Into The Wild: Northwestern Graduate Braves Rural Alaska to Bring Chiropractic Care
Posted on April 14, 2008
It’s a frigid winter weekday. In a rush to make it to work to time, you step outside, bracing yourself, as that tentative first breath of painfully cold air hits your lungs. Taking your first step into the freshly fallen snow, you trudge to your vehicle. Turning the key once, there is a mild sputtering sound, but nothing indicating the engine has ignited. You try again, with the same result. Sighing, you adjust your seal skin and beaver hat, abandon your snowmobile and take off for a walk through the arctic wilderness to your office.
For some this may seem like an exaggerated tale of winter in Minnesota. For Lewis Pagel, DC, a chiropractor and 2004 Northwestern Health Sciences University graduate, it’s just the beginning of another workday – north of the Arctic Circle. In a place where he sometimes receives payment in native crafts and caribou meat and common injuries include broken backs due to falling off cliffs, Dr. Pagel has found his chiropractic calling in Kotzebue, Alaska, located north of the Arctic Circle on a peninsula.
Dr. Pagel, who says he was born with a sense of adventure, feels he is living a dream. Although he owned his own practice in Owatonna, Minn., he longed for something unique, that would enable him to help others with little or no access to health care. Fortunately his wife, Rachel Ahrens, was more than willing to encourage his passion for the unknown, and actually found the job posting for him through Northwestern’s online resource center.
Now, a year later, Dr. Pagel, who works for Arctic Chiropractic, wouldn’t have it any other way. Arctic Chiropractic is owned by a native Alaskan, Walter Campbell, D.C., and is part of a chain of small clinics.
"This clinic is over two years old, but Kotzebue only had a part-time chiropractor before,” Dr. Pagel says. “It’s hard to sell this type of job because it’s very isolated. I think it probably takes a certain type of person to do this.”
When Dr. Pagel first arrived at his new home, two months before his wife, he says it was an exhilarating moment.
"It was negative 60 degrees, but clear and sunny,” he says. “It’s a dry cold, not like Minnesota, so it doesn’t feel as cold. I can cruise around on a snowmobile, but everyone has to have the right gear. Here, you get to know people by their coat rather than by how they actually look. There’s no road system, you can only get in and out of Kotzebue by boat or plane.”
Usually Dr. Pagel takes his snowmobile to the clinic, which is located in a hotel a few blocks from his house. Some days, however, even the snowmobile won’t start due to the cold. On those days, Dr. Pagel says, he and his wife have to walk.
"Everything here was very new to me,” Dr. Pagel says. “A lot of these people, the majority of who are Native Eskimo, don’t work in the traditional sense. They work very hard and hunt for the community, but aren’t paid in money or have access to health care. They live what is called a ‘subsistence’ lifestyle. I was ice fishing one day next to about 10 ladies doing the same thing. They fish to feed their families and dog sled teams. They shoot caribou and moose and save it. If they shoot more than they need, they take it to the radio station in town, KOTZ radio, and an announcement is broadcast.”
And when it comes to health care, Dr. Pagel says, tribal doctors are usually the first choice, but people come to him often as well, due to the natural approach chiropractic offers.
"There is a hospital here, but most people hate medications and pills more than I ever have,” he says. “For some people I’m the only doctor they see.”
Dr. Pagel said most of the people he treats have back or neck pain, which is largely due to their lifestyle, which consists of day after day of manual labor and harsh weather conditions. He also travels out to smaller surrounding villages when possible, sometimes on cargo planes.
"I have a surprisingly large number of people who have broken their backs, it’s very common,” Dr. Pagel says. “When recording medical histories, I’ll often discover someone has fallen off a cliff 20 years earlier or had a snowmobile accident. Long rides over rough tundra on four wheelers and constantly skinning caribou cause a lot of pain as well.”
Despite the feeling one has taken a step back in time when visiting a village like Kotzebue, there is a hint of modernity camouflaged among the lives of these traditional people.
