One of my patients in clinic yesterday was 77 years old, from the village of Scammon Bay.  Dressed in traditional attire and speaking not a word of English, she began weeping when I asked, through a translator, how she was doing.

She had lost her husband 4 months previously, and was still missing him greatly.  She took comfort in the fact that he was happy with his grandchildren and the creator in the sky, and no longer suffering on Earth.  Hearing the story in the native language, though I understood not a word of it, was especially powerful.



Walking on the Tundra in the summer is like walking on a giant sponge – mud-soaked greenery sinks about two inches to permanently frozen sod, the effect of which makes shoes dirty.  It feels not unlike walking on freshly-laid carpet with very thick padding.  It’s actually quite fun.  What I didn’t realize is that tundra stops and marsh begins where the tangled greenery is replaced by tall grass.  My attempt to walk through a marsh soaked my pants halfway to the knee, and my shoes are still drying.



Found and walked through the cemetery in Bethel a few days ago.  I’d assume that people can only be buried in the summertime, given the weather otherwise, and not too deeply given the permafrost.  Most of the graves are marked by wooden crosses – I’ve been told that headstones are too expensive to fly in for most families.  A few existed, but I’d say that a majority of the graves were marked only by the crosses.

One of the headstones that did exist marked the grave of the last great Yup’ik steamwheeler captain of the Kuskokwim River.  I would have liked to have met him.



A certainty of Bethel is that the beauty exists on a micro rather than a macro level.  The overall town is nothing impressive, but in the details lie a world not seen anywhere else.




At 6:30 this evening, I headed from my house down Main St. toward the river, where I met the husband of my boss.  Dave McCormick owns a marine store that sells boats, motors, 4-wheelers and snowmobiles, dirt bikes and accessories.  My job was to assist him in dropping a boat motor onto his wooden craft.  This activity went smoothly after 3 hours of shuffling boats, ATVs and snowmobiles around his lot and now, hopefully, there’s little else to do but go fishing.

Next door to Dave’s shop is a small green house on permafrost stilts that I believe to be a speakeasy – or at least a racketeered liquor store.  Remembering that Bethel is traditionally a dry town, a great number of drunks stumbled out of the building – some after walking in sober.

Backing up a moment, to the fishing, it’s wise to know the traditional seasonal varieties of salmon on the Kuskokwim River.  Around the first week in June, King Salmon swim down the river, getting larger as the weeks wear on.  Some three weeks later, chum salmon follow.  Later come red salmon, then silver salmon.  Always a salmon to look forward to.


3/11/09 – Let’s not forget smelt.  Smelt fish run before the king salmon.


Earlier today, I gave a 91-year-old woman better vision than she’s had in some three years.  Afflicted with a degenerative, blinding disease, her acuities would be unacceptable to any of us.  I got her knitting again, and she – and her daughter – were grateful.

Play practice cancelled tonight.  Half the cast absent.

Hail the size of BBs fell from the sky on the walk home this afternoon, and strangely I found it a preferable alternative to the thousands of mosquitoes I’d be facing otherwise.  Walked to work today on an old boardwalk connecting 1st Avenue Access Rd. to the site of the old hospital – a ground with stilts still beaten into the permafrost located behind the eye clinic.  There, I was swarmed.  Had my face well protected with OFF, but the damn things bit me on the parts of my hairline not covered by my hat.  I think I’ll take the main road tomorrow.

Last night was my first official play rehearsal, and the Bethel Actor’s Guild seems amazingly adept at theatrics.  They’re not quite the amateurs I expected in a place like this.  I, on the other hand, can’t seem to find my muse, even for a collection of one-acts.  In the first, I’m a grief-stricken homosexual, and in the second, a college student holding his breath while the moon rises.  Good fun, these shows.


3/4/09 – Really?  I say I can’t find a muse to play a grief-stricken homo?  Am I serious?


In clinic today, a village elder came in, fresh from the pneumonia ward.  One wonders why, after having been cooped in the pneumonia ward for days, a village elder would opt to have his eyes checked.  I suppose that’s not for me to say.

As it was, at 1:00 in the afternoon, a wheezing, bronchial coughing old man perched in the waiting room as a walk-in.  I was in my room in the back when I heard the throaty death rattle and throat clearing begin.  It sounded not unlike a goose honking, only more sustained, as the man was clearly expecting fluid.  After several minutes of this, I queried the receptionist as to the status of this gentleman.


3/4/09 – “What the fuck is going on out here? ” I asked.


