Technology on ICE:  Telemedicine in Antarctica
 

 


Information Services' Jake Angelo, left, and Dr. Steven Viegas  conquer the South Pole for UTMB

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       The Preparation

The invitation to the ICE, as it is called, actually began over a year ago when the UTMB Telehealth Center asked that we facilitate a connection from the three Antarctic Stations at Palmer, McMurdo and South Pole to UTMB for telemedicine.  This request started a chain of events that eventually ended up at the 2002 Ice Summit meeting of Raytheon Polar Services hosted by UTMB.  The meeting was held in Galveston to give the physicians headed to and returning from the region a chance to interact with the consultants with whom they have been and will be working as part of the telemedicine contract for services.

On September 19, 2002, Dr. Ronald Shemenski, Acting Medical Director, Raytheon Polar Services asked me if I thought a trip to the ICE would help us understand the environment under which they work on a daily basis.  My reply was positive and was the trigger for the events to follow.  The next day Dr. Ben Raimer, Vice President for Community Outreach, asked if I would accept an invitation to visit McMurdo and South Pole stations along with a UTMB physician and I immediately answered “yes.”

After a brief discussion with Dr. Shemenski and Dr. Betty Carlisle from McMurdo Hospital , I began making plans for this exciting adventure.  The start of the preparation was to break the news to my wife and family.  This was the easy part since my wife supports me in numerous off-the-wall schemes which I have attempted during our 29 years of marriage.

Next was the process of physical qualification for the trip, a requirement of the National Science Foundation and Raytheon.  This process can be compared to a scavenger hunt with attitude.  Knowing what was to follow I made a medical and dental appointment in order to present the documents to the respective services for completion.  At this point in time my co-adventurer was named and I learned that Dr. Steven F. Viegas, who has been an active part of telemedicine at UTMB, was to travel with me on this wonderful journey.  The physical qualifications (PQ) turned out to be two months worth of work which was crammed into just a few days.  All inclusive were complete physical and dental exams (with accompanying x-rays and a page and a half of lab tests).  These were rushed through the system in just a few hours. 

The grand part is that this 55-year-old fat man actually passed the “PQ” process and was fit enough to survive the trip.  What this really meant is that my physical condition was no excuse for backing out now. Tickets in hand, calendar cleared, bags packed and attitude maximized, I was ready to experience whatever was to follow.

 

The Journey Begins

As it turned out the actual trip to the pole included some 27 flying hours in a variety of aircraft.  The journey began at Hobby Airport with an American flight to Dallas and then to Los Angeles .  After a short wait it was time to board the Qantas flight for Christchurch , New Zealand .

Five movies and several short tours of the 747 (to keep my legs from revolting) later and we landed at Auckland , New Zealand where we cleared customs and boarded a domestic flight to Christchurch . 

We were met at the Christchurch airport by a uniformed Raytheon employee who gave us our hotel assignments (and immediately took our return tickets) and directed us to the shuttle vans into the city.  We were assigned a time to go to the Clothing Distribution Center (CDC) and delivered to the hotel for the rest of the day. 

The next morning we were directed to the International Antarctic Center for the official distribution and fitting for our Extreme Cold Weather gear (ECW). This event gave an air of reality to the trip.  Piles of coats, fleece, long-johns, very heavy sox and what proved to be the best pair of boots I have ever worn along with several hats and caps, three progressively larger pairs of glove/mitten combinations, snow goggles and sun glasses all of which had to be packed into two large orange bags for the trip to the ICE.

The first afternoon in New Zealand was beautiful – lots of people, very clean streets, and due to the location of the Heritage Hotel, it was easy to walk Cathedral Square and take advantage of the street vendors and shops in the area.  The trip would have been wonderful if this had been our destination but reality struck with our wake up call to head for the airport.  The flight to Antarctica checked in at 6 a.m.

Once at the airport we began the preparing for the C-130 flight to McMurdo Station Antarctica, a flight which we knew would be long, tiring and cramped.  It proved to be all three and as an added feature there was a deafening roar from the props.  As we arrived at McMurdo Station Antarctica and the aircraft door opened the cold air rushed into the cabin as if to say “this is not Texas anymore.”  Even though the temperature was only about 24° F it was colder than I have been in a couple of years being a coastal dweller.

As I exited the plane it became obvious that this was going to be an adventure.  We rode a bus-like vehicle with tires taller than me affectionately called “Ivan the TerraBus” to the station which Dr. Viegas likened to a college campus and old mining camp.  The streets were rimed with ice and snow but the majority of the terrain was black rock, no grasses and no trees of any kind.  I saw two birds and one seal.

