On Call in the Arctic

by Thomas J. Sims

An extraordinary memoir recounting the adventures of a young doctor stationed in the Alaskan bush.

The fish-out-of-water stories of Northern Exposure and Doc Martin meet the rough-and-rugged setting of The Discovery Channel’s Alaskan Bush People in Thomas J. Sims’s On Call in the Arctic, where the author relates his incredible experience saving lives in one of the most remote outposts in North America.

Imagine a young doctor, trained in the latest medical knowledge and state-of-the-art equipment, suddenly transported back to one of the world’s most isolated and unforgiving environments—Nome, Alaska. Dr. Sims’ plans to become a pediatric surgeon drastically changed when, on the eve of being drafted into the Army to serve as a M.A.S.H. surgeon in Vietnam, he was offered a commission in the U.S. Public Health for assignment in Anchorage, Alaska.

In Anchorage, Dr. Sims was scheduled to act as Chief of Pediatrics at the Alaska Native Medical Center. Life changed, along with his military orders, when he learned he was being transferred from Anchorage to work as the only physician in Nome.  There, he would have the awesome responsibility of rendering medical care under archaic conditions to the population of this frontier town plus thirteen Eskimo villages in the surrounding Norton Sound area. And he would do it alone with little help and support. All the while, he was pegged as both an “outsider” and an employee of the much-derided federal government.

In order to do his job, Dr. Sims had to overcome racism, cultural prejudices, and hostility from those who would like to see him sent packing. On Call in the Arctic reveals the thrills and the terrors of frontier medicine, where Dr. Sims must rely upon his instincts, improvise, and persevere against all odds in order to help his patients on the icy shores of the Bering Sea. 

Genres: Nonfiction, Memoir, Medical, Audiobook, Medicine, Travel, Book Club

333 pages, Kindle Edition

First published September 4, 2018

Reviews

[Dr. Appu Sasidharan (Dasfill) · Rating 4 out of 5]

Why did I study all this if I was destined to work in a small hospital in a rural area? This is the question one of my closest friends asked me who had completed his Residency from one of the best hospitals in the world, which has all the latest technology and infrastructure. He always liked to face challenges, but he was compulsorily posted to a rural area that he thought would never challenge his abilities. My reply to him was Dr.Ben Carson's famous sentence,

"No knowledge is ever wasted."

When I started reading this book by Thomas J.Sims, this is the first thought which came to my mind as the author also faced a similar situation like my friend when he was posted in Alaska. Even though he didn't like to go to Alaska, he was forced to go there. He never knew that many incredible experiences were waiting for him, which will change his life forever.

The severity of Alaskan winter, various blizzards that strike Anchorage regularly, the lack of infrastructure, the love of local people, the ability to perform duty with the least amount of infrastructure, the presence of mind to make crucial decisions that will change patients lives are all marvelously portrayed by the author in this book. He also had to face racism and hostility while trying to carry out his job in the best manner. Racism is an important theme in this book. The only negative I saw with this book is that I didn't particularly appreciate how the author mentioned Eskimos in some areas of this book. This is a must-read book if you are a Doctor.

"When faced with difficult decisions in the future, I would tally up my intellect and emotions and allow my heart equal influence with my head before deciding how to act. I learned that more than likely, whichever way my heart leaned is probably the way I should proceed."

[Petra X · Rating 4 out of 5]

The author only spent just over a year in Nome working amid lovely people, Eskimo and white, some of the nurses are Christian volunteers, others are Eskimos and just one or two are public service nurses, doctors and administrators who set out to make our long-haired hippie this is 1971 doctor hero's life an absolute misery. And they do.

They are really like fairy-tale villains, absolutely wicked people with no redeeming qualities whatsoever. So when the great redemption scene comes (as it always does in fairy tales) and the ugly evil nasties get their comeuppance, each sin, each crumb revealed and piled upon the next with great, revengeful relish from the author. I was cheering along with him, heyyyyyy! And as they slink home, tails between their legs, he gets a posting to the Emerald City, well Anchorage which has running water and proper flush toilets which must be quite magical after having someone come to empty your 'honey bucket' from the rear (even if you are sitting on it).

