Closing Time

It’s February 15.  I’ve been at the South Pole for a bit over two weeks, and had ownership of the Medical Clinic for the last ten days.  My predecessor flew out last week and, according to the Arbiter of All Things True and Meaningful…and by that, of course, I mean Facebook… he has gleefully resumed his retirement among the hoary heads of Margaritaville.  But today my adventure really begins, because today is the day that nearly half our number go home and the last flight leaves for the summer.  It’s Closing Day.

I had mentioned in a previous post that the numbers of folks at both McMurdo and the Pole are seasonal.  The height of summer at the Pole usually finds the place full to the gills with nearly 200 people, and more in temporary huts, tents, and other housing if there are special construction or scientific projects going on during the daylight months.  By the time of my arrival at the end of January the number had fallen to 140, and it’s been decreasing ever since, with a few more souls out on each LC-130 flight bringing us supplies for the winter and taking others back to McMurdo and home.  Today we lost the last 38 summer denizens, bringing our over-winter total to 44.  The SPOT (South Pole Overland Traverse) folks are still here for one more night, and are having an open house tonight serving fresh-baked cookies and hot chocolate.  They’re great folks; I’ll be sorry to see them go.  But off they must be tomorrow, for a three-week trip back to McMurdo before it gets too cold, and then we’ll be on our own until mid-October, when we trust the next aircraft will arrive bringing fresh food in and a few of us out. 

For the summer crew headed north, it seemed that they couldn’t find the exit fast enough.  The bags had been packed and palleted the day before; the goodbyes had been said in small groups and toasted with whatever was on hand late the night before.  All that lay ahead was three hours to McMurdo, then another eight to Christchurch; maybe a fitful night’s sleep in an airport hotel before another 13 hour flight to the United States, and perhaps another 4-5 hours to home.  Any moments saved were moments closer to home.  So as soon as it was announced that departing passengers should report to DA (Destination Alpha, the main entrance to the Station which is closest to the skiway), the crowd moved.  No more goodbyes, no last looks, no final embraces or penultimate pictures from your new polar family.  As soon as the plane stopped, they spilled out to march the 300 yards to the “Welcome” sign, standing in place like a line of wary meerkats, nearly three-quarters of an hour in the cold as if to make sure they wouldn’t be left behind.  In eight months, that’ll be me.

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The reliability of the flight schedules (or lack thereof) are another polar lesson in flexibility.   As mentioned, the New York Air National Guard operates the LC-130 Hercules flights to and from the Pole.  During the summer months, there may be plans for 3-4 flights each day.  Each flight has an alphanumeric mission identifier, but we simply call all the aircraft skiers (because they have skis), and each gets a number based on the day of the week and the number of the flight for that day.  So the second flight inbound on a Thursday would be called Skier 42; the first 4 for Thursday, the fourth day of our six-day work week, and the 2 because it’s the second flight that day.  These flights work fine, unless they don’t.  Aircraft are often grounded due to weather, usually on the coast rather than here. The aircraft are older and though exceptionally well-maintained, are subject to mechanical issues like any aircraft.  This gives rise to a Polie joke, announced over the radio in conjunction with the cancellation of a flight:

“How many mechanics does it take to fix an LC-130?

Apparently one more than we have on continent.”

The skiers aren’t the only planes that visit.  Dual-engine, high wing Twin Otters and refurbished DC-3’s (called Baslers) operated by a Canadian partner in support of several nations’ Antarctic programs stop in for fuel and use us as a base to supply field camps.  They are much smaller planes that the LC-130 and usually focused on a specific mission.  Some of these will continue to arrive after our closure date, but really only to allow the pilots rest time and then “gas ‘n go.”  Many of these aircraft work on the North and East sides of the continent, towards New Zealand or South Africa, but as Canadians these aircraft and crew fly home up the west coast of the Americas.  They use the Pole as a refueling stop as they fly across the continent to the Antarctic Peninsula, and from there they hop across the Drake Passage and start the long journey home.  But even these will stop by the end of next week.

The flights to the Pole stop over the winter for a number of reasons, including unpredictable weather, high winds, and perpetual darkness.  But at this point in the season, with the sun still up, 24 hour daylight, and frequent clear skies, it’s really the cold.  The temperature drops precipitously in mid-February; as the sun starts to descend below 13 degrees above the horizon, significantly less heat reaches the surface.  We’ve already gone from -30 F with wind chills in the -50’s F down to -60 F with a wind chill in the upper -90’s F in the nine days since closure.   (There’s a mouthful for you…down to the upper – 90’s).  For the first time, under my usual three layers of outdoor gear, I’m feeling just a bit of a chill; and the temperature in the station feels just a bit off.  You can tell something’s different out there, but there’s nothing you can see to say what it is.

