Creative spirit

April 26, 2012 / Sheila / 4 Comments

“If we let ourselves, we shall always be waiting for some distraction or other to end before we can really get down to our work. The only people who achieve much are those who want knowledge so badly that they seek it while the conditions are still unfavorable. Favorable conditions never come.”
― C.S. Lewis

I’ve been thinking a lot about time, and the spending of it. I go through my days, spending my time, as if there were an infinite supply of the stuff. I have periods of great energy, great productivity, and then I slump. I hit the proverbial wall. I do the minimums. Get through my days, do my basic chores, exist. This is a frequent lament.

Why do I cycle? I can’t point to any outside influence. There are times of hurriedness, of pressure, and periods of casualness. This isn’t solely about having weekend time, or time carved out of a traditional work life. It is about a cycle of energy and creativity.

I’ve finally come to see this cycle as a break in my ability to create. And I’ve come to recognize that my creativity thrives when I am writing or engaged (whatever the activity) for the pure pleasure and desire to be creative. I am not writing or creating for other purposes. Something more may eventually come from my creativity. Let it! I would love to experience new opportunities because of work I’ve done. But for me, the work should be done for its own reward, and stand on its own merit, first. And here is where I also acknowledge: I am my own audience. This is not an exercise in self-absorption; it is an exercise in self-expression. I am writing, creating, to express myself. Period. If something I write or create touches someone else, I am humbled and happy. But that is not the focus. It can’t be the focus. Because I am not a wise woman, sharing knowledge with others. I don’t have profound thoughts. I have thoughts. I am a woman, sharing my experiences. Others can determine if there is wisdom, or joy, or humor, or anything else of value. I have come to see that creativity is its own reward.

I began this year thinking that I wanted to create a new way to work, and that I wanted to channel my work through writing, through online opportunities. I still want that end result. But I am coming around to the realization that, for me, this process has to begin with the desire to write, rather than the desire to create income. The two may be connected. Or not. I don’t have the answer to that yet. But I know that if I am writing from the heart, the practical details will sort themselves out in time. That’s the nature of life. Maybe some people can make it work from the other direction: set a goal and create to fulfill it. I can’t, and it’s time I acknowledge that.

Obsessed champion

April 21, 2012 / Sheila / 10 Comments

This week I gave myself a new title. I am an obsessed champion! This is a new term to me. Have you noticed how corporate entities embrace favorite trendy words…you know, the terms that you’ve never heard before, until suddenly, you hear them at every meeting, every week? I’ve been out of the corporate fold the last few months, and am back now doing a stretch of relief work. It is possible that this is the new buzz word, and I’m just late hearing it. Or maybe this is unique to the organization I’m working for. Either way, I thought it had a certain charm. “Obsessed champion” is just someone who is very focused, and very excited about…something. I met this term in the context of a new program being rolled out soon in my region, and employees will be recruited to be “obsessed champions,” spreading enthusiasm to the rest of the staff. Sort of like spreading a virus, only with positive impact.

I plan to make this a flexible title for myself. I’m not going to squander it on a one-shot deal, or some program being rolled out at work. Oh no, I’m saving this for things that are really noteworthy in life: the most decadent dessert, or a great new book; a nifty do-it-yourself skill, or some amazing new product. I can think of a lot of potential uses.

Wonder how this will look on my business card?

March 28, 2012March 28, 2012 / Sheila / 17 Comments

Chasing rainbows in the Caribbean

Periodically, for various reasons, life needs a reset. We are in one of those times now, and have been for a while. We began our Alaska adventure in 2006, and through ups and downs, good and bad, it has been an adventure. But now we find ourselves ready for a new address, one that is drier, warmer, and has potential to be a long-term home for us. We started this process last year, but a slow housing market and our own indecision derailed us a bit. We’re ramping up to try again this spring.

