Thursday, September 11, 2014

Down East

We spent 10 days in "down East" Maine which, for us out of staters, means the eastern half of the Maine coast. Why "down east"?  According to Down East Magazine, "When ships sailed from Boston to ports in Maine (which were to the east of Boston), the wind was at their backs, so they were sailing downwind, hence the term 'Down East.' And it follows that when they returned to Boston they were sailing upwind; many Mainers still speak of going 'up to Boston,' despite the fact that the city lies approximately 50 miles to the south of Maine’s southern border."  Above Lubec, the rest of Maine slopes inland to the northwest and the rest of the Atlantic coast belongs to Canuckistan.  This is a very rural area with no cities, no significant museums or historical sites, few restaurants or theaters but lots of forests, rivers, blueberry fields, estuaries and fishing villages.  It's lovely but hard to make a coherent narrative out of.   So I'm going to switch into full photo-journal mode to give you my impressions of  Down East.



 The coast is rocky and rugged with packs of wild schnoodles and those seagulls you remember from "The Birds"

Lobster are quite big in this area
 






And hugely advertised.




Wild flowers abound...
... as do old cemeteries
Every town has a church or two...
...mostly white with pointy steeples...
... some bigger than others.






Lots of quaint houses

...and a few more impressive ones.

We took a boat tour of the Pleasant River estuary

...saw some fishing shacks in need of repair...
... and a few birds.

Canadian geese just passing through on their way south.
Quoddy Point Light sits as far east as you can go in America
The other side of the bay is Canada



Wednesday, September 10, 2014

Blueberry Pie by Vicki Rains

I have a new favorite pie – blueberry.  August is blueberry harvesting month and the blueberries are plentiful in down east Maine.  About 6 miles from here is Blueberryland, a store that sells fresh blueberries from their farm. 
Roger's blueberry pancake, ready for the butter and blueberry syrup
Oh boy, more blueberry pancakes!  (The Maine Blueberry Syrup was wonderful.)  They also sell freshly made blueberry pies, not like Cocos or Marie Calendar, they are made throughout the day and are still hot when you purchase them.  So why are all the blueberry pies we’ve had in Maine better than any fruit pie we’ve had before?  They are literally stuffed with blueberries.  You can stand there and watch them make pies.  Take a fresh crust, scoop in about 5 or 6 cups of fresh blueberries to make a small mountain in the pie tin, sprinkle on about a cup and a half of sugar.  Add a little cinnamon and a couple other spices I didn't recognize, lay on an upper crust, pinch the edges and toss that sucker into the oven.

Blueberry barren ready for harvest
My Fodor’s travel guide says that Maine produces about 1/3 of the commercial harvest of  "wild" blueberries, with most of  the rest coming from Canada. "Wild" has been adopted as a marketing term for harvests of managed native stands of lowbush blueberries. The bushes are only about 4 inches high and the berries are quite sweet and have a more intense indigo color than the "high bush" berries grown in most of the rest of the country.  The berries are not planted or genetically manipulated, but they are pruned or burned over every two years, and pests are "managed".  Blueberry barrens apparently stretch for miles in Washington County,
Berries on the bush.
which is the county furthest east in our country.  Now that we know what they look like we see them all over the place around here.  And they are starting the autumn color change before the trees. The blueberries are harvested by migrant workers just like in California.  Supposedly 80% of the crop is harvested by machinery but the field we saw yesterday was being harvested by hand.

Maine blueberry pie with lighthouse crust
The good news for us pie eaters is that blueberries have antioxidants so that means we can eat all we want, right?  I mean, what's a little sugar compared to antioxidants?  They must balance out.  Anyway, that's my story and I'm sticking to it. So tonight we are having lobster cooked by our campground owners for $7.00 a pound (for the whole lobster), corn on the cob from the local market and fresh blueberry pie for dessert from a shop up the road that looks like a 75 foot diameter blueberry.  Somehow that makes the pie taste better.




Last winter we spent three months working on the Navajo reservation in Arizona.  Here is the final segment of my ruminations on the subject.


The Navajo People
 

One gets a fairly interesting view of people and their culture when it is based on visits with a doctor.  They have all the usual diseases but, as Roger has mentioned, they lost the gene pool lottery when it comes to rheumatologic disorders, diabetes and alcoholism.  What I found was that many of the inhabitants of Chinle had been working somewhere else in the country until they lost their jobs in the recession and came back to the “res.” (reservation).  There are very few jobs available on the res.

Hogans on the reservation
I had a number of elderly women, who lived in hogans without electricity, plumbing or running water come in requesting a letter from a doctor for improved housing.  One of these elderly women chopped her own firewood for heating.  I admit I got a skewed view of people but my impression of what I saw is that most had little hope for improvement in their lives.  I asked one patient why there was no barber, beauty salon, movie theater or library in town.  He responded that the political situation in town made it impossible to get the approvals that were needed. 

