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Meet the Doctors of Antarctica

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When physician Dale Mole stepped off the C-130 turboprop plane that had landed at the South Pole in January 2012, he felt a twinge of disappointment. It was only minus 25 degrees Fahrenheit. Granted, it was summer—but he had expected worse.

“The average winter temperature is minus 85,” he says. As the weeks and months passed, however, the thermostat dropped as low as minus 107. Mole’s exhaled breath would freeze in mid-air; no one dared leave bare flesh exposed more than 10 or 15 seconds; teeth would ache for hours after exposure.

Once, as Mole was cresting a snow bank, his face mask froze. “I had to remove my mask to breathe and the super-cooled air felt like ice daggers in my throat,” he says. “I was afraid my windpipe was going to freeze, which could prove fatal.”

The Amundsen-Scott South Pole Station at twilight. Courtesy Dale Mole.

In Antarctica, the coldest and most isolated place on the planet, even the simple act of breathing becomes an endurance test. Home to three permanent U.S. expedition outposts—McMurdo Station, Amundsen-Scott South Pole Station, and Palmer Station—it’s inaccessible eight months out of the year due to oppressive weather conditions. Researchers from a variety of countries fly in with the knowledge they’re about to be effectively cut off from the world.

But what happens when a medical situation arises? More than 2800 miles from the nearest hospital in New Zealand, Antarctic crews must rely on the expertise of a single physician responsible for upwards of 150 people. (The number varies by season.) Working autonomously, the doctor is charged with analyzing x-rays and blood work, providing aftercare, overseeing pharmaceutical duties and even performing dentistry. Serious conditions that could be managed in a major facility become radical emergencies. Surgery is a major undertaking, and intensive care can’t be sustained.

Such adversity is not for the claustrophobic or easily shaken. But for Mole, volunteering was academic. “I signed up,” he says, “because I wanted the challenge of providing medical care in the most remote and austere environment on Earth.”

The Right Stuff

The view from the observation deck. Courtesy Dale Mole.

Scott Parazynski, M.D., had spent 16 years in NASA's astronaut corps and was an experienced mountaineer when the offer came to become Chief Medical Officer overseeing healthcare for the National Science Foundation’s U.S. Antarctic Program (USAP). Having tended to climbers all the way to the summit of Mount Everest, he was familiar with the psychological and physical demands of practicing medicine without a net.

“It takes a really broad skill set,” he says. “I call it MacGyver medicine. What can you do to diagnose and treat conditions in a really remote environment when the chips are down? You have to invent solutions on the fly.”

Physicians who volunteer typically have backgrounds as surgeons or emergency room veterans. When Parazynski selected former submarine medical officer Mole to go to the South Pole, the 63-year-old underwent a rigorous screening: an EKG to assess cardiovascular health, an ultrasound of the gallbladder to rule out any simmering problems, and a psychological test.

Once approved, Mole left Denver for New Zealand, which connected him to McMurdo Station. There, a dentist gave him a crash course on fillings and root canals. After a week, he boarded a flight to the South Pole, where his patient base of 49 scientists and researchers studied everything from geophysics to astronomy in a fuel-powered compound; the dry air (the area averages seven percent humidity) forces residents to guzzle four to six liters of water a day. Mole was careful not to touch any metal with his bare hands—it can take the skin right off—and investigated his professional tools, a mixture of modern and museum-worthy.

“Some of the items I remember from visiting the doctor in the 1950s,” he says. There was a World War II embalming kit, a straitjacket, and glass syringes with reusable needles. “Some of our lab equipment was also designed for use on animals, but was perfectly suitable for humans. The x-ray unit was the portable kind used by veterinarians, but it worked.”

Ventilators, ultrasound, and critical life support devices are also present, though luxuries like an MRI device would be cost-prohibitive owing to the small population. “You’re relying upon clinical judgment and your resourcefulness,” Parazynski says.

Because the Antarctic workers are carefully screened for any major conditions, Mole and other physicians frequently find themselves treating conditions common to any industrial environment: slips, common colds, and lacerations. The plummeting temperatures and non-existent humidity also give rise to dry skin conditions and respiratory ailments. One, “the McMurdo crud,” is a hacking cough that tends to nag at patients.

Dawn at the American base. Courtesy Dale Mole.

Despite the cold, frostbite is not as common as one might expect. Mole saw only a few cases, albeit one that resulted in a patient losing part of an ear. Most injuries, he says, “were sports related, as many played basketball, volleyball and dodge ball on their off-duty time.”

Sean Roden, M.D., who stayed during the comparatively warmer summer months prior to Mole’s arrival, recalls that altitude sickness was a problem for many: Antarctic stations are 9500 feet above sea level. Staff and crew take Diamox, a drug that helps adjust the body’s chemistry to the environment, but it isn’t always effective. “I had a headache for over two months,” Roden says. “Everyone was just constantly short of breath, had a headache, had a hard time sleeping. You get winded just brushing your teeth.”