Most people (I think) make the decision of where to live based on job, family, or some combination of likes and life needs that help to narrow the focus and direction. We did too, in the past. We moved for training and jobs, and we looked for opportunities in regions of the country that we wanted to explore. Family is important, but with family spread far and wide, from east to west and across time zones, it is difficult to use family, at this point, as a filter. We find ourselves without a lot of anchors. We certainly know what states and regions draw us, interest us, and there is temptation to re-visit the places we lived in the past that we enjoyed. But we also know that it is important to make a good decision, and that means taking time, doing our homework, and looking beyond the most obvious options.

To complicate the process, we still have a house to sell in Ketchikan, where the market in our price range is not robust. And we will likely continue to work there for the foreseeable future. We are networked, and known entities, which is important when you work like we do. We can search without the house being sold. And as we have an episodic work style, we can structure time to travel and investigate in our time off. The downside to not working is that we don’t get paid. There is no paid leave in our work structure. But the upside is that we can put together significant blocks of time for exploring our options.

There are all sorts of online tools to help you. There are lists for every type of filter you can think of…low tax rate, health care facilities, climate, population, amenities, recreation, mountains, beach, schools, organizations…choose your priorities and you can find a list of places that will accommodate your must-haves and your wish-fors. One of these is Find Your Spot. There are lists from any number of periodicals and organizations. You can also find a plethora of information on any community online by going to resources like the local Chamber of Commerce page or the website for specific cities. Information is not the problem. Filtering it appropriately is the difficulty.

Aside from doing online research, another resource we have is a Class C RV, which is large enough that we can live in it for extended periods of time without going crazy or coming to blows. Our plan is to use it to do some in-depth exploration of various regions of interest, to use it as our mobile hub. We tried this once before, and it was working quite nicely, when we sidetracked ourselves by accepting a job offer. This time, we’ve agreed: we’re not looking for full-time work, and we are choosing the location we want. We’ll make jobs work around our choice.

Dinner on board: the wanderers

So, with all that said, I’d be interested in hearing ideas from anyone reading this post. We like the west, the not-too-cold mountain west, the southeast, and the mid-Atlantic. We like small to medium size communities…no big cities for us, although it is desirable to have a city within a reasonable driving distance for airports, shopping, etc. We like ocean, mountains, and lakes, but realistically, would probably not choose to pay for an ocean front view. This choice needs to be sustainable in every way. So ultimately, we are looking for a place that offers a variety of amenities, a cost of living that is not extreme, and a place that feels like home. Any ideas out there? We’re open to suggestion!

Full time, temporary

February 18, 2012 / Sheila / 3 Comments

There are many different work styles. I only knew of a handful until the last few years. I knew people worked regular 5 day work weeks, traditional schedules that you could count on. People worked in rotating shifts, or worked out of town, doing things like flying planes or driving trucks. I knew of part time work. But living in Alaska has been an education in work style creativity.

The energy industry in Alaska seems to run in two week shifts…two on, two off, and people commute from other states, or great distances within Alaska, to accommodate this schedule. There are people who live here during the school year, then live in “America” (aka the lower 48) for summers. Some, like Rob and me, work in varying blocks of time. Full time when working, but working as temporary staff. I didn’t know, until Alaska, that many, maybe all, healthcare professionals can work this way. Physicians, nurses, lab, x-ray, allied health professionals…all can work from a few weeks to a few months, then move on to the next place. In a hospital setting, they’re called “travelers.” Travelers often rotate with a particular health care institution, cycling in and out. Even temporary faces become familiar after a while. Many other professions have a seasonal cycle here. Tourism, construction, even forest service jobs are full time and temporary, typically excluding winter months.

So what’s the benefit to working this way? The two week on, two week off workers and teachers are in their own category. These folks really are employees. They have employment with benefits and diversity of location. Those working in block time are typically contractors, and may or may not have some benefit structure in place. Rob and I do not have benefits. We pay our own health insurance, to the tune of about $1000 a month for the two of us. We make a better rate for unit of time, but there is no paid leave, no access to other employer benefits for us.

What we do get is freedom, and change of pace, scenery, and people. We are free to commit when and where we want. That doesn’t mean we don’t work, but it does mean we can decline to work if we want to be “off,” or we can choose which organization we will work for. Currently we have multiple options for work, so we have choice. Commitments are typically a week at a time, minimum, and we are able to plan weeks, even months, in advance.