I noticed that the only Navajo professionals I saw were school teachers.  I asked one teacher why this was.  She responded that the Navajo don’t value education or going off the reservation for additional schooling.  In fact, if someone does, that person is often not treated well.  


One thing that disturbed me was that I never had so many patients, probably one every week or two, leave my office angry with me.  I had refused to refill their prescriptions for narcotics.  One of my most rewarding situations was when a recently retired Marine sergeant came into my office for a job physical to drive a truck.  He seemed rather despondent because he had been having trouble finding a job.  I asked why and he said that the Navajo didn’t value those who leave the reservation to work.  I asked what he did in the Marines.  I forgot the term but it had something to do with installation of electrical equipment.  I suggested that he go on the internet looking for jobs in areas that are known as “high tech.” and either did not have a bad recession or else are recovering well from it.  I also said that there are a lot of short term jobs in the country and with his pension and health insurance covered he could get an RV and go where ever there is a job.  He left my office smiling.  I had given him hope.


Time Off


Monument Valley
On sunny weekends we did occasionally take off to visit tourist sites.  We like Monument Valley so one Saturday we drove there to take pictures. Canyon de Chelly National Monument (pronounced “deeshay”, is a lovely canyon carved out by a stream.  We had been there a couple of years ago but since it is right next to Chinle we
Walking the dogs along the canyon rim
would take an hour or two and see one part of the canyon rather than doing the whole thing at once.  We had intended to take a jeep tour at the bottom of the canyon, but in May, when it was greener we just didn’t care anymore.  We were just ready to leave.  There were a couple of other scenic areas that we took pictures of but much of the Navajo reservation is desolate. 








Navajo reservation - pretty to look at but hard to live in

Sunday, September 7, 2014

Fort Knox

Quick trivia quiz.  Who was Major Hoolihan's husband on the television version of M*A*S*H?  If you said Donald Penobscot, give yourself 10 points.  As a Californian, I always assumed Penobscot was just a name they made up because it sounded funny but the fact is that this is not exactly true.  Penobscot is the name of an Indian tribe in Maine.  They picked the wrong side (i.e. the froggy side) in the French and Indian war and were relegated to obscurity and near extinction.  About 450 of them still live on a small reservation just north of Bangor.  Their main claim to modern fame is that they opened the first Indian gambling establishment, a high stakes BINGO parlor, back in 1973.  They also lent their tribal name to the Penobscot River.

The old Waldo-Hancock Bridge
At the mouth of the river is a narrows that made a convenient spot to build a bridge across to connect Waldo and Hancock counties between the town of Prospect and Verona Island.  So, in 1931 they built the Waldo-Hancock bridge across the narrows.  It used some new construction techniques, like pre-fabricated, pre-stressed cables and something called a  Vierendeel truss that were  used a few years later in another little project called the Golden Gate Bridge.   But the most significant thing about the Waldo-Hancock bridge was that it came in way under budget and they were able to use the leftover money to build a second bridge from Verona Island to Bucksport, completely eliminating the need for the Prospect Ferry.

The Waldo-Hancock bridge served faithfully for 70 some odd years, but by the start of the new millennia was showing its age and a major project was undertaken to rehabilitate it.  In the process however, they discovered it had more problems than they had realized and could not be satisfactorily repaired.  So they spent about 20 times the original cost of the bridge to do some temporary strengthening, then got to work on a new bridge about 10 feet to the south.

Penobscot Narrows Bridge from the east...
The Penobscot Narrows Bridge was completed in 2006 and we had to drive across it to get from Boothbay to Acadia NP, but it was a hazy, yuk day and stopping the motorhome for pictures and sightseeing is usually a pain in the butt, so we drove on, then picked a nice sunny day and drove back to it in the car later in the week.  The new bridge has some innovative engineering stuff of its own to brag about, but I'm not enough of an engineer to have understood most of it.  Some of what I did understand is that the cables are all encased in steel tubes filled with pressurized nitrogen gas to help prevent corrosion.  And 6 of the cables were made of experimental carbon fiber which is being monitored to see how well it holds up for possible use in future bridges.
... and from the west
It is a striking looking bridge and has one additional feature that makes it definitely worth a visit.  They installed an observation area in the west tower giving fantastic views of Bucksport and the Penobscot River.  It is the tallest bridge observatory in the world, reaching 420 feet, and you get to it via the fastest elevator in Maine.  Vicki, you may recall, is not too keen on heights, so I took the elevator ride up alone and snapped a few pics for your edification.

Bucksport from the observatory

View across the bridge from the tower - you can see the pylon from the old bridge which was demolished in 2013

Fort Knox entrance
For the same reason this was a good place to build a bridge, it was also a good spot from which to defend the river.  The  British navy had sailed up the Penobscot in both the Revolutionary War and the War of 1812 in order to bombard Bangor and whatever else in the area seemed bombardable.  In order to prevent future recurrences of this, the young US decided to install a granite fort at the narrows which we also visited while we were there.  This is Fort Knox (no not the one Goldfinger broke into, that's in Kentucky).  Both Ft. Knoxes were named after Henry Knox, the first US secretary of war, who retired nearby in Thomaston.

