For the past several years, when not practicing medicine, I have been working part-time as a professional pilot, and my plan for last July was to fly around the world as co-pilot in a Citation Jet. But insurance problems and a volcano in Iceland grounded that plan a week before departure, leaving me with spare time on my hands and a slightly useless feeling. Then my cell phone rings and Dan, the medical director for Quark, says, “Hey, Kevin, you still want to do that North Pole trip?” Yes!

Quark is a very high-quality expedition/cruise company, headquartered in Vermont, that leases Russian vessels for polar trips and staffs them with Western expedition crews. Most of the passengers – “pax” – are usually adventurous Europeans and Asians. The ship for this trip was the “50 Years of Victory” (the VIC), a 450-foot icebreaker built in the late 1990s and powered by two nuclear reactors sending 75,000 horsepower to its three propeller shafts. It also has a huge 1960s vintage MI-8 Russian military helicopter with twin turbines of 1,800 HP each. The VIC’s paramilitary Russian crew looked like Navy Seals.

I had worked as the expedition physician on Quark polar trips before and had been lobbying for one of the once- or twice-yearly North Pole assignments for some time. As a flying physician, I thought riding around in that MI-8 helicopter over the frozen Arctic with the icebreaker below crushing through ice and exhaling air heated by radiation, plus dealing with any medical emergencies that might come up, would just have to be a lot of fun.

The departure point for the trip was Murmansk, the only Russian port to remain ice-free year-round. A couple of weeks after Dan’s call, I flew into Finland and then to Murmansk. A fairly new Volvo bus delivered me to the pier at the military-style Cold War-era base just outside of town, and there towering seven stories above us was the VIC. Definitely a well-used vessel, with faded red paint on the super structure and patchy black paint on the hull. Only its designer would consider this ship good-looking. But looking up at that massive floating piece of steel with all its rough welds, I had no doubt whatsoever that it was built to handle anything.

On the back deck the vaunted MI-8 was tied down. What an ugly helicopter. The orange and blue paint had seen better days. The five main rotor blades were covered with wet, sagging canvas. The thing was so large that the tail rotor hung over the stern.

Not exactly pretty: Kevin Ware poses near the "vintage" MI-8 Russian military helicopter.

The VIC departed forthwith in order to make the evening tide at the rather shallow harbor entrance, passing some threatening-looking Russian military ships on the way out. About an hour later and 15 miles into the Barents Sea, my Blackberry quit working. After a very decent French dinner, I headed to the doctor’s cabin, which was on the main deck. Very nice! I went to bed right away and slept 10 hours.

After breakfast I wandered aft to find my Russian medical colleague. The VIC has a full-time Russian crew of about 150 with their own physician on board. Dr. Tatianna was a very pleasant but stalwart Russian general surgeon who unfortunately spoke no English whatsoever. Through the ship’s government interpreter, we discussed how we would collectively handle emergencies. My experience has been that Russian medical practice differs considerably from that of the West, but in the event of a real problem, my sense was Tatiana could probably teach me a few things. Interestingly, the ship has no narcotics on board and uses local lidocaine, or “bullet biting,” for emergency procedures. I wasn’t sure how that would go over with our Western pax but decided to not mention it to the helpful Dr. T.

Thirty-six hours later and still some 800 miles from the Pole, the Arctic ice pack was visible 10 miles ahead on the VIC’s bridge radar. Some 40 minutes later, with the VIC still in open water doing some 15 knots, the crew did not even think about slowing down before colliding with a wall of 10-foot-thick sea ice, with the impact and noise of a train wreck. The hull design calls for the ship to ride up and crush the ice with its weight. At 15 knots this causes a new “train wreck” about every 15 seconds, which continued all the way to the Pole and back.

The next morning the weather cleared a bit and, between the crashes coming from the bow, there was discussion about reconnoitering the ice ahead with the helicopter. Sounded like a fine idea to this Flying Physician. A group of us expedition staffers wandered back to the helicopter deck where some military-looking fellows with shaved heads, excellent muscle tone and obvious evidence of old nasal fractures were untying the MI-8. We boarded. The flight mechanic led us to believe that seat belts and ear protection were entirely optional.

