Northwest Arctic Borough, Alaska Summer 2019

By this point in my photography career, I knew that I wanted to focus on the stories of those around me. I wanted to use my lens to give others a greater understanding of the world we live in and create a dialogue around issues like climate change, health disparities, and cultural dilution.

Between my 1st and 2nd years of medical school, I worked with a rural family doctor to provide medical care for communities which are only accessible by boat or plane. I wrote more than I ever have, took photos that I found beautiful for the stories they told AND for the landscapes they sensationalized, and began integrating my understanding of medicine into my writing. The stories I heard, lessons I learned, elders I met, and fish we caught are documented below.

“My First Rotation… Above the Arctic Circle”

Published In Academic Medicine, Sept, 2020

“When someone invites you to hunt, you never be late.” The Iñupiaq elder’s words rang in my ears as I tugged a second pair of jeans on over my first. I barreled out of my tent and onto the 16-foot aluminum Jon boat, barely on time and hardly prepared for the next 6 hours of scouring the Ambler River for moose—or if it was Nature’s will—bear. The white fish’s scales hardened that week, a subtle preamble to the return of winter, making the success of subsistence hunting trips increasingly important for surviving another season of snow and ice. 

I spent the 5 weeks between my first and second years of medical school in Alaska’s Northwest Arctic Borough, taking bush planes from one remote village to the next with a doctor who has served these communities for her entire medical career. Officially, I was there to conduct sports physicals for the village children; unofficially, I was there as a sounding board for the doctor as she weaved Iñupiaq culture, Western medicine, and tribal dynamics into each patient’s care plan. 

This was my first medical rotation. It was the first time I tasted words like “lisinopril” and “metoprolol” roll off my lips, each as new to me as the muktuq (beluga blubber) and tuttu (caribou) I was offered during patient home visits. While antihypertensives followed me on my journey back to the lower 48 states, certain experiences will forever be unique to the arctic tundra--unless patients in Michigan ask me to join them in picking blueberries, felling trees, or filleting salmon. 

In isolation, these Arctic experiences are fond memories and great stories, but in context they tell the story of the medicine I provided. Combatting hyperlipidemia and hypertension included discussions about cutting back on seal oil while preparing beluga and how spicing caribou stew with wild herbs is a healthy alternative to using salt. We treated chronic back pain with ibuprofen, an ice pack, and some extra strength Tylenol, but also talked with our patients about new ways to bend while picking blueberries and how to engage their core while mushing dogs. 

In my first medical rotation, I learned that caring for my patients starts with understanding who they are. While I didn’t see many zebra diagnoses, I did help hunt for the village moose.

“A Cultural Quarantine”

Exposé Pending Publication | April 25, 2020

There is (and will continue to be) much to lament as we bob in the wake of COVID-19. The loss of loved ones, jobs and financial security, and even the Olympics will be felt long after curves have flattened and life has begun to regain its old luster. As the virus sweeps through neighborhoods, across borders, and between social classes, almost every aspect of modern life and culture has tectonically shifted. While people’s suffering may not be equal in magnitude or duration, we remain universally united in mourning the loss of what was. In a twisted way, this unanimity is as beautiful as it is unprecedented. As the experiences of billions converge, my hope is that a similarly universal empathy will flourish, for none of this is as novel a situation as we may think.

For centuries, in fact, communities have been decimated by the contagious spread of something infinitely more deadly than coronavirus. In August of 2019, I experienced this firsthand, some 50 miles above the Arctic Circle in Alaska. Despite having infected the community more than 100 years ago, the aftershocks of an ideology, rather than an organism, were unmistakably present everywhere I turned. Westernization and industrialization, rather than the need for respiratory resuscitation, were the deadly blows striking the communities of Northwestern Alaska.

Before I say much more though, it is important to recognize that there is some good that has and will continue to come from western influence in the lives of Alaska’s Inupiaq population. Now, homes are heated by more than just a fire, and families are protected against the winter winds by more than snow and animal hide. Predictive weather modeling means that snowstorms are no longer a surreptitious danger to hunting parties. Modern fishing equipment, cold weather gear, boat motors and snowmobiles have all changed the cultural environment of the Inupiaq people, and largely for the better. Just as the coronavirus has begun to lend us advances in various medical and epidemiological sectors, not all that has come from western influence in the indigenous communities I visited was negative. 

There are certain aspects of life, however, which are unmistakably altered for fault of the world outside of Arctic Alaska. In the same way that inhumane animal markets thousands of miles away in Asia—where it is thought that the coronavirus originated—have changed the lives of people all over the world, the pollution of industrialized countries with apathetic environmental regulations is being felt by those who are thousands of miles away from the offending parties. Most acutely, the ramifications of a warming climate are felt in locations at the far ends of the environmental spectrum. Near the equator, new patterns of flooding and drought are disrupting the lives of millions. And in the Arctic, the ocean temperature is rising more quickly than any other ocean in the world. Therein lies a whole host of problems which impact Inupiaq culture. The lack of sea ice in the spring means that unabated waves now consume riverbanks and overtake sea walls with a ferocity that has displaced entire native villages inland. Additionally, for many Inupiaq, the changing ice patterns have dissolved the practice of subsistence hunting and fishing, activities steeped in Inupiaq culture and vital to the survival of families during the long Arctic winters.