The author went the extra mile to make a place for himself and be accepted in the local culture and that is what made the book interesting. He does relate some cases that don't end well (which most doctor stories don't) but they aren't anything gripping, although the author thought they were but then he lived through them.

My initial thoughts (below) were totally wrong. It seemed dangerously racist having the Eskimos talk in bad English and the whites talk normally but it turned out to be just a quirk of the writing.

It was a good, enjoyable book. A solid 4 star
__________


Notes on reading This book is written in a racist way. I don't like that. Recently I read a book by a South African pathologist who practiced there and, mostly, in New Zealand. At no point did he feel the need to identify the living or the dead by their race or how they spoke. This author always tells us if someone is Eskimo he says this is the correct inclusive term, Inuit and other terms are only of certain groups, and since he lived in Alaska, I'm sure he's correct.. But he always has them speak in what sounds like uneducated English, Sam Nanouk: "Everyone know dis is where Sam Nanouk drop net every year. No one ever bother other people's nets. Become outsider in community if dey did". He doesn't report on the different speech patterns of the non-ethnic Americans he worked with in the US or Alaska. He isn't racist himself in his actions but this book was published in 2018 so it doesn't have the benefit of that hokey old excuse (not reason), 'it was different back then'.
____________________

The worst possible situation imaginable The author has four days, during which he has no medical insurance between finishing his internship and getting to Nome to take up his commission in the army, as a doctor. It's that or Vietnam. It is a 4 hour flight. He is flying with an aquarium on his lap, an aquarium on his lap, his little boy and his 9-month pregnant wife. She goes into labour.

Luckily it's Braxton-Hicks.

[Natalie Herr · Rating 4 out of 5]

Enjoyed this book so much! I love real life stories that are crazier than fiction. If you like memoirs or medical dramas or Call the Midwife or anything like that, you’d enjoy.

[Vannetta Chapman · Rating 4 out of 5]

I very much enjoyed this look into practicing medicine in the Arctic!
I had never even heard of the U.S. Public Health Service, and I certainly didn't know that they could send people to far-reaching spots of America.

Recommend for anyone who likes true stories that take place in remote locations.
Note: Some "adult" language.

[Jennie Hasty · Rating 4 out of 5]

Listening to this book was a little like sitting down and listening to my Uncle Ed tell stories about all the wild things he did when he was young. My favorite aspects were the harrowing medical situations he found himself in, the community they found in Nome, and the transportive descriptions of nature in the arctic. So basically the entire book.

[Renée | apuzzledbooklover · Rating 5 out of 5]

4.5/5 stars

‘Hope is being able to see there is light, despite all the darkness.’
- Desmond Tutu

This was such an interesting book! It comprises the experiences of Dr. Thomas Sims and his time stationed in Nome, Alaska, in the early 1970s with the US Public Health Service. It’s a desolate place, and he went through some harrowing times. I love what he shared. I’d highly recommend this book.

Contains a moderate amount of strong profanity, and a few gruesome descriptions.

[Vgathright · Rating 5 out of 5]

I love uplifting memoirs and this was a great example of my favorite genre. Easy to read, inspiring, a pull-yourself-up-by-your-bootstraps type of book. The young doctor had a pretty terrible childhood, but he mostly focuses on the gratitude he has for his wife and children and challenges and triumphs of his work in the arctic frontier. Fun, light, episodic. Wish he had written more about his daily life after his time in the arctic was over.

[Amanda (The Little Book Spot) · Rating 4 out of 5]

Extremely fascinating and easy to read. Only negative was explicit language throughout.

[Mary Burkholder · Rating 4 out of 5]

I enjoyed this and would have given it five stars if it had not had so many four-letter words in it.

