Doctor, Doctor

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Welcome to M4 Medicine, mystery,
mayhem, and sometimes murder.

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I'm Andrea Marciano and RN with
35 years of experience across

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various fields.
From direct patient care in

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hospitals to home health,
geriatrics, and injury medicine,

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I face life, death, and
everything in between.

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And I'm Crystal Miller and RN
with 13 1/2 years of experience.

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My work spans home health,
Hospice, emergency care,

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geriatrics, and occupational
health.

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From the chaos of trauma based
quiet moments with patients,

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I've seen stories that defy
explanations.

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We've been friends for over 25
years and as nurses we've shared

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countless stories that have left
us and our families speechless.

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Now we're bringing those stories
and many more to you in

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medicine, mystery, mayhem, and
sometimes murder.

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Each week, we'll uncover cases
that challenge the boundaries of

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medicine, sharing the human
stories behind the science.

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From puzzling medical mysteries
to shocking real life crimes,

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we'll bring you stories that'll
leave you questioning everything

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you thought you.
Knew while we're both

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experiencing treats nurses, we
want to make it clear we're not

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here to give medical advice.
This podcast is about

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storytelling, education and
exploration, not diagnosing or

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treating medical conditions.
This is medicine, mystery,

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mayhem and sometimes murder.
Let's dive in.

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Hey Crystal, how are you doing?
I'm doing all right.

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I'm a little tired, didn't sleep
well last night, so if you catch

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me yawning in this episode, my
apologies.

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Yeah, that can happen, can't it?
I'm sorry you didn't sleep well.

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Is there any particular reason?
Yeah, I I think it's because I

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had a late night snack of some
really garlicky hummus with

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chili crisp on it.
So double spicy hummus at 11:30

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at night.
The food of regret.

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That's right, exactly.
Well, hopefully we can get

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through this and you can go to
sleep early tonight.

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I hope so.
I've been going to sleep early

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every night recently.
So I also wonder if I if I maybe

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have some some residual COVID
going on.

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Not necessarily long COVID
because it hasn't been that long

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since I had COVID, but you know,
just like kind of some still

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recovering because I've been
going, I've been going to sleep

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early a lot of nights this week,
but who knows.

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Yeah, well, I know I don't, but
what do you have for us today?

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Today I'm going to tell you
about the survival story of

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Doctor Jerry Nelson and our my
sources are her biography, which

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was which is called Icebound, a
doctor's incredible battle for

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survival at the South Pole, her
treatment timeline that she kept

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in the Antarctic, the American
Medical Association Journal of

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Ethics, which is interesting
because that's the third in a

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row that we've cited this
specific journal, the cancer

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network news reporting on the
Antarctic evacuation mission and

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then obituaries and long term
medical history for Doctor

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Nielsen so.
Cool.

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You know, I just watched a
program with Will Smith and he,

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it's called Pole to Pole and he
went from South Pole to North

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Pole and various points in
between.

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It was fascinating.
He did a really, really good

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job.
I believe it was on Disney

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actually.
Interesting.

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Not positive, but it was, it was
really, really good.

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I I watched it, it was I think
A7 part deal where he went to

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the various places.
It was.

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I really, really liked it.
So that's interesting.

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That's cool.
All right.

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Stories about survival often
begin with disaster.

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This one begins with a decision.
In the late 1990s, Doctor Jerry

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Nielsen made a choice that most
physicians would never consider.

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She accepted a position as the
sole Dr. at the A Munson Scott

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South Pole Station, one of the
most isolated medical

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assignments on Earth.
Antarctica is not simply remote.

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It is operationally cut off for
months at a time, especially

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during the long polar winter
when flights cannot land and

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evacuation is impossible.
Yeah, I mean.

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It's not even just not advised,
it is impossible.

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It is impossible, and that's
one.

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Of the things we'll talked about
was that it's, it's so remote

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and so unapproachable for so
many months.

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Like you say, it's, it's just
not a, it's not a preference.

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It is a total thing.
Yeah, anyone who winters over

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understands that emergencies
must be handled internally

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because help may not arrive.
This reality shaped the nature

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of Jerry's role.
She was not joining a team of

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clinicians.
She was becoming the entire

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medical system for a small
community at the bottom of the

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world.
Jerry.

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I know, right?
No, thank you.

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There's a a show I watched where
it takes place in Antarctica and

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I want to think it was one of
the true detectives.

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Is that what they're called?
Yeah, True Detective seasons.

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But every time I, every time I
think about the story, I think

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about that because something
comes into the into the

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Antarctic station and that kills
people.

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I won't, that's all I'm going to
say, even if I'm not even may

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not even be right, but I think I
am.

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I think it's one of the True
Detective seasons anyway.

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Jerry Nelson had trained as an
emergency physician, A specialty

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that requires rapid decision
making, comfort with

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uncertainty, and the ability to
act without complete

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information.
Her professional background made

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her uniquely suited to the
unpredictable nature of remote

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medicine.
Personally, she was also in a

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transition point in her life.
She had experienced divorce,

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career fatigue and the familiar
search for meaning that often

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follows years in high stress
medical environments.

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The Antarctica posting
represented more than a job.

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It offered reinvention,
challenge and distance from the

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pressure she had been carrying.
When she arrived at the South

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Pole station, she stepped into a
role defined by autonomy,

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responsibility and the
understanding that she would

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sometimes have to make decisions
without backup.

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So life at the South Pole
follows a rhythm shaped by

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environment rather than a
calendar.

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During winters, darkness
persists for months,

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temperatures plunge far below 0,
and the small crew becomes a

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self-contained world.
Jerry provided routine care,

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managed injuries, monitored
mental health, and handled

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everything from dental issues to
emergencies.

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The job required adaptability
because resources were finite

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and replacement supplies were
limited.

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Remote medicine demands constant
awarement, constant awareness of

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logistics.
Every decision must account for

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what is available, what can be
improvised, what cannot be

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replaced.
Yeah, think about it like, you

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know, we, you and I both have
been, have previously been

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involved with Element 11, which
is the, which is the Utah

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sanctioned Burning Man summer
event.

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Basically it's a little
miniature Burning Man where we

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go out to the desert camp for
three days.

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And we, you and I were involved
with the medical side of that.

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And so we have a little taste of
this.

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We were only out there for what,
3-5 days?

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Five days I think with, with
building and tearing down.

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You know, you think about how
much we had to improvise in just

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five days.
Imagine being somewhere where

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where your resources are finite
and it's months.

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Yeah.
And we could, we could get

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resources.
We just it was a little bit of a

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jaunt.
Right, right.

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Exactly.
We also had an ambulance we

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could call and such.
We had a lot of backup and we.

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Had a room there, we had a lot
of backup.

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Wasn't just us.
But yeah, but my point being,

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like, we in our little air
quotes, remote part of the

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desert where we had finite
resources.

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So, you know, to a degree, it's
nothing.

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I mean, that was difficult
enough, is my point.

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It's nothing compared to months
somewhere where you're literally

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inaccessible to the rest of the
world.

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So early in 1999, that awareness
became deeply personal when

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Jerry discovered a lump in her
own breast.

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Physicians are trained to
evaluate symptoms clinically,

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but that knowledge carries
emotional weight when the

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patient is oneself.
She understood immediately that

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the finding could represent
cancer.

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The timing created a critical
constraint.

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The last plane had already left,
and the station was sealed for

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winter.
Evacuation was not an option for

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months.
This transformed the situation

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from a typical diagnostic
process into a problem of remote

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medicine, logistics, and time.
Jerry contacted physicians in

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the United States using the
station's communication systems,

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initiating what would become one
of the most widely discussed

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early examples of telemedicine
in extreme environments.

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Specialist advised that a biopsy
was necessary.

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Performing a biopsy on oneself
is medically possible but

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psychologically complex because
the physician cannot fully

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separate clinical judgement from
personal fear.

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Can you imagine having to do a
biopsy on your own breast in a

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remote outpost in the South Pole
and you're the only medical

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personnel on site?
Nope.

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I mean, I know there could do
it, but it would be very much I.

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Don't know if I could.
I can't even give myself a shot.

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I can't even give myself an
intramuscular shot.

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I can do.
I can do sub Q shots now but I

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have yet to be able to give
myself an intramuscular shot so

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I've.
Had to do.

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I've had to do.
I am.

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But you know, if it was a choice
of figuring out if I was going

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to die or not, I would probably
do it.

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But once I found out then what?
Anyway.

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Well, regardless of her fear,
Jerry proceeded.

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The first samples were
inconclusive due to limitations

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in laboratory supplies,
including outdated pathology

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materials.
This uncertainty created a

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difficult reality.
She strongly suspected cancer

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but could not yet confirm it.
The response required

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coordination across continents.
Because a definitive diagnosis

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depended on proper equipment, a
decision was made to send

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supplies by AirDrop.
Landing aircraft at the South

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Pole during winter carries
significant risk due to extreme

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00:11:12,560 --> 00:11:15,520
cold affecting mechanical
systems and navigation.

