There may be no place on Earth less visited by humans than the South Pole. Despite a permanent research base with buildings clustered about the pole and active scientific programs, comparatively few people have made the arduous journey there. From October to February, up to 200 people may be stationed at the Amundsen-Scott South Pole Station for the Antarctic summer, and tourists checking an item off their bucket lists come and go. But by March, when the sun dips below the horizon for the next six months, almost everyone has cleared out, except for a couple of dozen “winter-overs” who settle in to maintain the station, carry on research, and survive the worst weather Mother Nature brews up anywhere on the planet.
To be a winter-over means accepting the fact that whatever happens, once that last plane leaves, you’re on your own for eight months. Such isolation and self-reliance require special people, and Dr. Jerri Nielsen was one who took the challenge. But as she and the other winter-overs watched the last plane leave the Pole in 1998 and prepared for the ritual first-night screening of John Carpenter’s The Thing, she had no way of knowing what she would have to do to survive the cancer that was even then growing inside her.
The Only Doctor in the World
Hired for a one-year stint on the medical staff of the Amundsen-Scott South Pole Station, Nielsen knew that things wouldn’t be easy. Even during the brief summer when planes come and go regularly, moving people and supplies is an ordeal, and everything that needs to be done to prepare for the long night of winter needs to be tended to carefully. Nielsen threw herself into the work, using the challenge as a way to move on from a painful divorce.
The medical department of the station, while well equipped, is obviously limited. While the clinic has been upgraded since Dr. Nielsen’s stint, advanced diagnostics like MRI scanners are still not feasible, and physicians have to rely on simpler tools like X-rays and simple blood tests. Dr. Nielsen’s background as an ER doctor positioned her well for the challenge, but even the most austere hospital anywhere else in the world is likely to have at least one other doctor to consult with, and some sort of staff to assist. Not at the Pole — Nielsen was the one and only doctor on base, charged with caring for every aspect of the health and well-being of the winter-over crew. Nielsen had no way of knowing that within a few month, she’d be one of her own patients.
In June, she felt a lump in her breast. With no one else to turn to on staff, she reached out to physicians in the US via email, describing her findings. The nature of the lump had to be determined, and without the specialized X-ray gear needed for a mammogram, Dr. Nielsen would have to perform a biopsy on herself. She briefed some of her overwinter colleagues on the procedure so they could assist, but in the end, Nielsen had to guide a hypodermic needle through her breast and into the lump to aspirate enough cells for examination. This is difficult enough to perform on another person, but nearly impossible to do to yourself. Add in the anxiety of knowing that you’re probably going to learn that you have cancer, and it’s a wonder that Nielsen was able to perform the delicate procedure at all.
Physician, Heal Thyself
Despite the challenges, Nielsen managed to get enough material to biopsy, and after more consultations with pathologists back home, she prepared slides of the cells. Pathologists have fully equipped labs with a wide range of cell preparations at their disposal that let them analyze the morphology of cells and make a diagnosis; Jerri only had a few simple stains to use. Worse, she was not a trained pathologist, so the slides she prepared would have to be imaged and sent back to the states for diagnosis. Despite the poor sample preparation and the low-quality images obtained from the jury-rigged microscope, pathologists were able to tell her that the lump was probably cancer.
To have any chance of surviving, Jerri needed to start treatment as soon as possible. The medical clinic at the South Pole is not equipped to handle oncology cases, and under ideal circumstances she would have been evacuated. But circumstances are never ideal at the Pole, and in midwinter, rescue is unthinkable. With temperatures around -75C (-100F), ground travel to bases on the coast is suicide, and planes that try to land stand a real chance of never taking off again when their landing skis freeze to the runway or their fuel turns to jelly.
But airdrops are possible, and Jerri’s support team quickly put together a bundle of supplies for her. They wanted better images, so a better cell staining kit was added, as was a Siemens ultrasound machine for direct imaging of the tumor. Six bundles of supplies were pushed out the cargo door of a military transport into the frigid Antarctic night, but only five survived the drop. One parachute failed to deploy, and in a stroke of horrendous luck, it was the ultrasound machine that was destroyed.
Jerri soldiered on, and with better images from a second biopsy, she and her support team confirmed the initial diagnosis of cancer. With no way to perform a mastectomy on herself, she started chemotherapy and hormone treatment using drugs that were included in her care package. Again she had to train her colleagues to help, but between July and October, when rescue was finally an option, she managed to not only treat herself and deal with the ravaging side-effects of chemo, but still saw to the medical needs of everyone else, including a colleague with a hip injury bad enough to be evacuated with her.
Dr. Nielsen returned to the US and went through multiple rounds of treatments and surgeries, including a mastectomy. Her treatment put her into remission, and she wrote a book about her experience and traveled the world, even returning to Antarctica. But in 2005 her cancer returned, having metastasized to her bones, liver, and brain. She died in 2009.
When faced with impossible odds, Dr. Nielsen did everything she could with what little she had on hand. She put together an impromptu medical team from people with minimal training, devised a treatment plan, improvised tools, and leveraged the limited technology available to her to get the job done. With a little luck and a lot of courage and skill, she survived the last place on Earth, at least for a while.