[Gayle · Rating 4 out of 5]

Once upon a time, Dr Sims had in immediate need to choose to go to Vietnam to serve in the war as a doctor, or to rural Alaska, where he could serve locals as their one and only doctor. So he packed up his young family and settled into Nome as the doc for not only the hospital but by daily radio calls to six or so other more remote villages. How he provides this care is fascinating: flights to remote areas, or to lifesaving care in Anchorage, working with caring neighbors and bigoted busybodies, and learning the realities of getting food, medical supplies, and other essentials in the forbidding climate of the Arctic.

[Melodi | booksandchicks · Rating 4 out of 5]

I loved following along with his adventures medical and locational in the faraway Nome, Alaska.

[Sophie · Rating 2 out of 5]

I listened to this book via Audible. This book is about a Doctor who is transferred to a very remote outpost in the Arctic as an alternative to becoming a part of the Vietnam war back in the 70s. The settlement of Nome had very limited electricity and landline phone connection along with almost no medical equipment. Dr Sims is to be the only Dr for thousands of people in Nome and for a good few villages in a large area. This means he has to work out novel ways of diagnosing conditions, over the phone if possible, with limited connection and reception, treat multiple emergencies at a time and be on call 24/7 and he literally is for much of the time. At one point, he is trying to deal with someone who's due to give birth at any minute, an appendix operation without light or electricity and someone with a suspected broken arm at the same time! It's no wonder he is under a lot of stress! This didn't necessarily convey well though because the tone was generally a bit depressing with a gloomy outlook, one of desperation and disappointment, which made me not enjoy most of it. I found it a little slow moving.


There was an AMAZING bit in the middle of the book - I had to tell mum about it straight away. You were really left on edge, not knowing what the outcome would be and really desperate measures were called for. 

Certainly different to any other book I've read/listened to.

[Linda Hunt · Rating 5 out of 5]

Incredible! It's hard to imagine life in the Arctic - even more so to be serving there as a doctor with few of the medical necessities usually considered as "on hand" to be able to do things like tend to a difficult birth. And yet it can be done - Dr. Sims did it successfully.
I enjoyed his adventures. I also admire his wife for always supporting him, and for being creative in coming up with ways to make their life in Nome not only bearable, but often even fun!
The people there were lucky to have a doctor who cared about them, and who had the work ethic to be available 24/7. I appreciate that he wrote some of his memories - they made a great book.

[Jillian Vincent · Rating 5 out of 5]

This book had me captivated and kept my attention! I loved the stories shared in this book. It was a good mix of funny, intense, and adventure. If you are into Alaska stories or doctor stories at all, you’ll like this one.

[Liralen · Rating 4 out of 5]

One for fans of House Calls by Dogsled. Sims landed in Alaska only semi-willingly: facing bring drafted into the military and sent to Vietnam, he accepted a commission that would send him to Alaska instead. The landscape in Nome (which would have had a population of about 2,300 at the time) was about as far from Vietnam as he could have gotten:

Our first impression was that Nome was a shantytown; a settlement of tiny houses built of plywood and corrugated metal, lined up door to door on streets made of matted down dirt and gravel. There was no landscaping around the houses because there were no yards to accommodate landscaping. There were no services such as water or sewers, streetlights, telephones, curbs, or sidewalks, and nothing to give the town personality. Everything was build from a functional standpoint to get through the brutal harshness of winter. Survival was the only concern; aesthetics mattered little. (70)

But in other ways, it sounds like there were some similarities. Sims was the sole doctor on hand in Nome (on call 24/7, in addition to his daily working hours) and was also responsible for care in the outlying villages, many of which comprised little more than a cluster of shanties. Take this observation when he was called out for a tricky birth:

I made a mental inventory of what I had and what I didn’t.

Obviously, there was plenty I needed: anesthesia; scalpels; suture material; an umbilical cord clip; sterile surgical instruments; forceps, needles and syringes; dressings; IV fluids; medications to stop bleeding; oxygen; isolette for the newborn; diapers. All the normal things a hospital supplies for mothers about to have a child.