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Instead, a cargo plane released
medical equipment by parachute.

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The image of barrels burning on
the ice to mark a drop zone

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while medical supplies descended
from the sky illustrates how

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00:11:27,240 --> 00:11:30,280
medicine sometimes intersects
with survival logistics.

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So just picture that.
I I love that description.

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They actually put barrels on the
ice and lit them on fire to give

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the cargo plane a drop zone.
But a target basically found

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00:11:44,960 --> 00:11:48,360
really fascinating, like it's so
rudimentary, you know, it wasn't

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like they were lasers or like
LED lights burning, literal

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burning barrels.
That was really interesting.

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With the new equipment, Jerry
performed another biopsy,

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transmitted imaging to
specialists and received

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00:12:01,120 --> 00:12:03,080
confirmation that she had breast
cancer.

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00:12:04,280 --> 00:12:07,840
Yeah, as we've mentioned, I
think on several occasions

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00:12:07,840 --> 00:12:11,680
throughout this podcast, Andrea
has a cancer experience, and it

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00:12:11,680 --> 00:12:16,480
happens to be breast cancer.
So Can you imagine Andrea being

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00:12:16,560 --> 00:12:19,240
again alone like this?
You're the only medical

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00:12:19,240 --> 00:12:22,600
professional and you it's
confirmed that you have breast

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00:12:22,600 --> 00:12:26,280
cancer.
Yeah, And, you know, in my head,

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I understand that cancer is
typically slow growing.

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00:12:28,840 --> 00:12:31,800
My tumor actually was one of the
fastest growing.

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00:12:32,080 --> 00:12:35,960
I don't know how I would feel
knowing there's probably what, 3

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00:12:35,960 --> 00:12:37,640
months before I could go
anywhere.

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00:12:39,000 --> 00:12:43,600
Yeah, it would be a huge stress.
Most cancers are slower growing,

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00:12:43,600 --> 00:12:45,560
but still, Oh my goodness, I
can't.

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00:12:45,680 --> 00:12:50,080
That would be horrible.
Yeah, yeah, and it doesn't.

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00:12:50,080 --> 00:12:54,120
I didn't look into how fast
growing her cancer was, but I do

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00:12:54,120 --> 00:12:57,160
know that she was advised to
start treating it by the

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00:12:57,160 --> 00:12:59,000
specialists.
At this point, the question

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00:12:59,000 --> 00:13:02,320
shifted from diagnosis to
treatment under isolation with

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00:13:02,320 --> 00:13:05,920
guidance from remote oncologist
Jerry Begin therapy while

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00:13:05,920 --> 00:13:08,680
remaining responsible for the
medical care of the station

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00:13:08,680 --> 00:13:12,400
crew, her colleague.
Wait a minute, so she had chemo

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00:13:12,440 --> 00:13:17,040
with her?
I don't know if she had chemo,

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00:13:17,040 --> 00:13:19,840
she just started treatment.
What would that be though?

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00:13:19,840 --> 00:13:22,920
Except for chemo?
I mean, did she excise her own

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00:13:22,920 --> 00:13:24,400
lump hormone?
Therapy.

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00:13:24,880 --> 00:13:27,080
Oh, OK.
So to slow it down, but she

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00:13:27,080 --> 00:13:28,880
still had hormone therapy
available.

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Oh yeah but it looks like she
did have chemo.

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00:13:30,960 --> 00:13:33,800
Sorry, I'm looking up weird
because I'm reading down my page

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even though I can scroll.
Yeah, I was wondering, reader,

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00:13:37,800 --> 00:13:43,320
She had her neck turtling.
So yeah, so she did have

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00:13:43,320 --> 00:13:45,800
chemotherapy.
I don't know, maybe probably.

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00:13:45,800 --> 00:13:48,240
They probably sent it in the
AirDrop would be my guess.

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00:13:48,240 --> 00:13:51,360
They were probably being an
abundance of caution type

237
00:13:51,360 --> 00:13:52,880
situation, right?
We're only going to make one

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00:13:52,880 --> 00:13:54,400
drop.
Yeah, maybe.

239
00:13:55,120 --> 00:14:00,560
But I don't know.
So her colleagues, none of whom

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00:14:00,560 --> 00:14:03,080
were oncology professionals,
became assistants in her

241
00:14:03,080 --> 00:14:05,760
treatment after receiving
instruction from doctors

242
00:14:05,760 --> 00:14:09,320
thousands of miles away.
This dynamic transformed the

243
00:14:09,320 --> 00:14:11,200
station into an improvised care
team.

244
00:14:11,760 --> 00:14:14,600
She initiated hormone therapy
and later chemotherapy,

245
00:14:14,920 --> 00:14:17,360
experiencing the physical
effects while continuing her

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00:14:17,360 --> 00:14:20,880
duties as physician.
The dual identity of caregiver

247
00:14:20,880 --> 00:14:23,840
and patient created a unique
psychological strain because she

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00:14:23,840 --> 00:14:27,160
could not step away from
responsibility even while

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00:14:27,160 --> 00:14:30,360
undergoing treatment.
And again, I've having never

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00:14:30,360 --> 00:14:34,960
gone through chemotherapy, I
have no idea how difficult it

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00:14:34,960 --> 00:14:36,520
would be.
I know you talk all the time

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00:14:36,520 --> 00:14:38,640
about chemo brain.
I have.

253
00:14:38,760 --> 00:14:40,600
I can't.
I have no idea how difficult it

254
00:14:40,600 --> 00:14:44,840
would be to continue to be a
practicing physician and be

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00:14:44,840 --> 00:14:48,920
going through chemotherapy and
hormone replacement therapy and

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00:14:49,720 --> 00:14:52,520
just the toll that must have
taken on her.

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00:14:53,160 --> 00:14:57,040
Yeah, All I know is that I was
able to be off work because the

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00:14:57,040 --> 00:14:59,480
job I had was not one I could
drop in and out of.

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00:14:59,480 --> 00:15:00,960
So they just said we need you
off.

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00:15:01,480 --> 00:15:03,840
And I was grateful every single
solitary day.

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00:15:03,840 --> 00:15:07,160
I know a lot of people who did
work full time, even as nurses,

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00:15:07,680 --> 00:15:11,280
who were going through chemo
treatments and had a day here or

263
00:15:11,280 --> 00:15:13,920
a day there.
But in this case, she couldn't

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00:15:13,920 --> 00:15:16,560
even have a day off potentially.
Yeah.

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00:15:17,000 --> 00:15:19,400
On the worst days of chemo,
because there were worst days of

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00:15:19,400 --> 00:15:22,840
chemo and I was just, like I
said, grateful I did not have to

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00:15:22,840 --> 00:15:25,920
work.
Yeah, I'm grateful for you on

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00:15:26,280 --> 00:15:30,120
your behalf.
Her experience highlighted the

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00:15:30,120 --> 00:15:33,720
emerging role of telemedicine is
more than consultation, remote

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00:15:33,720 --> 00:15:37,480
specialist guided procedures,
interpretive diagnostic data and

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00:15:37,480 --> 00:15:40,000
help coordinate treatment
decisions across extreme

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00:15:40,000 --> 00:15:42,560
distance.
The case demonstrated the

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00:15:42,560 --> 00:15:46,040
expertise could extend beyond
physical presence, but it also

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00:15:46,040 --> 00:15:47,920
underscored the limits of
technology.

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00:15:48,440 --> 00:15:51,320
Communication provided guidance,
yet the physical work of

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00:15:51,320 --> 00:15:54,960
treatment still depended on
local execution, improvisation

277
00:15:55,320 --> 00:15:58,400
and resilience.
As winter progressed, the

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00:15:58,400 --> 00:16:00,680
central concern became
evacuation.

279
00:16:01,200 --> 00:16:04,080
Rescue from the South Pole
during winter is considered one

280
00:16:04,080 --> 00:16:07,400
of the most dangerous aviation
missions due to temperature,

281
00:16:07,400 --> 00:16:10,240
weather, unpredictability and
the risk of aircraft failure.

282
00:16:11,000 --> 00:16:14,280
Eventually, planners determined
that an early evacuation attempt

283
00:16:14,280 --> 00:16:19,000
would be made when conditions
allowed in October 1999 and

284
00:16:19,000 --> 00:16:22,640
LC130 aircraft successfully
landed at the South Pole.

285
00:16:23,200 --> 00:16:26,240
You know that really cool LC130
aircraft that.

286
00:16:27,400 --> 00:16:29,120
That.
Real cool one, love that guy.

287
00:16:29,440 --> 00:16:33,160
Me too.
Transported Jerry, along with

288
00:16:33,160 --> 00:16:35,560
another injured crew member out
of Antarctica.

