The Plucky PA

Greetings followers…if you are still out there.  It’s been a while and I’ve had an exciting career as a PA.  The excitement continues as I’m a PA working for the ER group at the Hospital where all this COVID19 outbreak happened here in Seattle, well in Kirkland actually.  I wasn’t the only one who had been noticing some respiratory illness that wasn’t Flu but wasn’t just allergies, and then it hit, our hospital.  I’m proud to be a part of this hospital at a time like this.  They identified something different with a cluster of flu like illnesses coming from a nursing home.  They pushed the CDC for the ability to test two of them and they caught the COVID19 outbreak and acted fast.  On a larger scale, I’m also proud to be a part of the general scientific community.   Thanks to scientists quickly identifying the genome sequencing of this virus in China and sharing it openly with the rest of the Scientific community, we might have a change to find a treatment, a vaccination and a cure.  If only everyone on this planet was able to cooperate that way we would be living in a much different world.

All this sharing of scientific information reminded me of the Antarctic Treaty and the feeling of community and family I was able to experience down there and the fantastic other opportunities I’ve had including working on a remote island in the Pacific and running a 6 person trauma MCI (mass casualty incident) in a National Park with the support of amazing other first responders.

But back to this outbreak and working at this hospital and living in this city during this current situation.  I don’t know how I’m gonna put this into words to share, but I’m gonna try.  First of all I’ve appreciated all the acknowledgement and praise from everyone.  I think as Physician Assistant that has, for the most part, has been in an Emergency setting for most of my career its second nature.  To go to work no matter what… that’s why I got a Subaru (for all of you who make fun of me).  But to hear it from coworkers, friends, neighbors, family old camp friends, and even ex-boyfriends…its really appreciated.

For some reference, I little history as to how my first week of PA school went.  I woke on the second week of PA school to hear about an attack on my city and watched as the Twin Towers fell.  I was just starting school and not heading into the ER, but it didn’t matter.  Really there were not many patients, not many survivors in that tragedy that was happening in my backyard.  But it was still my city and from time to time that sense of panic and sadness sets in.  Then I would walk through grand central to the subway passing the billboards posted of people looking for their loved ones.  An image that still haunts me as no one was found.

This is different, this is the calm before the storm.  I’m impressed actually with the government and my city for actually flattening the curve.  I can see it and we need to keep doing this.  The more people stay in the less we are passing this virus to each other. This is a smart virus…though it’s mostly killing the elderly, and immunocompromised and generally un healthy people with high blood pressure and diabetes, it it finding its way to them through the young and healthy who barely have detectible symptoms.   So that’s where we are…the calm before the storm as we await a solution, a treatment, a vaccine and a cure.  And yes, I go to work and see person after person with “possible COVID19 symptoms” and follow guidelines of who gets tested and who doesn’t and hope I give good instructions as to when to return as some will get really sick but hopefully most don’t.

I’m not going to say everything is going to be ok.  It’s not.  There is going to be a tremendous loss of life from this, there already has.  It’s going to affect people we know and there’s no way around it.  Sadly, I once worked with one of the nursing home patients that fell victim to this.  With him being one of the first deaths I had a fast and rude awakening.  It’s also been in the news about a coworker who is currently fighting this and I think about it all the time, and all my friends who are ER docs and first responders.   We are at risk, we can’t just stay home and what scares me more is if I do get it with mild symptoms, will I give it to someone else.

It’s been a rough week for sure.  At work I feel good, I’m doing what I can and what I’m supposed to as a provider.   There’s a laundry list of names and faces and people I care about that run through my head and I just hope it doesn’t take them.  I reach out to them.   I do my part in the community too.  When I’m not working I stay home in my PJs and I clean out my closet, shred the pile of papers I need to shred, make giant batches of Penang Curry and broccoli soup, wash my hands often and stay in close contact with my loved ones who hold me up as much as I try to do for them.  As much as this is physically pulling us away from each other it is also bringing us closer together.   The same feeling I had in NY after 9/11.

So friend’s and followers I just ask that you do the same to #flattenthecurve.

Below is pic from the newspaper reporting on a biological warfare drill I took part in during an Emergency Medicine rotation in PA School.  I’m the one in green. and what you can’t see is that I got to sponge down these firefighter rookies before I hosed them down! #foundmycalling

 

This is a really tough post to write.  I’ve always felt strongly against the waste problem we have in this world since the development of plastic and the issue of where our garbage is going.  I’m the girl who comes back from a leisurely kayak paddle with a bunch of plastic I picked up on the deck of the kayak.  It’s a big problem.  Back in Seattle I’m diligent about my compost/recycling/garbage sorting.  I remember my sister was once visiting and she would leave her “garbage” on the counter for fear of putting it in the wrong receptacle.