What I had was: two pairs of sterile gloves; Betadine soap; a bundle of Band-Aids held together by a rubber band; a couple of syringes, but no helpful medicines to use with them; scissors that were not sterilized; and my stethoscope. It was an “up shit creek without a paddle” scenario and I knew it. (194)

This is the sort of medicine that requires constant outside-the-box thinking: a little bit of everything and whole lot of sink-or-swim.

I'm not fond of the 'My thoughts drifted back to ____' structural device that appears on and off throughout the book, but Sims is good about letting stories breathe: many of the scenarios he details are spread over multiple chapters, but they don't drag. It sounds like he and his family managed well, largely because he was willing to go outside the box and to accept that standard medical (and military!) conventions, not to mention white American cultural conventions, wouldn't always apply. The end reminds me, though, that unlike Billington (of House Calls by Dogsled) Sims wasn't in the Arctic by choice: his family spent sixteen months there and made a point to integrate as well into the community as they could, but they were more than ready to leave by the time they did and would have left earlier, given the option. Choice makes a difference, doesn't it?

(Three and a half stars.)

[Jessica · Rating 4 out of 5]

Dr. Tom Sims was working an internship at San Joaquin hospital in California in 1971. This was during the Vietnam war, but his draft had been deferred by college, then by his hospital internship, but now the military wanted to rescind his deferment and send him to be a MASH surgeon in Vietnam. At the time Dr. Sims had a wife who was pregnant and a two-year-old daughter. When a coworker gives Dr. Sims an out he jumps at the opportunity - he can serve as a PHS physician in Alaska under a military contract helping care for remote Native communities AND bring his family with him. So, Dr. Sims, his wife Pat, their daughter Chantelle, and a menagerie of pets all pack up and move to Nome, Alaska. Dr. Sims and his family weren't quite prepared for just how rustic Nome would be, but they make the best of it. Dr. Sims being the only physician for several miles around has some interesting experiences - an early one was performing an emergency appendectomy by flashlight when the power goes out at the hospital. For all the hardships, there was also a lot of good during their time in Alaska - they made friends and experienced things many people would never experience outside Alaska. But, the remoteness and some political issues between the private hospital and PHS push Dr. Sims and his family to transfer the Anchorage for the rest of his military service. Dr. Sims does a great job in telling the stories of his family's time in Nome. The book reads almost like fiction and has a lot of action. I do wish there had been some follow up about some of the more memorable cases, but overall it was a great book that I just could not put down.

[Brenda · Rating 4 out of 5]

4.5

A young doctor being trained in the finest facility to become a pediatric surgeon is about to be called up and sent to Vietnam as a MASH surgeon during the war. He is given another option - go to Nome, Alaska as the ONLY doctor in the area to serve about 3000 people in the Alaskan Bush (as it was called then). He chose Nome so he could bring his young daughter and very pregnant wife, along with all their pets, and not leave them behind. And, the adventure begins! One doctor and a very reliable nurse with a very belligerent man who was playing dirty politics with the young Dr. Sims faced a year of unbelievable adventure and challenges.

I loved the goodness and bravery and most of all his love for the people in Nome as he faced every situation as one he wanted to provide the best medical care possible, even if he had to be pretty creative at the time.

[Carrie Elizabeth · Rating 5 out of 5]

I just loved this memoir. Dr Sims on the verge of being drafted as a MASH surgeon opts for Alaska instead. He winds up in Nome Alaska a rural area where the last doctor was recently "run off" by the people due to his inappropriate behavior. With little equipment, minimal but great nurses, a terrible hospital administrator and often his wife's help he must earn the respect while treating the people of Nome and multiple surrounding Eskimo Villages.

What an adventure. As a nurse i love this. Dr Sims creative ways to handle emergent, unusual situations was entertaining and comical. He made the best of a situation that clearly was disastrous. From on the fly appendectomies to treating residents animals to delivering multiple babies this was wildly entertaining. I listened to the audio version and the narrator was fantastic.