What does all this mean? It means we are sometimes in Ketchikan, working in the clinic there, and at home. The rest of the time we’re working, we’re in small bush communities in SE Alaska, living in furnished apartments, not quite living out of a suitcase, but definitely not at home either.

If your family structure is flexible, if you can weather weeks when you are not working, and are thus without income; if you are not climbing a corporate ladder, or running your own business empire, you too could work like this. Maybe the question is: why would you want to?

This is our transition plan to our next stage. Not sure yet what that will look like, but in the interim, we need time to explore other geography, other ways of earning an income, and our own interests and desires. We also still need income. I describe it as being at that awkward age…too young to retire, but ready for change. Working in block time gives us ability to structure travel and time to think, which is essential when you’re planning a reconstruction of your life.

To live this way, and assuming you’re not just working for the fun of it, you’ll probably have to cut some expenses. And you have to have financial cushions. You have to think outside the box. And you have to plan. This takes a lot of planning.

At this point in my life, I’m relaxed enough to enjoy living this way. I have to be honest to say that Rob invented this lifestyle for us. I wouldn’t have done this on my own. I’m not inventive. I only go outside the box when I’m dragged out. But once I get out, I usually like it.

So, on with our year of transition. That’s what we’re calling it. It may or may not be a year by the calendar. But I can already tell: we’re definitely in transition. See you on the merry-go-round!

This is a problem money can solve

January 25, 2012 / Sheila / 10 Comments

Tonight we came home from work, and I discovered an unpleasant surprise: the load of laundry I had left going this morning had been washed with a tube of lipstick, and several things were ruined…or at best will only be salvaged with a lot of effort on my part. I think there are a few things that will be total losses. Since we’re in an apartment (for this work stint) that is somewhat sparsely supplied, there were no stain treatments with the laundry supplies. I drove back to the small grocery to see what options were available. I bought four different products, hoping that something would help.

After an hour of rubbing, scrubbing, soaking and working, I had made some progress. Enough to let the things soak while we ate dinner. While we were eating, we talked about our day, Rob in the back of the clinic seeing patients, me in the front, dealing with forms, schedules…the admin side. As I’ve said, I don’t do blood.

The other staff members are great; some of them have worked here a long time. They know everyone, and everyone’s story. I hear bits and pieces, put a few names and faces together. The last time we were here, I got a little taste of clinic life, the up close and personal view you get of patients when you sit at the front desk. But when I was here before, I was primarily training staff. I had limited exposure to the patients coming and going. Not so this trip. I’m working at the front desk, filling in until the new hire starts. It was a convenient opportunity. Rob was already scheduled to work, and it was nice that I could come along, and be paid to be here.

The view is different from the front. For the past five years, I’ve worked in healthcare administrative offices, hospital settings that put me in the healthcare arena every day. But in my role, I’ve primarily been involved with the business of healthcare. I’ve had almost no patient connection. The past few months, working with document management, and now sitting in the front office seat, I am seeing the patient population for the first time.

Of course I’ve known they were out there, real people with real illnesses. I’ve witnessed the healthcare system in a limited way for myself and my family. But we’ve been fortunate, and healthy, by and large.

Now I’m seeing, from a perspective I haven’t had before. Patients come in for everything from colds to cancer, broken bones to pregnancy. They come in all ages, shapes, sizes. This is a primary care clinic. Some patients’ stories are poignant reminders that life is fragile. Some are working the system…what can they get for pain? What diagnosis will get them a trip to a specialist in Seattle, conveniently paid by Medicaid? It is unbelievable, the parade that passes on a daily basis.

There are happy patients, women in for prenatal visits, or young parents with little ones for routine checks. There are older folks who come to be monitored for some condition, but who are generally well.

And there are the others…the ones with serious issues that usually can’t be fixed, or cured, or healed. They have too many complications, too many barriers, and many people are their own worst enemies. I often see references to behaviors that are creating the reasons patients come to be seen. But regardless of cause, self-inflicted or just an act of nature, it is a sad thing to look at people who are broken.

