was pleased that she had made such progress in advancing her independent career.  Russ was doing graduate work in anthropology at the University of Texas, and Scott had begun a career in industrial and scientific photography by 1971.

Health:  My health remained robust in Alaska.  The only new medical problem that developed there was conversion of my PPD TB skin test to 12 mm induration by November 1971, and an initial suggestion of a possible wispy infiltrate that developed on my chest X-ray.  (The skin test indicated at the least that I had been exposed to tuberculosis—not a great surprise, as TB was still endemic among our population of patients, and I had for instance treated a patient with a nosebleed who proved to have active TB.)  I was cultured up and was started on isoniazid (INH) and rifampin (the latter turns the urine a bright orange), and Becky and Wendy were possibly also placed on INH for a short time.  Eventually, follow-up X-rays were compared to old outside X-rays, and to my relief it was determined that they showed no change, so my TB specialist Dr. Chao concluded there was no convincing evidence of active TB.  He stopped the rifampin, and I simply took the INH for one year, fortunately without complications.  My discharge physical in February 1972 noted only borderline hypertension and an early systolic flow murmur thought to be insignificant—my weight was 162 and I was very fit and physically active.

Becoming Parents 1971

Becky and her mother Joyce with Wendy March 1971 
Becky and her mother Joyce with Wendy
March 1971
Becky's father Charles with Wendy June 1971
Becky's father Charles with Wendy
June 1971
 Mike with Wendy June 1971
Mike with Wendy
June 1971
Becky with Wendy and Tina August 1971 
Becky and Mike's mother Tina with Wendy
August 1971

Wendy Born:  Our daughter Wendy Loraine was born after a fairly short labor in the spring 1971 in the Alaska Native Medical Center—the only newborn there with blond hair.  Becky recalls the experience as more exciting and exhilarating than painful.  Wendy was the first grandchild for our four parents.  Her middle name honors Loraine Gonzalez, who had played such an important role in our lives.

Concerns About Parenthood:  I had had some modest reservations about having children, and had mentioned these to Becky.  We enjoyed a good life together already; I was not certain I wanted to share her attentions and love with competing children; the effects of overpopulation were becoming very apparent to us; and we were living in an era in which the question was being asked whether to even bother with having children.  As a result of effective contraception, it was certainly no longer an inevitable biological consequence of marriage.  A number of our more hedonistic or career-oriented friends were deciding against child rearing.  And I had some doubts as to how good a father I would be.  I recalled the rather unhappy and unstable family environment in which I had grown up, and the inconstant and uncertain role model that my father had provided in my own life.  Would I, for instance, know how to deal effectively with adolescent rebellion, or be able to teach a son what he needed to know about sports, or be able to provide the proper moral guidance in the absence of a conventional Christian upbringing?  But being aware of her strong desire to be a mother, I did not impose my own inclinations and hesitations on Becky—this was a tacit concession I made to please and respect her, without my customary elaborate discussion or agonization on such an important decision.

Wendy McGoodwin May 1972
Wendy McGoodwin
May 1972

The Positives of Parenthood:  As things turned out, I was glad to have become a parent, and would soon conclude that my life would have been far less complete if we we had not had children.  I have the impression that having children changes and expands one's perspective, gradually turning the focus away from the preoccupations of the self and the sheer pursuit of career and pleasure, and turning the focus more toward the family, toward consideration of multiple generations past and future, and toward one's nurturing instincts in general.  I recall, prior to Wendy's birth, absurdly predicting to my medical co-workers that having children would have little impact on my own life (assuming somehow that Becky would do most of the work of child rearing).  And indeed I did continue doing some of the activities, such as backpacking, skiing, and other arduous outdoor excursions, that Becky no longer felt she could do at least as a new mother while still living in Alaska.  But it soon enough became apparent even to me that my life had changed permanently—that new responsibilities were placed before me that I could not in good conscience avoid, that new demands on Becky took precedence at times over satisfying my own needs, that a father as well as a mother were needed to make a family with kids succeed—and I gradually found myself giving up my most selfish perspectives and becoming more of a loving and giving parent.  However, I was a hard working physician, often out of town, while Becky was a stay at home mom, and this time period preceded the era (apparently beginning in the mid or late 1970s) when fathers began to enthusiastically take on more of the formerly maternal tasks of parenting, such as changing diapers—this I left to Becky.  Becky, I might add, did an outstanding job as a young mother, and in parenting in the years to come, and did not seem to mind that I was often away for short periods of time.  (We regretted, however, that she did not have the opportunity to see the wide sweep of the Alaskan Bush that I experienced.)

The Role of Fathers for Young Children: Whether or not participation in changing diapers or in other traditionally maternal nurturing activities is really all that important for fathers in families that have a good mother, I read in 2005 (see References below) that fathers typically play a different role than mothers, and that one of the key roles of good fathers is to play with their children, typically in a more boisterous and stimulating manner than mothers engage in:

 "Whatever its origins, this more playful, jocular approach carries major consequences for developing children. Where the 'average' mother cushions her baby against irritating stimulation, the 'average' father heaps it on, consistently producing a broader range of arousal.  The resulting ups and downs force children to 'stretch', emotionally and physically.  This emotion-stretching dynamic becomes more pronounced as father-child relationships enter into their second and third years.  When playing, fathers tend to be more physical with their toddlers—wrestling, playing tag, and so on—while mothers emphasize verbal exchanges and interacting with objects, like toys.  In nearly all instances ... fathers are much more likely 'to get children worked up, negatively or positively, with fear as well as delight, forcing them to learn to regulate their feelings.'  In a sense, then, fathers push children to cope with the world outside the mother-child bond...  But more than this, fathering behavior also seems to make children develop a more complex set of interactive skills, what Parke calls 'emotional communication' skills."

As I read this article, I was reminded that this boisterous fatherly behavior was probably somewhat lacking in my own life growing up, perhaps to my detriment, but that I instinctively did indeed try to engage in it as my kids became toddlers and young children.  We wrestled and roughhoused, they piled on and playfully ganged up on me (which they called "playing horsey"), we chased each other around the house, I tossed them high in the air in the swimming pool, etc.  How much I succeeded in providing the needed paternal role model throughout their childhoods I can't really judge.