Coming to the island I knew I would be in the great garbage gyro of the pacific and I knew it would be upsetting to see what washes ashore.  Sure enough, it was disturbing.  While I got used to seeing it everyday, it was always still disturbing to see and it was difficult to walk the beaches without picking up garbage as I went along which gave me somewhat of a hopeless feeling.  I managed this by spending at least one day a week picking up at one stretch of beach between cargo pier and turtle beach.  I’d drag easily hundreds of pounds in an afternoon up to the seawall where I’d come back later in the week with a vehicle and take it to the “bone yard”.   When I told a friend back home about this, he called me Sisyphus.  Maybe I wasn’t making such a huge difference but it mad eye feel better all the other times I took walks on the beach and didn’t pick things up.  I referred to it as my beach body work out!

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Ever hear of the terms flotsam and jetsam?  Flotsam is debris from a ship wrekage that floats to the surface while jetsam is unwanted material or goods that have been thrown overboard from a ship and washed ashore.  Theres more to those terms when it comes to maritime law.   Much of what washes ashore is likely from Asia.  It is amazing, not just the quantity of the garbage but what washed ashore.  I saw tires, tubes from monitors/TVs, glass bottles, plastic bottles, thousands of bottle caps. There were lighters, tooth brushes, handles from umbrellas, plastic toys and those foam letters from the kids playroom mats.  Debris from boats like ropes, baskets and plastic tubes and funnels from eel fishing.  The video below is of a pile of debris we picked up on an island beach clean up.   It took about 12 people in just over an hour to drag all this up to one pile, the results was a beautiful clean beach that lasted…maybe a day or so before more flotsam, jetsam and trash washed ashore.

Also buoys of all shapes and sizes and occasionally an old buoy made from glass. These were a rare treat to find and a treasure for sure.  I found a bunch of small glass balls around the size of a baseball, some smaller, some slightly larger, and also what they call a “rolling pin” which is also a buoy of sorts in in interesting shape.  The real treat is to find a large glass ball, like the size of a basketball or even larger.  Those are even more real and in the time I was there I only found one.

 

 

 

One thing is for sure… the islanders like any reason to have a friendly celebration.  Sometimes it was just after dinner or pickle ball hosted in one of the backyards of the Thai residences or hosted by the company that runs the ins and outs of the island from the “morale funds”, it was always nice to kick back and enjoy each other’s company.

With a population of Thai Nationals on the island I got to enjoy some of their culture which included BBQ’s eggs, coconut rice in banana leaves, homemade poke from fresh caught fish and their interesting “Thai Whiskey.”   I called it “wood juice” since its some form of alcohol with wood chips soaking in it and supposedly it makes you “strong” (which can be interpreted a multitude of ways).   I was always on call so thankfully I didn’t partake much which probably saved me from some nasty hangovers.  The Thai’s don’t like to see an empty glass, so I had to always make sure some was in my glass or I’d instantly get a refill.

Other pastimes on the island for sure include some good karaoke and pickle ball.  I was in the tournament when I left, leaving my partner to find another teammate.  We were in the losers bracket but still in the running, hopefully he’ll take us to the final and win!

First and foremost I’m most definitely not a morning person.  Maybe it’s the full moon causing me to wake so early the past week but since I was wide awake at 4 am this morning I decided to make my coffee then head out to watch the sunrise.

With the moon all big and bright it was easy to bike across the island to the far side of the harbor where I set up my hammock to kick back and watch the sunrise over Eastern Island (another small island in this Atoll inhabited only by a whole bunch of birds).

The clouds were big and billowy and slowly moved closer where the drizzled on me.  So I just rolled my hammock around me for the few minutes of rain and hunkered down while I waited for it to pass.

I saw the usual Albatross flying around but also some Albatross chicks,Frigates, Sooty Terns and White Terns.  It was pretty, here’s some pics…but all in all, I think I’m more of a sunset person and less of a morning person.

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(While this post is in present tense, it was written while I was on the island…posted off island where the internet is much more cooperative.)

 

I’ve been off the island for barely two weeks and already onto my next adventure (stay tuned I’ll post that soon).   No more walking to those sand dunes to watch the sunset.  My last night there I went out to watch the sunset with my island peeps and they sang me a mahalo ole… a Hawaiian song of thanks, that brought tears to my eyes.  I tried to tape it, they might hate that I post it but it was just so lovely.  I had to put my phone down halfway through and stop taping so I can just enjoy the aloha of it.