289
00:16:35,800 --> 00:16:38,720
The mission drew significant
attention because it represented

290
00:16:39,080 --> 00:16:42,240
A calculated decision to accept
operational risk in order to

291
00:16:42,240 --> 00:16:44,920
save a life.
Back in the United States, Jerry

292
00:16:44,920 --> 00:16:48,160
continued treatment, which
included surgery and further

293
00:16:48,160 --> 00:16:50,600
therapy.
Her story became widely known,

294
00:16:50,880 --> 00:16:53,960
and she later wrote the memoir
Icebound, describing the

295
00:16:53,960 --> 00:16:56,960
medical, emotional, and
logistical realities of her

296
00:16:56,960 --> 00:16:59,920
experience.
Public narratives often

297
00:16:59,920 --> 00:17:04,160
emphasize survival and heroism,
but her life after Antarctica

298
00:17:04,599 --> 00:17:07,640
included ongoing medical
challenges, recovery, and

299
00:17:07,640 --> 00:17:10,599
adaptation to the visibility
that accompanied her story.

300
00:17:11,440 --> 00:17:14,440
Survival stories frequently
simplify complex medical

301
00:17:14,440 --> 00:17:17,800
journeys, yet long term cancer
treatment rarely follows a

302
00:17:17,800 --> 00:17:20,960
single narrative arc.
That's true.

303
00:17:21,800 --> 00:17:23,680
Yeah.
Several years later, her cancer

304
00:17:23,680 --> 00:17:26,800
returned and metastasized,
spreading to multiple organs.

305
00:17:27,240 --> 00:17:30,400
Despite this, she continued
speaking publicly about

306
00:17:30,400 --> 00:17:34,120
resilience, remote medicine, and
the psychological dimensions of

307
00:17:34,120 --> 00:17:39,280
facing serious illness.
Her experience resonated beyond

308
00:17:39,280 --> 00:17:42,760
the dramatic circumstances of
Antarctica because it reflected

309
00:17:42,760 --> 00:17:45,840
broader themes familiar to many
patients and clinicians.

310
00:17:46,400 --> 00:17:49,960
Uncertainty.
Identity changes and the tension

311
00:17:49,960 --> 00:17:53,360
between professional competence
and and personal vulnerability.

312
00:17:54,200 --> 00:17:58,880
Jerry Nelson died in 2009,
approximately 11 years after her

313
00:17:58,880 --> 00:18:01,160
initial diagnosis at the South
Pole.

314
00:18:03,200 --> 00:18:06,360
That brings a lot of.
Questions to mind such as.

315
00:18:06,800 --> 00:18:11,680
Like was she really getting the
care she needed at the pole?

316
00:18:11,680 --> 00:18:15,680
Because if she had, would she
have died as soon?

317
00:18:16,080 --> 00:18:18,560
I don't know.
What was your diagnosis?

318
00:18:18,560 --> 00:18:21,840
Did you read it and I missed it?
Breast cancer, Breast just

319
00:18:21,840 --> 00:18:23,720
plain, I mean not any
specialized.

320
00:18:24,960 --> 00:18:29,120
Yeah, Her case remains
significant within medical

321
00:18:29,120 --> 00:18:31,040
literature and ethics
discussions because it

322
00:18:31,040 --> 00:18:33,800
illustrates how healthcare
systems operate in extreme

323
00:18:33,800 --> 00:18:36,680
environments.
It raised questions about single

324
00:18:36,680 --> 00:18:40,120
physician deployments,
preparedness for serious illness

325
00:18:40,120 --> 00:18:43,440
in remote settings, and the
responsibilities organizations

326
00:18:43,440 --> 00:18:46,400
hold when personnel are
geographically isolated.

327
00:18:47,040 --> 00:18:50,040
It also contributed to the
evolving acceptance of

328
00:18:50,040 --> 00:18:53,040
telemedicine as legitimate
component of clinical care,

329
00:18:53,520 --> 00:18:56,120
particularly in environments
where physical access is

330
00:18:56,120 --> 00:18:58,760
limited.
Now you and I have a shared

331
00:18:58,760 --> 00:19:03,360
experience that's coincidental
and that is kind of the

332
00:19:03,360 --> 00:19:08,040
emergence of telemedicine in the
in Utah and that was through

333
00:19:08,040 --> 00:19:10,480
FHP.
And you as a nurse who was

334
00:19:10,480 --> 00:19:15,520
taking telemedicine calls and,
and a very rudimentary, not, not

335
00:19:15,520 --> 00:19:19,520
what we consider telemedicine
today, but still taking calls.

336
00:19:19,520 --> 00:19:23,200
And I as a patient and my mom on
my behalf because I was young,

337
00:19:23,520 --> 00:19:28,120
but as a patient receiving, you
know, using telemedicine as a

338
00:19:28,640 --> 00:19:34,920
form of treatment.
And so I remember for me as a,

339
00:19:35,040 --> 00:19:38,880
as a child patient, it was a
relief when I didn't have to go

340
00:19:38,880 --> 00:19:42,240
in and have my throat swabbed
for strep or, you know, my ear

341
00:19:42,240 --> 00:19:44,800
looked at or whatever.
I could, my mom could just call

342
00:19:44,800 --> 00:19:49,400
and they'd ask for symptoms and,
you know, did I have white spots

343
00:19:49,400 --> 00:19:52,120
on my throat or whatever.
And then they would call in a

344
00:19:52,120 --> 00:19:54,160
prescription and then my mom
could just go pick up the

345
00:19:54,160 --> 00:19:56,360
prescription.
It's interesting to note that

346
00:19:56,360 --> 00:20:01,840
that benefit and you know FHP
was this whole plan of it's

347
00:20:01,840 --> 00:20:04,080
actually kind of.
As I say, it was value based

348
00:20:04,080 --> 00:20:05,600
care, but it wasn't really value
based care.

349
00:20:05,600 --> 00:20:09,320
It was more like a subscription.
It was subscription type care,

350
00:20:09,320 --> 00:20:12,040
right?
Well, yeah, kind of.

351
00:20:12,040 --> 00:20:15,960
It was like kind.
Of yeah, I just remember you

352
00:20:15,960 --> 00:20:19,760
could go in, we could go in for
certain things.

353
00:20:20,440 --> 00:20:22,560
We could get discounts on
certain prescriptions, but we

354
00:20:22,560 --> 00:20:25,560
paid above and beyond or instead
of I guess probably instead of

355
00:20:25,560 --> 00:20:29,200
health insurance, we paid a
premium of some kind directly to

356
00:20:29,200 --> 00:20:31,440
FHP.
That's a good I was young too.

357
00:20:31,440 --> 00:20:32,440
I was like 12.
Who knows?

358
00:20:32,440 --> 00:20:36,280
Maybe I'm like I say, it's like
it's like the current day Kaiser

359
00:20:36,280 --> 00:20:39,600
where you are basically a
subscriber to the Kaiser program

360
00:20:39,760 --> 00:20:43,160
versus Blue Cross Blue Shield or
something that you can go other

361
00:20:43,160 --> 00:20:45,920
places.
Kaiser, you get Kaiser care at

362
00:20:45,920 --> 00:20:48,920
Kaiser unless sometimes if it's
an emergency and go elsewhere if

363
00:20:48,920 --> 00:20:51,400
there's no Kaiser facility in
the area.

364
00:20:51,800 --> 00:20:53,680
So yeah, it's almost identical
to that.

365
00:20:53,680 --> 00:20:55,200
It was just on a much smaller
scale.

366
00:20:56,000 --> 00:20:58,200
Just a little tiny guy.
Yeah.

367
00:20:59,960 --> 00:21:02,320
Psychologically, Jerry's story
offers insight into the

368
00:21:02,320 --> 00:21:04,560
experience of clinicians who
become patients.

369
00:21:04,960 --> 00:21:08,040
Medical knowledge can intensify
fear because clinicians

370
00:21:08,040 --> 00:21:11,200
understand probabilities,
complications, and worst case

371
00:21:11,200 --> 00:21:13,880
scenarios.
Medical training emphasizes

372
00:21:13,920 --> 00:21:16,880
objectivity, yet personal
illness challenges that

373
00:21:16,880 --> 00:21:19,440
boundary.
At the same time, that knowledge

374
00:21:19,440 --> 00:21:22,640
provides agency by enabling
informed decision making.

375
00:21:22,720 --> 00:21:25,640
Jerry's actions demonstrate how
training can shape response

376
00:21:25,640 --> 00:21:27,840
under pressure.
She could not control the

377
00:21:27,840 --> 00:21:31,080
diagnosis, but she could control
the sequence of decisions that

378
00:21:31,080 --> 00:21:33,080
followed.
Clinicians must navigate

379
00:21:33,080 --> 00:21:36,600
vulnerability while maintaining
decision making capacity.