One of my most beloved memoirs i've read 5 Star

[Lindsay♫SingerOfStories♫ · Rating 4 out of 5]

This was a really fun and interesting medical memoir about a doctor whose plans to become a pediatric surgeon were changed when he was drafted and sent to become the only physician in remote Nome, Alaska. I found myself listening for hours on end to his adventures in the clinic and in the tundra delivering babies, saving sled dogs, triaging all manner of injuries, and flying or snow machining to different locations to consult patients with limited resources. Laughs and heartache abound. What a ride!

[KayDee · Rating 4 out of 5]

If you like books like Call The Midwife or medical memoirs, you’ll enjoy this book. The isolation of a medical assignment in Nome, Alaska is apparent on every page. Dr. Sims was with the Public Health Service when he started a 2 year assignment in Nome and his wife and family accompanied him. It’s a book filled with excitement, trauma, laughter and tears. Plus, it fits in well with my “blizzard/snow” themes that it seems I’ve become addicted to.

[Heather · Rating 4 out of 5]

A well written memoir, On Call in the Arctic took me back to our first years in Onaway which is a far cry from Nome, Alaska, but at the time ...with it's extreme rural, snow-laden geography and small-town culture...felt like our great northern adventure. A notable difference: the author and his wife stayed 16 months; Chris and I made Onaway our home for 22 years!

[Gel · Rating 5 out of 5]

I really loved this story and hope the author will keep writing! He has a great narrative voice and captivated me from the first page. A great book for anyone into medicine and/or wilderness. It has a James Harriet and Jack London feel.
My only qualm is that it was very poorly edited - there were extra words and extra punctuation throughout.

[Isabela · Rating 4 out of 5]

The story was entertaining and heartfelt and also unbelievably relatable. It did not make me want to move to the Alaskan fronteir by any means but it surely made me love the people from there and respect their survival skills and way of life. I loved his relationship with his wife and the medical stories he told but, mostly, I loved how he grew, how he dared, and fought, and forged his way and grew strong friendships along the way. Also... it made me incredibly grateful for warm weather.

[Collin Filley · Rating 5 out of 5]

Great read! Really cool story about adapting to practice medicine in a harsh environment.

[Dane · Rating 5 out of 5]

Almost quit this book in the first couple chapters. So glad I didn’t!

A “James Herriot” feel in the arctic Eskimo village of Nome.

[Joy Carrington · Rating 4 out of 5]

A fascinating memoir about the experiences of the author practicing frontier medicine in rural Alaska. I really enjoyed it!

[Elizabeth (thebookedcookie) · Rating 4 out of 5]

I’m always interested in books about medicine. This book not only involves medicine, but it’s in a remote setting in the 1970’s. It’s a fascinating look at the Alaskan frontier with its accompanying racism and lack of up to date resources.

This was a fast paced story with plenty of misadventures and heart stopping moments. The politics that were present in the medical setting in Alaska are not so different than hospital politics today. I found it interesting to see how Dr. Sims dealt with the lack of equipment and the ways he was able to improvise to save lives.

I can’t imagine moving to such a remote place with a pregnant wife, trying to win over a community, and deal with non medical people who think they know best. I could feel the stress. I haven’t read very many memoirs. I found this to be enjoyable and was grateful to read it in my comfortable home which is located close to a state of the art hospital.

This book contains strong profanity and medical gore.

[Liz · Rating 5 out of 5]

Really enjoyed listening to this audiobook of a physician’s memoir of his experience with an unexpected placement in Nome, Alaska.

[Caroline Filley · Rating 4 out of 5]

Good little heart warming read. I am always a sucker for some stories about rural medicine, something about it touches on the root of why I am becoming a doctor so it makes me feel sentimental :,)

[Kimberly · Rating 5 out of 5]

A well-written memoir that I found fascinating! Audio narration was well done too. Some language but not excessive.