Adventures of a Bush Vet

Right off, I feel it's necessarily to clarify that, by "bush vet," I do not mean this guy:

Nor do I mean that other thing. C'mon people:

No, I mean "bush Alaska," which is to say:

Here are some examples:

Akiuk, Alaska (pop. 346)

St Mary's, Alaska (pop. 500):

Togiak, Alaska (pop. 809):

It should go without saying that communities of this size lack certain facilities, such as a grocery store. Or a hospital. Or a school. They're usually fishing villages (a blog unto itself), with more boats than cars:

However, that's not to say that residents of these villages do not also hanker for the companionship of their furry little friends. No, not these guys:

THESE guys:

Usually, seeking medical care for dogs & cats in bush Alaska requires the owner to put the dog on a plane (sometimes a very small plane) and fly it in to a bigger town like Anchorage, Wasilla or Fairbanks. Occasionally, however, some intrepid veterinarian will take matters into his or her own hands and fly out to one of these villages to conduct a weekend clinic, to include basic services, such as vaccinations, health check-ups and even surgeries like spay or neuter.

A couple of years ago, an intrepid non-veterinarian named Sally Clampitt saw the need, and established the Alaska Rural Veterinary Outreach (ARVO), which recruits veterinarians to fly out with her support team to try to provide some of these necessary (and sometimes long overdue) services.

This past weekend, I volunteered to fly out with ARVO for a three-day spay/neuter clinic in the community of Dillingham, Alaska. 

At a population of 2300 people, it's a burgeoning metropolis by bush Alaska standards. 

(Anchorage @ upper right; Dillingham @ upper center of photo)

Nevertheless, I was told to bring a sleeping bag, because we weren't certain of sleeping arrangements. I dunno, sounds rustic to me. And, aside from the desire to "get out there and do some good!"...

… I also recognized that I haven't seen much of bush Alaska, especially not being a fisherperson.  Since nearly twenty percent of Alaska's population lives remote, I was feeling like a bad Alaskan. So, you know, "Join the Army, See the World."

Next thing I know, I'm on a plane -- a little plane, a noisy plane -- flying over hundreds of miles of frozen tundra, which still never ceases to awe & inspire me with its vast beauty:

Yep. No houses down there. 

We touched down safe & sound and were shown to our new home, our "clinic" for the next 72 hours: Dillingham's National Guard Armory.

A bit rustic, but clean and spacious and actually a pretty ideal fit for us, it was split up into a receiving/recovery area and a surgery room:

Recovery

Our "cages"

Surgery room, before...

… and after.

Fortunately, it turns out our sleeping bags weren't needed, as a couple Dillinghamians offered up their spare bedrooms to pitch in to the community effort. At my particular B&B, our incredible hostess Michele cooked us quiche for breakfast and made pumpkin soup & salmon casserole. Someone else in town donated their car for the weekend. I was becoming very grateful for the gradual introduction to bush living.

Nevertheless, the following morning found an eager group of citizens waiting with their slightly less eager furry companions for our clinic to open. The ARVO medical team this trip was comprised of three vets (from Anchorage, Cantwell, and Massachusetts -- her daughter lives in Dillingham), and three technicians (from Anchorage, Denali, and … Dillingham), plus a whole slew of community support without whom the whole thing would've simply been a nightmare. Community members came out in droves to help us recover the pets post-operatively, to wash and sterilize surgical instruments, to run and fetch more syringes when we ran out, …. They even brought us food -- some homemade, some store-bought, all of it welcome and much-appreciated by our busy busy group.  Because now it's time to get down to business.

And business, we did. Over the three days of the clinic, our teams spayed & neutered nearly one hundred dogs and cats, many of them (many of them) in heat or early pregnancy. Oh yes, ladies and gentlemen, Mother Nature loves procreation! And Spring is in the air! (Now's the time to avert your gaze if you're easily queasified.)

Diva Doctors need not apply.

No gown, no problem.

Good things we had lights! No sunshine those days!

IV catheters for emergency support

Prep sink -- no, that's it, as clean as it's gonna get.

Klieg lights, but headlamps were still sometimes needed.

Six fewer kittens in Dillingham this year.

Kitty waking up by the Toyo stove.

I don't honestly remember much of those three days. It was just one surgery after another after another. Twelve hours on my feet. I think I stopped to pee. Once. One of the days.  But there are few standout memories.

I remember being frugal. After I bloodied up my first "disposable" surgery drape, a tech glared at me for not being tidier so we could save it and re-sterilize it for another patient. We saved every drape- and pack-wrapper layer to use again for … something else. Just save it! 

Even paper towels became a hot commodity. Suddenly, a little square of clean paper towel could be saved to use as a clean up for a pet post-operatively:

Another thing, I think we all thought all our patients were gonna look like this:

But far more of them looked like this:

And, actually, more than a few of them looked remarkably like Thor:

whom the Animal Control officer was very very very happy to see had come in to be neutered.

I also remember being very nervous beforehand about the anesthetic drugs. In most vet clinics, anesthetized patients are maintained on gas anesthesia combined with oxygen, which can be easily and quickly adjusted if necessary. In the bush, there are no anesthetic machines, no oxygen tanks… it's all done by injectable drugs. Smoke and mirrors, I thought when I saw the protocol chart. But, you know what? The cocktail of medications we used (assorted analgesics, like the morphine relatives and anti-inflammatories, combined with dissociatives and sedatives) worked so well that some patients just "assumed the position":

Of course, there were a couple of hairy moments -- but, then, if it were simple, any idiot with a syringe and a pair of scissors could do it. And none of them were half as terrifying as the idea of having to live full-time in a bush town:

But overall, it was a great experience. We met some fantastic people and some pretty terrific dogs and cats, as well. And, 178 gonads later, we did -- ultimately -- do some good.