Breakup

As the snow melts and the temperatures begin to warm up people here begin to get anxious.  The ducks and geese have returned to the area, and just like everything else the land provides, people here love hunting birds.  But the birds are not the reason for the increased tensions around town.  The reason for the tension is the river.  For a few weeks between winter and spring travel to and from Bethel is strictly by plane.  The ice road is no longer safe to drive even a snowmachine on, but is still covered in ice also eliminating boating as a means of travel.  People flock daily to the river to keep vigil in anticipation of the ice breakup.  One longtime Bethel resident even told me that tradition mandates you should not make any major life decisions within 3 days of the river's breakup.  The longer breakup takes to occur, the more anxiety there is around town.  Some people have literally spent hours just watching the ice, listening to it pop and crack, waiting.  
Every year for I don't know how long, a town wide bet attempts to predict the exact date and time the river will breakup.  This year's pot was over $12,000!  A tripod marker is positioned in the ice.  When the marker moves the bet is over and the breakup has officially begun.  This year breakup was later than most years past.  It officially began May 28th at 7:42 PM.  The following day the town hosted its annual Breakup Bash, a party on the river bank complete with live music and free hot dogs.  We aren't big crowd people (and the Breakup Bash usually draws a big crowd), so rather than joining the party I decided to wait till later that night to go check out the river.  Mark had driven past just before the Bash started and reported there was still plenty of stationary ice.  The river may have moved enough to break the marker, but by all intensive purposes was at a stand still.

After getting the kids to bed I grabbed my camera and headed for the river.  The sun isn't setting until about midnight, so I knew I had plenty of light remaining.  I also knew if I didn't go that night I might not get another chance to take pictures of breakup until next year.  Once the ice starts moving the river is usually cleared in less than 2 days.  

When I first got to the river, I thought I had read the official breakup time wrong, because the river I was looking at was not moving at all and was still covered in ice.  There were even some people out on the ice, chipping it away and loading it into their truck beds.  There were several other people down there too, just watching and waiting for the ice to clear.  I had been snapping pictures for probably about 20 minutes when I was ready to leave.  As I packed up my stuff however I noticed that the popping of the ice suddenly seemed louder and more frenzied.  When I looked out at the river I also noticed that there was water splashing up between the cracks in the ice.  Then, quite suddenly, the whole river surged forward.  Chunks of ice, tree limbs and debris rushed past all of us.  People started cheering and clapping, I think I even saw one lady start crying.  The noise was incredible.  
I didn't stay too long; it was late, and I had to work the next day.  But I am really glad I went when I did.  Most people, even people who have lived in Bethel for years, don't ever get to see anything like that.  By the next day, most of the ice had cleared out.  By the day after that people were putting their boats back in the water.

Making Beer

Bethel is what we call a "damp" city.  While most of the villages in this part of Alaska are completely dry, Bethel at least allows its residents to consume alcohol.  What makes Bethel damp and not wet is the fact that you can only consume alcohol here, you can not purchase it.  This brings about many creative ways to get alcohol into Bethel.  Like everything in Bethel getting alcohol here is very expensive.  You can bring it in yourself if you fly to Anchorage, but a ticket to Anchorage and back is about $400, plus hotel, plus car rental... quite the expensive beer run.  You can NOT have family or friends mail it to you through the post office (we found that out the hard way).  There is a small airline here that will go to Anchorage for you, pick up your alcohol and fly it back (legal bootleggers) but you're looking at a shipping fee of about 65 cents per pound, it adds up quick.  Or, you can order a kit and ingredients and make it yourself.  After trying all of the options above, we have found this last option to be the best bang for your buck!  In fact, as I write this, Mark is working on his second batch.  It takes about 4 weeks from stovetop to mug, but it's worth it.  The kit costs about $300 and the various recipe ingredient packets about $50.  The kit is a one time purchase and each ingredient packet makes about 5 gallons of beer!  If you live out here and enjoy a beer with dinner every now and then, this is by far the way to go.  

 The ingredients for a light wheat beer with a hint of orange and coriander.  It turned out to be a more complicated beer than some, but leave it to us to start out with the difficult brews first!

Always nice to have
help from someone
who has done it before

The hops

 After all the ingredients have been added, the brew simmers on the stove filling our small house with the yeasty, hoppy smells of a microbrewery.

 From the stove the hot brew is funneled into a carboy and then set outside to chill until its just the right temperature.  Once the right temp, we add the yeast.  Once the yeast is added the carboy is set aside in a warm area to ferment for about a week and a half.

After the fermentation period is complete, the green beer is separated from the sediment by transferring it from one carboy to another carboy.  Then... it sits some more.