Aircraft than turn off their engines in polar temperatures have great trouble getting them started again, the same as you might have difficulty cranking your car on a January morning in Minot.  Ever since the flight I arrived on was stuck here for three days due to weather up North, I haven’t seen an LC-130 shut off their engines…they’re on the taxi pad (“on deck”) for a bit less than an hour and on their way again.  There’s even a technique where, if there’s no need to come to complete stop to take on cargo, fuel or passengers, they taxi at a slow but constant speed as the cargo ramp is lowered and pallets pushed out the back to alight on the ice while the aircraft proceeds back to the skiway and takes off to being the journal home. 

(A brief aside:  The tourism slogan in Minot is “Why Not Minot?  To which a Minotan…Minotian…maybe a Minotite…in the gift shop at the Scandanavian Heritage Center confided, “Freezin’ is the Reason.”  It’s also my understanding from several residents of the Peace Garden State, among which my son, that the actual state motto of North Dakota is “Cold keeps the Riff-Raff Out.”)

You might be thinking that cold shouldn’t be that much of a problem for airplanes.  We’ve all been on commercial aircraft with flight information screens that tell us we’re cruising along at 36,000 feet and the outside air temperature is -60 F.  The difference is that the engines have already started up at a lower temperature on the ground, and the fuel and hydraulic fluids are already running through lines heated by electrical systems powered by the engines.  On the ground, fuel and hydraulics freeze up as well.  And despite the internal heat, there’s still a safe operational temperature limit below which aircraft can’t fly.  For the next eight months, we live below that line, which means no visitors and we get all the powdered eggs and reconstituted milk to ourselves.  Hooray!

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I’ve been looking forward to the departure of the summer folks.  The ones I got to know I really enjoyed.  Some gave me clues to surviving the winter, others enlightened me with tall tales….or maybe true confessions…of the follies of winters past.  I very much hope to stay in touch with many of them.  But their departure means that my adventure, the one where I am the Rugged and Self-Reliant Pioneering Physician Hero of My Own imagination…really starts.  

The past few days have been busy without much time for contemplation.  In one way, it’s been very familiar.  Folks have come in with problems they would like solved before they get home, or asking for some medication to tide them through a chronic problem until their arrival home.  While admittedly a crude example, it’s very similar to those roving relationships I see in the ER where one partner needs a problem “fixed” before the other one comes home.  (Don’t worry, gentle reader…I have yet to see any of that.) But some of the clinical work is new to me.  I’ve seen two patients, both relatively young with no prior medical history, with new-onset but asymptomatic high blood pressure.  In the ER, I would normally ask them to get a blood pressure cuff, check their blood pressure twice daily for a week or so to see what their BP really is outside of the hospital, and have them follow-up with their primary care physician for further review of their blood pressure needs.  Here, however, I am the primary care doctor, and I need to strike a balance between an appropriate workup to look for more severe causes of high blood pressure and trying to keep the patient on station, as no over-winter position is superfluous and each is critical function to the success of the whole.  Studies I might order in the usual clinical setting are sent to New Zealand, and by the time results come back it’s likely too late to send the patient home. So there’s a learning curve here, but my plans are supported by my clinical colleagues in Texas, and I feel positive about that.

Speaking of outside contacts, we’ve been able to set up a regular call with our physician and PA compatriots wintering at McMurdo.   They’ve seen a few patients for injuries that they’ve flown to New Zealand, more because they were heading home anyway after the summer season and not because they couldn’t handle it medically.  In other news, the penguins have arrived and it's been determined that they are so adorable he’ll be injecting one with ketamine to bring it home in a box.  The "Spare Doc" has left, but not before walking to Scott Base again to purchase trinkets because on his first visit he bought three stuffed penguins when he has four children, a situation for which he was counseled “You think one kid will be okay without a souvenir when the other three get one?”  There was also a fight at the bar one night and some foreign military folks chose to show their displeasure with the lack of after-hours service by drawing a crude representation of male anatomy on the shuffleboard table.  I always thought I was the cool kid working in the ER. Compared to what goes on on the coast, working at the South Pole has turned me into a suburban pediatrician.  

