Spring

Again I hiked alone in the Chugach mountains along Turnagain Arm, climbing the same mountain today as I climbed one week ago.  But, how different it was! A week's time can change so much in nature, and so little out of it.

Henry Thoreau spoke of the honking of Canada geese as one of the archetypal sounds of his Walden woods.  I can see him stopping, during one of his walks, to look up through the canopy of mostly bare spring or autumn trees at the groups of passing geese, their anxious, clownish calls halting his thoughts. 

Beyond the summit today I had continued along the high ridge another mile, farther than I had walked before, on large drifts of snow, until I reached a small rocky overhang where a swift and sailing rock ptarmigan had earlier made his descent.  There I lunched, enjoying the warm sun and pleasant absence of wind.  

On my return to the summit, I heard Thoreau's goose, distant but ringing, far above and far to the south, above adjacent higher peaks.  There in the bright sky a dark and thin line approached, rising and undulating until it passed above me.  The flock of seventy geese, the first of the season in this area of Alaska, shone brightly as they migrated over the range of alpine ice and rock, nearly one mile high, yet much closer to me, to their breeding grounds.

This was my day's elation.  The previous week, it had been the discovery of the diminutive golden-crowned kinglet, reaching four inches from bill to end of tail, high amongst the distal branches of a tall white spruce, busily conducting his business.  I had patiently waited, binoculars at hand, until I caught a glimpse of this new bird who had called as I passed, a call that I could not ascribe to any bird in my mind's catalog.  Returning to this area of spruce and birch, today I flushed one of my favorite friends, the spruce grouse, from the base of a large and healthy tree. Spreading the lower boughs, I peered into his dark canopy home after he had departed, orange-tipped tail fanning as he soared swiftly into a secluded recess, and found his humble quarters to be quite suitable indeed.   

It would be a good week for a spring grouse, tired of sustaining himself on nothing but spruce tips for the duration of Alaska's long winter, to be out.  New to the woods this week, and to the upland shrubs above them, were butterflies, brown, orange, and yellow, another first of spring.  

At home, I learned that this was the Milbert's tortoiseshell, a hardy creature that hibernates in the snow through the winter until the  sun stirs it back to life.

Hiking Alone

I hiked alone in Chugach State Park two days ago, up and along a coastal mountainous rib known as Bird Ridge, on an early Spring day that followed a few weeks of warm weather.  The winter had been mild and dryish and was over, and I went to shake off the infestations of my primary environment, a city dense with people, and its unceasing demands of me.  I also went to see if I could find some interesting birds.

I wore a new lightweight shell, and as the wind whipped and roared along the cliffs and lower hills near the coast, and as light, ephemeral rains fell, I climbed gently, warm and dry.  This trail was an old acquaintance, I having hiked it some dozen times over seven years, and I knew it well enough to not feel lonely, despite the morose weather.  Small, thin clouds, wispy collections of fog, moved hurriedly down the coast, bunching together and coalescing as they rolled up a slope, and then splayed over a peak would encounter a wide space and dissipate.  Underneath my feet, the snow and ice had melted and there was wet earth and rock.  My route took me east and up the southern face of a large hill, and the spruce and poplar forest, where I had once found a moose and her calf, and another time a young goshawk, then began to thin.


How peculiar and familiar is the happiness one feels, alone in the woods, on the mountain's side, indeed! How free one knows himself to be, in that moment at least, when the straight lines and right edges of the manufactured environment are not around him, not walling him, corralling him, leading him, penning and pinning him! How awake one does become when he drinks air agitated and fortified so by its rough course over coast and cliff and woods! When his purpose is only to breathe deeply and follow a meandering foot path, how content one is! 

In the upland of these mountains, thick grasses and thickets of alder and willow carpet the earth, and it is here that I see the willow ptarmigan in my mind.  There, in a small clearing in the thicket, recessed in a shadow, sits silent and motionless the sentinel cock, betrayed to me only by his red eye comb and his heavy grouse form, painted white and auburn, perched above snow and amidst bark.


...

Back in the trenches and thinking BIG

The crux of our problem in underserved primary healthcare is the competition between access and quality.  The demand for primary care providers like myself far outstrips the supply, so unless we work at a frenetic pace, the majority of patients can't access our services.  The government, providing public insurance to the underserved, cares about access for its people, so reimbursement rates to clinics are set to essentially guarantee we maintain this pace, to keep our clinic open.

Providers also yearn to provide adequate access to care, but we get are ensnarled trying to deliver it.  Electronic health record programs and information technology setups in our clinics are purchased on the cheap, and rate-limit the provision of health care.  The relative financial cost of this mismatch between actual and adequate IT power seems difficult to overstate.  Providers like me cite "the EHR" and "the computer" as major and permanent job dissatisfiers, and fewer patients are seen due to sluggish, cumbersome processes.

I imagine a clinic where the EHR is intuitive, lightning-fast, and virtually crash-free,  and smoothly integrates with the larger IT setup.