380
00:21:37,360 --> 00:21:40,720
This dual role can produce
cognitive tension because

381
00:21:40,720 --> 00:21:43,720
professional knowledge does not
eliminate fear and emotional

382
00:21:43,720 --> 00:21:46,360
experience does not eliminate
responsibility.

383
00:21:46,960 --> 00:21:50,200
That's true.
And this reflects A broader

384
00:21:50,200 --> 00:21:55,560
theme in medicine competence.
No, sorry, that was that was the

385
00:21:55,800 --> 00:21:57,640
eight-year old me reading
scriptures in the morning.

386
00:21:57,640 --> 00:21:59,360
This reflects A broader theme of
medicine competence.

387
00:22:01,600 --> 00:22:02,960
No connection to the brain.
This.

388
00:22:04,560 --> 00:22:06,280
Reflects A broader theme in
medicine.

389
00:22:06,680 --> 00:22:09,680
Competence does not prevent
adversity, but it influences

390
00:22:09,680 --> 00:22:14,480
navigation of adversity.
Her experience also underscores

391
00:22:14,480 --> 00:22:16,240
the role of community in
survival.

392
00:22:16,400 --> 00:22:19,280
Although she was the only
physician, she was not alone.

393
00:22:19,800 --> 00:22:22,200
The station crew became
participants in her care,

394
00:22:22,200 --> 00:22:24,920
whether they liked it or not.
Yeah, no kidding.

395
00:22:25,800 --> 00:22:28,680
Illustrating how non medical
individuals can contribute

396
00:22:28,680 --> 00:22:31,160
meaningfully when guided by
expertise.

397
00:22:31,640 --> 00:22:34,680
This collaborative dynamic is
increasingly recognized in

398
00:22:34,680 --> 00:22:38,800
disaster medicine and remote
operations where formal medical

399
00:22:38,800 --> 00:22:42,280
infrastructure may be limited,
but collective effort can extend

400
00:22:42,280 --> 00:22:44,440
capability.
Cross training and shared

401
00:22:44,440 --> 00:22:47,760
responsibility, increase
resilience in small communities

402
00:22:47,920 --> 00:22:51,520
operating under constraint.
And when I was reading this, it

403
00:22:51,520 --> 00:22:55,080
made me think of disaster
response teams in neighborhoods.

404
00:22:55,080 --> 00:22:57,880
Right?
And you have your your, your

405
00:22:57,880 --> 00:23:00,200
flags.
Red, black, yellow, green.

406
00:23:00,600 --> 00:23:02,640
Yeah.
Those again are just typically,

407
00:23:02,640 --> 00:23:05,320
I mean, you have people that are
medical professionals like you

408
00:23:05,360 --> 00:23:07,280
and I are.
And we can be on that disaster

409
00:23:07,280 --> 00:23:10,960
as well response team, but for
the most part, the majority are

410
00:23:10,960 --> 00:23:13,840
just lay people that live in the
neighborhood that volunteer to

411
00:23:13,840 --> 00:23:17,120
be part of that.
And it's that organizing and

412
00:23:17,120 --> 00:23:20,320
that cross training and, and
like I said, this shared

413
00:23:20,320 --> 00:23:24,720
responsibility that really makes
those those disaster response

414
00:23:24,720 --> 00:23:28,320
teams work even though they
don't have formal training.

415
00:23:29,560 --> 00:23:31,720
Within the broader context of
medical history.

416
00:23:31,720 --> 00:23:34,560
Jerry Nielsen's story joins a
small group of cases in which

417
00:23:34,560 --> 00:23:37,040
clinicians have performed
procedures on themselves due to

418
00:23:37,040 --> 00:23:39,920
necessity.
These cases influence policy

419
00:23:39,920 --> 00:23:43,480
because they expose expose
vulnerabilities in the systems.

420
00:23:44,040 --> 00:23:47,480
Extreme medicine emphasizes
redundancy, cross training, and

421
00:23:47,480 --> 00:23:51,200
contingency planning.
Jerry's case revealed the

422
00:23:51,200 --> 00:23:53,600
vulnerability of single
physician deployments,

423
00:23:53,800 --> 00:23:56,320
particularly when the physician
becomes the patient.

424
00:23:56,480 --> 00:23:59,280
Her experience influence
discussions about staffing

425
00:23:59,280 --> 00:24:02,600
models and preparedness in
remote research stations.

426
00:24:03,360 --> 00:24:06,920
Systems evolve when individual
cases expose structural risk,

427
00:24:07,280 --> 00:24:09,960
and her situation became a
reference point for policy

428
00:24:09,960 --> 00:24:13,040
conversations about medical
redundancy and evacuation

429
00:24:13,040 --> 00:24:15,360
planning.
Ultimately, the story of Doctor

430
00:24:15,360 --> 00:24:18,840
Jerry Nelson is not solely about
survival in Antarctica.

431
00:24:19,280 --> 00:24:23,080
It is about medicine practiced
under constraint, identity under

432
00:24:23,080 --> 00:24:26,160
pressure, and the intersection
of technology, logistics, and

433
00:24:26,160 --> 00:24:30,360
human resilience.
Extreme environments remove

434
00:24:30,360 --> 00:24:33,720
assumptions about access,
forcing healthcare to rely on

435
00:24:33,720 --> 00:24:37,400
preparation, adaptability, and
decision making rather than

436
00:24:37,400 --> 00:24:39,920
infrastructure.
Her experience demonstrates that

437
00:24:39,920 --> 00:24:43,600
competence can function as a
stabilizing force when

438
00:24:43,600 --> 00:24:46,360
circumstances are unstable.
And I really like that.

439
00:24:46,480 --> 00:24:48,320
I'm going to say it again
because I really like it.

440
00:24:48,320 --> 00:24:53,120
Her experience demonstrates that
competence can function as a

441
00:24:53,120 --> 00:24:56,480
stabilizing force when
circumstances are unstable.

442
00:24:56,560 --> 00:25:01,600
So had Jerry been a crappy
doctor, this probably would have

443
00:25:01,600 --> 00:25:05,440
gone very, very differently.
But because she had the

444
00:25:05,440 --> 00:25:09,520
competence, because she was a a
good doctor, because she had the

445
00:25:09,520 --> 00:25:12,840
training and the and the what's
the word I'm looking for just

446
00:25:12,960 --> 00:25:14,680
the.
Experience.

447
00:25:14,920 --> 00:25:20,360
Wherewithal, the willingness,
yeah, to do hard things like it

448
00:25:20,360 --> 00:25:24,800
makes it made a big difference.
Her experience exists within a

449
00:25:24,800 --> 00:25:28,360
broader category, sometimes
referred to as extreme medicine.

450
00:25:29,240 --> 00:25:31,280
This field examines how
healthcare operates in

451
00:25:31,280 --> 00:25:33,200
environments where
infrastructure is limited,

452
00:25:33,520 --> 00:25:36,040
evacuation is delayed and
providers must function

453
00:25:36,040 --> 00:25:38,600
autonomously.
And you think about areas where

454
00:25:38,600 --> 00:25:42,120
this happens, and it all of a
sudden, it all comes full

455
00:25:42,120 --> 00:25:46,520
circle, at least for me.
So examples include hello, Space

456
00:25:46,520 --> 00:25:52,800
Flight, polar research stations,
submarines, disaster zones, and

457
00:25:52,800 --> 00:25:56,280
remote expeditions.
In these settings, preparation

458
00:25:56,280 --> 00:25:59,720
and decision making often matter
more than access to technology

459
00:26:00,120 --> 00:26:02,720
because resources cannot be
replenished quickly.

460
00:26:03,320 --> 00:26:05,920
Yeah, I have to definitely think
outside the box.

461
00:26:06,600 --> 00:26:13,080
Yeah it like it reminds me of oh
gosh, I might be wrong.

462
00:26:13,080 --> 00:26:16,360
I'm going based on pop culture
but I believe it was Apollo 13

463
00:26:16,360 --> 00:26:19,280
where they had to think outside
the box and build some part.

464
00:26:19,520 --> 00:26:23,880
Yeah, I think it was.
For the yeah, for the well said.

465
00:26:23,880 --> 00:26:27,160
For the space machine Crystal,
what are you, 11?

466
00:26:27,160 --> 00:26:30,280
Space machine.
For the space machine, for the

467
00:26:30,320 --> 00:26:34,480
spaceship to get home, right.
So yeah, it's the same sort of

468
00:26:34,480 --> 00:26:36,120
thing.
And actually that's a great

469
00:26:36,120 --> 00:26:38,600
example, even though it's not
medicine necessarily.