(On the subject of high-spirited mischief, remember how I was caught out in political incorrectness at that Wilderness First Responder Course in Denver?  Well, I did it again.  I was talking with a colleague at the Pole about how the previous doctor had shown me a bag of condoms in our closet pharmacy and remarked that nobody will pick any up for weeks, but right before people head to Christchurch they grab a generous handful because, and I quote, “Everyone thinks they’re going to get lucky when they get off the ice.”  I was laughing about it, but was later informed that this sort of comment might be considered inappropriate to others, and I should cease and desist from telling this story or others like it. In a way, I see the point.  Suppose you grabbed a handful of condoms and left them unused?   You’ve now failed to meet your own expectations for success, and this has made you ashamed and lowered your self-esteem.  No wonder you found my story offensive.  But as misery loves company, the leader who counseled me let me know that they too had fallen afoul of the speech police from time to time, most notably when they stated the best alcohol-on-station policy would be “Don’t be a dick,” a succinct statement of intent to which most of us would unequivocally agree.  And by way of follow-up, I has asked early in my tenure for our supply folks to find us some latex gloves and Band-Aids.  When the first box was brought up from the storehouse, I was presented with eight boxes of latex gloves, 19 individual Band-Aids, and 500 more unrequested condoms.  Having nowhere to put them in the clinic itself, they wound up in the storage room next to the orthopedic supplies, because they both deal with things that are…well, I can’t make this stuff up.)

We did five days of mass Covid testing last week, and we’re also doing a lot of cleaning.  We’re straightening up and restocking the clinic area, not because it’s dirty, but the very act of cleaning helps us to know where everything is.  The most time-consuming project has been dealing with humidifiers.  The humidifiers are an important part of life at the Pole.  Despite being surrounded by frozen water on the ground and living atop nearly two miles of ice, it’s one of the most arid places on earth.  Water vapor doesn’t stay aloft, but precipitates out as ice crystals, so there’s no moisture in the air.  We rely on humidity to keep our respiratory tree slick and clear; dry air may also lead to airway irritation and bronchospasm (a narrowing of the airways that makes it hard to breathe.)  Issuing a humidifier for the polar denizens to use in their rooms is a fundamental piece of polar prevention.  When they’re ready to leave, they bring the humidifier back to us for cleaning before they can be handed out to the next occupant. 

There are step-by-step instructions for cleaning the humidifiers taped to the wall beside the two-sided sink in the linen/laundry room in the clinic.  I followed most of them; the one where I added my own touch was the part where I was supposed to add one capful of bleach to each gallon of water in the sink.  Since I had no idea how much water each side of the sink could hold, I figured each time the container of bleach made a “glug” sound that was better than a capful, and five “glugs” seemed a fine amount.  Noting that the bleach-infused water splashing upon my clothes depigmented my garments such that I looked like a blue-spotted newt supported my hypothesis.

(To be fair, neither the BGFE nor I are big cleaners.  We do enough to prevent the vermin from dropping by, though Zach the Otherwise Brainless Squirrel-Killing Dog would probably be just fine with that.  We’re the kind of people who are compelled by our own sloth to clean up before the cleaning people arrive, but because we can’t find reliable cleaning folks we’ve let ourselves off the hook.)

You dunk the top part of the humidifier (the part that holds the water) into the water-bleach mix, and submerge it until the container is full and it stops bubbling.  You let it soak for twenty minutes and then put the bleach water into the base of the unit (which produces the mist) to kill any nasty stuff there.  You rinse it out with cold water, then set it aside to dry.  Twenty minutes later, you do the same with the base unit.  Soak, rinse, repeat.  As I decided my drying rack was a series of bath towels on the floor, eventually you wind up with a scene out of Star Wars, where a bunch of little droids…the ones you’re looking for… are lined up on the floor with their little blue domes and their little white bodies all lined for final assembly and the Artoo Family Reunion.   

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In the few hours since the summer crew left, you could already detect a change in the family dynamics.  The higher leadership amongst us (Area Managers and the like) departed on the last flight out, so there’s this sensation of freedom, a weight being lifted, like your parents have gone away and left you the keys to the car and a fully stocked bar and said it was okay to invite 43 strangers over to stay and we’ll be back in eight months.  It’s not that there’s a feeling of revenge or rebellion; far from malignant thoughts, it’s more of a mindset that now we can do what we came here for, and it’s up to us alone, for better or worse, to create a team and make this happen.  It’s the same reason I worked so many night shifts during my tenure in clinical Emergency Medicine…administration never shows up after 5 PM, so you build your team to do what needs to be done in the best way you know to get the best outcomes for all without oversight from the Peanut Gallery.