Child Safety and Transport:  We tried to provide for the comfort and safety of our new infant.  Car seats for children were not at the time in common use or required, but we used an infant carrier which we had to place loosely on the floor of the car as we drove, as it could not be strapped in.  On outings, we initially carried her positioned in front in a baby snuggler, and at about five months, we began to carry her nearly everywhere we went on our backs in a Gerry Pack—this great device had only recently come into widespread use, though it drew on the ancient Indian practice of carrying one's papoose on the back.

Other Recreational Trips in Alaska

Kenai Peninsula and Valdez:  When Becky's family visited us in June 1971, we made a nice trip to the Kenai Peninsula, driving to Seward, and probably putting the car on the train to Whittier, where we caught the ferry to Valdez.  (This was before the 2000 opening of a highway link via tunnels from the Kenai interior highways and Whittier.)  We enjoyed seeing the seabirds at the Kittiwake Rookery (especially Black-legged kittiwakes), Tebenkoff Glacier, Columbia Glacier (where we saw calving of icebergs and many seals), and Valdez Glacier.  Sadly, as of about 1980, many of these glaciers are increasingly rapidly receding.

Mt. McKinley (Denali) NP:  We had an especially enjoyable trip to Mt. McKinley National Park in July 1971 (this park area was enlarged in 1980 and renamed Denali National Park and Preserve).  This was before the park restricted driving on the road leading to Wonder Lake, and we camped within the park for several days.  It was hazy and smoky from regional forest fires, and one could barely make out Mt. McKinley, but the wildlife viewing was spectacular, including grizzly bears (see photo above), caribou, sheep, goats, ptarmigan, and a friendly red fox who entered our camp.  One time as we drove along Wonder Lake road, our fearless but foolhardy dachshund flew through the car window before we could catch her, and chased after some rattled caribou until we finally caught up with her and got her back on a leash.  (Perhaps this kind of incident is just what led the park service to close the road to unlimited tourist access.)  We had a nice hike providing good vistas from the Mt. Healy Overlook Trail.  This trip necessitated a 135 mile drive along the mostly gravel Denali highway connecting the Richardson Highway to the park, as there was not yet a road reaching all the way to the park entrance directly from Anchorage.  Along this highway was some of the most spectacular wilderness we saw in Alaska, but we also recall the fearsome black clouds of voracious mosquitoes that immediately enveloped our hapless pooch and tried to carry away our infant daughter (who was swathed in mosquito netting) when we stopped to make camp.

Kenai Peninsula and Fairbanks:  In August 1971, when my mother Tina visited us, we went on a driving excursion north to Fairbanks, visiting the Matanuska Glacier, camping along the way, and seeing the musk ox farm (an innovative project headed by John Teal with help from the University of Alaska).  We subsequently took her on a trip that she always recalled as one of her favorites.  We camped on the Kenai Peninsula, visiting Portage Bay.  We took a single-engine small plane flight from Girdwood around 20-Mile Glacier, enjoying great views of the many glaciers and peaks in the area and of Harriman Fjord.  We also stayed and dined at Land's End Resort at Homer, where we enjoyed all-you-could-eat Dungeness crab dinners.  (The crabs were so large we could each eat only one.  We were saddened to learn on returning in 1996 that the seemingly inexhaustible bounty of crab in Kachemak Bay, like so many of the world's seafood resources, had in fact been depleted, and that Dungeness crab were no longer offered on the menu at this resort.)  We also took a boat ride out around Gull Island in Kachemak Bay (where we saw kittiwakes and murres).

Mt. McKinley and probably Mt. Hunter seen from Talkeetna highway October 1971
Mt. McKinley and probably Mt. Hunter seen from Talkeetna highway 
October 1971

Vistas of Denali:  On another memorable occasion in October 1971, we drove north from Talkeetna (on what is now called the George Parks Highway) and stayed for a night in a primitive hunting cabin with our friend Ross Brudenell and his daughter (he had treated a patient who owned the cabin).  We had a wonderful log fire, which partially made up for the chilly outdoor privy.  (Becky recalls the cabin less fondly than I do: it was very dirty, littered with rusty tin cans and boxes, had no running water or electricity, and was freezing cold inside, and there was therefore nowhere to put a baby down.)  It was very cold but clear, and the views along this highway of the Alaska range including Mt. McKinley, Mt. Foraker (southwest of Mt. McKinley), and Mt. Hunter (south of Mt. McKinley) were truly spectacular.

Backpacking:  My first backpacking trip was made in Alaska, on the Crow Pass Trail in August 1971 with our friends Paul and Marilyn Duncan, while Becky stayed behind to tend our new baby.  We three also tried in February 1972 to ski in along Devil's Creek to Devil's Pass near the Resurrection Pass trail, but avalanches had destroyed the trail a few miles in, so we contented ourselves with snow camping near where our way was blocked.  (I have also mentioned above the backpacking trip I made on snowshoes for a winter survival course in December 1971.)

Grand Tour of Europe 1972

Texas:  In late March 1972, Becky and I flew with Wendy to Texas to visit with our families. There we also visited with family friend Richard Gonzalez, and my maternal grandfather's widow Edith in Kerrville (her husband having died in November 1970).  We toured the San Juan Mission in San Antonio and the Natural Bridge Cavern, and enjoyed Easter in Katy.  In a babysitting arrangement which we marvel at today for its audacity, we left Wendy to be shared between Becky's and my parents while we spent five weeks in Europe.  I used up virtually all of my accumulated 30 days of leave per year on this trip.

Amsterdam:  On April 4, we departed Houston on a KLM 747 jet (a Boeing model in service at that point for only a few years), stopping in Montreal and continuing on to Amsterdam.  I recall how passengers including ourselves were allowed to visit the pilot and crew in the cockpit, watching them navigate over the seemingly endless Atlantic Ocean at 2 AM.  (Regrettably this relaxed accommodation to passenger curiosity can no longer be allowed.)

This was a very long trip with a myriad of sights and events to enjoy, so I will just name some selected highlights, extracted from our extensive trip log, with little comment.  We used Eurail Passes to travel by trains ad lib while in Continental Europe.  We traveled light—I wore a day pack and carried a small suitcase. 

In Amsterdam, we took a boat tour of the canals; enjoyed Indonesian Rijkstafel (also spelled Rijsttafel, a meal by which we were reminded of the legacy of Dutch colonialism in that country); visited the Anne Frank House, the Pas-Smit diamond factory, and the Rijksmuseum (where we saw many Rembrandts including the Night Watch); and attended the Concertgebouw Orchestra with Bernard Haitink conducting.  In Lisse, we toured the Keukenhof Gardens; in Harlaam, the Frans Hals Museum.