This afternoon I saw a man who is obese, can only walk with a walker, who looked hopeless, almost lifeless. He has a heart condition, but I don’t know what brought him in today. Regardless, he’s in bad shape. Then I saw his wife, who had come to pick him up. She is a cancer patient who had part of her jaw removed. It is unsettling to look at her. I found myself looking away, uncomfortable to see someone who has been literally defaced by her disease.

I sat tonight, eating dinner, frustrated at my own innatention to detail that allowed me to wash a tube of lipstick with the laundry. If I had only checked my pockets! And of course, several things I had recently bought were in that load.

But as we ate and talked, perspective grew. My thoughts cleared, and I realized, in the words of a friend, “this is a problem money can solve.” Worst case, I spend a little money to replace what I can’t salvage. The truth is, I’m as irritated at myself for causing the mishap as I am over the ruined clothes. I get impatient when I do foolish things.

Well, there are enough bumps in life to keep me appreciative of days that run smoothly. But no ruined laundry, fender bender, burned dinner…name your pet peeve…can compete with the sadness of serious illness, life-threatning disease, chronic pain. And so far, I’m blessed to be free of any of those conditions. So with that perspective, a little ruined laundry doesn’t seem too bad. Hey, it’s all replaceable or fixable, and non-essential. I mean no disrespect toward the value of money…I know money, or the lack of it, creates hardship too. But that’s another post. And still, in the big picture, things are just things.

I wish I could say I won’t need to be reminded of this again. But that isn’t true. I’ll be frustrated at some other slice of life in a few days, or a week or a month from now. And I’ll have to remind myself what’s important. Who’s important. And that if money can solve the problem, it isn’t really a problem after all.

January ReVision

January 15, 2012January 16, 2012 / Sheila / 6 Comments

So, two weeks since my last post. Seems longer than that! How quickly my rhythm is derailed by work, travel, and life pressing in!

The first week of January was a mix of work, two days in Ketchikan, two days at the clinic in Metlakatla. I’m doing some project work there, and I try to coordinate with Rob’s schedule when he is there. We came back to Ketchikan on the 7th and traveled to California last week, to give a helping hand with a family need that is brewing. Got home last night to begin another week.

While I’ve been distracted, I’ve been out of touch with my fellow bloggers, reading many posts, but commenting on none, and I haven’t made so much as a keystroke on my WordPress site. I’ve missed it, the little community of bloggers. (My community is small; of course the overall blogging community is enormous.) This happens to me on a fairly regular basis. When I travel, I’m an infrequent writer.

But not an infrequent reader. I’m researching my next phase in life, and here’s the plan: I’m going to test my services on myself. That’s right, I’m going to be my own first client. I want to create a business that works with people and organizations to reinvent themselves. Call it a mid-course correction. Just like I need. My term for this is ReVision. That works nicely with the writing concept, which always requires revision. There are so many lovely “re” words…renew, restore, repurpose, refocus, revive, redesign…all referring to some sort of do-over. Just like I need. The other piece that works nicely is the concept of vision. I need a new vision for my life. Rob and I want to make changes in how we work, how we live. He’s fueling us while I come up with a plan.

So I’ve been mulling over how to make this happen. How do I take the life experience and the education I have and translate it to a service that helps people reinvent…ReVision….themselves? I have hazy ideas. I see potential. I need to synthesize a lot that I’ve read, a lot that I’ve experienced, and a lot of possibility. I began to think if I could do it for myself, really make the changes I need, I could do it for others.

We’re beginning a process of life mapping and I’m reading a lot, everything from Entrepreneur magazine to recent books on happiness and fulfillment.

In the meantime, I’m working on a logo, business cards, putting together content for a website. I’ve created lists and lists and more lists. I’m energized and motivated. And I’m hopeful.

And wouldn’t it be nice if I’m successful? Oh, I’d like to be financially successful. That’s part of it. But more than that, I’d like the concept to be successful. Of course, there are consulting firms and life coaches already doing this. But this particular venture would be my own, would have my unique stamp. My unique vision. I’m curious to see how it turns out. I’m curious to know how the story will unfold. I need a new vision. I need a ReVision.