View of the fort from the bridge tower
Construction began in 1844 but because the US was mostly broke most of the time and they were trying to build similar fortifications on every major river along the east coast, funding was inadequate and construction sporadic.  The fort was nearly complete in 1869 but by then it was already obsolete.  It never defended the river, never fired a shot in anger and was never garrisoned until the Spanish American war when a regiment from Conneticut was supposed to be stationed there for a few months.  Since the enlisted quarters had never been completed, a few officers stayed in the officers quarter while most of the regiment camped in tents a half mile away.  When
10 inch gun threw a 100 lb. ball up to 2 miles
that war ended, the garrison was reduced to a single man, "the keeper of the fort" and that's how the situation remained until 1929 when the feds declared the fort "excess" and sold it to the state of Maine for a couple grand.  On the bright side, the fort never suffered much wear and tear so it's in remarkably good shape and makes for a pleasant afternoon's exploration.

As for Hotlips' fictional hubby, I don't think Penobscot was ever actually used as a family name in real life.  The Maine phone directory shows no one named Penobscot and extending the search to New York and Massachusetts still comes up with zilch.  So my original speculation still stands. They just used the name because the writers thought it sounded funny.  After all, the writers were all Californians too.
Civil War era medical transport
Parade ground inside Fort Knox


Last winter we spent three months working on the Navajo reservation in Arizona.  After a few months to sort through her feelings about it, Vicki has written up her impressions of the experience which we will be including in segments over the next few posts 

Working in Chinle
By Vicki Rains


Chinle healthcare facility
The hospital and clinic in Chinle, built in about 1982, is a fairly nice facility.  It has separate Internal Medicine and Family Practice clinics, but in fact they are really one ambulatory care clinic.  They are staffed with doctors and nurse practitioners with Navajo “health techs” covering the jobs that Roger’s office staff did in CA.  All the doctors and nurse practitioners were from elsewhere in the country.  None were Navajo.  Almost all the health techs were Navajo. 
 

The visits were 20 minutes each, which was fine for straight forward ambulatory patients and follow ups but for patients who were new to us and had multiple medical problems it was difficult.  The reason is the computer program.  It was not a terribly bad program but nobody bothered to orient us on it.  We got about a ½ hour video on it and that was it.  Fortunately we both are pretty computer literate but at the beginning we were constantly having to ask a doctor or NP how to do something.  Since they hadn’t been trained any better, they didn’t always know the answers.  When we went looking for someone, they weren’t always available so we had to wait.  Even after 3 months there were still things we didn’t know how to do. 
 

Window Rock
We worked from 8 AM to noon and then from 1 PM to 5 PM.  We weren’t supposed to do overtime.  We didn’t always finish on time but on Thursday mornings we had administrative time which we didn’t need all of so it usually balanced out pretty fairly.  Roger covered call, I think twice, and for that he made $ 5 more an hour than I did, but I haven’t worked in a hospital for over 5 years so I wasn’t interested in it and they weren’t interested in me covering it.  We had weekends off.  

A day trip to Monument Valley
Most people took off for the weekend.  We often left for a day trip but we don’t like to travel any more than 90 miles one way in a day trip so we didn't go to places like the Grand Canyon.  However, we have previously been at least once, and often twice, to every tourist destination around Chinle.  We did stop at the Grand Canyon on our way back to CA.
 

One of my challenges while working in Chinle was to see if I could still work as a general internist.  I started my geriatric fellowship in 1987 and haven’t done pure internal medicine in a clinic since then.  I am happy to say that my skills came back readily.  The drug formulary, in order to have reduced costs, consisted mostly of generic drugs I prescribed way back when.  Yes, I succeeded, but I didn’t really like it.  I remembered why I went into geriatrics and then into hospice and palliative care.  

Before we left for Chinle I interviewed for a job with Vitas Hospice.  Yes, it’s the company I used to work for.  Fortunately, the general manager that I despised had left.  I started working for Vitas again when I got back to California from Chinle.  The job I have now is part of what I used to have to do 2 years ago before I quit.  I can do it anywhere in the country as long as I have access to a phone and internet.  It takes me about an hour a day.  When I am in SoCal I can potentially do patient visits and cover team meetings.  This way I can keep my hospice skills intact.
 

Spider Rock in Canyon de Chelly right next to Chinle
So would I do it again?  Well, obviously not at the moment since I am working for Vitas again but neither one of us will likely ever want to go back to Chinle.  Yes, there were a lot of negatives and few positives but the prevailing negative was the fact that the doctors that we worked with were not very friendly.  They were nice when they answered our questions, but other than that they mostly ignored us.  I doubt anyone knew we are full time RV’ers because nobody asked anything about us.  There was nothing social offered to us.  They even had a journal club and didn’t ask if we would like to come.  So we felt pretty isolated.