470
00:26:38,600 --> 00:26:45,000
That's a great example of how,
how expert expertise has to be

471
00:26:45,000 --> 00:26:50,640
communicated clearly over voice,
you know, just with voice, just

472
00:26:50,640 --> 00:26:57,160
with words because there, there
was no way to send them diagrams

473
00:26:57,160 --> 00:27:00,480
or, you know, it was literally
bend it this way, fold it this

474
00:27:00,480 --> 00:27:02,480
way, staple it.
I'm just making stuff up,

475
00:27:02,480 --> 00:27:04,800
obviously.
But like, it's same sort of

476
00:27:04,800 --> 00:27:07,200
thing, right?
Like it's just fascinating.

477
00:27:08,680 --> 00:27:11,440
It's just fascinating.
The enduring impact of her story

478
00:27:11,440 --> 00:27:13,240
lies in its illustration of
agency.

479
00:27:13,640 --> 00:27:16,840
She did not wait for evacuation
to be in treatment, nor did she

480
00:27:16,840 --> 00:27:19,000
allow isolation to halt clinical
action.

481
00:27:19,520 --> 00:27:22,080
Instead, she applied the
principles of medicine within

482
00:27:22,080 --> 00:27:24,840
the limits available,
transforming a situation defined

483
00:27:24,840 --> 00:27:27,400
by constraint into one defined
by response.

484
00:27:28,120 --> 00:27:31,680
That shift reflects a core theme
in both medicine and survival

485
00:27:31,680 --> 00:27:34,640
psychology.
Outcomes are shaped not only by

486
00:27:34,640 --> 00:27:38,320
circumstances, but by how
individuals navigate them.

487
00:27:38,440 --> 00:27:42,720
And I said it before, but her
case is frequently cited in

488
00:27:42,720 --> 00:27:45,760
telemedicine literature because
it demonstrated practical remote

489
00:27:45,760 --> 00:27:47,840
guidance in a high stakes
situation.

490
00:27:48,080 --> 00:27:51,920
Prior to widespread telehealth
adoption, remote consultation

491
00:27:51,920 --> 00:27:54,800
was often viewed as supplemental
rather than essential.

492
00:27:54,960 --> 00:27:58,600
Jerry's experience showed that
remote expertise could shape

493
00:27:58,600 --> 00:28:01,800
diagnostic and treatment
decisions even when physical

494
00:28:01,800 --> 00:28:04,960
presence was impossible.
The case highlighted both the

495
00:28:04,960 --> 00:28:07,240
promise and limitations of
telemedicine.

496
00:28:07,320 --> 00:28:10,600
Communication can extend
knowledge, but execution remains

497
00:28:10,600 --> 00:28:14,160
dependent on local capability.
I also like that, 'cause if you

498
00:28:14,160 --> 00:28:18,720
have somebody as a clinician on
one end of a telephone, if you

499
00:28:18,720 --> 00:28:22,000
have somebody that cannot
understand your instructions,

500
00:28:22,000 --> 00:28:24,320
then you're of no use to them,
you know?

501
00:28:24,360 --> 00:28:26,480
Or will not do it.
Or will not do it.

502
00:28:26,480 --> 00:28:29,000
Yeah, you can be the smartest
doctor or nurse in the whole

503
00:28:29,000 --> 00:28:33,880
wide world, but if you're not,
if the communication fails

504
00:28:34,240 --> 00:28:38,640
between the two of you, then
it's or you know, or the

505
00:28:38,640 --> 00:28:41,120
capability does not meet the
communication, I should say,

506
00:28:41,120 --> 00:28:44,120
then you're just bumped on a
log, right?

507
00:28:44,840 --> 00:28:48,240
Right.
And also I still get the thought

508
00:28:48,240 --> 00:28:52,400
of they remember or they thought
of bringing chemo because one of

509
00:28:52,400 --> 00:28:54,960
the odds that one of their
people would get cancer while

510
00:28:54,960 --> 00:28:57,560
they're gone and why and if they
have the right chemo.

511
00:28:57,560 --> 00:28:59,680
I mean, chemos are different for
different things.

512
00:28:59,680 --> 00:29:01,120
I.
Know, I don't know.

513
00:29:01,400 --> 00:29:04,600
And I guess, as you said, they
had a drop, which means that

514
00:29:04,920 --> 00:29:07,760
maybe they had time to gather
it, maybe it wasn't on their

515
00:29:07,760 --> 00:29:11,600
list, but they were able to get
in right quick before everything

516
00:29:11,600 --> 00:29:14,320
shut down.
But even still that window.

517
00:29:14,800 --> 00:29:18,120
And then there's actually the
whole thing, especially in 99,

518
00:29:18,200 --> 00:29:20,760
chemo has to be handled very
carefully.

519
00:29:20,760 --> 00:29:24,280
Like you can't just throw chemo
in a in a first aid kit, some

520
00:29:24,400 --> 00:29:26,520
Tylenol, you know?
Is that a work?

521
00:29:26,520 --> 00:29:29,680
It should be fine.
So that that's interesting too.

522
00:29:29,680 --> 00:29:33,600
Like, yeah, I, I don't, I
didn't, it didn't occur to me to

523
00:29:33,600 --> 00:29:37,480
look into how she got or how she
had chemo or got chemo, but it's

524
00:29:37,480 --> 00:29:40,920
an interesting idea.
And maybe what she was doing was

525
00:29:40,920 --> 00:29:44,480
more palliative sort of things
like improved diet and as you

526
00:29:44,480 --> 00:29:47,280
said, hormone therapy, which
might have kept it from growing.

527
00:29:47,400 --> 00:29:52,480
But even still, just to have
whatever any of that was was

528
00:29:52,560 --> 00:29:54,880
pretty wild.
Yeah, I agreed.

529
00:29:55,160 --> 00:29:58,600
Jerry's story contributed to
broader acceptance of remote

530
00:29:58,600 --> 00:30:01,000
clinical collaboration,
particularly in rural health.

531
00:30:01,360 --> 00:30:05,800
Rural healthcare say that three
times fast expedition medicine

532
00:30:05,800 --> 00:30:08,600
and disaster response.
Additionally, we have to

533
00:30:08,600 --> 00:30:12,240
consider isolation, right?
Isolation alters perception of

534
00:30:12,240 --> 00:30:16,080
time, risk, and decision making.
Research on polar cruise shows

535
00:30:16,080 --> 00:30:19,600
that prolonged confinement can
influence mood, cognition, and

536
00:30:19,600 --> 00:30:22,320
interpersonal dynamic.
For a physician managing

537
00:30:22,320 --> 00:30:24,960
personal illness, these factors
add complexity.

538
00:30:25,480 --> 00:30:28,360
Jerry's situation required
simultaneous processing of

539
00:30:28,360 --> 00:30:32,040
professional responsibility,
personal fear, and environmental

540
00:30:32,040 --> 00:30:35,560
constraint.
Knowledge can intensify anxiety

541
00:30:35,560 --> 00:30:38,760
because clinicians understand
probabilities and complications.

542
00:30:39,120 --> 00:30:42,480
Yet knowledge also provides
agency by enabling informed

543
00:30:42,480 --> 00:30:44,960
action.
Her story also illustrates a

544
00:30:44,960 --> 00:30:47,760
central concept in survival
psychology.

545
00:30:48,320 --> 00:30:51,200
When options are limited, focus
shifts from avoidance to

546
00:30:51,200 --> 00:30:52,560
response.
The.

547
00:30:52,760 --> 00:30:58,120
It's funny that it's funny that
it says that because I not being

548
00:30:58,120 --> 00:31:02,520
in this situation by any stretch
of the imagination, I believe of

549
00:31:02,520 --> 00:31:04,760
myself that I would go into
avoidance.

550
00:31:05,280 --> 00:31:09,760
I don't know that I would do a
biopsy on myself and treat

551
00:31:09,760 --> 00:31:12,640
myself and all of that.
I just kind of feel like I'm, I

552
00:31:12,640 --> 00:31:14,920
don't know though.
Then there's the whole, see, it

553
00:31:14,920 --> 00:31:18,400
gets tricky because then there's
the whole, you're the only

554
00:31:18,560 --> 00:31:21,160
medical professional there, a
side of it, right?

555
00:31:21,160 --> 00:31:25,840
If I were the only clinician on
the base, I might.

556
00:31:26,920 --> 00:31:30,760
That responsibility, that
accountability, might outweigh

557
00:31:30,760 --> 00:31:36,400
my desire to be avoidant and
spur me into action to try to

558
00:31:36,400 --> 00:31:41,480
stay alive long enough for
everybody to have my clinical

559
00:31:41,600 --> 00:31:44,280
skills and have me available to
them.

560
00:31:44,720 --> 00:31:46,640
Yeah.
No, I don't remember if you

561
00:31:46,640 --> 00:31:49,120
said, did they, how long were
they intended to be there?

562
00:31:49,480 --> 00:31:51,440
It just said months.
I'm not sure.

563
00:31:53,040 --> 00:31:55,920
So in my mind, I, this is
completely made-up.