Following a loud whine the port turbine lit off. Some 30 seconds later the second turbine wound up and lit off. The main rotor started to turn, producing some truly astounding vibration.

Russian-style helicopter weight and balance calculations then followed. These involved pulling enough collective to raise the helicopter a couple of feet off the deck with the flight mechanic carefully eyeing the torque cages. They moved into the red range while we were still in ground effect (IGE) hover, and we plopped back down on the deck. With the main rotor still at 100 percent RPM and the turbines making a horrific whine, a yell came from the cockpit in Russian that a couple of guys would have to get out. Without too much encouragement, three of our group jumped out the small door. We moved out of IGE hover and through the vibrations characteristic of translational lift over the ice.

Circling over the VIC as it forced its way north through a sea of ice as far as I can see is a sight worth all the time and trouble required to get there. We are 400 miles from the Pole and 800 miles from the nearest land. The ice beneath us is 14 feet thick and itself moving at one to two miles per day. The Arctic Ocean under that is 10,000 feet deep. As the MI-8 climbs, we look for possible open water leads ahead of the ship, but we see little in the way of openings to the north. By now the turbines have been running for about 45 minutes, we have burned nearly 250 gallons of jet fuel and it is lunchtime. We return to the helicopter deck.

The next afternoon we reach 90 degrees north. When the finicky Russian navigator gets the ship, using a GPS antenna, positioned exactly at the North Pole, the horn is blasted and vodka served all round. The ship is then driven into nearby unbroken ice and the anchors are dropped onto ice that is as thick as a house and floating on water that is over two miles deep. I get off the ship and onto the ice. It looks a bit scary to me. But the Russians are already running all over, drinking more vodka and having a great time. We exchange cameras and take pictures of each other.

Ware at the North Pole marker after he "walked around the world" in two minutes.

Position markers are placed at the Pole and the pax are allowed to disembark. We all form a circle around the marker. We then turn on our heels and move counterclockwise. In two minutes we have all walked “around the world.” While this is going on, what open water there was around the ship has frozen solid right up to the hull, except for a small clear area aft where the propeller is slowly turning in order to keep a “swimming hole” open. The propeller is stopped and we place a makeshift ladder from the ice down into the rapidly re-freezing water. A rope is tied to crazy volunteer swimmers, mostly young women in small bikinis. The rope is to retrieve the swimmers if they faint in the water. The doctor (me) is advised to monitor the proceedings carefully.

Polar bears 10 miles away could hear our bikini-clad Western volunteers scream as they hit the water. They then frantically grab at the ladder and climb out, mouths wide open in silent agony. The Russian males with the old nasal fractures are dressed only in brief Speedos. They dive in headfirst and seem to enjoy swimming out 100 yards or so, playing with ice chunks the size of basketballs, then lollygagging around near the stairs before leisurely getting out. The bikini wearers are very impressed. Vodka is served to all.

About 15 minutes later I find one of our swimmer expedition staffers not speaking clearly, still in his bathing suit, his hair frozen solid in vertical spikes, trying to put his boots on while standing in the ice and slush with bare feet. With considerable medical skill I diagnose early hypothermia. He goes back to the ship for re-warming and returns an hour later, speech and mental status normal, hair still askew.

After a barbecue on the ice, loud Russian rock music over boom boxes, some dancing by the recently bikini-clad crowd under a panoply of international flags, and further photo ops, a nasty freezing fog sets in, reducing visibility to near zero and forcing nearly everyone back on board in full daylight at midnight.

We break free of the ice by pumping air along and under the hull, and head south. The bikini crowd continues dancing in the bar. A male in his 20s falls doing an exotic dance maneuver and lacerates his chin. I repair it with five 5-0 monofilament nylon sutures. His girlfriend assists, looking at him with stern disapproval. It is two o’clock in the morning when I finish. I return to bed with the VIC crunching on.

Two days later we are mostly out of the ice and just north of Frans Josef Land, a Russian archipelago famous for being the departure point of numerous and frequently fatal early polar attempts in the late 1800s. The helicopter is launched to ferry us and our pax ashore. By company policy, the doctor flies out on the first trip and returns on the last. The staff call this policy “polar bear baiting.”