Paris:  In Paris, we visited Sacre Coeur in Montmartre, the Champs d'Elysee, the Louvre (admiring especially the Winged Victory of Samothrace, the Venus de Milo, the Mona Lisa, the Great Sphinx, and the Seated Scribe), Notre Dame Cathedral, the Galerie nationale du Jeu de Paume (where we saw Manet's Olympia and Dejeunee sur l'Herbe, Degas's dancers, and several Renoirs).  We also made excursions to Chartres Cathedral and Versailles.  I was grateful for and proud of Becky's French-speaking ability, as the Parisians gave her respect and a degree of warmth not as readily offered to English-only speakers such as myself.

Switzerland:  In our first of two visits in Switzerland, we briefly toured Geneva, Lausanne, and the Chateau de Chillon (on Lac Leman).

Italy: In Rome, we walked probably more than 100 miles in 5 days, visiting: the Terme (Baths) di Diocleziano, Museo Villa Giulia, the Coliseum, the Roman Forum, the Museo Capitoline (seeing the Dying Gaul, Eros and Psyche, and Venus of the Capitol), the Pantheon, the Vatican (St. Peter's Basilica, the Pietà of Michelangelo, Bernini's Baldaquin, the Sistine chapel, the Vatican museums including the Laocoön group, and the Vatican library), the Borghese Museum and Palace, and St. Paul's Basilica.  We made excursions to Ostia Antica and to Villa d'Este.  In Florence, we visited Museo San Marco (viewing frescoes of Fra Angelico, etc.), the Accademia di Belle Arti di Firenze (seeing the original Michelangelo David), the Piazza del Duomo and the Duomo (Cathedral of Santa Maria del Fiore), the Campanile (on the top of which we heard hissing of static electricity from lightning rods during a storm), the Uffizi Museum, and the Pitti Palace and Museum.  We enjoyed great cannelloni at the Ristorante Orcagna on the Piazza della Signoria—it included an excellent fegato (liver) alla venziana.  In Venice, we saw St. Marks Square (in which flooding was not yet a problem as I recall) and the Basilica, the Doge's Palace, and the Accademia di Belle Arti di Venezia.  We had a fine dinner including fritturas mista at Ristorante Peoceto Risorto.  

Austria:  In Vienna, we toured the Kuntsthistorisches Museum and the Schönbrunn, and heard The Marriage of Figaro at the Vienna State Opera.  In Salzburg, we toured the Salzburg cathedral (Dom); took the steep cog-rail up to Hohensalzburg; visited Petersfriedhof and the church (where we heard great pipe organ music being played); and enjoyed the local desert, Salzburger Nockerl.  In Innsbruck, after weeks of shivering in the unexpectedly cold and rainy spring weather, we each bought wool knickers (mostly for XC skiing) and heavy wool sweaters, as well as mittens for Becky.  I was soon mistaken for a native (until I opened my mouth to speak in my primitive version of German).  We enjoyed the Tyrol Museum of Folk Art, the Dom-zu St. Jakob, the Hofkirche, the funicular to Hungerburg, and the excursion to Igls and the funicular to the top of Patscherkofel.  I commented in our trip log that Innsbruck was the first city on the trip that I might wish to return to (because of the region's great beauty, the warmth and graciousness of the people there, and the fact that our new clothing let us be warm for the first time on the trip).

Becky and Mike atop the Zugspitze in Bavaria April 1972
Becky and Mike atop the Zugspitze in Bavaria
April 1972

Germany:  In Munich, we enjoyed the Hofbräuhaus, the Frauenkirche, the Alte Pinakothek, and a full day at the fascinating Deutsches Museum (a great museum of science and technology, complete with working models and demonstrations) .  We also attended the Munich Philharmonic, and heard the Bavarian State Opera perform Wagner's Der Fliegende Holländer (we had to stand for this, and gave up after 2 acts).  In Garmisch-Partenkirchen, we took the cog train to Schneefernerhaus on the Zugspitze and then the Gipfelbahn to the summit.

Switzerland:  Returning to Switzerland, we went to Zurich, where we toured the Schweizerisches Landesmuseum, and enjoyed raclette at the Raclette Stube.  In Lucerne, we visited the Hofkirche and had some good fondue.  We caught a paddle steamer from Lucerne to Weggis and to Vitznau.  We also took the train to Interlaken and Lauterbrunnen, walked to Kleine Scheidegg, and enjoyed good views to the Jungfrau, Jungfraujoch, Mönch, and Eiger peaks.  In Bern, we visited the Kunstmuseum and the Naturhistorisches Museum.  In Basle, we visited the Hofkirche Münster and the Kunstmuseum.

Mt. McKinley and the Muldrow Glacier May 8, 1972
Mt. McKinley and the Muldrow Glacier May 8, 1972

London and Returning Home:  After crossing from Calais to Folkestone port by ship, we arrived in London to complete our Europe tour.  There, we toured the London Zoo and the British Museum, had excellent Indian food at New Madras (reflecting the legacy of England's colonial past—this was perhaps our first taste of Indian food), and attended the London Philharmonic Orchestra.  I escorted Becky to the airport for her to fly back to Houston to pick up Wendy, visited Foyle's bookstore, and later took a BOAC flight directly from London to Anchorage.  This was an all-daylight "circumpolar" flight reaching about 81 degrees N, and I greatly enjoyed the spectacular views from Greenland westward, including the mountainous east coast of Northern Greenland, the vast Greenland Ice Sheet (sadly now rapidly melting), the heavily crevassed glaciers on the western edge (a major source of icebergs in the North Atlantic), Ellesmere Island, the Brooks Range, and spectacular views of Mt. McKinley (including the Muldrow Glacier) and Mt. Foraker.  I arrived in Anchorage on May 8 after more than six weeks away from home, and Becky returned from Houston a few days later.  Both Wendy and Freude took a little while before they seemed to remember us very well, but we all quickly readjusted.  Although we had seen and learned a great deal in Europe, the trip was arduous and rather exhausting due to the rapid pace and many cultural and language transitions, and we resolved that on future trips to Europe we would try to visit only one or two countries with a single foreign language at a time to deal with.