This new attitude is reflected in many small ways.  The gallery is rearranged, as many of the tables lined up in neat rows are removed and stored, replaced by chairs and couches moved in from different parts of the station to create an informal coffee lounge.  The few tables that remain are lined up end-to-end so that everyone eats together, family-style, at our own Last Supper.  In order to give the remaining galley staff days off, we take turns in the dish pit each weekday night and all weekend; our previously opulent Sunday brunch is replaced by scavenging in the leftover cooler or getting creative with deli meats.  With less steward and cleaning staff, our “House Mouse” housekeeping duties have expanded to include things like mopping hallways and shoveling snow away from exits. We participate in human chains to load “Freshies” (fresh food) into the coolers, move furniture throughout the station for movie nights, and to load the alcoholic inventory of the Booze Barn indoors to our small retail store.  It’s the latter task that generates the most enthusiasm.  Who knew?

(The first time I saw the e-mail about the dish pit, my mind kept transposing letters.  I kept telling myself.  “Dish pit.  DISH PIT!”  I’m not proud, but it’s where my head goes.  Too many years in the ER.)

A word about alcohol on the continent.  You would imagine that with the isolation and limited opportunities to be out and about, especially during winter, that folks would value an opportunity to free their minds from the monotony of life.  Given that the USAP started life as a United States Navy operation, and that the daily ration of grog has been a tradition in most of the world’s maritime forces, it’s not surprising to think that alcohol on the ice might be a treasured commodity.  At McMurdo, alcohol is sold on the basis of rations.  Everyone get three “rations” of alcohol a week.  A bottle of spirits costs three rations; a six pack of beer or a bottle of wine are one ration each. It’s not free; you still pay for it, but at a somewhat lower price than back home.  Most of the beer is expired, but in most cases the need outweighs the stale.  The bottle of vodka I’ve purchased (to be held until time zones and satellites align so the BGFE and I can share an intercontinental happy hour) doesn’t seem to have an expiration date, which is probably why all the pickled animals in high school biology jar seem to do pretty well. 

(Speaking of alcohol, we have two bottles of Everclear in the South Pole Clinic’s controlled medication stores.  It’s my understanding that in the distant past, someone on station suffered from methanol poisoning.  Methanol…also known as wood alcohol…is found in solvents, wiper fluids, and poorly made moonshine.  When ingested, it’s metabolized into formaldehyde, the stuff that’s really in those jars of high school pickled fauna.  Methanol is metabolized in the liver by the same enzyme that metabolizes ethanol…the formal name for the alcohol we drink…so to stop it from being converted info formaldehyde you have to tempt the enzyme with something it likes better.  The enzyme in question (alcohol dehydrogenase) likes to play with ethanol twenty times more than it enjoys processing methanol.  So the way to stop the conversion of methanol to formaldehyde is to offer ethanol to the enzyme.  In short, you get the patient drunk and keep them there for two to three days.)

But back to getting hold of the bottle.  At McMurdo, it’s a pretty bland process.  You go to the Company Store, give them your name, pick your poison, and pay on the way out.  The store is open for a goodly number of hours every day.  At the Pole the ration system still holds.  However, getting your weekly portion during the summer becomes an adventure, as the liquor is stored in a small blue shack known as the “Booze Barn,” secured behind the obligatory freezer door about 300 yards from the station.  The Barn is open for a single hour on Saturday evening.  So what this means is that not only do you have to put on your ECW gear to march a quarter mile across the frozen tundra at temperatures that drive fear into mortal men, and then cart it back to your place of consumption.  You have to earn your ration here; it’s a meaningful experience and one that deserves a reward.  But since everyone does this all at one, looking out the window towards the Barn one sees a nature documentary, where a herd of red-coated elk migrate from one place of warmth to the next in search of sustenance to get through the harsh winter.  You could almost hear Marlin Perkins narrate while poor Jim Fowler was stuck out in the cold.  I go to the Booze Barn and buy something wherever its’ open, not because I need anything, but just to say I did.  Now that the adult beverages have been moved back in Station for the winter, the thrill is gone.

One of the other group tasks (which I admittedly ditched) has been to sort items from the “Skua.”  The skua is a predatory scavenger bird that lives in polar regions, both north and south.  The Skua as a place is essentially the Goodwill Store of the Pole.  When people leave things behind, they wind up in the Skua Shack which lives just behind the station.  Before winter, the shack is emptied and the contents sorted, to see if anyone wants anything left over and what can be thrown away.  Gleaning from the Skua is actually a good deal if you didn’t bring much with you, as lots of folks just leave shirts, pants, sweaters, and jackets behind. Folks also tend to bring a lot more toiletries than they‘ll really use (just like at home…I would suspect most of us have a bathroom drawer filled with far too much toothpaste and cabinets under the sink crammed full with extra bars of soap and bottles of shampoo).  You could make a case that all you really need to bring to the Pole are shoes, socks, underwear, and a toothbrush…and even then, if you’re not too picky, maybe just a toothbrush.