564
00:31:55,920 --> 00:32:00,280
I, in my mind it was like 4
months, but I didn't actually

565
00:32:00,280 --> 00:32:03,480
get a, a specific time.
I don't know if I'd be avoided

566
00:32:03,480 --> 00:32:07,560
or not.
It's it's I, I just, I would

567
00:32:07,560 --> 00:32:08,880
like to not be put in this
position.

568
00:32:08,880 --> 00:32:10,200
Thank you very much.
Knock on wood.

569
00:32:10,760 --> 00:32:15,400
Right, exactly that's.
The inability to evacuate forced

570
00:32:15,400 --> 00:32:18,120
clarity about priorities,
decisions, and next steps.

571
00:32:18,720 --> 00:32:21,040
This psychological shift appears
frequently in extreme

572
00:32:21,040 --> 00:32:24,360
environments where uncertainty
cannot be eliminated but action

573
00:32:24,360 --> 00:32:26,200
remains possible.
The decision to attempt

574
00:32:26,200 --> 00:32:29,240
evacuation raised ethical
questions that extend beyond

575
00:32:29,240 --> 00:32:32,360
this single case.
Rescue operations in extreme

576
00:32:32,360 --> 00:32:36,160
environments involve risk to
flight crews, logistical cost,

577
00:32:36,160 --> 00:32:39,280
and operational impact.
Determining when a rescue

578
00:32:39,280 --> 00:32:42,800
attempt is justified requires
balancing individual need with

579
00:32:42,800 --> 00:32:45,000
collective risk.
These decisions occur in

580
00:32:45,000 --> 00:32:48,480
disaster response,
mountaineering, maritime rescue,

581
00:32:48,480 --> 00:32:52,200
and polar operations.
Jerry's evacuation illustrates

582
00:32:52,200 --> 00:32:55,440
how institutions weigh medical
urgency against operational

583
00:32:55,440 --> 00:32:57,160
danger.
I do also find it very

584
00:32:57,160 --> 00:33:00,920
interesting that they considered
her cancer urgent enough to

585
00:33:01,080 --> 00:33:03,400
early evacuate.
It wasn't that it was slow

586
00:33:03,400 --> 00:33:06,600
growing enough that they could
that she could fulfill her, her

587
00:33:06,600 --> 00:33:09,040
contract, right?
Her contractual time.

588
00:33:09,400 --> 00:33:12,880
They did evacuate her early and
it sounds like based on the fact

589
00:33:12,880 --> 00:33:15,640
that they said that her cancer
returned, it does sound like she

590
00:33:15,640 --> 00:33:20,640
went into remission at some
point upon returning to the US.

591
00:33:20,640 --> 00:33:24,760
But I also that's just what I'm
inferring from the wording.

592
00:33:25,520 --> 00:33:28,320
Her case also raises questions
about occupational risk

593
00:33:28,320 --> 00:33:30,600
disclosure.
Individuals who accept remote

594
00:33:30,600 --> 00:33:33,880
assignments understand
environmental hazards, but

595
00:33:33,880 --> 00:33:37,000
serious illness introduces
scenarios that cannot be fully

596
00:33:37,000 --> 00:33:38,920
predicted.
Ethical planning requires

597
00:33:38,920 --> 00:33:42,880
transparency about limitations,
contingency protocols, and

598
00:33:42,880 --> 00:33:45,600
support systems for personnel
working in isolation.

599
00:33:45,760 --> 00:33:48,520
Her experience also highlights
how healthcare not solely

600
00:33:48,520 --> 00:33:51,720
defined by professional roles,
but by coordinated action.

601
00:33:51,840 --> 00:33:54,600
The willingness of colleagues to
assist with treatment

602
00:33:54,960 --> 00:33:57,800
demonstrates the important of
trust, communication, and

603
00:33:57,800 --> 00:34:00,560
collective problem solving in
extreme environments.

604
00:34:00,880 --> 00:34:04,040
The story of Doctor Jerry
Nielsen is often framed as

605
00:34:04,040 --> 00:34:07,600
survival against the odds, but
it's significant actually lies

606
00:34:07,600 --> 00:34:11,560
in what it reveals about systems
preparation and human response.

607
00:34:11,600 --> 00:34:14,960
Extreme environments remove
assumptions about access and

608
00:34:14,960 --> 00:34:18,199
expose the foundations of
healthcare knowledge, planning,

609
00:34:18,199 --> 00:34:21,639
and decision making.
Her experience demonstrates that

610
00:34:21,639 --> 00:34:24,280
medicine can function beyond
traditional settings when

611
00:34:24,280 --> 00:34:27,639
clinicians adapt principles to
available resources.

612
00:34:27,840 --> 00:34:30,639
Her story also challenges the
narrative that rescue is the

613
00:34:30,639 --> 00:34:33,560
beginning of survival.
And I really like that.

614
00:34:33,560 --> 00:34:36,199
Also, it challenges the
narrative that rescue is the

615
00:34:36,199 --> 00:34:39,840
beginning of survival.
So Jerry didn't wait to be

616
00:34:39,840 --> 00:34:42,120
rescued.
She didn't say, Oh no, I have

617
00:34:42,120 --> 00:34:43,800
cancer.
Somebody she, you know, she

618
00:34:43,800 --> 00:34:46,080
wasn't a damsel in distress.
Oh, what was me?

619
00:34:46,080 --> 00:34:50,040
Somebody come save me.
She took deliberate action,

620
00:34:50,199 --> 00:34:55,960
knowing that rescue would not be
would likely not be the first

621
00:34:55,960 --> 00:34:57,920
option.
In reality, survival often

622
00:34:57,920 --> 00:35:00,600
begins with action taken before
rescue arrives.

623
00:35:01,320 --> 00:35:03,680
Jerry begin treatment while
still isolated.

624
00:35:04,080 --> 00:35:07,880
It's illustrating the importance
of agency even when circumstance

625
00:35:08,240 --> 00:35:11,320
circumstances are constrained.
This perspective appears across

626
00:35:11,320 --> 00:35:14,040
survival literature, where
outcomes are shaped not only by

627
00:35:14,040 --> 00:35:17,160
external intervention but by
internal response.

628
00:35:17,160 --> 00:35:21,280
We hear the same sort of story,
you know, in cases where people

629
00:35:21,280 --> 00:35:26,160
are caught in an avalanche and
they choose ways to survive and

630
00:35:26,720 --> 00:35:30,800
whether it's building a cave
that they can shelter in while

631
00:35:30,800 --> 00:35:33,920
they wait for rescue or whatever
the case may be.

632
00:35:34,360 --> 00:35:37,000
It's the same sort of thing of
am I going to lay here and die

633
00:35:37,000 --> 00:35:40,160
or am I going to do something?
And, and it's actually, it's

634
00:35:40,160 --> 00:35:43,920
interesting because on paper,
Doctor Nelson's experience

635
00:35:43,920 --> 00:35:47,280
doesn't seem necessarily
equivalent to that because she's

636
00:35:47,280 --> 00:35:50,880
warm and comfortable inside of a
research laboratory.

637
00:35:50,880 --> 00:35:54,000
But just because she's not
trying to survey survive in an

638
00:35:54,080 --> 00:35:58,600
avalanche cave doesn't make her
survival any less any less

639
00:35:58,600 --> 00:36:02,400
miraculous or dedicated or
extreme.

640
00:36:02,400 --> 00:36:05,680
I guess honestly, you look, you
look like you have something to

641
00:36:05,680 --> 00:36:09,040
say.
No, I'm just thinking about how

642
00:36:09,360 --> 00:36:13,160
we talked about her being warm
and comfortable but but knowing

643
00:36:13,160 --> 00:36:16,120
she's potentially dying would
put a little crimp in that.

644
00:36:16,360 --> 00:36:18,480
Sure, sure, I agree.
I just.

645
00:36:18,880 --> 00:36:21,480
The whole thing is just mind
boggling and like I said,

646
00:36:21,480 --> 00:36:25,720
knowing typically cancer grows
very slowly, but if it's to the

647
00:36:25,720 --> 00:36:28,120
point where she's noticing A
lump, it's been there a while.

648
00:36:28,120 --> 00:36:31,280
Usually they say, I think it's
two years that it's been growing

649
00:36:31,280 --> 00:36:34,280
before people notice the lump.
Wow, wouldn't have been nice if

650
00:36:34,280 --> 00:36:36,480
she noticed it before she went
to the Ant doctor.

651
00:36:37,360 --> 00:36:39,280
Yeah, right.
Oh.

652
00:36:39,320 --> 00:36:42,880
There it is.
It would and I just that's.

653
00:36:43,000 --> 00:36:44,840
Pretty wild.
Doctor Nelson's experience

654
00:36:44,840 --> 00:36:47,520
continues to be referenced in
discussions of telemedicine,

655
00:36:47,520 --> 00:36:50,520
remote healthcare, medical
ethics, and resilience because

656
00:36:50,520 --> 00:36:53,320
it represents a moment when
modern medicine encountered one

657
00:36:53,320 --> 00:36:56,560
of Earth's most unforgiving
environments and continued

658
00:36:56,560 --> 00:36:59,800
anyway.
Extreme conditions did not

659
00:36:59,800 --> 00:37:03,040
eliminate medical care, they
changed how it was delivered.

