Why this book: I continue to be inspired and fascinated by Alaska – especially remote areas.  I saw this book in a used book store in Florida, and picked it up.

Summary in 3 Sentences: As Tom Sims was finishing up his medical internship in 1971 on his way to becoming a practicing physician, he got a letter from the draft board telling him to report to his local recruiter, which he knew would probably mean being sent to Vietnam.  Recently married with a child, he accepted as an alternative an offer to join the Public Health Service in Alaska (part of the Uniformed Services of the US) and after reporting, learned that he would be the lone doctor in Nome and a radius of close to 150 miles. He spent just short of 2 years there and this book is him telling his story in the first person, chronicling his challenges, adventures, life and other amazing experiences as the only doctor in a small town on the Bering Sea above he arctic circle, 50 years ago.   

My Impressions: This was a fascinating memoir of about 2 years in the authors life. The book is written in a first-person, conversational and personal style, as if he were sitting with the reader and telling the stories.  The chapters are short, the print is easy to read, and these 307 pages were fun and went by quickly.  

He begins with a little bit of background on himself and his life, and the series of events that led to him finding himself in Anchorage, getting a very brief indoctrination into being in Alaska, the Public Health Service and his role in it.   In very short order, he, his very pregnant wife Pat and their daughter were on a plane to Nome, where they would live for the next 20 months.  Sims is humorous in describing his introduction to government military bureaucracy -very different from being an intern in a civilian hospital in California. 

His introduction to his new life in Nome was not auspicious.  His home was temporary, he had very little support, his personal goods wouldn’t get there for months, his wife was soon to give birth – and he was quickly thrust into the breach of being the only doctor in that entire region.  The nurses and assistants in what passed for a “hospital” were hard working and resilient, but from day one, he was on- call, largely on his own, and expected to respond to cases 24/7/365.  

He shares with us the challenges of adapting to an austere life in Nome which indeed was a good sized town by remote Alaskan standards.  But the meat of the book is the author relating stories of medical emergencies he had to deal with, for which he had little to no training, and very little support. He was on his own to improvise and trust his instincts to save people’s lives, under very austere conditions, and he shares numerous such incidents – some in Nome itself, and some in remote villages where he had to fly in to deal with a crisis which demanded immediate personal attention.

The remote Eskimo villages each had a health and medical advisor who could contact the hospital in Nome for guidance or counsel,  or to report serious incidents that might require the doctor’s presence. In emergency cases, Dr Sims would call on one of the bush pilots to fly him out to the village, where he could treat the patient in person, and occasionally, a patient would have to be flown to Anchorage if the problem required advanced care or facilities. In one case, he was flown to a village, saved a patient’s life, and then a storm came in and it took him 9 days to get back to Nome. And just getting back to Nome proved to be an edge-of-the-seat adventure in its own right. 

During the winter, Nome only got a few hours of daylight per day, and then total darkness. Sims became depressed and struggled with the lack of daylight, experiencing a condition known as SAD – Seasonal Affective Disorder.  He describes how slowly after 21 Dec, they got a few more minutes of daylight per day and slowly he recovered.  He also described the breaking up of the ice in the Bering Sea in the spring as a remarkable and dramatic event, with what sounded like explosions and the crashing of the huge ice blocks against each other.  

Sims and his wife established close relationships with the local community and made many friends.  They were’n’t always welcomed though – there was jealousy on the part of one of the other senior government officials in Nome, who was jealous of Sim’s close ties and credibility with the locals and he sought to make Sims’ life difficult.  One of the older local indigenous women resented that Sims and his family had integrated so well with the indigenous community; she didn’t like that their popularity lent credibility to some of their “white culture” practices and many of the locals enjoyed participating in such things as a fourth of July parade. 

The book concludes with Sims being offered another position in Anchorage, which would give him and his family access to many of the comforts of the lower forty-eight, as well as a position that gave him regular hours, and thus more time to be with his family. He was happy to leave the harassment from the other senior official in Nome, and being on-call round the clock 365 days a year, but he knew he would miss the intimacy of small town living. The final chapter is an epilogue which shares that Sims and his family then moved to a small town in Oregon with many of the charms of Nome, but without the many inconveniences. 

This is short and fun book provides insights not only into life in remote towns in northern Alaska, but also the tribulations of medical doctors treating people in remote areas with little support. This is a great book for people like me who are fascinated with Alaska, its culture and people and how intrepid men support people living on the edges of civilization.