We were issued our room keys and taken to the dorm to unpack and settle in.  Dr. Viegas and I quickly claimed our spaces in the four-person room and went off to the hospital.  We were met by Drs. Carslile and Otto along with the staff from the hospital.  All of them were very excited to see us.  Dr. Carslile called the Information Technology office and Rick Pierce came over to meet with me to plan our next few days together.  Rick and I had worked together over videoconferencing for a long time on this project but never in person so we did not feel like strangers.  Over the next few days we went over the video system, discussed the network issues and became familiar with each others working environments. 

There was an urgency to fix the ultrasound equipment which had never successfully transmitted real time cardiac images from the station.  The National Science Foundation (NSF) wanted to participate in a video call with a real patient but their flight from the South Pole was delayed and they missed the live telecast. Dr. Otto provided a video camera to record the event which they watched the next day.  Rick and I had solved the problem with the ultrasound unit and for the first time the ultrasound was used in a live telecast and it proved very effective in diagnosis of the cardiac condition of the patient.

Between duties at the hospital Dr. Viegas and I both managed to do some selective sightseeing and participated in the research projects on the ICE, all of which were fascinating and unusual.  One of the first research events was a Wednesday night presentation by none other than the marine team from Texas (see related links at the bottom of this page).  I guess – “Here for the Health of Texas” is true.  Not only were we able to assist in the telemedicine project but we were afforded the opportunity to see inside of some of the projects that are ongoing in the Antarctic, an experience which I will not soon forget. 


South Pole Station

There was much discussion about our next leg of the journey, that to the South Pole Station.  With the posting of our date and time for what is called “South Pole Bag Drag”, a little ceremony at which you hand carry everything needed at the Pole up the hill to the transfer station and weigh in for the flight.  Ours was 7 p.m. the night before the trip.

The next morning we arrived at the aircraft which would take us some three and a half hours south to the bottom of the earth.  The LC-130 (C-130 Transport with "skids" where the wheels were) was old hat by that time and we settled in quickly.  As we approached the Pole the crew announced our arrival and that we should make sure that all of our cold weather gear was in place.  This proved to be very good advice.

The landing was smooth even on skids instead of wheels.  After a few minutes arrived at the “terminal” which was a box with a fuel hose in it and some orange safety cones with a van parked next to it. 

Once out of the plane it hit me.  “I am standing on the coldest, driest, windiest and most barren spot on the planet; 9,800 miles from home; 10,000 feet elevation, minus 37° F with a wind chill factor of about minus 65° F, and fewer than 300 people for 1,000 miles around. 

There were no smells, nothing of color, 2 inches of powdered snow and two miles of base, as they say.  It was a scene I will carry in my mind forever.  There was nothing – in all directions.  The rise to the North (every place you look is to the North) hinted of civilization but not much of that.  The largest terrain feature was the C-130 and it was loading to go back to McMurdo with more people and stuff leaving the South Pole Station.  We were then whisked away by Dr. Will Silva, resident physician at the Pole to the warmth of the dome and to a good hot lunch and orientation talk.

The South Pole Station is an interesting place.  Activities center around a large dome constructed to protect the buildings inside from the wind, snow and cold.  Within the dome are a number of small buildings I refer to as “walk-in coolers.”   These all have cooler outer doors, an inner door and inside you can find the dining room, communications center, library, post office, gift shop, hospital, and fire station all within their respective coolers (or warmers in this context).

Outside the dome is the new station opening soon and some well insulated huts and out buildings which serve as dormitories for those of us lucky enough to visit there for any length of time. 

Generally I found everything there difficult and very cold.  The day we arrived I was invited out to do some work on a satellite antenna which failed to track the daily satellite as it peeked over the horizon.  We took a short ride across the ice to another freezer attached to a large antenna which had a software glitch, thus cutting off communications from the station for most of the day.   While I visited the satellite facility Dr. Viegas worked with Dr. Silva and his staff on a hand lecture series.

While posing for a photo at the antenna site I had my face uncovered and with a wind chill of about minus 70° F, it did not stay uncovered for very long.  At one point my hair started to crunch when I touched it – not a good sign.

We spent the remainder of the trip working out some bugs in the system and making video and images from the Pole more reliable.  It was a productive two days.


The Return

The one memory that I will carry with me forever and am happy to share came from Dr. Will Silva.  In a conversation we asked him why he came back to the Pole time and time again to care for this handful of people.  He likened the experience to a garden.  “When tended it reaps much produce … if left alone it overgrows, dries up, and dies.”  He warned me to “tend to my garden.”

It may have been the feeling of being alone at the bottom of the earth, the vast emptiness of the environment, the thin air or high altitude but the experience at the South Pole was a life changing one for me.  I can't explain it just yet but I seem more committed than ever to the mission of UTMB and much more committed to my family and my friends.

The trip home was nothing out of the ordinary – other than the knowledge that I and the telemedicine program had gained from the experience.

 

Jake Angelo , Retired

Information Services
and Director of Technology for
UTMB's Center for Telehealth & Distance Learning

 

 


 

 

 

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