The internet was super sucky on the island so there’s a lot I couldn’t get posted.  I’m going to try to knock those out soon so I can tell you what I’m up to now.  All in all I’m so glad I went to Midway.  How lucky am I to get to live on a remote island, a Fish and Wildlife refuge and bird colony?  It’s pretty much what I expected. The Thai community was warm and the nicest bunch of people, not to mention the food they cooked was amazing! (I gained at least 10lbs but they are already coming off back to my crunchy way of eating.)  The other full time inhabitants were also nice and a unique crew who, as I expected, mostly keep to themselves.  The Fish and Wildlife interns and volunteer were a lot of fun and I commend them on the hard work they do and the sacrifices they make to do it.  I’ll be following their careers on Facebook for years to come.  Being their medical provider was rewarding, to take care of the people you care about.

 

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The Island itself was probably unlike any other.  A relic of post World War II, crumbling around us, I was so brutally aware of it when I first arrived.  Bunkers here and there, and old sea spline hanger surrounded by the pitting of cement from an attack of cannon balls, and the recreational facilities for the upwards of 2000 people who once inhabited the island were so harsh to my eye compared to the background of a beautiful white sand Atoll with teal blue lagoons, giant sea turtles, snorting monk seals and birds aplenty.  The island was desperately trying to take itself back from the abuse of a naval base with the help of its new landlords.

While the medicine part of my job ebbed and flowed with the occasion blood pressure check and borderline hypochondriacs to the crushed fingers, chest pains and belly pains… it barely consumed my time.  Unlike the other island inhabitants, I had plenty of free time to explore the island.   Seeing a beach full of giant sea turtles or a snorting Monk seal was a day to day event for me.  I watched the albatross chicks grow and the affects the world has had on them all the way out in the middle of the ocean.  I filled my days cleaning the beaches (the amount of marine debris is crazy), walking the beaches, biking the island, hanging in the hammock, reading Harry Potter (on the 5th book) amongst other books about random stuff.   I got to know my little island.

Back in “the real world” is an adjustment.  It wasn’t as hard as acclimating from Antarctica.  I remember walking through the Sydney airport coming home from the ice and just not being able to cope with all the people and noise.  A couple days hanging with a friend in Honolulu probably helped with that.  Funny enough, my first night in Honolulu we walked into a restaurant that was loud and packed with people.  When the hostess asked if we wanted to wait for a table my friend said “no that’s OK, she just got off a small island” leaving the hostess somewhat confused as to what Oahu was or what exactly that meant.  Being a friend from the ice, he understood and helped with the acclimating.

So while there’s good coffee off the island, like everything else, I have to pay for it.  Having not carried a wallet for four months, paying for stuff sucks and the cute new jingle that replaced the jarring beeps on the credit card machines at Trader Joe’s just don’t make up for that.  I miss my bike back on the island.  I miss the people but they still check in on facebook.  I miss the quiet sense of peace I can find sitting on a sand dune at sunset.   So when I fade into a highway of traffic and a sea of strange faces, I know I got to have this great unique experience and it only makes me wonder what else is out there to see and do.

 

 

 

 

 

 

 

 

 

 

One of the very cool spots on the island, both literally and figuratively, is under the Cargo Pier.  The Cargo Pier really isn’t used much for cargo or mooring up a boat, at least never since I’ve been here.  It is however used plenty for recreation.  Usually by the volunteers and “Kupus” who do so much to support the Fish and Wildlife efforts out here.  Those guys work diligently to weed and plant and restore the habitat as well as monitoring the wildlife so they deserve some fun.

 

The beach near the Cargo pier is pretty shallow for a smidge then it drops of dreastically deep.  This was dredged long ago when the military was here.  Now there’s a spot where you can jump off the Cargo Pier into the deep.  Maybe it’s about 15 feet??  I’m sure it’s refreshing but I haven’t had the courage to jump off yet.  Yes I’ve kayaked miles upon miles in lots of amazing and remote places (Patagonia, the Baja outback, New Zealand, San Juan Islands and the Florida keys) and I might seem all tough and courageous but there’s something about deep natural water that freaks me out.  I know some close friends have seen this IRL. I think it stems from hearing stories as a little girl about mafia and “cement shoes” that maybe makes me afraid a dead body is gonna pop up even though I’m not afraid of water or dead bodies, just deep water where I can’t see what’s under me.

The Cargo Pier is also a great place to go snorkeling.  The water here is about 2-3 feet and I can see the bottom so I’m good there.  However, there are sharks that hang out under the pier.  Not huge ones and they’re reef sharks (whatever that means but the way people say makes them sound “safe”).  I’ve snorkeled up near some and they look just a few feet long so I guess they can’t do that much harm.   It’s cool to snorkel though I’ve been laughed at for standing in the water wearing my mask w my snorkel in my mouth and just looking down from about 3 feet about the water level (5’8”-about 2 1/2 feet of water).