Summer also invites a scourge of insomniacs, with the sun refusing to go away and inhabitants putting up blackout shutters to try and cope with the irregular seasons. “People were walking up and down hallways, not really awake, not asleep,” Roden says, like zombies.”

When Doctors Get Sick

The modest inpatient ward. Courtesy Dale Mole.

It’s a hypochondriac’s worst nightmare: alone in the Antarctic, with the lone physician too ill to care for anyone else. Modern screenings have reduced that possibility, but the area has been home to a series of legendary crises.

Some countries require their doctors undergo an appendectomy to ward off the potential for appendicitis. If that seems excessive, consider the case of Leonid Rogozov, a Russian physician who diagnosed himself with a swollen appendix during a 1961 expedition. Trapped in the Austral winter with no flights in or out—the harsh weather can prevent aircraft from functioning properly—he deputized a few researchers to be his surgical assistants and cut out his own organ using only local anesthesia. He recovered in just two weeks.

In 1999, Jerri Nielsen discovered a lump in her breast. She performed a biopsy using only an ice cube to numb the area; upon discovering a cancerous growth, she had drugs air-dropped to her until she was able fly out for treatment.

If anything similar were to occur today, physicians would have the benefit of teleconferencing with colleagues. “We can look remotely in someone’s ear, eyes, listen to their heart, share views of ultrasound or EKG tracing,” Parazynski says. “We can look over their shoulder and be part of the decision making process.”

That assumes, however, communications are working. Mole says Internet access was available only a few hours at a stretch. Without it, “You rely upon textbooks you either brought with you or were available in the small South Pole medical library.”

Dental concerns are treated here. Note the armrests for ease of gripping and writhing. Courtesy Dale Mole.

Much of a physician’s time is spent in preventative preparation, training staff in the event of an emergency. During his stay, Roden orchestrated the medical evacuation of a crew member who had fallen ill with a neurological issue more than 400 kilometers from base. “We had rehearsed it in a drill, so we were prepped for it.” (The patient recovered and returned to work.)

Off-duty, Roden says numerous groups were devoted to salsa dancing, knitting, or Doctor Who viewing parties; Mole read, ran four to six miles a day on the treadmill, and ventured outside sporting at least six layers of insulation—anything to stretch out from his cramped 6 x 10-foot living quarters. He says he experienced none of the depression that can result from a lack of sunlight for months at a time.

“Being at the South Pole was like living on another planet, one with only one day and one night per year,” he says. “There was always something unique to experience, so I was never bored or felt an overwhelming desire to leave.”

Breaking the Ice

The remains of the cables used to power the station, stacked up by workers and dubbed "Spoolhenge." Courtesy Dale Mole.

After 10 months, Mole saw his first plane, thought of his wife, and breathed a sigh of relief. With winter over, he was able to return to the States in November 2012. During his tenure, he had attended lectures on art history, cared for a group requiring everything from dentistry to physical therapy, and trained non-medical staff to provide critical care in the event of an emergency.

Roden’s four-month stay was a kind of sensory deprivation. Back home, life had gone from being a blinding sea of white to glowing Technicolor. “Coming off the ice, seeing a sunset, the colors were just, wow,” he says. “Getting back to sea level was amazing. I felt great.”

Such experiences are more than an endurance test: they help inform future remote care in environments as varied as rural America, third world nations, and even Mars. Advanced handheld diagnostic tools, Parazynski says, are already on the way. “The notion is to develop a device that would have the diagnostic capabilities of a full lab in a major hospital. Not overly prescriptive, just basic physiological parameters, blood chemistries. It will help revolutionize healthcare in remote and in regular health care.”

While the efforts of Mole and other physicians are a valuable learning tool for future explorers, it’s the physician who may benefit the most. “The months of profound darkness, the majestic starry skies, the shimmering auroras, the icy desolation, going to bed at night a few feet from where all the lines of longitude converge …” Mole trails off. “These are the memories I will carry with me to my grave.”

This story originally appeared in 2015.

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Live Smarter
Here's What You Need to Know Before Getting Inked or Pierced, According to Doctors
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Getting inked or pierced is a rite of passage for many teens and young adults. But before getting that belly ring or butterfly on your back, experts want you to be aware of the risks, which are reviewed in a new clinical report from the American Academy of Pediatrics (AAP). According to NPR, it's the first set of recommendations the professional association has ever released on the practices.