660
00:37:03,120 --> 00:37:05,640
Her story illustrates that
Healthcare is not defined solely

661
00:37:05,640 --> 00:37:09,040
by infrastructure, but by the
decisions clinicians make within

662
00:37:09,040 --> 00:37:11,960
the realities they face.
The enduring impact of her story

663
00:37:11,960 --> 00:37:15,840
also lies in its demonstration
of agency under constraint.

664
00:37:16,040 --> 00:37:18,560
Isolation did not halt clinical
action.

665
00:37:18,680 --> 00:37:21,080
Uncertainty did not prevent
decision making.

666
00:37:21,440 --> 00:37:25,840
Instead, the situation required
adaptation, collaboration, and

667
00:37:25,840 --> 00:37:28,240
the application of medical
principles in unconventional

668
00:37:28,240 --> 00:37:30,280
ways.
This reflects a central truth

669
00:37:30,280 --> 00:37:32,600
about medicine and survival
psychology.

670
00:37:33,160 --> 00:37:37,080
Outcomes are shaped by response
as much as by circumstance.

671
00:37:37,280 --> 00:37:40,440
Her story reminds us that
Healthcare is ultimately a human

672
00:37:40,440 --> 00:37:44,120
practice carried out wherever
people exist, even at the end of

673
00:37:44,120 --> 00:37:46,640
the world.
The environment may change,

674
00:37:46,640 --> 00:37:49,840
resources may shrink, and
certainty may disappear, but the

675
00:37:49,840 --> 00:37:53,160
core of medicine remains the
same commitment to act, to

676
00:37:53,160 --> 00:37:57,000
adapt, and to continue care even
when conditions are far from

677
00:37:57,000 --> 00:38:00,120
ideal.
Hey, was there any indication of

678
00:38:00,120 --> 00:38:02,560
what other kind of medical
conditions or problems were

679
00:38:02,560 --> 00:38:05,640
addressed while she was there?
I didn't see anything like that,

680
00:38:05,640 --> 00:38:08,200
no.
I wonder how heavy a lift it was

681
00:38:08,200 --> 00:38:10,680
for her.
I wonder I, I wish I knew also

682
00:38:10,680 --> 00:38:12,360
how many people were on the
crew.

683
00:38:12,360 --> 00:38:14,960
Like, was she caring for five
people?

684
00:38:14,960 --> 00:38:18,080
Was she caring for 30 people?
Yeah, I don't know.

685
00:38:18,080 --> 00:38:21,280
I'm just looking to see if I
have anything else in my notes

686
00:38:21,280 --> 00:38:24,680
that's not part of my narrative.
So during the winter months in

687
00:38:24,680 --> 00:38:28,760
Antarctica, temperatures can
fall to around -60°C or lower,

688
00:38:29,240 --> 00:38:30,760
and the station is completely
cut off.

689
00:38:31,120 --> 00:38:33,760
No flights could land from
roughly February until late

690
00:38:33,760 --> 00:38:35,320
October.
So they would have been there

691
00:38:35,320 --> 00:38:37,800
from February until October,
February, March, April, May,

692
00:38:37,800 --> 00:38:39,400
June, July, August, September,
October.

693
00:38:39,640 --> 00:38:41,160
So I said four months.
How about 9:00?

694
00:38:42,280 --> 00:38:44,400
That's a lot different A.
Little different.

695
00:38:45,120 --> 00:38:48,480
And I'm thinking nine months
could be a really big difference

696
00:38:48,480 --> 00:38:50,360
in prognosis.
Yeah, for sure.

697
00:38:50,400 --> 00:38:52,400
I'm so sorry.
I do have this information.

698
00:38:52,440 --> 00:38:55,240
I'm totally embarrassed.
But she was the sole physician

699
00:38:55,240 --> 00:38:58,640
for about 40 people, scientists,
engineers and support staff.

700
00:38:59,160 --> 00:39:01,400
She was responsible for their
physical health, mental health

701
00:39:01,400 --> 00:39:03,120
emergencies, dental care,
everything.

702
00:39:03,200 --> 00:39:05,720
Dental care too.
I imagine she must have gotten

703
00:39:05,720 --> 00:39:08,200
some extra training because
most, I don't think most doctors

704
00:39:08,200 --> 00:39:10,520
I know have dental training.
Yeah.

705
00:39:10,720 --> 00:39:13,680
I don't think so either, unless
maybe it was just pulling teeth.

706
00:39:13,680 --> 00:39:16,120
I guess in the ER, physician
might be able to pull teeth.

707
00:39:17,200 --> 00:39:20,880
She recalled in her biography
that the thought that hit her

708
00:39:20,880 --> 00:39:23,280
when she when she felt the lump,
the thought that hit her

709
00:39:23,600 --> 00:39:26,520
immediately was not denial, not
confusion, but a blunt

710
00:39:26,520 --> 00:39:28,080
realization that this could be
fatal.

711
00:39:28,080 --> 00:39:31,560
So she felt a lump in her breast
and was like oh shit, this could

712
00:39:31,560 --> 00:39:33,040
kill me.
Yeah.

713
00:39:34,400 --> 00:39:37,840
Like, Oh no.
Right.

714
00:39:38,080 --> 00:39:39,720
That would be bothersome.
Yeah, it.

715
00:39:39,840 --> 00:39:43,040
Really would.
On a high level of bothersome

716
00:39:43,040 --> 00:39:44,440
the.
Military, This is the AirDrop.

717
00:39:44,760 --> 00:39:47,080
The military aircraft was
dispatched to AirDrop medical

718
00:39:47,080 --> 00:39:49,440
supplies and medications.
Landing was too dangerous.

719
00:39:49,440 --> 00:39:51,640
Extreme cold could freeze
aircraft systems and trap the

720
00:39:51,640 --> 00:39:53,920
plane.
So the crew created a drop zone,

721
00:39:53,920 --> 00:39:56,560
like I said, with the barrels
burning.

722
00:39:56,680 --> 00:40:00,800
And sure enough, it included the
six bundles of medical

723
00:40:00,800 --> 00:40:03,200
equipment, including
medications, and the equipment

724
00:40:03,200 --> 00:40:05,440
to form another biopsy.
OK.

725
00:40:05,720 --> 00:40:09,720
So they planned guest or they
they said we're going to err on

726
00:40:09,720 --> 00:40:12,000
the side of you have cancer, you
have breast cancer.

727
00:40:12,800 --> 00:40:16,720
OK, so that came with some
educated guessing.

728
00:40:16,840 --> 00:40:18,200
Gotcha.
Yep, Yep.

729
00:40:18,280 --> 00:40:21,600
Some of her symptoms while she
her side effects while she was

730
00:40:21,600 --> 00:40:23,240
on hormone therapy and
chemotherapy.

731
00:40:23,240 --> 00:40:25,560
I don't know how none of this
got into my paper.

732
00:40:27,560 --> 00:40:31,000
Nausea, hair loss, sudden
menopause symptoms, exhaustion.

733
00:40:31,000 --> 00:40:34,120
All while continuing to care for
the station's crew, right?

734
00:40:34,880 --> 00:40:37,120
Wow.
Even less fun.

735
00:40:37,360 --> 00:40:39,440
Less fun.
So let's see.

736
00:40:39,440 --> 00:40:45,000
She was born in, I want to say
52.

737
00:40:45,000 --> 00:40:46,240
Yeah.
So she was born in 52.

738
00:40:46,240 --> 00:40:49,480
So she was 40.
Seven that's considered young.

739
00:40:50,360 --> 00:40:52,120
That's.
Very young, that's how.

740
00:40:52,440 --> 00:40:54,440
I think I was 45 when mine
happened.

741
00:40:54,760 --> 00:40:57,720
Oh, interestingly enough, she
was rescued weeks ahead of

742
00:40:57,720 --> 00:41:00,520
schedule, so it was still
October, so she was still there

743
00:41:00,520 --> 00:41:02,880
for nine months.
But they were to push it a

744
00:41:02,880 --> 00:41:05,320
little bit earlier, I guess,
yeah.

745
00:41:05,440 --> 00:41:07,440
Interesting.
So we're a little short.

746
00:41:07,440 --> 00:41:09,600
I don't know why this went
faster than I had planned for,

747
00:41:09,600 --> 00:41:13,720
but any closing thoughts before
we?

748
00:41:14,480 --> 00:41:17,760
You know, I think when a person
commits to doing something this

749
00:41:17,760 --> 00:41:21,720
remote and this treacherous,
really I, I think they're a

750
00:41:21,720 --> 00:41:28,280
special kind of person because
you've got the staff of 40 who

751
00:41:28,440 --> 00:41:30,440
know that they have one
provider.