Or, as a consolation and a viable workaround, one where the providers quickly dictate orders to other staff.  While others are fighting tortuous computer workflows, we are spending time with patients and making medical decisions with them.

In either scenario, the clinic operates at a higher level. More patients receive healthcare, providers are more content, and revenue increases.

Alaska moves now into winter.  After such a long and brilliant summer, my heart almost forgot about winter.  An equal entity.  Like good and evil, or male and female.  Summer and winter.

I'm considering the idea of taking more control over my life, and when I consider that, I look at this Alaskan winter as potentially my last.  One more winter, then one more summer, and then goodbye.
It's like jumping out of an airplane:  you go all out, knowing you're safe, and that it won't last forever.

My life, like that of everyone I know, is in a particular stage of senescence.  An early stage, to be sure, and to be hopeful, but, senescence none the less.  My body, my virility, even my mind - these things aren't as sharp as they were a decade ago.  And why should they be?  I don't want to cheat time.  We have our day, and then, that day is over.  And the next day comes.

I think about returning to the southwest and settling there.  Working part-time in primary care.  Having time to sleep in, or stay up late, or drink hot tea leisurely with something to read and my cat; time for mid-week hikes; for three, four, or five day road trips; for hunting; camping; touring; bouldering; piano; photography.  Time for friends, old and new.  And time for a home, for a wife, and for a family? The latter are such giant dreams they are difficult to know.

I wanted to write about what I've been doing up in Alaska, and share some of my thoughts about this place.  It may take me a while to get there, or, I might get to the point.

People will sometimes say, in earnest or with the hope of propagating the idea, that all places on Earth are beautiful, perhaps equally so.  I've explored that idea here and there.  I don't see the beauty of all places, but probably all places where the built environment is limited.  Nature really can do it better.  Has taken me years to figure that out.

There are many environments in Alaska, many of which have little in common with one another.  It is such a huge piece of land; of course it's a diverse place.  

The tundra in particular really is beautiful to me.  It's the landscape mostly ignored by the business of selling Alaska to tourists.  And it's the place where Alaska is most definitely sold to the business of energy.  No judgement here and now about that.

It's the starkness and openness of the tundra, macroscopically, along with the exotic tiny units that are it's building blocks, that interest me.  Fully aware of the relative nature and thus limited value of the adjective 'exotic', it still feels like the right descriptor.   Nothing strange or new about the tundra to the people and other creatures who have lived here for thousands of years, but in context to what I know and where I'm from, it is exactly those things.

I'm just learning the first things about the tundra, and these little things promise me a lot more discovery and wonder.  It's a fleeting place, as a prime example, and of course this makes for all sorts of make-the-most-of-it moments.  If I could sit still long enough, I'd write pages about the bog blueberries alone. If I ever got a handle on the birds of the tundra - where they're from and how they live their breeding lives out and when they decide to go - I'd lose myself trying to present that subject in a form that could fit into anyone's modern schedule of rushing around.

When I look out at the expansive rows of slopes that stretch for miles toward the modest ranges of mountains over there, or, the blue sea over here, I see inward.  Here in myself I see a scattered collection of life ways that would never fit here, that would have no place and would not last more than a season.  It becomes obvious, put plainly, what unnatural and therefore unhealthy things I'm stuck on.  The tundra, I guess, feels therapeutic.  

This is how I must begin to do it - describe my experiences in Alaska.  The cheerful, linear, and so easily accessible format of something like a photo-blog, my initial plan, I discarded as soon as I stared at a blinking cursor on this plain white screen.  The pictures I have don't tell much of the story.  At least not the back-story. Very few things are easily accessible here, and there has been little immediate bliss for me in Alaska, so offering up that feeling for a reader seems totally unsatisfying for me.  So that's it:  I embrace the opportunity to color your impressions of what things are like here.  Having been someone who couldn't see the beauty for too long, I'm afraid you'll miss it too, if I don't spell it out.  But, with an atrophic mind for writing these days, I'm not sure if you'll understand.  Will I get you to where I want you to go? Ha.

So much of the built environment of Alaska, especially rural Alaska, looks overwhelmingly shabby at first.  I don't think many people can get over this sentiment quickly, or ever.  It has taken me years to appreciate this genuine, beautifully pragmatic, aspect of human life here.  It makes me chuckle to see so many of my assumptions and paradigms turned over on themselves, as confusing as that can feel.  Spend some time in the tundra, and it feels lunatic to consider replacing anything for reasons of form alone.  You don't build beauty here; you live amongst it, and you add or subtract to it in small ways.

Wealth has a completely different meaning here, and a facade that betrays you, if you apply the dominant explanation for wealth to the people or built places in Alaska.  I have never considered that a non-cash economy existed anywhere on American ground, but, here it is, persisting underneath.  I have this vague feeling that potential answers to many of our modern social diseases might just be here with it.  No more about that, though.