Serving in the Indian Health Service in Alaska 1970 – 1972

Native Population:  The Alaskan Native populations in Alaska then consisted of about 28,000 Eskimos, 8,000 Aleuts, and 19,000 Indians (consisting of the Athabascan / Athapaskan / Athapascan Indians in the interior, and the Tlingit, Tsimpshian, and Haida Indians in Southeast Alaska).  I will not try here to give a more detailed description of Alaskan Native distribution or ethnic group characteristics, etc., though during my time in Alaska I made use of several additional books and monographs, in addition to those previously cited, to improve my understanding (some of these are listed in the References below).  

Natives who were not already citizens of the US had been collectively naturalized by the Citizenship Act of 1924.  There were approximately 175 villages in Alaska that had predominantly native populations, accounting for about 70% of the native population.  Levels of education were fairly low by Lower 48 standards, with 50% of Alaskan Natives having attained no more than sixth grade level, and 21% no more than seventh or eighth grade levels.  Housing tended to be substandard, as were water supplies and waste disposal systems.  Per capita income was low, costs of living were high, and alcoholism, respiratory illness, and tuberculosis were major problems.  (However, the incidence and death rate for TB had been markedly reduced from the 1950s.)

The US Public Health Service and The Indian Health Service:  In 1970, the Alaska Area Native Health Service (AANHS, serving one of eight areas in the US) was part of the Indian Health Service (IHS, headquartered in Rockville MD), which was in turn a part of the Health Services and Mental Health Administration (HSHMA), which was part of the US Public Health Service (USPHS or PHS), which was part of the Department of Health Education and Welfare. (The DHEW is now termed the Department of Health and Human Services or HHS.  See below regarding the somewhat uncertain status of the name "United States Public Health Service".)  John F. Lee, MD was Medical Director for the Alaska Area IHS (a man I barely knew).

Alaska Native Medical Center:  The Alaska Native Medical Center (ANMC) in Anchorage was part of the Anchorage Service Unit (the largest one of seven service units dividing up the AANHS for all of Alaska).  The Anchorage Service Unit in which I worked encompassed a 2,000 mile wide area of 104,325 square miles (out of 586,000 total square miles in the state), was centered on Anchorage, and extended from the eastern border of Alaska southwestward to the tip of the Aleutian Islands (excluding all but the western tip of the Alaska Peninsula) and the Pribilof Islands—it also extended to include the Kenai Peninsula, Kodiak Island, the Prince William Sound area, and interior villages south of Tanana and Fairbanks such as McGrath and Nikolai.  (The remaining Service Units were Mt. Edgecumbe, Barrow, Kotzebue, Bethel, Tanana and Kanakanak Service Units.)  The ANMC was also the major referral center for complicated cases for Alaskan Natives from all Service Units.  At the village level, the PHS had trained about 150 community health aides to assist with day-to-day medical evaluation and health care.  These individuals were typically persons with only limited medical training (lasting 2 to 5 weeks), though in some of the large villages they were nurses.  They communicated with Anchorage medical personnel by phone or by radio.  There were also regular visits to villages by health care teams (including physicians such as myself), and by others representing various programs of the PHS such as maternal and child health, health educators, dentistry, private medical care, sanitation improvements, etc.  (I won't even attempt to describe the extensive programs, beyond direct physician-oriented medical care, that were offered by the PHS in Anchorage and in its service unit.)  Martha R. Wilson MD was Service Unit Director of the Anchorage Service Unit, and M. Walter Johnson MD was Clinical Director of the ANMC—I had only limited contact with either of them.

My Medical Role and Assignments:  I have previously discussed how my interest in serving in the Public Health Service in Alaska began.  My orders, dated  May 14, 1970, appointed me as an Assistant Surgeon (Reserve), and also promoted me to the temporary rank of Senior Assistant Surgeon (Reserve) (T), having commissioned officer rank or pay grade of O-3.  This military rank (O-3) is equivalent to Captain in the Army, Air Force, and Marine Corps, and to Lieutenant in the USPHS, Navy, and Coast Guard.  It is apparently abbreviated "LT" in the USPHS.  I was ordered to begin active duty on July 1, 1970, but was allowed travel time, so I did not actually have to report for work in Anchorage until July 11.

I was assigned to work as a General Medical Officer (GMO) in the Outpatient Department of the Alaska Native Medical Center  We performed what is today called Ambulatory Medicine.  There was no emergency room that I recall, and we did our best to handle and admit emergencies in our clinic-like setting.  The hospital also had specialty clinic and inpatient services, including Internal Medicine, Pediatrics, Surgery, Ob-Gyn, Orthopedics, Ophthalmology, ENT, Pathology, Radiology, Dentistry and Psychiatry.  

Dr. Gloria Park December 1971
Dr. Gloria Park
December 1971

Physician Colleagues:  My supervisor and Chief in the Outpatient Department was Dr. Gloria K. Park.  Dr. Park was great to work for, a seasoned and pleasingly old-fashioned clinician, and a kind, warm and generous person who took good care—like a mother hen—of her flock of Outpatient physicians, some of whom were still fresh out of internships.  She seemed to know every patient in the entire Anchorage Service Unit, and gave me good briefings, before I first went out into the field, about the various idiosyncrasies of the patients, health aides, and other persons that I would be encountering.  (Becky and I enjoyed seeing her and husband Orlo again on returning to Anchorage in 1996, though we were saddened to learn that both her sons had died in the interim.)

Besides Dr. Park, my physician colleagues in the Outpatient Department the first year were Allan R. "Al" Frost, Paul R. Duncan, and Eugene W. "Gene" Pflum.  During the second year, Stanley "Stan" Hadley, Jr. replaced Al Frost (Al was a nice guy and a great fisherman, and handed down his best fishing villages to me when he rotated out), Patrick C. "Pat" Freeny replaced Gene Pflum, and Mary Brudenell was also added.  Dr. Marilyn Hey Duncan, though not a commissioned PHS officer, worked part-time with her husband Paul in performing important medical field work and health education programs primarily in Kodiak.  We enjoyed a good work environment and camaraderie in the Outpatient Department among the nurses and docs, and I have kept up a friendship and correspondence with several of those I worked with.

Salary:  Although rents and expenses were high in Alaska, my PHS years were the first to provide sufficient income for my growing family to live comfortably.  My annual PHS salary, including an Alaska cost of living allowance, was about $13,300 gross, and Becky added a little more through very limited substitute teaching.