Months of collecting bottles pays off as these can be reused and saved us from having to buy all new bottles.  These bottles are being sterilized in preparation for our beer.

Once the specific gravity is just right, we know it is time to add the sugar water and then bottle.






Each bottle is filled and then capped, no twist offs here!

                                                                                   

 The individual bottles go back into their warm hiding place for another couple weeks.  The sugar water finalizes the taste and creates the carbonation.  After the waiting period is up, the warm beer is transferred to a cold mug and enjoyed!  Bottoms up!

 

Hawaii

As our first Alaskan winter begins to melt away we felt it was the perfect time to get out of Bethel for a bit.  I found a conference through the University of California San Francisco on a Primary Care Update for 2013 in Maui, April 7th through the 12th.  In addition to the great topics offered by the conference, lectures adjourned everyday at 11:00am!  To sweeten the deal my mom was willing and able to come to Bethel and watch the kids for us so Mark and I could go just the two of us. 
We left Bethel Saturday morning and arrived in Maui that night.  We wanted to spend a good deal of our free time just laying on the beach or by the pool, but we also wanted to see some of the sites.

Conference registration didn't start till 3:00pm Sunday afternoon with two lectures later that night, so Mark and I decided our first day would be a beach day.  I was foolish enough to think I could go an hour or so without sunsceeen, and Mark was foolish enough to think the hair on his arms and legs would protect him.  In the end, after about an hour and a half we were both fried to a crisp.  So much so, that the next day when we picked up our rental (a convertable Camaro) we couldn't stand for the top to be down as the sun made our skin feel like it was going to melt completely off!  Needless-to-say, when people saw our beefy red burns and then found out we were visiting from Alaska, they had a sudden look of understanding (and pity) pass across their faces.  We spent the next 3 days hiding from the sun like vampires. 

Drive up to Halaekala, just below
the cloud line

A few moments later and we were
above the clouds

Crater of Haleakala Volcano

One of our car rental days we drove to the West side of Haleakala National Park.  This side of the park features the summit of Haleakala Volcano at over 10,000 feet above sea level.  The last time any lava flowed from this volcano was in 1790.  Very beautiful, but much dryer than we expected to see on a lush Hawaiian island.  We wandered on the trails around the crater for a couple of hours before making the curvy drive back to the hotel.
As our skin still felt very sensitive, we decided to rent the car one more day and drive the famous Highway to Hana and visit the East side of Haleakala park.  The East side of Haleakala park is just a few miles past Hana.  There is no road through the park to  connect the West and East sides.  To get to the East side you have to make the drive all the way around the island.  Many people only make it part way before turing back before their car sickness gets the best of them.

Highway to Hana

The drive was amazing; everything we had heard about it and more.  Although only about 50 miles long, it takes nearly 3 hours to drive as the speed limit rarely goes about 20 mph.  The road features some 620 curves and close to 60 bridges, the majority of which are a single lane.  At some points, the curve is so sharp and the road only one lane that signs are placed directing people to blow their car horns as they drive around so oncoming traffic can hear you.  This side of the island is what tropical is all about!  Waterfalls and flowers, bright green trees and plants everywhere!   
Our second to last day we decided to venture back out into the sun.  Equipped this time with broad spectrum, waterproof sunscreen of 70spf.  We applied, reapplied and reapplied some more.  Still we managed to get charred!  (Although, not quite as bad as day 1) 
From our hotel, it was easy and common to spot humpback whales out in the water.  Usually it was just their spray you saw, but more than once we saw the whales break the water.  Green turtles also frequented the shore line of the hotel.
We had a great trip!  But perhaps the event that we have told and retold to friends is this:

On one of our first nights in Maui, we walked to a little ABC store next to the hotel to pick up some beer and snacks to keep in our room.  (Resort alcohol is SO expensive.)  As we stood at the register checking out, the lady asked if we needed anything else, "some barbed wire perhaps?"  Without missing a beat Mark pipes up and says, "No thanks, just some handcuffs."  My face turns redder than my sunburn and the check out lady gives that embarrassed awkward laugh, the one that says "did I just hear what I think I heard?"  As we are walking back to the hotel, I ask Mark what on earth possessed him to say he wanted handcuffs to a complete stranger?!  He replied that she had started it with asking if we wanted any barbed wire.  Aghast I looked at my husband (who thought he was pretty slick with his quick response) and informed him, "Honey, she asked if we wanted any bottled water!  NOT BARBED WIRE!!"