752
00:41:30,960 --> 00:41:34,200
And if something happens to that
person, even if it's not a

753
00:41:34,200 --> 00:41:36,440
cancer experience, you know,
something could happen.

754
00:41:36,440 --> 00:41:37,880
They could have a heart attack
and die.

755
00:41:38,560 --> 00:41:41,600
That means those people are
there without any kind of

756
00:41:41,600 --> 00:41:44,040
medical assistance.
So I'm sure they must be trained

757
00:41:44,040 --> 00:41:47,440
in emergency medical.
Care of some sort and how to

758
00:41:47,480 --> 00:41:49,760
use?
And how to use whatever supplies

759
00:41:49,760 --> 00:41:53,880
they do have.
But it still is a kind of person

760
00:41:53,880 --> 00:41:57,640
that is willing to take a lot of
risk and really trust the

761
00:41:57,640 --> 00:42:01,760
process, if you will, that I
don't feel like I'm that person.

762
00:42:02,480 --> 00:42:04,800
I could be, I guess, if I had to
and there's no choice in the

763
00:42:04,800 --> 00:42:07,400
whole world and maybe the world
was collapsing around me and I

764
00:42:07,400 --> 00:42:10,000
didn't have a choice.
But I wouldn't step into it

765
00:42:10,080 --> 00:42:12,200
voluntarily, I don't think.
Yeah.

766
00:42:12,320 --> 00:42:16,280
No, not that, not that truly
remote.

767
00:42:17,440 --> 00:42:22,080
I mean, I would if I were there
and not the physician and the

768
00:42:22,080 --> 00:42:26,720
physician died, I would probably
step into a leadership role just

769
00:42:26,720 --> 00:42:30,640
because that's my personality.
But I mean, if I look back to

770
00:42:30,640 --> 00:42:35,480
before I was a nurse, I would
have had no idea what to do as

771
00:42:35,480 --> 00:42:37,840
far as medical care.
I mean, I can put a Band-Aid

772
00:42:38,240 --> 00:42:42,400
back then, of course I can put a
Band-Aid on a wound and roll a

773
00:42:42,400 --> 00:42:45,520
sprained ankle in a in a ACE
bandage, Right.

774
00:42:45,960 --> 00:42:49,080
But that's about it.
Yeah.

775
00:42:49,280 --> 00:42:52,760
And I'm sure that there's, I'm
sure that there have been

776
00:42:52,760 --> 00:42:54,920
changes of standard operating
procedures.

777
00:42:54,920 --> 00:42:59,240
I doubt that they send only one
physician to isolated stations

778
00:42:59,240 --> 00:43:02,600
like this.
At the very least, if they send

779
00:43:02,600 --> 00:43:06,760
only one physician, I would hope
they send NPS or PAS or nurses

780
00:43:06,760 --> 00:43:10,440
or all of the above.
Frankly, I still can't believe

781
00:43:10,440 --> 00:43:14,240
she had 40 people that she was
in charge of, that she was in

782
00:43:14,240 --> 00:43:17,040
charge of their medical care.
That's just far as I can tell.

783
00:43:17,040 --> 00:43:20,280
None of them were medical
professionals in any way.

784
00:43:20,280 --> 00:43:23,560
Because I feel like it would
have said and five nurses or but

785
00:43:23,560 --> 00:43:27,240
it didn't just said scientists
and sports engineers and sports

786
00:43:27,240 --> 00:43:29,320
staff.
Yeah, that's that's a lot.

787
00:43:29,600 --> 00:43:31,040
That's a lot of responsibility
at.

788
00:43:31,280 --> 00:43:35,000
What point and how far do you?
Well, first of all, I don't even

789
00:43:35,000 --> 00:43:37,080
know who organized the
expedition.

790
00:43:37,080 --> 00:43:40,840
So I don't know who if it was a
government situation or if it

791
00:43:40,840 --> 00:43:45,600
was private, what point is there
liability on the part of the

792
00:43:45,760 --> 00:43:49,920
company that organized it that
said that made the decision?

793
00:43:50,000 --> 00:43:54,360
I mean, nobody died, obviously.
So I guess I'm I might be

794
00:43:54,400 --> 00:43:58,360
catastrophizing a little bit,
but it just seems like there

795
00:43:58,360 --> 00:44:01,880
should have been some sort of at
the very least, I hope whoever

796
00:44:01,880 --> 00:44:05,360
organized it was shamed in the
by the public.

797
00:44:06,680 --> 00:44:09,040
Shamed.
I don't know, It just seems like

798
00:44:09,040 --> 00:44:11,800
it just seems like obviously
Hindsight's 2020, but it just

799
00:44:11,800 --> 00:44:17,080
seems so foolish to only send
one physician to an isolated

800
00:44:17,080 --> 00:44:21,960
station with 40 other people.
Yeah, if you consider just nurse

801
00:44:21,960 --> 00:44:25,960
to patient ratios right, 40 is a
lot.

802
00:44:26,720 --> 00:44:29,800
Yeah.
A lot I know that they're not

803
00:44:29,800 --> 00:44:32,320
all being sick at the same time.
It's not the same as if you had

804
00:44:32,320 --> 00:44:35,600
40 patients in a hospital.
But it just seems like, I know I

805
00:44:35,600 --> 00:44:39,360
keep being speechless, but it
just seems so I'm surprised

806
00:44:39,360 --> 00:44:42,960
anybody would agree to it also.
And I guess, again, ignorance,

807
00:44:42,960 --> 00:44:44,880
you know, you don't know what
you're getting yourself into

808
00:44:44,880 --> 00:44:46,640
and.
Well, and also you consider most

809
00:44:46,640 --> 00:44:49,840
of the people are probably young
and healthy and I'm sure they

810
00:44:49,840 --> 00:44:54,480
have to go through physicals and
doctors just was missed because

811
00:44:54,760 --> 00:44:57,960
even if they did a full complete
physical, if it was months

812
00:44:57,960 --> 00:45:02,120
before, they may not have done a
full exam that included any

813
00:45:02,120 --> 00:45:05,200
screening for cancer cause.
What are the odds still?

814
00:45:05,680 --> 00:45:08,000
Yeah, it seems like a huge, huge
deal.

815
00:45:08,000 --> 00:45:12,040
I agree.
Well, I'm not going to either

816
00:45:12,040 --> 00:45:17,280
pole to stay in their facilities
because when I vacation I prefer

817
00:45:17,280 --> 00:45:19,280
to have something a little more
friendly.

818
00:45:20,520 --> 00:45:22,280
Well, thanks, that was that was
interesting.

819
00:45:22,280 --> 00:45:24,600
I'd heard her story, but not in
detail.

820
00:45:24,600 --> 00:45:28,600
So just the kind of person with
the resilience it takes to be

821
00:45:28,600 --> 00:45:32,040
able to do any part of this is
pretty amazing.

822
00:45:32,400 --> 00:45:34,720
Pretty amazing, I agree.
Yeah, I agree.

823
00:45:34,920 --> 00:45:37,000
Well, thank you very much.
You're welcome.

824
00:45:37,240 --> 00:45:38,840
All right.
If you've made it this far,

825
00:45:38,840 --> 00:45:41,520
clearly you like a little mayhem
with your medicine.

826
00:45:41,840 --> 00:45:44,320
Or you just enjoy hearing us
ramble about weird medical

827
00:45:44,320 --> 00:45:46,560
mysteries.
Either way, we'd love you for

828
00:45:46,560 --> 00:45:48,760
it.
So hit that follow or subscribe

829
00:45:48,760 --> 00:45:50,160
button wherever you're
listening.

830
00:45:50,280 --> 00:45:52,280
And toss us a rating or review
while you're at it.

831
00:45:52,560 --> 00:45:55,160
Helps other curious weirdos find
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832
00:45:55,840 --> 00:45:57,920
And we know there are a lot of
you out there.

833
00:45:58,240 --> 00:46:00,760
Oh so many.
Come join the chaos.

834
00:46:00,800 --> 00:46:03,960
Thanks for listening to
Medicine, Mystery, mayhem, and

835
00:46:03,960 --> 00:46:06,600
sometimes Murder.
Do you have an idea for an

836
00:46:06,600 --> 00:46:09,480
episode of this podcast?
Just want to say hi?

837
00:46:09,880 --> 00:46:12,880
You can get in touch with us at
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838
00:46:13,360 --> 00:46:19,880
That's OURM
thenumberfourpod@gmail.com.

839
00:46:20,600 --> 00:46:24,400
We read every e-mail, and
sometimes we even respond just

840
00:46:24,400 --> 00:46:27,200
like real professionals.
Because we are.

841
00:46:27,320 --> 00:46:32,080
Old friends with new twists and
lots of body bags.