Last Friday of the year, last day of full time

December 30, 2011 / Sheila / 9 Comments

Well, it’s finally here. If life goes as I’m planning, I’ll be in my office tomorrow for my last day of full time work. Not that I’m retiring…oh no, I’m at that awkward age…too young to retire, but old enough to be ready for a change in my work life. And definitely still in need of income…haven’t won the lottery yet, or made the proverbial fortune.

So I’m launching…I’m not quite sure what, just yet! There are ideas rolling around in my head…possibilities…I’m cushioning the first few weeks with some project work and relief work I had already lined up. But I’m also building in down time. I’ve discovered it is almost impossible to design a next step in life when you’re consumed by the commitments you’ve already made.

Some days I’m brimming with ideas and energy. And some days I’m scared. I haven’t been without income for twenty years, except for a few months here and there when we’ve made a geographical move. I’m also lucky. I have savings, and I have a safety net. Rob is able to keep us afloat while I sort myself out, so this is not going to be an experiment in Ramen noodle recipes.

I’m excited because I get to see what I can do, all on my own. I’m scared because I get to see what I can do, all on my own. If you’ve stepped away from the corporate security blanket, you know what I mean. I keep reading about all the entrepreneurs this economy is producing, and I hope I can soon be part of that group.

I’ve been a great employee, if I do say so myself. I take direction easily and work well with others. How can it be so frightening to take control of my own destiny and be the one in charge? I think it may be a matter of experience. I’ve only known what it is like to work in a corporate structure. The freedom and reward I’ve glimpsed are out there, somewhat obscured by the risk of solo flight.

Well, in a few more hours I’ll know. Or at least I’ll begin to know. Do I have what it takes? Can I transition to a self-starter? Here’s hoping! May the bridges I burn light the way! And may the future be bright!

See you on the other side of the new year! Happy 2012!

Monday morning Cinnamon Rolls

December 11, 2011December 11, 2011 / Sheila / 12 Comments

So tomorrow I’m bringing cinnamon rolls to work. These are not from a bakery or out of a refrigerated roll tube. These are homemade, gooey, delicious and oversized. These are the real deal. The recipe follows below.

But first, let me tell you that this isn’t just a bit of holiday festivity for co-workers. No, this is part of my work philosophy. I believe in doing a good job of fulfilling my responsibilities. But there are things that go along with doing a good job. This is what I do try to do:

~ Try to say “yes” more than “no.” Be positive. I call this my “yes policy.” This is not about being a “yes man,” or about letting others dump on me. It is about being willing to try, and being gracious.

~ Be transparent; apologize when necessary; take responsibility!

~ Smile; have an attitude of gratitude. But be sincere; you can’t fake this.

~ Commit to what you’re trying to accomplish; coach it; be it.

~ And last, bring food. I’ve never worked in any setting where good food isn’t appreciated. This isn’t about getting anything in return. This is about now and then sharing a treat, whether homemade or a pickup from the local doughnut shop. I used to buy ice cream fudge bars or ice cream sandwiches in the summer to take in at a past job. It really doesn’t matter what the treat is. Just do it, and do it regularly.

Cinnamon Rolls
(thank you, Ann!)

I’ve never had a failure with this recipe; it was given to me by a dear friend whose skill in the kitchen is legendary! This isn’t a recipe to make if you’re watching your calories. But for those occasions when you want a wonderful breakfast treat, to pull out all the stops, this is a winner. Although the instructions are long, each step is actually quick and easy…don’t let the lengthy instructions intimidate you!

The dough is easier to make if you have a stand mixer (like a Kitchen Aid) so the mixer does the work for you. You do not have to knead the dough by hand, you only need to mix it with the dough hook. (If you don’t have a stand mixer, you can mix the dough by hand, that’s easy too).

