Two years ago, a quest for adventure led emergency physician Jason Matyascik, DO, to a position in Barrow, Alaska. At the top of the state, Barrow is the country’s northernmost city. It has roughly 4,400 residents and gravel roads because the harsh weather would damage asphalt. Much of the year, Barrow is landlocked and the only option for entering or exiting the city is by plane.

In this edited interview, Dr. Matyascik talks about working at Samuel Simmonds Memorial Hospital, the primary medical facility for the North Slope region.

What’s an average day like for you?

Some days, I’ll see close to 30 patients in a shift, and I won’t lose a bead of sweat over any of them. Other days, I might only have two patients, but they’ll both be flown in from nearby villages.

Our hospital is a critical access hospital. When we get a patient who’s in critical condition, everything comes to a screeching halt, and we use all of our resources to take care of that patient.

Some days, I do a lot of telemedicine. In addition to Barrow, the hospital covers five villages in the area that are only accessible to our hospital by air. I spend a lot of time speaking with staff at the village clinics about their patients. I often have to decide if a patient can be treated in the village or if he or she needs to be flown here or to a bigger hospital.

A novel approach to work-life balance Dr. Matyascik works two months on and two months off, which means he has six months of vacation time every year. When he's off, he usually travels or heads to Pennsylvania, where he's based, and fills his days with gardening and outdoor activities. In Barrow, Dr. Matyascik works 60 to 80 hours per week, but preserves work-life balance by exercising five days a week and playing guitar with fellow musicians on Saturday nights. "I play classic rock with several musicians in their 50s and 60s who are really talented," he says. "They call themselves the Barrow Tones. We play in an old roller rink."

What is your patient population like? What are the common illnesses and injuries you see up there?

The population of Barrow is about 60% native Alaskans. Most young people speak English, but many seniors only speak Inupiaq, so I use a translator when I treat them.

Subsistence hunting is huge here because it’s expensive to have meat shipped in. The locals eat a lot of meat from marine mammals such as whales, seals and walruses. It’s also quite dry here. The local diet and dehydration produce some of the worst cases of constipation I’ve ever seen. Patients come in with terrible belly pains. After treating them, I tell them to drink more water.

Children of all ages drive all-terrain vehicles here. They rarely wear helmets, so I see a lot of trauma from accidents. I also see a lot of mountain bike wrecks, especially in the summer when it’s daylight all the time. I’ll get kids coming in at 2 a.m.

What’s the most challenging thing about practicing in Barrow?

The greatest challenge is working with the limited resources we have here. We don’t have a surgeon, an anesthesiologist or an operating room.

Equipment failures can be a problem. I once had a ventilator that wouldn’t work, and I had to have one of the hospital staff hand-ventilate the patient for five hours until we could get a plane over that had a vent inside.

What’s the best thing?

I have more freedom to practice medicine as I want. I’m the admitting physician here. If I want to admit a patient, I just do it. I don’t have to explain to anyone how the patient meets admissions criteria and how the hospital will be paid for the stay.

There’s also a real sense of community here. People look out for one another. One time, the police called me because they saw one of my patients at a party. “Doesn’t he need to have his stitches taken out?” they asked. They picked him up and brought him over. After I removed the stitches, they took him back to the party.