Although children do attend school in Alaska, they aren’t really required to attend the way children in most states are. Dr. Pagel says many parents and grandparents don’t see the need for that type of education when they will spend their lives as hunters and gatherers. However, like any American school system, sports play an important role. In Kotzebue, it’s basketball that ignites the passion of the people.
"Basketball is huge here,” Dr. Pagel says. “People will ride 200 miles on their snowmobiles to see a game. It’s fun, but rough on your back.”
Back pain is something Dr. Pagel has a personal understanding of. As a sufferer of Scheuermann's disease, which increases the normal round back in the upper spine and results in a hunchback appearance, Dr. Pagel endured chronic pain.
"I always had back pain and I couldn’t stand up straight,” Dr. Pagel says. “My friends used to push my back and tell me to ‘straighten up’. I had never been to a chiropractor, and was actually scheduled for spinal surgery when I met Jay Fox, DC, a Palmer College of Chiropractic graduate, at a high school job fair. Dr. Fox pointed to me and told me I needed to come see him. He had me standing up straight with less pain in only a couple of months. It was my chiropractic miracle.”
Not only did Dr. Pagel gain two inches from his exposure to chiropractic care, but also a desire to become a practitioner himself. After getting his biology degree at the University of Wisconsin in Oshkosh, he started looking at chiropractic colleges.
"I thought Northwestern was the best one,” Dr. Pagel says. “I’ve always been a science person and was impressed with the amount of research that was being done.”
Even with his passion for the outdoors, Dr. Pagel never expected to find himself in Alaska. There are different challenges there, he says. Often, they are about survival. This makes a sense of community essential in a state where the suicide rates are among the highest in the world, and an injury can lead to starvation.
"Things aren’t as available here,” Dr. Pagel says. “We make the best of what we have though, and people are more than willing to help out. It’s great to see everyone working together; the community support is amazing.”
Whether that means dragging someone out in the “dark season” to play bingo to combat depression, or sharing resources, Alaskans meet the task. Dr. Pagel takes his role as a health care provider seriously. He has learned the ability to work the land is mandatory.
"If I can help these people with pain so they can go back to picking berries, hunting, or fishing, I know I’m helping them survive,” Dr. Pagel says. “In most states, you can order food and have it delivered. Here, about 50 percent of the population I treat work off of a trade system, not a monetary system.”
Receiving payment as part of the trade system is something Dr. Pagel says he does from time to time.
"I got a nice cheesecake a month ago as payment,” he says. “That was good. My wife and I also traded some hand-picked blueberries for Caribou meat.”
In such a minimalist society, one might wonder how a new chiropractor in town would advertise. Dr. Pagel, however, said it wasn’t difficult.
"When I moved here I did an interview at the radio station,” Dr. Pagel says. “Sometimes I’ll fax in song requests and the D.J. will say it’s from me and throw in a free ad. Plus there’s no mail delivery service, so everyone goes to the post office each day. If you want someone to know something, you post it there. Mostly it’s word of mouth though. In such a tight knit community, news travels fast.”
What Dr. Pagel gives the people of arctic is apparent – a way to continue living the life they want. When asked what he’s taken from them, he was silent for a moment before answering.
"They’ve given me an appreciation for the simpler things,” he says. “I am taken aback daily by the things I witness, but are commonplace in the lives of these wonderful people. Recently I took a 100-mile snowmobile ride to the village of Noorvik and came across two moose standing in front of me. I just stopped and watched them for 10 minutes, thinking about how few people will ever see that on their way to the office. In the summertime I can see seals bouncing up and down in the ocean from my office window. I can’t see anyone not getting something from this experience. It’s very rewarding and the people are so appreciative of what I do. To see that type of appreciation really changes you.”
As Dr. Pagel continues to change the lives of others through chiropractic and allow others to change his life, one thing becomes very clear. The only place for him is in the wild.