We all explore and hike around the island for a couple of hours. Seeing some fog creeping in, we start instructing the pax to return to the helicopter landing site where they are boarded in groups of 18. Unfortunately, as the last pax are assembling, the fog gets serious and reduces visibility to near zero. We call the ship and the bridge says they cannot see the back deck. Nevertheless, the helicopter gradually materializes out of the murk about 10 feet off the ground, spewing jet exhaust and feeling its way to our location.

I climb on board after all the pax and stick my head into the cockpit wondering how they found us. Surely they must have some very high-tech secret Russian avionics or military heat-sensing gear that they will not let me even see, let alone photograph. But no. There to the glare shield the crew have duct-taped a four-by-five-inch Garmin 396, a piece of American electronic navigational genius, made by a company in Kansas City no less, that gets its signals from our own Department of Defense satellites. Although a long way from home, the 396 was working just fine.

Our return flight is at very low altitude and I cannot see the water, which the altimeter says is less than 50 meters under us. The three-person Russian flight crew are paying a lot of attention to the Garmin 396 when finally the ship looms out of the murk less than 100 yards away. The touchdown was very smooth. The dinner and wine that followed that evening were exceptionally good.

A week later I am back home in Seattle. Maybe missing the Citation trip wasn’t such a bad thing after all, and being a doctor is not such a bad thing, either.

Phil Arnold, D.O.'01, pictured at the top of a jump, loves staffing the slopes as a volunteer ski team physician.

He’s bunked eight to a room with members of the U.S. Ski Team, as team physician. He’s taken care of ski teams and trekking expeditions in Chile, France, Italy, Austria and Tanzania as well as around the United States.

And when he isn’t doing any of that, Arnold treats patients of all ages in Door County, WI, as the local hospital’s attending physician and sports medicine director, medical director of a nursing home and a volunteer physician at a free clinic. A clinical assistant professor at the University of Wisconsin and the Virginia College  of Osteopathic Medicine, he also staffs local marathons and high school athletic events.

So when Arnold says, “I believe I have the best job on the planet,” you might ask: Which one?

The general answer is helping patients, athletic superheroes and average humans alike, to stay active, healthy and injury-free.

“I got into this because of my love of the outdoors and sports medicine,” says Arnold, who spent four years ski-bumming between his undergraduate years and medical school. While in Bozeman, MT, he met Steve Gipe, D.O., an emergency medical doctor who worked in search and rescue missions and extreme climbing expeditions. Years later, Gipe called Arnold to invite him to join the medical team for Erik Weihenmayer, a blind athlete, during the National Federationfor the Blind Everest Expedition in 2001. Arnold leapt at the chance even though he was a fourth-year DMU student and had to pay his own way to Nepal.

His adventures snowballed from there. During the expedition, he met Jeff Evans, a physician assistant and founder of Mountain Vision Inc., an international trekking company; Arnold eventually joined its medical teams on treks to Machu Picchu in Peru’s Andes Mountains and to Mount Kilimanjaro, Tanzania.

“Covering an expedition is a lot of fun but very challenging,” he says. “Getting to know the group members’ health histories, strengths and weaknesses is probably most important. You need to bring the right equipment and extra supplies, make local contacts and have evacuation plans.”

And sometimes you need to be creative. One team member fell victim to posterior nosebleed, one of many high-altitude conditions. “He used up all the team’s sponges and rhino rockets. We had to hit up the ladies,” Arnold recalls, showing a photo of the man with a tampon shoved up his nose.

In 2008, Arnold got a phone call from Gunnar Brolinson, D.O., associate professor and sports medicine chair at the Virginia College of Osteopathic Medicine, where Arnold completed his sports medicine fellowship. Brolinson was scheduled to join the U.S. Ski Team’s medical staff for the 2008 World Cup, but, due to his heavy research load, could Arnold go in his place? Five weeks later, the young doctor found himself stuck in a snowstorm with the freestyle team on a mountain pass near Lake Como, Italy. He was in heaven.

