East Tennessean

Issue date: 10/27/08 Section: The Scene

An abandoned bus on the tundra, one of the many things Gourley and other interns explored during their free time. [Click to enlarge]

When I was little, I used to want to be a cowgirl, or at least a pioneer like Laura Ingalls Wilder. Then I realized that the entire frontier had been claimed and all the open range was fenced-in and snaked with interstates, or so I thought.
Obviously, I didn't know much about Alaska when I was a little girl. The 49th state rightfully claims the title of "The Last Frontier." I've loved the atmosphere of flexibility, freedom and generosity that I've found in Nome and other parts of Alaska. It's been an incredible experience as I've made a house call in a rural village, learned about managing diabetes by bringing the physician, nurse and dietician to the patients' village instead of flying the patients to the physician.
I have sutured scalp wounds, delivered babies, started IV lines, gave fluids at 20,000 feet in the air, flown all over rural Alaska and seen and done anything and everything I could.
From eating dried fish to hiking over the tundra to a waterfall to trying to wrap my elbows around my arms (or was that my feet?) in one of the many fitness classes at the Nome Recreation Center.
And amidst learning so much about my community, Nome, I've learned about medicine. I've learned that the health of a patient doesn't depend solely on me, the physician, nor them, the patient.
A patient's health depends on the training of the village health aide to properly diagnose and triage the patient. It also depends on the skill of the pilot to land the plane in their village to transport them to Nome and on the attentiveness of the paramedics during the flight. The patient's health depends upon the availability of the medical technologist or X-ray technician at 2 a.m. when they've come in to the ER with a broken arm and need their blood drawn and analyzed.
A patient's health depends on the continuous care of the nursing staff. Also, a patient's health depends on the community of the patient, and a patient's health depends on the genes of their family and the behaviors they have learned.

Continued...

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