 

Cama-i Dance Festival

Mother of Mukluk dance with mask
and seal gut parka

Every March Bethel is host to the Cama-i Dance Festival.  People come in from all over Alaska to attend and participate.  Cama-i (pronounced ch-a-my) translated means "warm welcome."  Many of the villages have dance teams, and Cama-i is a chance for them to show off their skills.  One village that danced hadn't had a dance team in 100 years!  Most of the dancing Cama-i weekend is native dancing, but really any kind of dancing is fair game.  The weekend started Friday evening with events scheduled till midnight.  Saturday kicked off around lunch time and again went till midnight, and Sunday too was packed with dances.  Many of the groups performed 2 or 3 times over the weekend.  My favorites were the dances that included masks.  Almost as much as I loved watching the dancers, I truly enjoyed watching the elders watch the dancing.  The front row was reserved for elders, but people could sit on the floor in front of them.  Every single elder I watched was absolutely glowing. 
We had patients all week trying to use medical conditions as excuses to come into Bethel so they could be here for Cama-i.  (Most insurances will pay for travel and lodging if medical care isn't available where they live.)  Convenient when your asthma just so happens to flare up the weekend of Cama-i. 
In addition to the dancing, people set up booths to sell their crafts.  There were ivory carvings, jewelry, dance fans, seal skin hats and gloves... all kinds of beautiful artistry. 
The festival is run entirely by volunteers and donations.  Saturday evening there was a huge native foods feast.  First served were the elders, followed by the dancers and finally everyone else.  The feast included beaver, moose, caribou and goose stews, walrus, halibut, salmon, berry akutaq (Eskimo ice cream) and several other goodies all donated and served to over 850 people! 

A friend's mother, a 94 year old elder from Nightmute, was honored this year for her lifelong support of native Yup'ik daning.  She in turn honored all of us with a dance.  
Overall it was a really nice, really crowded event.  I'm glad I got a chance to get out of the house for a few kid free hours and get some nice pictures and experience something new!

Boston

Boston

The hospital I work for requested I attend a 2 day training on a new way to deliver prenatal care.  I had my choice of traveling to Austin, Texas or Boston, Massachusetts.  Easy!  Boston here I come!  Now I couldn't make a two day trip to Boston and not take a little extra time to visit all the family and friends I have in New England.  Once my parents and sister caught wind of my up coming trip they promptly booked their own tickets.  Since Gianna could sit on my lap and I would have 3 babysitters in Boston, I decided to bring her along.  Really, what part of 18 hours on a plane with an 18 month old didn't sound like a good idea?  

Plane Entertainment

We set out from Bethel Wednesday night and arrived in Boston the next evening.  Gianna did exceedingly well!  She slept for most of the flights.  For 2 of the 3 legs we sat on the aisle.  The aisle seemed like a good idea at first.  I wouldn't have to step over anyone to get to the bathroom.  However, as my daughter stretched out, arms, legs and at times her head were in the aisle.  I couldn't sleep for fear the drink cart would wack her in the head.  (Which turned out to be a legitimate fear, as the flight attendants were everything but polite and attentive.)   Ironically, I only got up once to go to the restroom.    

Alisha and Gianna at Sam
Adams Brewery 

Mom, Alisha and Gianna

I hadn't been outside the state of Alaska in over 9 months.  That first night I had a hard time sleeping.  Cars, horns, sirens.  It was so loud!  I had a village patient once complain about having to spend the night in Bethel because there were too many cars driving past the inn she was staying at, and she couldn't sleep because of all the noise.  That first night in Boston, I knew exactly how that patient felt.
The training itself over the next two days was excellent.  I learned so much and can't wait to implement it!  But while I was training, Mom, Dad, my sister and daughter were out exploring Boston.  Judging by their pictures, they had a pretty awesome time.
Following my training we set out for Maine to visit with family we hadn't seen in too long.  

Dinner

Dad and Gianna

Mom and Gianna at the
Boston Aquarium

It was such a great trip!  I got to visit loved ones (including my best friend from college), do some shopping, eat out and drink draft beer.  Gianna and I made the long trip back to Alaska (this time in the window seat).  We spent the last day in Anchorage to stock up on groceries.  After a final beer in the Anchorage airport we headed home.