“Working with the ski team has been one of the great things in my career,” says Arnold, who’s since served as its physician six more times. “The people are fun. You get to see some amazing jumps and travel the world.”

Arnold hanging out with pals like U.S. Ski Team freestyler Shannon Bahrke, and freestyle aerialist Ryan St. Onge

He’s also seen – and treated –some breathtaking disasters. At a campus presentation last fall, he showed a brutal video clip of U.S. Ski Team member Scott Macartney wiping out on the icy downhill event going 87 miles an hour. Miraculously, he broke no bones but was kept in a chemically induced coma for two days. Equally miraculously, the skier made the U.S. team the very next year.

“These are super-competitive athletes. You have to be a little off to do that,” Arnold says.

Ski team physicians are volunteers who pay their own expenses in addition to taking time away from their practices. They have to take the four-day Mountain Emergencies in Skiing and Snowboarding (MESS) course every three years. Still, Arnold is hooked.

“You get to practice the art of medicine, not having any labs immediately available and trusting what you know,” he says. “And the coaches and athletes are some of the nicest people you’ll ever meet.”

Dan Kraeger, D.O.’87

“How much can I do in a week? How much can I really change?” he asked himself. “I had those concerns. I talked to missionaries and asked that question. They said, ‘You wouldn’t believe it.”

Kraeger now believes: Since that first trip, he’s participated in trips to Lima, Peru; Alajuela, Costa Rica; Sumpango, Guatemala; and most recently Cartagena, Colombia. He and his fellow physicians, medical and pre-med students, often accompanied by members of his church, treat patients and work with local physicians, residents and churches to sustain their impact.

“When you go to a location for the first time, they don’t know if you’re a one time deal,” says Kraeger, director of Point Sports Medicine Center in Stevens Point,WI. “That’s why we are not just trying to do things for those we serve on medical mission trips, but rather come alongside them and help them to take ownership in what we are doing in the community.”

For example, at the clinic his group established with a church near Sumpango, local volunteers installed televisions in the waiting areas so patients could watch videos, in Spanish, on topics including general hygiene, safe food preparation and nutrition.

“That was totally their idea,” Kraeger says. “I am happy to say that after three years in Sumpango and four years in Lima, those two churches and communities are shining examples of people being empowered to make their communities and the world a better place.”

Education is an important component of his global health work, too, especially given the lifestyles of people in poor countries like Guatemala. Kraeger and his colleagues strive to teach people about exercise and balance as well as provide patient care.

“In Guatemala, many women do laundry as a career, all by hand. They carry all that wet laundry in baskets on their heads,” he says. “All the fieldwork is done with hoes. I grew up on a farm and we hoed our garden, but not a field on a mountainside to earn a dollar a day.”

Team members also educate the medical students and premedical undergraduates who accompany them. The group that went to Guatemala in 2009 included Michael Braunsky and Sara O’Meara, then students at the University of Wisconsin-Stevens Point, where Kraeger regularly talks with the pre-medicine club; both are now osteopathic medicine students at DMU.

Now a DMU student, Michael Braunsky checks the blood pressure of a patient in Guatemala in 2009.

“I watched and learned how a caring and empathetic doctor works with patients,” Braunsky says of working with Kraeger. “The trip reaffirmed everything that I had always thought about the desire to be a physician. Although the clinic was rudimentary, the Guatemalans could not have been happier to receive care. Even the patient with severe hepatitis, as yellow as my T-shirt, who was told that her only chance at minute hope was to get to a hospital, left with gratitude for us coming to see her.”

O’Meara echoes those perspectives. “We went to help them, but they taught us so much – to be grateful, to realize we can make an impact and how sacrificing just a little bit of your time can make a difference,” she says. She planned to join DMU’s first service trip to Honduras this March. “After I came back from Guatemala, I made a promise to myself that Iwould make medical missions a large part of my career and life as a physician.”

Instilling the “art of compassion and service” in students is important to Kraeger.

“Global health is transformational. It puts into perspective why you got into medicine in the first place,” he says. “Visiting families who live in 12-foot by 12-foot homes made of woven cornstalks, dirt floors and tin roofs certainly changes one’s perspectives of how blessed we truly are.”