One might ask, at this time, exactly what an “elder” is.  I think, sometimes, that it’s a creation of crazy white people, because nobody seems to be able to define what it takes to be an elder.  One must be a native American, it would seem, and in ones sixties at the youngest.  Or at least looking sixty.

It’s difficult communicating through a language barrier, much less to somebody with an old-school culture whose values and traditions I still don’t necessarily understand.  Perhaps I must work harder.

Cinco de Mayo


I guess that the alarm bells should have rung when the Yup’ik woman who had dragged me onto the dance floor began baying like a yak.  I’d been dancing on the floor to a mobile DJ at the Cinco de Mayo party for a short while when the front of my shirt was grabbed by a woman I recognized as an employee from the hospital cafeteria.  With little haste, she threw her large arms around me with great force and pressed her boobs to my chest.  Spinning, she ground her fat ass against me, and pinned me.  There was no retreat. 

Suddenly, she began baying like an ox, and within seconds a drunken man was threatening to beat the shit out of me unless I left her alone.  Me leave HER alone?  I wanted nothing more than a cattle prod to keep her, in her drunkenness, away, and for her to release me from her clutches of lard.

I wanted no part of whatever was going on and literally forced myself away from the crazy woman who, even then, still gripped me tightly.

Native American Eskimos and alcoholism is a well-documented problem.  There are laws in Bethel against the sale (but not possession) of alcohol as a result.  Perhaps there is good reason behind the decision.  It would seem that there’s something cultural regarding the amount of alcohol consumed in a setting, as a bottle that’s started apparently has to be finished.  Nobody – at least at this party – stopped after one or two.

Moreover, could there be something genetic about HOW alcohol affects Bethel’s citizens?  I ask, because people tend to get very drunk very fast, and hammered particularly hard.  The result was a party with grown adults falling over, dropping bottles without realizing it, trying to start fights, and driving home afterword, even if unable to walk.

Overall, however, things went very well.  I took my first tequila shots this evening, which were especially potent.  I’m surprised I didn’t go blind.  The DJs were good, too, spinning club tunes -a couple of high school guys.  While others continue to party, I’m going to bed.  Tired.


3/2/09 – Coming home from the party, I remember staring up at the midnight sun.  It wasn’t the solstice QUITE yet, but getting there.  Pretty cool.

The mosquitoes have made themselves known to me over the past two days.  Though my first several days here were insect-free, I was swarmed on my way to work yesterday, ultimately fumbling for my bug spray (“bug dope” to the locals) all the while wishing that I could pull my jacket over my head and run, beating them away like Tippi Hedren in “The Birds.” 

Insect repellent is only half the battle, though.  These bugs bite through clothing and hair, often getting tangled and requiring brushing out.

According to the locals, these mosquitoes last until July, when much smaller “no see-ums” appear in their stead.  At this point, I wish that there were a bat population to offer control.

The most trifling part of the Alaskan mosquito issue is that there’s no rhyme or reason to their attacks.  Early morning, late afternoon, sun, shade – they seem less a problem in the wind and more attracted to dark clothing, but shy of that they could attack (or not attack) at any given time.


3/2/09 – Many houses in Bethel are built near still water ponds that, while frozen and inert most of the year, thaw into mosquito puddles come summer.  Our house, on Mission Lake, was no different.


Today I begin work on a couple of one-act shows for the Bethel Community Theater Company, the Bethel Actors Guild.  This should give me something new to do and memorize.  The company works out of the old Swanson’s Theater – a former movie house.  The inside of the building – a mess of old props, bills and construction equipment – re-awakened my love of theater and I can’t wait to get started.


3/2/09 – I’m still impressed that a small town like Bethel had a theater troupe that presented shows like Agnes of God, and had quirky theater-types.  It truly filled a niche in my soul that had been missing since the end of college.


Today, on the 8th of June, a Cinco de Mayo party is scheduled.  From the sound of it, most of the town is going.  Admission cost bought T-shirts for the event.  Some are for men, some for women, and each has a unique sombrero design.  It should be a fun time.



The hospital for which I work – The Yukon Kuskokwim Health Corporation – is the biggest game and only healthcare provider for an area the size of Oregon.  It has 27 Beds, satellite clinics exist in smaller villages, and smaller clinics yet exist in smaller villages, yet.  Still, the hospital is the epicenter for all things medical in SW Alaska.

Across the street from the big yellow space-bubble-like hospital is a brand new annex housing the optometry and dentistry divisions.  This is where, along with three staff doctors and 2 other interns including my roomie, I practice daily.

