Doctor Antarctica

Plunging temperatures, epic darkness, a profound feeling of isolation... and an army of penguins. No, it's not Alaska this time. It's Antarctica.

"There are actually a lot of Alaskans down there," noted Mark Peterson, a UAA alumnus who took the reins as lead physician at McMurdo Station-the largest settlement on Antarctica-earlier this year. "You have to have kind of an adventurous spirit to live in Alaska and you have to have the same to go down to McMurdo."

As you can imagine, being the lead physician on the continent's largest base is a major responsibility. With an incredibly scattered population performing risky tasks in dangerous circumstances and using flaky communications across a thousand-mile span of ice road (all under the looming shadow of a debilitating government shutdown), medicine in Antarctica is, in a word, extreme. It's a place where things can easily go wrong, and often do.

And that's exactly why Mark headed south.

The lay of the land

The flat maps in classrooms worldwide never give much attention to Antarctica-it's just a long strip of land, with one tentacle-like peninsula creeping towards Argentina. The continent, though, is massive. If it were an independent country, Antarctica would be the world's second largest, sandwiched behind Russia and above Canada.

As it stands, though, Antarctica isn't a country at all-it's jointly 'managed' by a 50-nation treaty and the only settlements are purely research-based. It's a strange EPCOT-like arrangement, where South Africa and Norway are neighbors and Poland's base faces Brazil's across an island bay.

With jagged peaks, endless ice, razor-sharp winds and a temperature that rarely tips above freezing, Antarctica is a completely unforgiving place. But extreme places call out to extreme people and each summer (roughly October to March) scientists head south for the season to study everything from moss growth and whale diets to black hole formation in deep space. Research teams are accompanied by an adventurous crowd willing to wash dishes and scrub toilets for the chance to live on the edge of the planet.

Despite the volume of international operations, there are no sizable settlements in Antarctica. McMurdo Station-the main American base-has a summer population of around 1,000 scientists, mechanics, cooks and custodians, making it the largest hub of activity on the entire continent (across the map, Antarctica only hosts around 4,500 summer workers). The Americans operate several satellite bases and research camps, including a station at the South Pole where winter brings six months of straight darkness. The South Pole station is nearly 1,000 miles from McMurdo-double the distance from Fairbanks to Deadhorse-and there definitely aren't gas stations en route.

Amid all that vast space, there are hundreds of first aid kits, but essentially one place for treatment.

"McMurdo is kind of the only medical facility on the continent," Mark said of his role as lead physician.

Ticket to the edge of the world

Prior to his current globe-trotting chapter, Mark worked in tribal health in Juneau for over two decades. After so many years treating patients, he decided to expand into preventative medicine as well with a Master of Public Health (M.P.H.). UAA's distance-learning program is aimed at working professionals, so he continued practicing medicine in Juneau while taking online classes. After graduating in 2007, he was ready to chase down the next adventure.

Mark pursued the M.P.H. program because he knew it would create opportunities around the world. "It helped to do more of the international work," he explained. "If I was going to do this work internationally, I could have a different approach.

"I realized once you start doing international work, your impact as in individual doctor is fairly minimal. Where you're going to make your impact is in public health and education."

Mark wrote his thesis on AIDS treatment in rural villages of Kenya and, since earning his degree, has also worked in Central America and the Indian Himalayas-where he became very familiar with remote medicine. "A lot of those villages, the way we got to them we had to hike in with mule trains," he noted.

McMurdo General Hospital

He landed at McMurdo in late 2013, during the shoulder season between winter and summer known as winfly. Winfly lasts about a month, as the early arrivals get the base prepared for the full summer season.

His job got off to a quick and calamitous start. "Unfortunately we had one guy slip and he just shattered his ankle the day after the last flight went out," he recalled. Medevac in Antarctica is prohibitively expensive, so non-life-threatening injuries are generally handled on-site until the next regular flight. "He needed surgery but we couldn't get him out," Mark said. The solution was to splint, cast and wait it out.

McMurdo's medical space is small, but suitable. The facility is mostly up to date and well supplied, but only holds space for six hospital beds, with two additional gurneys next door in the mini-emergency room. Mark likened the setup to critical care hospitals in rural Alaska, and estimated about 20 patients came through the clinic each day. Most issues were minor and Mark's rotating staff treated everything from sore backs to colds, pneumonia, heart troubles and a norovirus outbreak. Mark oversaw a small team of revolving physicians who came and went as their contracts rotated through the season. "Staffing is constantly fluid," he added.

Just like in Alaska, distance and communications proved challenging. The American research team is spread across 1,000 miles of snow road, some stationed at two-person tent camps on the ice. Trying to keep tabs on this spread out population is further complicated by limited communications. Far fewer satellites pass over the southern edge of the planet, so even satellite phones are unreliable. Likewise, Internet is often available only a few hours a day. "Many a time I'd be talking to a colleague at the South Pole and suddenly the satellite went down and you couldn't talk anymore," Mark recalled.

"It's a challenging environment."

For perspective on Antarctica's remoteness, patients in serious conditions are taken to hospitals in New Zealand. In the dark of winter, that flight can cost about a million dollars. "It takes a lot to convince someone to medevac," Mark noted.

In certain situations, though, a medevac is absolutely necessary. In December 2013-a few months into Mark's time at McMurdo-a major crisis hit the South Korean research team. A four-man crew was shuttling from their under-construction base back to their icebreaker on the coast, but botched the helicopter landing and crashed into the ship. Italian doctors from the closest base ran to the site to assist and-as the largest medical facility on the continent-McMurdo flew out a plane to retrieve the victims.

"The Italian docs did the initial stabilization and flew them to McMurdo where we finished and arranged to fly them to Christchurch [New Zealand]," Mark recounted. "I think between when they crashed and when we got them to Christchurch was about 30 hours which, for Antarctica, is about as quick a medevac as you can get."

The victims suffered broken bones and third degree burns and were removed on U.S. Air Force planes loaded with medical supplies. "We had one guy on a ventilator the whole way," Mark said. Thankfully, Mark's team included several former military flight surgeons familiar with the planes and the protocol. "It was more typical of what you would see of a medevac flight from Iraq or Afghanistan to Germany," Mark added.

Continent crossing

After a busy season down south, Mark headed home in time to catch summer in the northern hemisphere.

As the earth tips toward long nights in Alaska, the next summer season is getting underway in Antarctica. Mark, however, is currently resting up in the green hills of Seattle. He has continued his work around the world-particularly with clinics in the Himalayas-but his next travel plans are a little different. In January, he intends to tackle the Tour d'Afrique-a 7,500-mile four-month monster, connecting Cairo to Cape Town on a massive organized bike race. Although his medical expertise will surely come in handy on the long trek south, he's joining the bike tour strictly as a participant this time.

"I'm just going to ride," he noted.