The polar skua is pretty benign…the most exciting thing I found was a corkscrew and a small book entitled “The Life of Che Guevara.”  At McMurdo, however, it’s my understanding that one of the exhibits at a past Alternative Art Festival was a collection of…um…marital aids found in the skua.  I understand why you might want to leave these behind prior to heading home to a loved one with some sort of explanation.  What I can’t figure out is how you would get it there in the first place, through the TSA and whatever nation’s customs service you encounter, without a high level of trepidation and some extended internal version of the Walk of Shame.)

Could you ship things back rather than leave them in skua?  The answer is yes.  The South Pole has its’ own small US Post Office that operates as an APO station.    So you can not only send letters and postcards back home (it’s amazing how many folks just want a postcard from the South Pole), but you can also ship things back and forth, but with a greatly exaggerated time frame.  To save space and weight, I sent a few boxes here from home in December, hoping they would arrive by early February when I was on ice.  I sent down some party games (Tellustraitons and Green Team Wins), toiletries, over-the-counter medications, and a weighted blanket; my friend Darrien who works with atmospheric research had Amazon send her a beanbag chair. In general, about two-thirds of shipments arrive in time.  The transition from the US to Antarctica and vice-versa can take months; even after your package arrives in Christchurch, personal mail is the lowest priority for flights to the ice.  Return mail has an even lower rank; it’s my understanding that if you send something home after the station opens up, don’t expect to see it for up to six months.  Still, I’ll need to have multiple holiday trinkets at the ready on my return in November, so I’ll be shipping home a lot of cold-weather gear just before I leave.

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Despite my excitement at the start of the real adventure, I find myself tired most of the time.  It’s admittedly hard to know why.  There’s likely some interplay of mild hypoxia (slightly lowered blood oxygen level that happen at altitude, dehydration, and twenty-four hours of daylight disrupting my norm rhythms.  The fact that the first few weeks here the best times to communicate with the outside world have been between midnight and nine AM don’t help.

I’ve not been a great sleeper for a while…always tend to wake up about 1 AM and then can’t get back to sleep for a few hours (or more if the dogs are snoring).  The afternoon nap has never been an unknown quantity to me.  Indeed, napping is one of the favorite shared activities of the BGFE and I.

(My Dad naps like me, too, but I have never been able to match him with the Jesus Nap, when he would lay on the floor or the formal living room…people had those once upon a time…with his feet up on a chair, back on the floor, and arms spread out to either side.)  

Could my lethargy be related to the magnitude of what I’m doing here, some kind of unconscious reaction to unfelt stress?  Perhaps, but the magnitude of all this still hasn’t really set in.  There are still lots of new experiences to see and do, things to learn, people to know, and new environments…the polar sunset, perpetual night, southern constellations, the Aurora Australias.  Every now and then I get a hint of what’s to come…long afternoons in the clinic with not much to do, Chef letting us know that the fresh eggs will run out by June…but aside from missing my son, my folks, and the BGFE at every opportunity, I don’t feel the impact quite yet.

I’d rather blame my lack of sleep on something else than my own psychic rumblings.  So my working theory is related to the fact that men of a certain age use the restroom a lot.  This is not a big deal when you’re at home.  You slip out of bed, stagger twenty feet, drain, and stagger back to bed.  It’s dark, there’s no one there except you and your beloved and a dog or three, and it doesn’t matter what you wear, or don’t, because they’ve seen it all before.  Three minutes tops, and only if you’re timing it.  Here, however, you get up, descend from your elevated berth while trying to avoid a desk chair,  throw on some clothing because Lord knows who might view all you have on offer, and open the door into a hallway full of blinding daylight no matter what the actual hours.  You walk about fifty feet to the communal restroom, then turn around and reverse the process.  It’s a fifteen minute production, and by now you’re so wired there’s no way to get back to sleep.  So you go online, because it’s the only time you can, and suddenly it’s five AM and you know a lot more about Hamster on a Piano.  It’s been suggested by some over-winter veterans that keeping a pee bottle in my room may solve the problem, but I just can’t go there. Yet.