UMSL College of Optometry alumna Dr. Marcy O’Neil (left) is one of the preceptors in the Norton Sound Regional Hospital eye clinic who supervises fourth year clinicals for students such as George Dowdy (right) in Nome, Alaska. During his eight-week rotation, Dowdy helped care for the vision of Alaskans Natives in Nome and in some of the 15 indigenous villages the eye clinic serves. (Photo by Michael Burnett)

Within minutes of stepping off the bush plane, George Dowdy’s goggles fog. The condensation freezes into two large cataracts until all he can see is white instead of the lone airstrip in the village of Wales, Alaska. When he removes his eyewear, cold strikes the now- exposed skin, but it’s nothing compared to what’s seeping through the soles of his boots from the frozen ground. Wind whips snow from the ground around him, and the sky is the cloudless blue that Dowdy has come to associate with extreme cold.

At minus 54 degrees with wind chill, today is the lowest temperature that the University of Missouri–St. Louis optometry student has experienced since arriving in neighboring Nome four weeks earlier for a clinical rotation in the eye clinic at Norton Sound Regional Hospital. Standing there waiting for a snowmobile pickup with his preceptor, alumna Dr. Marcy O’Neil, and 10 suitcases of equipment, might have been painful if Dowdy hadn’t deliberately chosen to visit during the coldest, darkest part of the year.

“It’s the most different thing you’ll ever experience,” Dowdy says. “From the hospital we get quite a view of the town and the Bering Sea, but now it’s all frozen. One of my preceptors and I walked out there probably about a half mile. That was something else. I’ve never stood on an ocean before.”

For all the delight Dowdy feels about the weather, it has presented some logistical problems. O’Neil and Dowdy had intended to set off for Wales and Little Diomede – two of 15 indigenous villages that the eye clinic serves – the previous Sunday for a six-day trip, but snow and crosswinds kept them grounded.

“We’re expected to at least try to get out to each village once a year,” O’Neil says. “Little Diomede has been very difficult. I tried three times in the last six months, but weather has socked us in, and we have not been out there in a year and a half.”

This trip would be no different. Travel to the village, an island in the Bering Strait that lies just 2 1/2 miles from the Russian Big Diomede, has become increasingly challenging with climate change.

The two had finally received clearance to fly four days later, arrive at 2:30 p.m. and start seeing patients within a half hour in Wales’ school. It is the only building with running water after a burst pipe. When they leave 24 hours later, they’ll have surpassed their goal of 20 by six patients.

Thanks to a Norton Sound Health Corporation community health aide practitioner who uses a robust telemedicine program to stay in communication with the Nome clinic, O’Neil and Dowdy start with known patients with serious, ongoing conditions such as glaucoma or diabetes. Then they move on to vision checks.

Throughout the day, Dowdy learns to move efficiently and effectively. Treating family groups adds a new challenge as does learning about common Native Alaskan nonverbal communication, where a raised brow means yes and a furrowed one no.