To say that I feel like a minority is an understatement.  The hospital preferentially hires Yup’ik Natives, and even during orientation yesterday we were privy to a propagandized video by the Indian Children’s Health Service.

The ICHS is an organization that takes native children who have been abused or neglected and places them in homes of other Native Americans in hopes of preserving their culture.  In the video, a young Alaskan girl is forced into a white home, where she sulks miserably and sadly as she is forced to eat lasagna.

Do the Yup’ik people never eat lasagna?  Is that such a terrible life?  Hell, the cafeteria served lasagna yesterday, and I’m sure that plenty of Alaskan natives ate it.  The Yup’ik culture is very important, without a doubt, and needs to be guarded.  But lasagna?  Really?

Permafrost is a swampland, only further north and with a fancier name.  Frozen solid in the winter months, it turns to mush in the summer, necessitating the construction of often crumbling boardwalks in many portions of the town.  The lack of paved road – impossible to maintain in the winter, I assume, gives a dirty feel to all of Bethel and one gets a vibe of entrapment and alcoholic hopelessness from many residents.  Dogs tend to roam the streets unleashed, not helping my nervous fear of canines.

For what is ugly in Bethel – the crumbling, shanty-town like horizon with only the faintest view of mountains far away – there is some beauty.  The sky is clear in a way I’ve not witnessed before, with no haze and huge clouds.  The river produces tons of fresh fish each summer, and one hears that wild berries exist everywhere and that a short boat ride on the Kuskokwim takes one to not only berry patches, but miles of untamed wilderness.  Tundra rains, lasting all of 15 minutes, give way to clear skies and sunlight.

Coming home from work today, I decided to take an alternate road.  Not two minutes into my detour, I regretted the move as unleashed dogs barked and snapped at one another ahead.  I did, however, spy a woman of about 50, jogging toward me in the distance.  She soothed my nerves as surely she’d be better prey.  It wasn’t the dogs to whom she fell prey, however, but a woman in her mid to late 40’s yelling at her from a porch about “pushing it without stopping.”  When the jogger was well past, the woman’s attention turned to me, still dressed in clinic attire.

“What,” she asked, is a jogging woman and a guy wearing a necktie doing on a road reserved for drunks?” she asked.

“I don’t know,” I replied, “but I’m starting to wish that I were, myself.” 

With this conversation began a strange friendship with Hoppi.  An American by birth, Hoppi previously lived in Mogadishu, Somalia and considered Bethel “a step up from that.”  She’d just obtained her first salmon of the season.  Her refrigerator was unusable, as it was filled with peat for gardening, so she gave me half of the fillet.  She invited me into her modest home and cleaned and prepared it for cooking.  475 degrees, 45 minutes.

She gave me a 20 minute tour of shortcuts to the hospital, with such advice as “if you turn down this path and hear dogs barking, find another one.”  Hoppi was friendly in a pure, earthy Hippie sort of way that I quite enjoyed.  As I walked home, raw meat in hand, I only hoped that the dogs wouldn’t notice.

Water came today – perhaps the best thing to happen in the past two days.  Tundra and sub-zero temperatures, not being friendly to underground pipes, mean that many houses are filled by the city water company every Monday.  When I arrived in Bethel on Saturday, the house was dry as the pump ran endlessly.

Before going forward, let me go back two days to Saturday, when half-drunk on Irish Cream I touched down in Bethel.  It’s amazing, really, that 737s even visit this barren land, so desolate is it in appearance.  Nonetheless, it is the transportation and dry goods hub of the Yukon-Kuskokwim Delta.  With few miles of paved road, Bethel is only accessible by air, even to many of the surrounding villagers.


11/19/07 – I miswrote this entry.  I was fully drunk on Irish Cream.  Imagine, in the following text, Dr. Pam Conrad meeting me at the airport and alcohol bubbles coming off of my head.  Irish Cream goes down too easy at altitude.  How embarrassing.


Dr. Pam Conrad met me at the airport, and after small talk and pleasantries, left me at a house on Killbuck Street where I learned I’d be living with a Canadian intern named Dave.  The house itself is beautiful, but with an open floor plan does not provide much privacy.  Surrounding both floors are wooden decks overlooking a large pond known as Mission Lake.  The house was equipped with DVD player and espresso machine – just no water.

Dave arrived soon after me, in from helping to coach little league, and we agreed that the first order of business was in fact water.  Emptying huge buckets of dog chow into garbage bags, we took as many containers as possible, including mosquito-ridden pails and a large black garbage can, to the community well.  25 cents provides 20 gallons of water, and we took as much as we could both at 9:30 PM Saturday and mid-afternoon Sunday.  This, at least, got us through to our water delivery.