I break this into three steps and it keeps the whole process from being too lengthy. To have warm rolls for breakfast, (this is our standard Christmas morning treat) mix the dough the afternoon or evening before. I usually try to mix the dough early enough in the afternoon so I can let the dough rise six hours and then roll the dough out and slice before going to bed. When the dough is rolled out, sliced, and the rolls are put into the baking pan, I cover the pan with Saran wrap, slide the pan into the fridge, and leave it overnight. In the morning, I put the cold baking dish into a cold oven. (Very important! Never put a cold dish into a hot oven; if the baking dish is glass it might crack.) I put the oven on the lowest temp, about 170 degrees, let the rolls rise about half an hour, or until the rolls have at least doubled in size, then turn up the oven to 350 degrees and bake the rolls for approximately 35 minutes. While the rolls are baking, mix the icing. This only takes a couple of minutes, so the whole process in the morning is just a matter of putting the rolls in the oven and drizzling the icing over the rolls after baking.

An alternative, if you have time, is to allow the rolls come to room temperature and rise till the dough is at least doubled. If your timing allows (perfect if you are serving these at brunch), just take the rolls out of the fridge in the morning and let them sit for at least a couple of hours prior to baking. If they still need a little more rising, you can always speed the process along a bit by putting them into a low-temp oven as described above.

Dough
1 cup softened butter
1/4 cup sugar
1 cup hot water
2 eggs
2 tsp salt
2 packages of active dry yeast
1 cup warm water, or you can use 1 cup of warm milk instead of water
6 cups of all purpose flour

Combine the butter, sugar and hot water in mixer bowl. Stir until butter is melted. Allow this to cool until just warm (if mixture is too hot, it will kill the yeast). Add eggs and salt to butter mixture when cooled. Combine yeast with 1 cup of warm water (or warm milk if substituting milk for water). Give the yeast a few minutes to proof (it will foam up). Add yeast mixture to butter mixture. Add flour 2 cups at a time and combine using mixer dough hook. When all the flour is added, cover the dough in the mixing bowl and refrigerate for six hours or overnight.

Filling
1/2 cup (1 stick) softened butter
brown or white sugar, 1 1/4 cups (more or less, to taste)
cinnamon (use a lot, these are cinnamon rolls!)

After dough has risen in fridge, (dough should be at least doubled in size) remove from mixing bowl and roll out on floured surface. Roll dough out to about 1/4 inch thickness in rectangular shape. Spread surface of dough with softened butter. Sprinkle buttered surface of dough with granulated or brown sugar, then with cinnamon. Cover the dough liberally with sugar and cinnamon. Roll up jelly roll fashion and slice rolls about 1 inch thick. Arrange slices in baking pan and allow to rise. You can let the rolls rise at room temperature for a couple of hours, or turn the oven on the lowest temperature (about 170 degrees) and let the rolls rise in the oven for about half an hour, as described in notes above.

When rolls have risen (at least double in size) bake at 350 degrees for approximately 35 minutes.

Icing
Combine a couple of tablespoons of melted butter, powdered sugar (I use two or three cups of powdered sugar) and milk (drizzle a little milk in until the icing is the consistency you want. It can be spreadable or pourable). Add a teaspoon of vanilla to icing and spread over warm rolls. If you make too much icing, this will keep in the fridge for several days. You can also use this icing on almost any dessert…handy to keep around for pound cakes, etc. For those who love cream cheese, add 3 or 4 oz of softened cream cheese to the icing and blend to remove any lumps.

Orange Rolls

I stumbled on this option (I was out of cinnamon and discovered my predicament at the last minute when I was making these recently) and it makes a nice citrusy treat.

All the steps for making the dough are the same, through rolling the dough out and spreading with butter and sprinkling the dough with granulated or brown sugar. I use less sugar in this variation, and I don’t measure these amounts, but I cover the dough a little more lightly with sugar than when I am making the cinnamon version. This can be adjusted to personal taste. After spreading the rolled-out dough with butter and sugar, using a jar of orange marmalade, (I use Smuckers marmalade) spread this over the sugar, roll up, and slice rolls to place in baking pan. (The marmalade can be a bit tart, and I use the sugar in the filling to cut the tartness of the orange peel in the marmalade.) Allow rolls to rise and bake as described above.