Beyond the harrowing changes of biomes lies the loss of culture, which calves and crashes into the abyss of westernization silently, without the pomp and press garnered by shearing icebergs. Traditions and languages are on the edge of extinction; dances, family histories, and entire livelihoods teeter on the brink of being forgotten. Although I had arrived in Arctic Alaska believing that environmental climate change posed the greatest risk to the communities, I soon realized that cultural climate change boasts a similarly daunting mortality rate for the Inupiaq people.

Raymond Woods, the elder responsible for integrating Inupiaq cultural and linguistic curriculum into Alaska’s Northwest Arctic Borough School District, was telling me about this as we sat around a beach fire grilling salmon. He is one of the few Inupiaq who can still fluently read, write, and speak their language. Although it is commonly said that the Inupiaq people have a history more than 10,000 years old, Inupiaq wasn’t a written language until 1946, 13 years before Alaska became a US state. The irony of Ray’s job is striking: he works tirelessly to bring Inupiaq culture back into the very same schools that were ruthlessly beating it out of their students not 50 years ago. We both looked solemnly into the campfire’s embers after the story was told; even the Arctic Ocean, not ten feet from us, fell silent in mourning the loss of a language and culture it had grown up alongside.

The most important thing to remind students of, Ray said, is their identity within the Inupiaq culture. This is a sentiment frequently echoed, heard everywhere from the musings a village elders to the writings of former Alaskan Senator and Northwest Arctic Borough native, William Hensley. Willie, as folks around here call him, attributes much of this cultural amnesia to alcoholism, acedia, and abuses of other kinds introduced as outsiders came to the Arctic in search of gold, timber, fishing, and communities to proselytize. Willie and his peers spent their professional lives fighting for an informed, culturally sensitive and respectful integration of US policies into the lives of Alaska Natives.

However, some aspects of western culture are fulminant beyond political reform. With the introduction of packaged, processed foods which are calorically dense but not nutritionally so, diseases like diabetes and obesity have become seemingly virulent in and of themselves. The convenience of going to a store, rather than out on a hunt, has dissuaded many Inupiaq from participating in traditions of hunting and gathering that have been central to their culture for thousands of years. The price of this alimentary transition lies threefold: in worsening physical health, in the loss of Inupiaq tradition, and as an immense financial burden.

As the late evening sun blazed on, still impossibly high in the Arctic sky, a silence draped itself across Ray and me. I felt grounded, comfortable, at peace… as though the proximity to Earth’s true magnetic north hugged me deeper into a connection with her land, air, and sea around me. I ventured out of our silence to ask Ray about spirituality in Inupiaq culture. I knew there was a long history of Quaker missionaries coming to the villages and wondered if that would come up.  He did not respond for quite some time, so long that I wondered if I had really asked the question aloud at all, but with time he said this,

“The most important thing to our people is our connection to land and nature. You know, we never even say we are ‘going hunting’, only that we are ‘going out’. If a caribou or moose or seal comes, it is a sacrifice the land makes to help us survive. This is why we pour fresh water in the animal’s mouth when we first reach them, to return their spirit to the land.”

He was speaking to the ocean as he told me this, in a similar way that he spoke to the road while we drove in his old truck. As Ray grew quiet again, Nature softly picked up the story where he had left off. The fire hissed and the salmon struggled against the nets we had cast. I understood that She was worried for the Inupiaq, that She too feared the ramifications of globalization, of westernization for Her next of kin. The changing Arctic climate means change for Inupiaq culture; the dissemination of western thought similarly writes a new chapter in their history… in English, not Inupiaq. Ray looked over at me and raised his eyebrows to ask, “You see?”. I did, I still do.

You see, a wounded culture can’t be fixed by medicine or science, no more than a facemask can protect from an ideology or a changing climate. Instead, they need more Rays, pouring fresh water into the mouth of a hunted culture on the verge of extinction.

“To Point at Mountains”

Journal Entry | September 1, 2019

I once heard a story about a father who wouldn’t allow his children to point at the mountains or the ocean. He told them that these were so ancient, so grand, that they were beyond a person’s ability to comprehend. Any attempt to quantify their beauty or describe their scale, he said, would leave a person understanding less than if they had said nothing at all.

The whole story seemed rather extreme to me. That is, until the night I saw the Northern Lights. Every picture I took felt like I was somehow stealing the incomprehensible away from the aurora. Each blink of the shutter took the lights from something that I couldn’t wrap my head around in person and turned it into this two-dimensional blasphemy that made the night tangible.

Although I remain grateful to have taken this picture, it was impossibly hard for me to load it onto my computer. That night was alive, sublime, and beyond understanding, just as the ocean is vast and the mountains are tall.

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