Freude & Michael with PHS Captain's uniform March 1971
Freude and
USPHS Lt. Michael
(my only photo in dress blue uniform)
March 1971

Military Dress Code and Behavior: Presumably feeling the effects of the radical let-it-all-hang-out 1960s, the USPHS at least in Alaska by the time I arrived was in the process of rapidly slackening its demands regarding appearance and the wearing of officer uniforms.  My commissioned officer's manual describes the need to wear our official uniform while on duty in Anchorage and when traveling on business—specifically the Service Dress Blue uniform in October through April, and the Service Dress Khaki or working khaki uniform for the remainder—and threatens punishment for violations of dress code.  Shortly after arrival, I dutifully purchased a used dress blue uniform from one of the seasoned officers, which I might have worn at most one or two days, but somehow the whole issue of uniforms evaporated, and I eventually sold off the uniform to someone who had more need for it than I did.  I felt somewhat ridiculous in this outfit (see photo with matching dog), and dreaded the possibility of having to salute my superiors or return the salute of my inferiors, and never really learned how to distinguish the various military ranks which would have governed my saluting behavior (particularly at one of the military PX's where we had shopping privileges).  I think we worked out some sort of compromise eventually wherein we wore khaki slacks, shirt and tie which at least bore some resemblance to the official summer uniform.  I wore this year-round, except when I was traveling in the dead of winter, at which time I wore heavy corduroy or wool Filson whipcord slacks (bought at Eddie Bauer's in Seattle) and my Kara Koram heavy parka (but not the prescribed "mouton cap with rank device").  Also according to the manual, we were to maintain a neat appearance with closely trimmed hair and no sideburns or beard (thus accounting for how square I appeared on arrival two years later in laid-back and long-haired Seattle).  The manual specified that we were to conduct ourselves in a manner befitting an officer and a lady or gentleman, and noted that our privileges on the bases could be revoked it we misbehaved or attempted to "pull rank".

Practicing Family Medicine:  After several years spent training mostly in high-powered tertiary care centers, a chance to practice what amounted to basic family medicine in a more down-to-earth clinic setting was a welcome change to me.  These two years gave me very practical and useful medical experience in common medical conditions, such as otitis media and ear wax, respiratory infections, pediatric rashes, sexually transmitted diseases and vaginal discharges, reproductive medicine including placement of IUDs, complications of alcoholism, GI disorders, dermatological infections and warts, etc.  One innovation I helped make, along with my other freshly minted colleagues, was to introduce problem-oriented medical record keeping—the so-called "Weed system" of SOAP notes introduced by Dr. Lawrence Weed.  (Prior to this innovation, medical charts were remarkably chaotic and unstructured.)  Though I followed a number of patients of my own in the clinic, we maintained a constructive tension with the specialists, who generally wanted us to take on ever higher levels of complex care and thereby reduce the number of referrals we made to them, while we GMOs in the Outpatient Department wanted to be sure that the patients received optimal specialist referrals when it seemed indicated.  When we were on call as "Officer of the Day", we did as much as we could to tend to the needs of the inpatients on the specialty services—for example, I delivered about 10 babies during my two years there, drawing on the excellent obstetrical training I had received at Baylor College of Medicine.  One night on call, I recall seeing as a patient a child who appeared to have mild encephalitis.  The worried parent who brought the child in was one of our own staff physicians, and I did my best to apply what little knowledge I had about this unusual condition and to comfort the concerned parent while seeking a pediatrician to take over. 

Michael holding clinic in Port Graham AK December 1970
Michael holding clinic in Port Graham AK
December 1970
Scenes at King Cove Alaska March 1971
Scenes at King Cove Alaska
March 1971
Nurse D. Peters with local resident at Nondalton AK September 1971
Nurse D. Peters with local resident at Nondalton AK
September 1971
Snowmobiling near Nondalton, view toward Six-Mile Lake, J. Chambers and Nurse M. Jensen March 1972
Snowmobiling near Nondalton, view toward Six-Mile Lake, J. Chambers & Nurse M. Jensen
March 1972

Medical Travel Destinations in the Bush:  The other major part of my job was traveling to the Bush on field trips, about 6 – 8 weeks out of each of my two years, in order to hold clinics in the Alaskan Native villages we were assigned to within the Anchorage Service Unit.  My assigned villages the first year included the Aleut villages near the tip of the Alaska Peninsula (King Cove and Belkofski on the peninsula, and False Pass on Unimak Island, the first of the Aleutian Islands), Tyonek (an Indian village across the Cook Inlet from Anchorage), and Port Graham and English Bay (villages on the Kenai Peninsula across Kachemak Bay from Homer).  In the second year, I added Tatitlek in the Prince William Sound region, and the villages in the Lake Iliamna region on the Alaska Peninsula (including Iliamna, Kokhanok, Newhalen, and Pedro Bay on Lake Iliamna, and Nondalton on Six Mile Lake situated between Lake Clark and Lake Iliamna).  Each Outpatient physician was expected to maintain contact with his assigned villages while working in Anchorage, and where possible to be the one whom they contacted by phone or radio when medical problems that required consultation arose.  Sick patients might be flown in on commercial flights to our hospital in Anchorage, and severe emergencies sometimes required evacuation by the Coast Guard.  We traveled to our villages with one or more nurses, and sometimes with other health care personnel.  

Mt. Pavlof from Belkofski Bay AK March 1971
Mt. Pavlof erupting, view from Belkofski Bay AK
March 1971
Fetching dinner near Nondalton AK March 1972
Fetching dinner near Nondalton AK
March 1972
Preparing to ski with Nurse Jensen at Kokhanok AK March 1972
Preparing to ski with Nurse M. Jensen at Kokhanok AK
March 1972

Accommodations and Hosts in Villages:  My overnight accommodations might consist of a room in the home of one of the local residents, a company guest cabin (in the cannery village of King Cove), a sleeping bag on the floor of the local school house (as in Nondalton), or a basic motel or hotel room (in Cold Bay, Homer, and Valdez). 