For the glaze, instead of adding vanilla extract and milk to thin the glaze, I use orange juice and a few drops of orange flavoring, or you could grate a little orange zest in the glaze if you have a fresh orange. Don’t add cream cheese…you just want to punch up the orange flavor.

Community in action

December 8, 2011 / Sheila / 17 Comments

In the last week I saw a community in action…well, it was a small group within the little town of Craig, AK. But these people accomplished a feat. They were able to get a man, virtually homeless and penniless, to the care of physicians at Duke University Medical Center in Durham, North Carolina.

This is the story.

Rob and I came to this clinic to work for three weeks on November 28. During our first few days, there were several conversations among clinic staff about a man who was in dire need of medical attention. He has no insurance, no money, and almost no support structure in Craig. I learned he had come here some time ago to take care of his mother, who died last year. He has some social issues, to put it politely. To put it bluntly, he is dirty, agoraphobic, and has a noticeable odor.

This man became a patient when he’d recently experienced a change in his voice. 50-ish, he has been a long-term smoker. A man in town who befriended him persuaded him to come to the clinic a few weeks ago to get checked out. A large tumor was found to be pressing on his vocal chords and impacting his airway.

The front office staff began to work on getting care lined up. You do not treat cancer in Craig. You leave and travel to a large medical center to get access to the various specialists your condition requires. From this region of Alaska, that resource is most often found in Seattle, WA. But in this situation, sending this man away with no funds and no support wasn’t an option.

It was discovered that there is a brother in North Carolina, living near Duke, one of the largest medical research facilities in the country. A medical referral was made; social workers contacted. The brother there agreed to receive the brother here. Medical costs will be underwritten by Medicaid.

But…Alaska is a looong way from North Carolina. It is expensive to make a trip like that. And this man couldn’t get there on his own. Turns out the brother is in financial difficulties too, so also unable to finance such a trip. Typically Medicaid will cover travel costs, but for some reason, not in this case.

So an application was made to a national organization that provides free air travel for medical emergencies…just like this situation. For a few days there was faxing and phoning back and forth. The office coordinator spent hours of her time working out details, making calls to solidify plans, meeting with the patient to reassure him of progress.

Then three days before the patient had to travel, the flight plans fell through. The organization was willing to cover travel to Seattle or Anchorage, but not to a location so far away, and outside the standard medical destinations for needy Alaskans. The manager was very polite…he wished they could help everyone, but this was clearly outside their policy parameters.

So, back to square one, with the clock ticking.

Someone suggested the local community cancer coalition might help. The office coordinator called, and within half an hour, two ladies representing the coalition were sitting in the clinic, listening to the story. Turns out they provide up to $1500 to cover travel expenses for medical care. You make an application, make the travel arrangements, and apply for reimbursement.

Someone produced a credit card. Airline ticket, ferry ticket to Ketchikan, airport ferry ticket were all purchased. The coalition would reimburse with a check.

The ferry travel to Ketchikan was full price, but when the accountant for the ferry company came in to the clinic for an appointment, the office coordinator mentioned to her that the staff was trying to assist this patient. The ferry accountant immediately offered to get the fare discounted, which she promptly did.

A nurse from Ketchikan with family in North Carolina was already scheduled to fly back and offered to escort the patient through the travel stages. The friend who brought the patient in escorted him to Ketchikan so he had no time on the journey that he was alone or without support.

So, a small town that supports a local cancer coalition, clinic employees, a caring friend, a nurse traveling home, a brother a long way off, social workers and medical providers on the other side of the country all worked together. And they pulled it off.

I don’t know how this story will end. I don’t know if this patient has a chance of surviving. I do he would have had no chance if he had stayed in Craig. Whatever happens, he has the gift of possibility this season. And the gift came from the community, given freely, knowing there would be no payback for the time, money or energy that it took to be successful.

Even more poignant, this man is not from Craig; he is not a pillar of the community; he is barely known here. But they helped anyway. No one will get credit, or special notice, for this effort. But this man will get a chance.

