I spent october of 2012 in anchorage at the ANMC MICU.  I had originally set it up as a split block: half MICU, half wards, but decided to just extend my ICU time once I was there.

It’s  a very interesting ICU to work in.  As always, spectacular nursing staff and respiratory therapists make ICU rotations some of my favorite.  They use pressure control instead of AC style ventilation as a default up there, which is a transition that was definitely useful if a bit challenging at first.

There’s an incredible variety of patients, ranging from the worst hyponatremia I’ve ever seen (Na of 98, a combination of beer potomania and schizophrenic polydipsia, wowza), to intense alcohol withdrawal, to the usual mix of sepsis and stroke management.

The opportunity to do procedures varies a bit based on the pathology mix, but even on slow days I would head across the hall to the OR and do scheduled intubations.  There was a nice mix of bronchoscopy, intubations, central lines, LP’s, and art lines otherwise.  Some people had much more procedural months than I did, I only did 3 or 4 of each of our internal medicine procedures.

The attendings come from all over, as they rely on a fair number of locums.  Dr. Madhani-Lovely is spectacular, and will force the residents to really justify decision making with an evidence base when she is on service.

The hospital itself is great, and the sheer splendor of alaska is literally breathtaking at times.   When I would leave the parking lot near sunset, I’d sometimes find myself waxing poetic and wishing for paints. The logistics of licenses and such can be a bit of a drag, so try to get started on those things way in advance.  In general, the people in the hospital are pretty motivated to help you out.