Our meal arrangements in the Bush were also quite variable though invariably hospitable.  In King Cove, we ate at the cannery dining room and were treated to all the freshly caught king crab or salmon we could eat.  One talented and hospitable host, a teacher named Mike Lockwood in Port Graham, took me out early one morning in a small boat and managed to catch an octopus and gather some clams, which made excellent additions to the morning's omelet.  Another accomplished teacher and pilot, Clark Whitney from Nondalton, took Nurse M. Jensen and me up in his ski-mounted small plane in order to gather some meat for the table.  He soon spotted a caribou herd, landed on a snowy field, bagged his prey with a rifle, had it gutted and cleaned in rapid order, and got us back in the air within a few minutes.  On another visit, he took me out to fish in a tributary of Six-Mile Lake—we had great fishing, and were able to haul in a graceful Arctic grayling with almost every cast.  The Lake Iliamna area was famous for its trophy fishing, especially rainbow trout and sockeye salmon, and although I was not all that well informed about the art of fishing, I was shown how to catch some pretty large rainbows on the Newhalen River.  I was also treated to locally harvested moose, smoked salmon, Dungeness crab, as well as fiddlehead ferns, berries, fruit leather, homemade root beer and wines, and other treats gathered and prepared by our many village hosts.

Michael with local residents the Lubanacks in Port Graham AK December 1970
Michael with local residents the Lubanacks in Port Graham AK
December 1970
Clinic at False Pass on Unimak Island AK, Round Top Mountain in background September 1970
Clinic at False Pass on Unimak Island AK, Round Top Mountain in background
September 1970

Holding Clinics In Villages: Upon arrival, the local residents in need of care would quickly line up for clinic with the expectation that the nurse and I would keep going long into the night until all had been seen.  This could be very taxing and unnecessarily stressful, and I quickly improved the system by establishing an appointment system for clinic visits, in order to spread out the visits in a more orderly and mutually satisfying manner over several days.  We Outpatient physicians had been taught how to do simple refraction, so that we could fit patients with prescription glasses while holding clinic in the field—this was one of the more gratifying services which I performed.  I have retained a check list I made for the equipment I was to carry for field clinics—these items included various medical records and references such as the drug formulary and Washington Manual of Medical Therapeutics, pap materials and IUDs, an extensive refraction kit (including large numbers of sample lenses, ophthalmoscopes, and a refraction device), otoscope, catheters, tonofilms (for tonometry for glaucoma detection), various probes, Labstix urine testing sticks, various forms, sex education aids (such as a movie on family planning, sex charts, birth control demo kit, etc.), a diet manual, and various topical and oral drugs including ophthaine, lugol's solution, etc.  The nurse organized and carried additional trunks of medical materials beyond the items I have named, including dressings, more acute and chronic drugs, etc.  Following the lead of my fellow physician colleagues assigned to Kodiak Island, the Duncans, I held sex education talks in several villages for those teens who were interested and who were given parental permission to attend.  The nurse and I also took the opportunity to visit some of the sick elders in their homes.  

Drs. Hal Schrott and WIlliam Hazzard drawing blood for cholesterol study March 1971
Drs. Hal Schrott and William Hazzard drawing blood for cholesterol study
March 1971

Hypercholesterolemia Kindred:  One kindred that I cared for lived in a remote Aleutian village and was afflicted with familial hypercholesterolemia, a condition which causes visible nodules from cholesterol deposits, especially in the Achilles tendon (tendon xanthomas) and in the eyelids (xanthelasmas), as well as accumulation in the coronary arteries, leading to early heart attacks and death in the most severely affected cases.  I had the privilege of accompanying a research team of three physicians from the University of Washington Department of Medicine on a trip to this village, and worked with them to facilitate their evaluation of this kindred.  Their work led to the scientific paper cited below.  I did what I could to help them accomplish this project, and they honored me by listing me as a co-author.  One of these three research physicians and co-authors, Dr. Joseph Goldstein, went on to win the Nobel prize for Physiology or Medicine in 1985.  This award, which was shared with his colleague Dr. Michael Brown, was for their work in cholesterol metabolism.  Among other important discoveries, they proved that a lack of or deficiency of functional LDL receptors causes the abnormal buildup of cholesterol in the blood of patients such as I have described.  Although my scientific contribution to the published paper was admittedly quite modest, my participation in the project also provided me the opportunity to go to New York City to present some of the data at the Seventh Joint Meeting of the Clinical Society and Commissioned Officers Association of the USPHS, held May 30 – June 2, 1972 at the Statler Hilton.  The title of my presentation was "An Aleutian Kindred with Autosomal Dominant Hyperbetalipoproteinemia and Premature Coronary Artery Disease."  (I stopped off for a weekend in Seattle on the way back to look for a house to rent.)

Nome Assignment:  I was also called upon to do temporary duty for five days or so in June 1971 as the sole physician in Nome Alaska while its only doctor was on vacation. This was one of the most nerve-wracking professional experiences I had while in Alaska.  The town had about 2,000 people in it, and I was quite busy with challenges that extended well beyond my areas of expertise and comfort level.  Almost as soon as I arrived, a young boy fell while playing in an abandoned gold dredge, and sustained severe pelvic and probably hip fractures.  I got on the radio to Anchorage to determine how best to treat him, but fortunately also had excellent and experienced nurses who helped to make up for my inexperience in orthopedics.  I also treated a child with a severe dog bite of the cheek.  I sewed it up, but within 12 hours it was badly infected—I had to remove the stitches, kept him on antibiotics, and hoped for the best.  This brief experience with truly solo general practice certainly affirmed my admiration for small-town doctors who bravely tend to the medical problems of their populace single-handedly.  What a relief I felt on returning to the security of our multi-specialty hospital in Anchorage!

Bush Dwellers:  Very few non-Native individuals in the Alaska Bush were there by birth or accident—most of them that I ran into had moved there by choice.  The reasons seemed to vary considerably:  Some were rugged pioneer types who wanted outdoor adventure and elbow room, or at least a return to a simpler and freer style of living.  Some were nonconformists or misfits who were trying to escape something in their pasts—perhaps even themselves—and some of these did not seem well suited for modern urban society.  Some were missionaries attempting to convert the local populace.

The isolation of Bush life could be extreme, and the long cold and dark winters even in the cities of Alaska could lead to severe "cabin fever".  The incidence of alcohol abuse in Alaska and especially in the Bush was high, as were the incidences of mental illness and suicide (including sadly one teacher named Tom who hosted one of my visits to English Bay). 

Money did not automatically solve the problems of the Alaskan natives living in the Bush, as I concluded observing the mixed impact on at least one native village of a sizable fortune gained from the sale of petroleum.