This isn’t a Christmas story of a gift given because of the time of year. Timing had nothing to do with it, except that the need was urgent. But it shows me the best of small town life. Small communities don’t have large medical centers. They don’t have unlimited resources. But when you need to get something done in a hurry, you know who to call. You’re not a faceless application form in someone’s email. And that’s the second part of this story.

Small towns can show off the best of community. And I just had a front row seat.

Craig, Aaska, take two

November 29, 2011 / Sheila / 4 Comments

It’s Monday and we’re back in Craig, Alaska. Rob will be working here the next three weeks, and I’m here to do some training for PeaceHealth. I’m winding down, about to enter my last full month of full time. Scary, daunting, exciting, a little surreal. Here we go!

This time we’re staying in a different place. When you do locums work (filling in for a permanent provider), a place to stay is part of the package. The accommodations can vary greatly. We’ve stayed in bed and breakfasts, efficiency apartments, cottages, hotels…The nice thing is that usually the place comes with basic kitchen stuff so you can have coffee and do as much cooking as you choose without going out for every meal. (I like to go out, but on rainy dreary nights, I just want home, and the comfort of getting cozy.) The place we stayed last week for Thanksgiving even came with a Butterball turkey in the freezer, the clinic’s holiday gift to each staff member. However, I did not choose to make the turkey for the two of us. We shared the holiday meal with several others and I brought my southern-style creamed corn and sweet potato casserole. The turkey (still frozen) flew home with us on Saturday and is now living in my freezer in Ketchikan. Hey, I’ll make a turkey dinner sooner or later…just won’t be this month, or in December.

We’re only a half hour flight from Ketchikan, on the island of Prince of Wales. We came over Sunday afternoon and I was surprised to see there is a lot of snow here. There’s a much bigger road system here than in Ketchikan, though not all of the roads are paved. This island was a major logging site years ago and a lot of the roads are from that era.

These little outposts are interesting. You never know what you’ll find in the way of stores and amenities. It can be hit and miss. I’m actually amazed at what is here when I realize that everything is either flown in or barged in. When you can’t drive in, the price of everthing goes up. Way up.

I enjoy the glimpse of small town life. Well, Ketchikan is small, but this is really little. I grew up in a small town, so this feels familiar. What’s different is the degree of isolation you experience on remote islands. Ketchikan has Alaska Airlines flying in and out several times each day, and the major state ferries stop there. You can’t drive out, but you can get out pretty easily. Not cheaply, but easily enough. The ferry from Prince of Wales (POW, locals call it) takes three hours to get to Ketchikan and the connection point for other travel. Or you can fly, but that’s pricey and baggage allowance is limited. Most folks here do an occasional ferry trip to Ketchikan to make a Walmart run or for some specialty need in healthcare. Women go over a couple of weeks before giving birth to deliver in the hospital there. There is no hospital here, just a couple of clinics on the island doing primary care and visiting clinic care.

Tuesday…Today the clinic has a visiting specialty provider coming over, and someone is coming for the day to set up the scanner and computer for the training I’m doing. Weather yesterday pushed both these visits to Tuesday. No planes were flying on Monday. But people around here are used to weather ruling. Ir makes a lot of decisions easy…bad weather, no flying. Really bad weather, no boating, although the ferries are big enough they usually keep to their regular schedules.

Ah, life on the frontier! Some things are so “normal,” you’d think you were on Main Street USA. There’s cable tv and Starbucks coffee in the grocery store and everyone has cell phones. But just when you think you know what to expect you’re caught by surprise…some pieces of life just work a little differently.

I’ve learned to accommodate. I bring my heels for work in a backpack and wear my snow boots. I bring snacks and a few basics. In some of these small communities the grocery closes at 6:00 and restaurants may or may not be open. Some businesses are only open seasonally. I’ve learned the hard way to be self-reliant, at least for the first night in a new place.

I often wonder if life will look different here years from now. Change comes slowly, but it does come. Who knows? But the weather, the remoteness, the ocean…nothing will change that. And for the people who choose this as home, maybe that’s a good thing.