The local AC Store is a very sizable supermarket, also featuring clothing and furniture, all at very sizable prices.  A 12-pack of soda is $7 in Bethel, and a bag of Doritos, $6.  Most of our food will come from meal vouchers provided by the hospital.

A black cat named Bob came with the house, and though he’s an added responsibility, I think we’ve become friends.

Anchorage, AK


Anchorage International Airport
Gate B8

In one hour, as I board my flight to Bethel, my stay in Anchorage will be at an end.  I have no complaints of the past two days.

The sun was still shining at 10:30 PM when I arrived in Anchorage on the 30th, and though I’m sure it set sometime after 11:30, the sky never went dark.  This fact, however, made jet lag slightly more bearable.

The Native Heritage Center
Yesterday was beautiful weather-wise, though my morning tour was beset with problems.  I was the youngest person on the bus by 30 years, with most of the passengers from cruises.  Because of technical and personnel problems, what should have been a tour of the grand highlights of Anchorage ended up being nothing more than a trip to the Native American Heritage Center.  Still, the center – full of its laminate displays and track lighting – was nice, as were the people I encountered.



11/18/2007 – Remembering this particular tour makes me remember the heritage center as being better than, simply, “nice.”  I ended up with a crush on an Aleut guy named Lucas, and for fifteen minutes I wanted to spend the rest of my life in his display hut.  Equally kind was medicine pillow-sewer Jessica though I didn’t have a similar desire to marry her and have kids.  On meeting people like Jessica and Lucas, I feel bad about being a tourist, watching the people I’m with ask for bathrooms and gift shops while I’m trying to flirt.


Portage Glacier

After finishing the Anchorage City tour that was anything but, I changed busses for a tour of Portage Glacier via the Alyeska Ski Resort.  Along the road southbound from Anchorage stretched Turnagain Arm – a large bay filled with water at high tide and silt at low tide – for miles and miles before a mountain range.  The silt was known for its deadliness, reacting with the salt water of the bay to harden like cement – ensnaring in it moose, wildlife, and unlucky boaters – before the high tide came back in to drown.  Bald Eagles and Moose were commonplace.

A quick cable car to the top of Mt. Alyeska revealed an impressive view before we continued south on the Seward Highway through the Chugack national forest in an area once covered by Portage Glacier.  The many glaciers in the area were expected to vanish within the next 100 years.  A cruise took us within 100 feet of Portage Glacier where, every 15 minutes or so, a chunk of glacier would crumble, or “calve” into the water with a thunderous roar not unlike that of a shotgun.  This is how glaciers recede, crumbling into icebergs and nothingness.

In the evening I headed to Anchorage’s only gay bar, about a mile from my hotel.  Mad Myrnas was, overall, a fun experience.Yesterday was spent on a walking tour of Anchorage in shitty weather that made the whole ordeal blase at best.  Talked to some drunks, had a cider, went to a small bookstore and marked time before my flight to Bethel.



Greater Pittsburgh International Airport
Gate D89

Ticket to AnchorageIt’s still not quite hit me, as I sit here at the airport, that I’m about to board a plane to St. Louis and then to Anchorage, Alaska.  Further, I can’t fathom that in two day’s time I’ll board another plane to Bethel, where I’ll be living for three months.

Somewhere in my mind I feel this to be a vacation – back to Philly in two weeks, and to my Lynnewood Gardens apartment and my former way of life – except that the apartment is vacated, the lease expiring in my absence, and Philadelphia a memory.

People ask why I willingly chose the last frontier as my first in my senior year of optometry school.  There are myriad reasons, I suppose, including the opportunity to travel and live where I’ll likely never live again.  But there’s something more to all of this that I have difficulty committing to paper.  I believe, in a sense, that I go to re-establish a sense of self – that I’m still human, and maybe that’s okay.

Pretty tired at present – woke at 4 AM to be here on time, and after check-in went downtown to catch up with my dad’s second cousin who works at the Omni William Penn Hotel.  It was good to see her again and that she’s doing well for herself and her family.

I was dropped here at the airport after a trip to the new mall in Robinson Township.  I now wait across from a very cute, most likely straight guy who will likely never look up from his climbing magazine to notice me.  Then again, why should he?

Flight to board in 15 minutes.  Wheels up at 2:59.

Copyright 2002, 2009 Carter Liotta