Approaching Nondalton AK and wrecked DC3 September 1971
Approaching Nondalton AK & wrecked DC-3
September 1971
Hauling medical gear back to the beach at Belkofski AK September 1970
Hauling medical gear back to the beach at Belkofski AK
September 1970
Nurse Hinson with local residents and king crab on fishing boat from Belkofski to King Cove AK March 1971
 Nurse Hinson with local residents & king crab on fishing boat from Belkofski to King Cove AK
March 1971

Getting Around in the Bush:  Getting to these villages could be complicated and at times somewhat risky due especially to stormy weather conditions.  We had to resort to a variety of transportation methods, and despite our best laid plans, could easily get weathered in for prolonged periods if we were unlucky.  For long travel legs, we often flew on Reeve Aleutian Airways DC-3's.  These twin-prop World War II-era planes were still going strong after many years and miles logged.  (However, as we approached the airstrip at Nondalton, we could not miss seeing a wrecked DC-3 that lacked its tail section, a silent and sobering reminder that not all large or small planes and not all passengers survived these trips to the Bush unscathed.) 

To reach King Cove, we flew by Reeve DC-3 about 630 miles from Anchorage to Cold Bay (located near the western tip of the Alaska Peninsula, now in the Izembek National Wildlife Refuge).  We passed numerous volcanoes along the Alaska Peninsula, some of which were active while I was in Alaska, including Mt. Augustine and Mt. Pavlof (see photo above).  From Cold Bay, we typically took a twin-engine amphibious Grumman Goose to King Cove, landing on the water and taxiing ashore on the beach near the cannery (see photo above), or we went by wheeled plane, landing at the airstrip a few miles to the north.  (There was no Alaskan Ferry stopping at King Cove in those days). 

Belkofski was my smallest destination village.  It did not even have an airstrip, perhaps because the terrain was too rugged, the population was too small, and the Pacific Ocean bordering it also tended to be rough and discouraging to visitors.  To reach it, we hitched a ride on a crab fishing boat out of King Cove, made our way east past Belkofski Bay and landed on Belkofski's beach in a skiff.  On at least one memorable trip, the crew paused mid-trip to pull up a crab trap, and harvested and boiled up some fine king crab for us to enjoy for lunch.  (According to this website, Belkofski's fortunes rose and fell with the sea otter harvest.  The population of Belkofski moved to King Cove in the early 1980s, taking with them the bell of the Holy Resurrection Russian Orthodox Church (photo above) and installing it in a new church at King Cove.)

To get to False Pass on Unimak Island, we typically went by wheeled plane, which could land on the gravel landing strip there.  The Grumman Goose pilot I flew with in the Aleutians was very much in need of a reminder as to which position to place his wheels in for landing—i.e., wheels up for water, wheels down for land.  He had gotten confused a year or so before I arrived while carrying an IHS physician, wrecking his plane when attempting to land on an airstrip with the wheels up, and if I recall correctly he had earlier done just the opposite in a Goose while landing on water.  By the time I flew with him, he had attached a little black plastic wheel to the all-important switch to remind him which position the wheels were in, up or down—fortunately, my landings with him there were uneventful.  The interior of Unimak Island as seen from the air is dominated by a spectacular 9373-foot intermittently active volcano, Mount Shishaldin and the somewhat smaller Isanotski Peak.  But from the ground at False Pass one looks upon a smaller eroded volcano, Roundtop (or Round Top), and I never found any opportunity to venture very far from the village into that dramatic but forbidding landscape.  From False Pass, we would fly by small plane back to Cold Bay. 

The other villages I visited in Alaska were also reached mostly by small planes, such as the DeHavilland Beaver single engine float plane that we flew to reach Tatitlek, probably starting from Valdez.  I took the occasion to hike between Port Graham and English Bay on one trip, and one winter was given a ride on a snowmobile (called in Alaska a "snow machine") to get to one of the snowed in villages in the Lake Iliamna area.  In the winter, I carried cross-country (XC) skis on my Lake Iliamna and Tatitlek trips, and enjoyed XC skiing recreationally as a break from clinic (but did not actually use this modality to travel between villages).

Attitudes toward Short Term General Medical Officers: The permanent mostly board-certified specialty physicians of the ANMC were generally well regarded by the patients, and many of the organized medical programs involving a wide variety of PHS staff were very successful.  But how did patients regard us two-year-term IHS GMO physicians?  It has been a long time, but as I recall, attitudes toward us varied somewhat.  I think it would be fair to say that although most of us were highly motivated and did our best to provide the best medical care within our power, many of our patients knew that we were not fully specialty trained, and that we were largely short-termers rotating into an assignment for no more than two years.  This planned transience, plus the sense that they were dealing in general with a large federal bureaucracy run ultimately from way back east (like the sometimes detested Bureau of Indian Affairs) undoubtedly led some of the patients to regard us with skepticism, irritation, or reluctant tolerance.  Where we were lucky enough to form solid doctor-patient relationships with patients, they expressed real disappointment (just like some of my patients when I was an intern) when the inevitable rotation off the service took us away and brought in a new crop of young doctors who would be starting all over with getting to know them.  However, I can say without qualification that I put my very best efforts into getting to know my patients and caring for their medical needs.  Many of them responded to us and the IHS with gratitude and appreciation (especially in regard to the risks we accepted to reach them in the Bush), while a few at the other end of the spectrum probably put up with us until they had the means to afford private medicine (if that were even an option).

The Rich Rewards of Medical Practice:  I felt proud to have served my country and the needy indigenous population of Alaska for these two years, and would not trade my experience as a USPHS/IHS GMO in Alaska for anything.  I did a lot of good, learned a great deal of practical medicine, and enjoyed the opportunity to practice a subset of general medicine just like a real doctor.  (For the most part, I overcame the uncomfortable feeling that I might not be genuine, the so-called Imposter Syndrome that many thoughtful and conscientious physicians feel early in their practice careers.)

