Many people are needed to keep base life running smoothly. There are mechanics and electricians, chippys and project managers, chefs and field assistants, radio (comms) operators, meteorologists and weather forecasters, pilots and plane engineers, base assistants (who drive the heavy machinery) and so on. And in order to keep all these people happy and healthy, there are two doctors on base in summer. This summer, Rothera has Dr Rose Drew and Dr Jen Hine. In this blog post, I conduct an Interview with the Doctor at Rothera Research Station.
Rose is normally an anaesthetic registrar in Sheffield, but has taken a career break to come down to Rothera. She will be here for 18 months, providing medical support during the long and isolated winter. During winter, the ships cannot come because the sea ice, and the planes fly north to Canada for essential maintenance and repairs. Flying into Antarctica during winter is extremely difficult, so medical evacuations are avoided at all costs. Rose must be able to cope, alone, with any emergency that could be thrown at her. I talked to Rose to find out more about being a doctor in this isolated, remote environment.
Life as an Antarctic Doctor
Rose must not only be a doctor, she (and Jen, during the summer) is also a dentist, pharmacist, nurse, physiotherapist, radiographer, tour guide for new arrivals, and perhaps most importantly, post mistress and shop keeper. In order to be able to do all these roles, all BAS doctors undergo six months of training at BASMU (BAS Medical Unit) at Dereford in Plymouth. BASMU also provides advice and support over the phone and through email, and Rose can ask the consultants there for a professional opinion. Learning dentistry is one of the most important parts of this training.
Although Rothera has reasonable facilities, there are obviously differences to Rose’s normal working environment. First and foremost, there are no other medical professionals. The doctors must be completely self-sufficient. They do have a ventilator, an anaesthetic machine, cylinders of oxygen and an oxygen concentrator, portable oxygen, surgical equipment, X-Rays and the ability to plaster broken bones, but they do not have any more imaging equipment (CT, MRI, Ultrasound). They lack mod-cons, and much of their equipment is rather dated, but still serviceable. The x-ray machine, for example, takes x-rays on film, which must then be developed in the dark room. Most hospitals nowadays take digital x-ray photographs. They have an impressive store of drugs, and can treat most ailments. Serious injuries are always medi-vacced to a hospital.
On a day-to-day basis, Rose’s duties are to provide a daily surgery (open 0830-1030, or as required), to look after the field medical boxes and keep their supplies and drugs up to date, to maintain the pharmacy, to train the winterers in Doc School, and to help out on base in general. Rose, for example, is training to crew the dive boats and may be able to cox them by the end of her winter. The doctors see, on average, one to two patients per day, and expect to medevac around three people per year. However, all people pass a medical to come to Rothera, they are self-selecting to be fit and healthy, and they tend to be a younger cross-section of society, so serious illnesses are not too common. Most people come to Rose’s surgery with musculo-skeletal problems, often associated with their physical outdoor work or from falling skiing. All wintering doctors also do a Masters in Remote Healthcare, and will do a dissertation during their winter. Rose is going to investigate the effectiveness of the anti-carbon monoxide measures taken in the field.
Challenges Down South
Rose was drawn to come to Antarctica by the opportunity to get to know a small group of people really well. She has previously been the doctor for a number of expeditions, and enjoyed the unique challenge that these presented. She was also intrigued by the different working environment, and by the romance of Antarctica. Who would not be drawn by glaciers, penguins, seals and icebergs? She was also interested in getting to know a very different and diverse group of people; to learn new skills and to challenge herself personally.
But some of these things can also make medicine difficult. Rose must be the doctor to her friends and colleagues, and this can present a unique challenge. She will see people every day, and will know if they are ignoring her advice! Living, working and being friends with your patients can be difficult. Rules about patient confidentiality can be difficult to untangle if your patient starts discussing their ailment with you in the bar.
Rose is responsible for health and safety on base and if she sees an unsafe activity, she will stop it (she doesn’t want any more work!) – and risks being a killjoy. One of the doctors is always on duty and therefore cannot drink or really let their hair down; in winter, this responsibility will be entirely Rose’s. She will occasionally be off base in winter – on a winter trip (each winterer gets a trip as a holiday), or out for recreation. In these circumstances, people are warned to make sure that they remain safe and well! The doctors are on call at all times, which means that they cannot entirely relax.
Partly in order to give themselves reassurance (who says the doc can’t fall?), and partly to fill the gap left by the absence of assistants, the doctors train up their winterers to be Medical Assistants. Doc School covers such things as plastering broken bones, major incidents (when they need all the help they can get), putting IV lines in people, giving injections, and developing X-Rays. The winterers volunteer, and are generally eager to learn new skills.
You can follow Rose’s own blog here: www.AnAntarcticDoctor.co.uk