Sled dogs exert powerful pull on these northern docs
From the April ACP Observer, copyright © 2007 by the American College of Physicians.
By Jessica Berthold
Sooner or later, most doctors are called upon to use their skills outside the office. For Beth Baker, FACP, a pulmonologist in Anchorage, that call came amid subzero temperatures in the Alaskan wilderness during the 1994 Iditarod.
It was Dr. Baker's first time competing in the rigorous dog sledding race, which runs about 1,150 miles from Anchorage to Nome. Two days in, she and her competitors stopped at a mandatory checkpoint in Finger Lake, about 115 miles north of Anchorage.
Several of the mushers hunkered down for the night in tents, which had been outfitted with propane heaters by race volunteers. Dr. Baker chose to sleep outside on her sled.
"At one point in the night, I saw someone come out to go to the bathroom, and the person sort of staggered and fell over. I ran into the tent and found others in similar conditions," Dr. Baker, age 57, said. "A couple of them were totally unconscious."
Twenty-two miles from the Iditarod finish line, Beth Baker, FACP, hit a blizzard that sent her off course. Forced to camp overnight on sea ice, she was rescued and hospitalized for severe frostbite.
Realizing the mushers had been poisoned by carbon monoxide from the heaters, Dr. Baker and others dragged them out of the tent, loaded them on to sleds and took them to a nearby lodge that lacked medical equipment.
"We jerry-rigged an oxygen system, setting up masks using welding oxygen," Dr. Baker said.
The sick mushers recovered and went on to complete the race. Dr. Baker wasn't so lucky. Twenty-two miles from the Iditarod finish line, she hit a blizzard that sent her off course. Forced to camp overnight on sea ice, she was rescued and hospitalized for severe frostbite.
"I couldn't do buttons, put on earrings or play harp for a month," Dr. Baker said.
Internist Robert Bundtzen, FACP, an infectious disease specialist from Anchorage, has had a different experience with the Iditarod. He's run the race 10 times since 1995, and has yet to use his medical skills for anything serious.
Robert Bundtzen, FACP, shown at an Iditarod checkpoint, has treated minor injuries along the trail during his 10 years of racing sled dogs.
"Once in a while someone will get hurt and they will come up to me, usually with an orthopedic injury," said Dr. Bundtzen. "A couple times I've been asked to examine fellow mushers on the trail for shortness of breath, wheezing or frostbite. Nothing major."
An Alaska native, the physician got his start in mushing by helping a colleague run a team of dogs. In 1993 that friend, busy with other things, gave Dr. Bundtzen the team, and he ran his first Iditarod two years later. His best showing was 28 out of about 60, he said; he usually finishes in the middle of the pack.
"Even if you know you won't win, you are still competing with the two or three people ahead of you, trying to do the best you can," Dr. Bundtzen said. "Everyone has his or her own race."
Mushing and medicine
Though Drs. Baker and Bundtzen said they don't think the Iditarod attracts doctors in particular, their interest does have a kind of logic. Originally a supply route from coastal towns to interior mining camps, the Iditarod trail was famously used by mushers in 1925 to bring serum to Nome during a diphtheria epidemic.
Nowadays, the Iditarod trail represents a spirit of endurance that starts with the training process. Mushers must finish two qualifying races to compete in the Iditarod, and typically log about 1,500 miles on their dogs between August, when training starts, and March, when the race is held.
"You're living on four hours sleep; you're grabbing a hamburger on the way from work to the dog track," said Dr. Baker, who was introduced to the sport by a friend.
During training, Dr. Bundtzen said he runs his dogs once or twice a week, and has a paid helper run them an additional one or two times. As the race approaches, the runs get longer—to about six hours each by the end of January.
Mushers usually keep some or all of the dogs they run in kennels at their homes, buying food by the ton and building sheds just to store the dog food. Currently, Dr. Bundtzen said he keeps 20 dogs at his house.
"It's a tremendous amount of work, effort and training," he said. "If I'm not on call, my weekends are all taken up."
Mushers also must ship food and supplies out to various parts of the trail in the weeks before the race. And physician mushers, of course, need to make arrangements for their patients' care while they are on the trail for 10 to 17 days.
"I was lucky to have good coverage from my colleagues during the Iditarod," said Dr. Baker. "But when I got back, I worked 24 straight days to pay it back."
Worth the trouble
Despite the hardship, Dr. Baker said she's glad she did the Iditarod—once.
"I just loved the challenge of getting you and your dogs from one checkpoint to the next, braving the wind and the temperatures and the cold," Dr. Baker said. "You are self-sufficient, and I liked that a lot."
Part of the thrill is in meeting the unexpected trials that crop up in the middle of a race, whether they be fixing a broken sled or staying warm at 40 degrees below zero, Dr. Bundtzen said.
"There's a real satisfaction to being out there in the middle of nowhere, keeping you and your dogs in good shape," said Dr. Bundtzen.
Indeed, fostering a relationship with a team of 12 to 16 dogs is one of the biggest joys of mushing, he added.
"The dogs all have different personalities, and you are kind of the coach of the team," Dr. Bundtzen said. "They have tremendous physiological capabilities that are fun to watch and manage."
Caring for the dogs ranges from changing their protective booties dozens of times during a race to fending off moose that chase them during practice.
"Moose will come along and run right through your team. I had one come through once and blind one of my dogs in one eye," Dr. Bundtzen said.
Dr. Bundtzen placed 43rd in this year's Iditarod, and said he plans to continue running the race for as long as he's able.
Dr. Baker's first Iditarod, for which she won a Sportsmanship Award, was also her last, but she mushed for eight years afterward. Eventually her dogs died and she chose to focus on other outdoor sports … but she still finds herself doctoring in unexpected places.
"I once wound up delivering a baby in the back of a pick-up truck during a river trip in remote northern Alaska," Dr. Baker said. "When you have doctor skills, people just sort of turn to you."
Internist Archives Quick Links
Internal Medicine Meeting Early Registration Discount
Register early for Internal Medicine Meeting 2015 in Boston, MA to lock in the lowest possible rate. Learn more or register now!
Are You Using ACP Smart Medicine®?
This online clinical decision support tool is a FREE benefit of ACP membership delivering point-of-care access to evidence-based recommendations. Includes more than 500 modules, images and reference tables. Start now or watch the video tour.