Forthcoming in the October 2017 issue of Pediatrics and available online, the report provides a general assessment of the types and methods used to perform body modifications, along with potential health and social consequences. Here are a few main takeaways:

—It's unclear how often tattoos cause health complications, but they're generally believed to be rare, with the greatest risk being infection. One recent study found that nanoparticles in ink can travel to and linger in lymph nodes for an extended period. That said, you should check with your doctor to make sure all of your immunizations are up to date before getting either a tattoo or piercing, and that you're not taking any immunity-compromising medicines.

—Before shelling out your hard-earned cash on a tattoo, make sure it's something you'll likely still appreciate in five to 10 years, as it costs anywhere from $49 to $300 per square inch to remove a tattoo with lasers. (This might provide all the more incentive to opt for a small design instead of a full sleeve.)

—About half of people 18 to 29 years of age have some kind of piercing or tattoo, according to Dr. Cora Breuner, who is chair of the AAP committee on adolescence. Many individuals don't regret getting one, with some reporting that tattoos make them feel sexier. But while millennials appear to be cool with metal and ink, hiring managers might not be too pleased: In a 2014 survey of 2700 people, 76 percent said they thought a tattoo or piercing had hindered their chances of getting hired, and nearly 40 percent thought tattooed employees reflected poorly on their employers.

—Not all tattoo parlors are created equal, as each state has different regulations. Keep a close eye on whether your artist uses fresh disposable gloves, fresh needles, and unused ink poured into a new container. This helps prevent infection.

—The advice is similar for getting pierced: Make sure the piercer puts on new, disposable gloves and uses new equipment from a sterile container. Tongue piercings can cause tooth chippings, so be careful of that—and remove any piercings before you play contacts sports.

The full report is available online.

[h/t NPR]

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The Body
7 Essential Facts About the Pelvis
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The human body is an amazing thing. For each one of us, it’s the most intimate object we know. And yet most of us don’t know enough about it: its features, functions, quirks, and mysteries. Our series The Body explores human anatomy, part by part. Think of it as a mini digital encyclopedia with a dose of wow.

The pelvis, which crooner Elvis was famous for thrusting around in ways that raised eyebrows, is not actually a single body part but a term that refers to a collection of bones, muscles and organs below the waist. We spoke to Katherine Gillogley, department chair of obstetrics and gynecology with Mercy Medical Group in Sacramento, California, for these seven facts about the pelvis.


"The pelvis refers to the lower abdominal area in both men and women," Gillogley says. "An important function of the pelvis region is to protect organs used for digestion and reproduction, though all its functions are crucial," she says. It protects the bladder, both large and small intestines, and male and female reproductive organs. Another key role is to support the hip joints.


Four bones come together to form a bowl-like shape, or basin: the two hip bones, the sacrum (the triangle-shaped bone at the low back) and the coccyx (also known as the tailbone).


At the bottom of the pelvis lies your pelvic floor. You don't have to worry about sweeping it, but you might want to do Kegel exercises to keep it strong. The pelvic floor is like a "mini-trampoline made of firm muscle," according the Continence Foundation of Australia. Just like a trampoline, the pelvic floor is flexible and can move up and down. It also creates a surface (floor) for the pelvic organs to lie upon: the bladder, uterus, and bowels. It has holes, too, for vagina, urethra, and anus to pass through.


Anyone who has ever broken a pelvic bone or pulled a pelvic muscle will know just how key a role the pelvis plays in such functions as walking and standing. "The pelvis also acts as a solid foundation for the attachment of the spinal column and legs," says Gillogley.


Gillogley says that the female pelvis "tends to be larger and wider" than the male, most likely to accommodate a baby during pregnancy and to make childbirth possible. However, women's pelvises narrow as they age, suggesting that they start out wider to accommodate childbearing and then shift when that is no longer necessary. A shifting pelvis shape is thought to be a key part of our evolutionary history, as it changed as when we began walking upright.    


During pregnancy the body secretes a hormone known as relaxin to help the body accommodate the growing baby and soften the cervix. However, what happens is, "the joints between the pelvic bones actually loosen and slightly separate during pregnancy and childbirth," Gillogley says. Sometimes, however, relaxin can make the joints too loose, causing a painful syndrome known as symphysis pubis dysfunction (SPD), causing the pelvic joint to become unstable, causing pain and weakness in the pelvis, perineum and even upper thighs during walking and other activities. Many women with the condition have to wear a pelvic belt. It usually resolves after pregnancy is over, though physical therapy may be necessary.


According to the American Association for the Surgery of Trauma, about 8 to 9 percent of blunt trauma includes pelvic injury, Gillogley says. "These accidents include falls, motor vehicle crashes, bicycle accidents, and pedestrians being struck by moving vehicles. With these serious injuries, pelvic bones can fracture or dislocate and sometimes bladder injury even occurs." So take care with your pelvis—in worse-case scenarios, breaks of the pelvic bones can require pins, rods, and surgery to fix.


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