Leading the Pack

How did you first get into pathology?

I did not consider pathology at all while in medical school. But, by the late 1960s, after gaining some general practice experience in the US Public Health Service in Alaska, I realized that caring for sick and terminally ill patients was not for me. I enjoyed basic science and I figured pathology would be more of the same. In 1969, I began a pathology residency at Mayo Clinic in Minnesota. Even then I had doubts about whether I had made the right choice – and it wasn’t until 1974, when I started working as a pathologist at Providence Hospital in Anchorage, that I finally felt comfortable and confident at the microscope.

And you’re an avid sled dog racer…

Growing up in Fargo, North Dakota, I was never allowed any pets, so when I became an Alaskan, my yearning for canine companionship became palpable. Soon enough, my back yard was brimming with dogs. The Iditarod is an annual sled dog race from Anchorage to Nome – a 938-mile journey across Alaska in early March. You might think this sounds daunting – and it often is – but I can’t get enough, even at the age of 79! I have competed at least once every decade since 1979, with a current total of 20 races. I enjoy training with the dogs to prepare for the race, planning and executing a race plan (even when it begins to fall apart), and the well-earned celebratory beer at the finish line. In 2019, I participated in Yukon Quest (a 1,000-mile race between Whitehorse, in Canada’s Yukon Territory, and Fairbanks, Alaska) for the first time. I had always wanted to run it and, at my age, it was now or never. Although the Quest is arguably tougher than the Iditarod, I jokingly stated in a speech at the banquet before the start, “The Iditarod was getting too tough for me, so I decided I should try an easier race!”

Surprisingly, there are a few parallels between pathology and sled dog racing, mainly in that both involve medical care. My knowledge of medicine, pathology, and physiology has enabled me to evaluate and treat canine health issues, sometimes in conjunction with a veterinarian. The same applies to nutrition and conditioning. And then there’s my own body, which is a museum of dog musher pathology in itself. Fractures, prosthetic joints, tendinitis, hemorrhoids, dog bites, lacerations, and amputations. The last is memorialized with a mummified big toe dressed in a tuxedo and lying in a coffin with the accompanying text of a eulogy. Both pathology and sled dog racing involve observation, diagnosis, and analysis – take stock of what happened, establish what worked well and what didn’t, determine how to fix it, and resolve to do it better or at least differently next time.

What was your toughest moment?

Every race has its tough moments. There is always at least one point where I question the dogs’ and my ability to make it to the finish or even to the next checkpoint. Difficulties have included blizzards, obliterated trails, temperatures below -50°C, broken bones, rough ice, thin ice, no ice, water immersion, frostbite leading to amputations, sickness, and hallucinations, to name a few. One of the toughest moments occurred during my first Iditarod race in 1979. After a few days of fine miseries – cold, dehydration, and exhaustion – I became delusional and paranoid. I believed that other mushers had endured the same fate and gone on to complete the race while losing their minds. They wanted me to continue and lose mine, but I thought I would retire from the race to foil their diabolical plan. Alas, instead, I struggled on to the finish. So I ask you – did I lose it?

How do you motivate yourself to carry on?

There are many times when I came close to giving up but, in these moments, I drew on experience. I knew that, no matter how bleak it seemed, things would get better – so I hung on. Despite this, there are times when I have had to retire. I have successfully completed 16 of my 20 Iditarod races; four ended in disappointing circumstances. One of these was due to a ruptured Achilles tendon, another a fractured clavicle, and yet another because I developed pneumonia. The fourth came in the 2018 Iditarod when, 40 miles from the finish line, I was blown out to sea in a fierce storm and had to be rescued.

As for motivation, I remind myself that I’m out there in a predicament of my own making and that I am supposedly enjoying it. Alternatively, motivation can come from an inspirational cause. In one race – dubbed a “Mush-a-thon” for a new thermal unit at my hospital – people pledged money for each mile I completed, so I was compelled to reach the finish line in Nome. I raised US$14,000 for the unit – and was then immediately admitted to it myself for frostbite suffered during the race!

What is the most valuable thing you’ve learned throughout your career – as a pathologist or as a sled dog racer?

Things will get better. But that doesn’t mean you should simply wait; if you take action, things will get better sooner. Tend to the injury, mend the broken sled, hydrate the dehydrated, form your alternate plan – and the same is true for crises in medicine. Believe it or not, my medical training prepared me well for sled dog races, especially the 1,000-mile events. During these long races, sleep comes in one- to two-hour increments – at most twice each day. Over the entire race period of more than 10 days, that leaves you with just 15 to 20 hours’ sleep. It’s grueling and things get pretty fuzzy, but you must continue to make decisions and take action. Being on call and taking care of patients for entire nights before working the next day helped prepare me for the races to come.

What advice would you give to those at the start of their medical careers?

These are the good old days. Life is great and so is your chosen profession, so make the most of it! And, importantly, make room for other things. In my case, that has meant music, mushing, and family, with a little commercial fishing on the side. For many years, after I had finished my day at the lab, I would hook up my team of dogs to go for a run after midnight and then get up the next morning to do it all over again. How did I manage it? Younger and dumber, I guess…