The Cargo Pier reminds me of the Giving Tree…  it offers so much to add to the happiness of the island residents.  The other day when it started to rain it offered shelter and a dry place for us to read our books.

And I guess you don’t always need two trees to do one of my favorite “activities”…

WE LOVE YOU CARGO PIER!!!

 

 

 

Midway is not only a Fish and Wildlife Refuge but also a National Memorial for the Battle of Midway which took place 76 years ago on June 4th 1942.
During our orientation here we watch a video of some veterans who lived out here talking about the friends they lost.  They paid the ultimate sacrifice to help us win this battle that was a turning point for the Us during WW2 shortly after the Japanese bombed Pearl Harbor.  Everyday I see signs of that battle that was fought here.  Amazing that this tiny little island of sand sitting on top of an old coral reef could be so important to our nation’s security.

 

 

 

I mentioned before that these Albratross are probably the goofiest and silliest birds I’ve ever seen, and they are everywhere.  All day long I see them having their silly interactions and dances like I posted previously.  It took some time to get a good video of them trying to take off.  They have a giant wingspan and pretty big floppy feet that go “flop, flop, flop” as they run down the road, the field or a path towards the beach.  Make sure you have the sound on for these videos to really appreciate the  silliness of the take off.

 

Landing is another story usually a face plant is involved.  HoweOnce airborne they are really a beautiful bird with a wingspan that’s got to be 5 feet wide.  If they fly close overhead, especially on a sand dune on the beach, you can really hear them “swish” by.  Here’s a slide show of some shots I took sitting on said sand dune…

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Per request, I’m adding some more “bird stuff” to the blog and I’m happy to do it.  I’ve been totally into watching the White Terns lately.  They are just a beautiful bird.  This white bird really has the most “pretty” eyes and they love to check you out with them. They are very curious creatures.  Often if I’m walking or biking by they will hover pretty close to me and look right at me, sometimes with come chatter that someone here described as “doink, doink, doink.”  When I’m biking along I know they are flying along side me without seeing them because I see their shadows right along with me.

It’s mating season for them now so I often see them flying around in pairs. Or even sitting on a branch together in a pair…

And the chicks are just as adorable!!!

 

 

I only have 6 weeks left and I still haven’t seen everything on this island. Since the days of WW2 the island has been returning itself to nature.  The Albatross are making nests, the Petrels are making burrows, the sand is blowing over old roads and the Ironwood trees are taking open fields and turning them into forests.

Biking around I can sometimes find a break in the trees or bushes that could have been an old road and I try to follow it without falling into my island nemesis…the petrel holes.  Last month I walked a total of 10 miles around this island that is only 2.4 square miles.  I found an old road that went into an Ironwood forest on the other side of the old airport runway and followed it. The Albatross nesting in there so rarely see a human, some were curious, but most clumsily stepped away tripping over branches and the like.

There wasn’t much back there, rumor has it that area was the most classified as to what was going on back there but now any buildings are essentially torn down leaving only a cement foundation in some areas, some mostly covered with the forest floor.  I did find one old bunker.  These hidden bunkers come up on you by surprise sometimes and though often open, they are super dark inside as you walk up to them.  I found this one deep in those woods that probably held some ammunition, who knows?!?!

I also walked down the south side of the island that day, on the other side of the “active” runway.   Planes only land here every 2 weeks to bring people and take people off the island.  It’s “active” because it also serves the FAA as a place for emergency landings from North America to Asia though only about 2 flights have had emergency landings here in the last decade (that I’ve heard of).   The entire south beach is closed for the Monk Seals who are currently pupping and are an endangered species so we really don’t tread on these beaches to give them their space and security to know they can return year after year.  I was able to peek out through the Naupaka Bushes to catch a glimpse of this “pill box” where soldiers were stationed with machine guns protecting that beach and the island from the Japanese during the Battle of Midway.

There was also another hidden bunker nearby, likely where more ammunition was stored. Hidden in the corner was an albatross.

There’s still another area in the woods that I haven’t yet explored but I read a lot about in a book about the island. Lots of top secret stuff. I’m for sure going to check it out in there before I leave. Surely all the buildings are torn down but maybe I’ll see a ghost! Maybe I’ll shut the lights out when its bedtime and I’ll be glowing from who-knows-what I got exposed to in those woods!

Stand-by for more “Scary Places.” I have a few more places I know of that I know are super spooky (that’s why I haven’t gone there yet!). Need to refill the batteries on my headlamp first. Eeeeek!!!!