Josh and Gianna enjoying Gianna's
new favorite pass time, the iPhone

River Walk

Oscarville

One of the really nice things about working at an Indian Health Service facility is several paid holidays off, certainly more than I am used to.  The most recent paid day off was President's Day.  Usually when I have a day off that Mark and the kids don't, I just roam about the house picking things up, doing the laundry, watch a movie... nothing too exciting.  But this day off would be different!  A good friend texted me Sunday night and asked if I would be up for a hike.  I said "sure!", getting out of the house and getting some exercise sounded like a great idea.  She followed up her text with another saying "I'm thinking of going kinda far... sure you're up for it?"  Well, now that just made it sound adventerous, and that much more appealing.  "Absolutely!" I texted back. We planned to meet for lunch at a local sushi restaurant (yes, we actually have a few restaurants here that serve sushi) and then walk to the next village up, Oscarville.  Oh, and did I mention, there was a wind advisory for that day, the temp would be about -35 degrees, and we were going to be walking on the frozen river!
We met the next day for an early lunch.  Once fueled up on sushi rolls we headed for the river.  The walk up wasn't bad, the wind was at our backs, in fact we both got a little warm and had to open our jackets.  Nearly every truck that passed us stopped and asked if we would like a ride.  They all looked rather confused when we declined and kept walking.  Even 2 state troopers stopped us and asked if everything was ok.  They too offered us a ride and seemed a little concerned when we declined.  I'm pretty sure they were thinking they'd get a report later that day for 2 missing white girls who were last seen walking on the river.  It's hard to get lost though when you only have the choice of 2 directions, forward or back.

We made it to Oscarville in exactly 2 hours.  We snapped a couple of quick pictures and then turned to head home.  Once we turned the wind promtly reminded us it had been there all along.  The precieved change in temperature was amazing!  Up went my face mask, which had unfortunately froze while walking to Oscarville.  Apparently, the moisture from my breath as I exhaled really built up on my face mask and created quite a bit of ice.  The googles that had been on my head on the way up had a sheet of ice on the inside.  This made visibility difficult, but again, it's hard to get lost when you only have one way to go.  (For those of you who are thinking "but what if you wander off the road?", the road has been plowed so there is a wall of snow on both sides.  To wonder off the road you would have to climb over the bank.  It was pretty easy to tell when you were on the road and when you had wandered away.) 
As we walked, we did manage to stay pretty warm.  The wind was brutel at times, we pretty much walked the whole way back with our hoods up and our heads down.  Despite my googles, my eyelashes still managed to get ice crystals on them.  As my eyes watered the water froze and the crystals kept getting bigger and bigger till my eyelashes fell from the weight of the ice.  I'd have to pick the crystals off and then the whole process would start again. 
It took us exactly 4 hours to walk the 11 miles to Oscarville and back.  Most people thought we were nuts, and maybe we were a little bit, but we had a great time.  I think we both felt about 100 years old that night, and I had a blister the size of a quarter on my heel, but I'd still do it again!

Hectic Couple of Weeks!

These last 2 weeks have been exhausting!  The hospital I work for has undergone one of the biggest (if not the biggest) changes in its history.  We transitioned from paper charts to electronic charts.  I have worked with electronic records before, but I have never been apart of the switch from paper to computer.  For the most part, the switch was a smooth one.  The system never crashed, and patients have been fairly understanding as we muddle along reading a computer screen.  To try and aide the transition we significantly reduced the number of patients we see in one day.  With our old paper system we saw patients in 20 minute appointment slots with three overbooks allowed.  This gave us a grand total of about 16-18 patients each provider a day.  Currently with the new electronic system we see patients in 40 minute appointment slots and no overbooks.  This gives us a grand total of only 8-9 patients per provider a day!  Despite the dramatic decrease in number of patients seen each day, we have all been exhausted with learning each little crevice of this new system (and trust me, there are thousands of little crevices to learn).  Each night I go home feeling more tired than I ever felt seeing twice the number of patients I currently see.  I usually go to bed shortly after the kids go down.  When I wake up the next morning I can remember all the strange dreams I had that night!  I don't know if that means I am sleeping harder or softer. 
One of the most exciting and frustrating parts of doing everything electronic is the radio medical traffic.  I've written about RMT before.  It's where the village clinics send the Bethel based provider an account of a patient they just saw and request a plan for this patient.  What's nice about the electronic system is that when a patient comes in from a village, I can see what was already done.  Before with the paper system, the patient's village chart was separate from their Bethel chart.  Ideally, information got sent back and forth, but this was rarely the reality.  Now it's all one chart!  The frustrating part is that computers rely on electricity, and electricity is very fickle in the villages.  Our email inboxes are ever flowing with up-dates on which village is currently down and reverting back to the old paper system. 
All in all its a good change.  No more misinterpreting something because of bad handwriting.  No more searching for paper notes you know should be in the chart.  No more searching for whole charts!  With time I will hopefully get faster and feel less exhausted by the end of the day.  Who knows, maybe soon I will be able to stay up past 8:30!