Applying to Radiology Residencies:  At some point probably in the fall 1971, I interviewed for radiology residency programs at the University of California at San Francisco, at Stanford University, and at the University of Washington.  In August 1971, I applied to participate in the National Intern and Residency Matching Program for radiology residencies.  Trying to get a head start, I subscribed in 1971 to Radiology, the American Journal of Roentgenology, the Radiological Clinics of North America, and Seminars in Roentgenology.  I continued in addition to read the Annals of Internal Medicine and the New England Journal of Medicine

Acceptance by the University of Washington Residency:  While on a field trip in the Alaskan Bush, I learned by radio from my colleague Paul Duncan that I had matched with the Seattle radiology residency program.  This was initially a bit disappointing to me, as I had listed UC San Francisco as my first choice.  UCSF was the preeminent radiology program on the West coast and one of the best and most coveted in the country.  It was the first time in my life that I did not win my first educational or career choice, and I initially felt that I had failed to some degree.  Perhaps, as I considered this rejection, it resulted from the perception that I was practicing in a medical backwater, well off the academic fast-track, or perhaps my somewhat rocky start in internship had downgraded me.  But looking at things more pragmatically, it soon became apparent that I had probably set my sights unrealistically high, and that I did not really fit their expectations well with respect to their very heavy emphasis on research.  Had I been accepted there, I would probably have found myself in another pressure-cooker high-stress situation for which I was not well suited.  I eventually concluded that Seattle's more clinically-oriented residency program was in fact perfect for me, and certainly Becky and I both concluded that the attractive and highly livable city of Seattle, when compared to San Francisco, was a better place in which to thrive and raise our young family.

Completion of PHS Service and Moving to Seattle:  Upon completion of my term of active duty on June 30, 1972, my discharge orders authorized travel back to Texas (though I went to Seattle), the shipping of our car, and moving expenses.  I left the USPHS as a Senior Assistant Surgeon (R), with final officer rank or pay grade still of O-3, equivalent to naval Lieutenant or army Captain.  I used up some terminal leave so that we could fly from Anchorage to Seattle on about June 17.  My Selective Service draft classification changed to 4-A, as I had completed my military service obligation and was no longer subject to the draft.  According to the US Census Bureau and other sources, my service as a commissioned officer in the USPHS qualifies me as a veteran.

Overall Reflections on Our Alaska Years:  We left Alaska with mixed feelings but fond memories.  I had worked very hard, and felt quite satisfied with my professional accomplishments, given the constraints and conditions I worked under.  Our stay there had provided us remarkable and unforgettable experiences in the professional, leisure, and native cultural realms, and in a totally new and spectacular outdoor-oriented environment, physically quite different from Texas and of course much colder.  I certainly could have spent more time acquiring further knowledge about native cultures and languages, perhaps getting to know better the specific leaders and other important persons in the native communities—and undoubtedly I would have done so had we stayed on.  These two years were some of the best and most exciting in my life.  We enjoyed a social circle that was easy to break into and that was warm and comfortable, and we found Alaskans generally to be quite hospitable and open.

But Becky's outdoor experiences, to her mild regret, had been more limited and less dramatic than mine.  She had been forced to stay home to tend to the baby while I was out having adventures in the Alaskan Bush at work and at play, and she also sustained a knee injury from skiing which further limited her movement for a while.  The winters dragged on much longer than we were accustomed to and spring could be unpleasantly slushy and muddy; the accident rate was high and this could seriously impact families with children; and we had felt considerable cultural isolation from the big city life that we had previously aspired to and enjoyed.  I also felt that the professional medical environment might ultimately prove rather limiting to me, compared to the professional sophistication I had already experienced in major medical centers in Houston, New York City, and Denver. 

We were glad to be moving 1400 air miles closer to our Texas families, even though Seattle was still some 1870 air miles from Houston.  We were unsure at the time whether we would ever choose to return to live in Alaska, even if a good professional opportunity were to come along.  Indeed, when I received a very appealing Anchorage private practice job offer at the end of my residency, I considered it carefully but decided to turn it down.

References and Notes

(1) HG Schrott, JL Goldstein, WR Hazzard, MM [sic] McGoodwin, AG Motulsky, "Familial Hypercholesterolemia in a Large Kindred—Evidence for a Monogenic Mechanism", Ann Int Med. 76:722, 1972.
(2) Public Health Service and Indian Health Service:  The Indian Health Service (IHS) is currently (2014) an agency of the U. S. Department of Health and Human Services (HHS).  The term "US Public Health Service" was for a while was missing in action when I checked in 2005 and 2011, but by 2014 it has reappeared on the HHS's webpage listing of its HHS Family of Agencies (though apparently used only as an umbrella term for officers serving in several agencies and functions).  Searching in 2014 for the entity and term, "United States Public Health Service", I find the website of the Commissioned Corps of the USPHS.  That website gives the distinguished history of the US Public Health Service.  It originated in 1798 to provide for the care and relief of sick and injured merchant seamen, and was renamed in 1870 as the Marine Hospital Service.  Its name "was changed in 1902 to the Public Health and Marine Hospital Service, and again in 1912 to just the Public Health Service. As of 2014, the website of the USPHS Commissioned Corps states that more than 6,500 officers are on active duty, and lists 13 HHS Offices and agencies in which USPHS Commissioned Corps officers serve (including the Healthcare Research and Quality, Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Food and Drug Administration, Centers for Medicare and Medicaid Services, Indian Health Service, National Institutes of Health, Substance Abuse and Mental Health Services Administration, and Office of the Assistant Secretary for Preparedness and Response).  There are also listed, in 2014, 9 "Non-HHS Agencies/Programs in Which Commissioned Corps Officers Serve" (including the Environmental Protection Agency, Federal Bureau of Prisons, National Oceanic and Atmospheric Administration, National Park Service, U.S. Department of Agriculture, U.S. Department of Defense, and U.S. Department of Homeland Security.  It therefore appears that officers of the USPHS Commissioned Corps remain available to serve in a variety of agencies throughout federal government, but that the distinctive entity and perhaps objectionable term "US Public Health Service" has been de-emphasized or marginalized from the HHS's own organizational hierarchy and lexicon.
(3) Paul Roberts, Bill Moseley, "Father's Time", Psychology Today, May/June 96, article found at http://cms.psychologytoday.com/articles/pto-19960501-000041.html on July 19, 2005, confirmed 2009.
(4) Wendell H. Oswalt, Alaskan Eskimos, Chandler Publishing, 1967.
(5) Margaret Lantis (Ed.), Studies in Anthropology , No. 7: Ethnohistory in Southwestern Alaska and the Southern Yukon, University Press of Kentucky, 1970.
(6) Cornelius Osgood, The Ethnography of the Tanaina, Yale University Publications in Anthropology No. 16, 1966 (reprinted from 1937 publication)
(7) Dee Brown, Bury My Heart At Wounded Knee: An Indian History of the American West, Holt, Rinehart, and Winston, 1970.
(8) Depletion of marine seals (pinnipeds): "Stock Assessment Reports (SARs) by Species/Stock", NOAA website, http://www.nmfs.noaa.gov/pr/sars/species.htm accessed 25 March 2009