Marc Traeger

Through the front windshield of the Navy Blackhawk helicopter, all I could see was the indigo blue Indian Ocean screaming towards us. We were plummeting straight down faster than gravity would pull us, as indicated by my laptop floating from the floor to the ceiling. It was all I could do to hold on to a side railing I was buckled in, of course but the G's we were pulling hardly allowed me to breathe, much less move purposefully, or think and I couldn't see how the pilots could possibly make any correctional moves. An Australian helicopter had crashed just a few weeks earlier, killing all the passengers, I recalled just a few miles from here, on the island of Nias, Indonesia, responding, as I was, to a post-tsunami earthquake. That was April, 2005.Such was one of the more exhilarating events of my post-residency years. If you are anxious to find out how it all turned out - (big mystery!) feel free to skip all the less than thrilling events that follow and jump to the last paragraph. If you are really that interested my life events (as Barry Weiss seems to be with his persistent emails) please read on. For the sake of brevity it might be most digestible in bullet format"_I started as a country doctor on the Apache Indian Reservation in Arizona (Whiteriver). I'm sure all country doctors have some stories to tell. Some more notable events includedDocumenting the disappearance of a bb from the brain of a young Apache, at the hands of a medicine man ( Am J Dis Child.1993 Aug;147(8):901-2. Radiologic Cases of the Month. The Migrating BB and the Medicine Man.).Pondered such curiosities as a screwdriver in a rectum, a bear in my Jeep, and the simultaneous delivery of babies from two sisters just seconds apart by Laura (my wife) and myself. These events are not related.Laura and my miraculous car wreck survival ("_We were heading directly towards the concrete freeway divider retaining wall. I watched the retaining wall approaching quickly. We were going to hit it at 55 mph, and there was nothing anyone could do"_) [Excerpt from theApache Scout newspaper, 1993].The birth of three of our four children, Jeremiah (1/29/92), Luke (12/11/93), and Adela (8/2/95). Not to understate their importance, miraculousness or curiousness, but I'm sure you are familiar with these type of events and I won't go into more detail!Mid-life crisis: a fellowship at the Centers for Disease Control and Prevention (CDC) in Epidemiology as a "disease detective" with the Epidemiology Intelligence Service (EIS) 2000-2002, stationed in Tallahassee, Florida"_Fairly slow start trace a hepatitis A outbreak to a Taco Bell, then linked it to other food outlets in Kentucky and Nevada, then to contaminated green onions from a field in California or Mexico"_Investigated West Nile virus as it struck Florida for the first time. Learned terms such as "gator bait," a common nickname for the youngest family member. These two statements are related.More interesting - adopted our 4thchild, George (DOB 10/22/97) from Ukraine in 2001. This is another story, as most international adoptions are. See Laura Brown's narrative. He arrived in the US August 25, 2001, just before"_The World Trade Center terrorist acts of 2001 resulted in my deployment to NYC to assist the NYC department of health at "ground zero" and surveillance for bioterrorism in local hospitalsGeorge noticed an adult male in the house (me), a curiosity since he was raised in an orphanage by women and his time in the US was initially spent almost exclusively with Laura and her mother while I was in New York or chasing West Nile illness around Florida, and then"_The curiosity was perpetuated. Upon returning to Florida, I was sent to Palm Beach County, FL to investigate a curious anthrax case. We discovered that the exposure took place at the media headquarters of all US tabloids, American Media Incorporated, and traced anthrax through the Florida postal system (First case of bioterrorism-related inhalational anthrax in the United States, Palm Beach County, Florida, 2001. Emerg Infect Dis. 2002 Oct;8(10):1029-34). As the Florida EIS officer, I was commissioned to author this account. Curious and interesting in more ways than one.Curiouser, more anthrax occurred in New York, DC, and in senators offices. More anthrax case investigations resulted (Investigation of bioterrorism-related anthrax, United States, 2001: epidemiologic findings. Emerg Infect Dis. 2002 Oct;8(10):1019-28.)Among other things, participating in investigations of such disease outbreaks as Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000 and Severe histoplasmosis in travelers to Nicaragua, 2001. Unfortunately, the afflicted arrived in Florida despite my suggestions I was not granted travel to investigate the origin of the exposures.A return to our roots in Arizona and work on the Apache reservation as a country doctor again (2002-present)Not everything was on the reservation. I briefly practiced tropical medicine and during a couple weeks in Kenya with my family, working at a mission hospital and with local community members on various projects.Back in Arizona, we discover that the common dog tick Rhiphicephalus sanguineous (the Brown dog tick) transmits Rocky Mountain spotted fever previously extremely rare in Arizona and New Mexico due to lack of the tick then known to transmit it (Rocky Mountain spotted fever from an unexpected tick vector in Arizona. N Engl J Med.2005 Aug 11;353(6):587-94). My most active on-going mission is trying to get an animal control program started on the reservation. Stray dogs are serving as tick buses, carrying rickettsiae-laden ticks throughout the reservation and resulting in nearly a child death every year. The tribe does not have the resources to deal with this issue"_I serve as the preventive health officer of our health facility. Led by Dr. David Yost, another UMC FP residency grad, and a great staff we have overcome disparity in vaccinations and surpassed Healthy People 2010 goals"_As a member of the US Public Health Service, I was deployed to Indonesia following the 2004 Tsunami and 2ndearthquake in March 2005 to assist earthquake victims, aboard the USNS hospital ship Mercy off the island of Nias, Indonesia. Teams are transported between ship and land by Navy Blackhawk helicopters - which leads to the first (and last) paragraph of this narrative.And so"_The mission was coming to an end. The naval hospital ship Mercy had served as the only tertiary-care hospital in the area while members of the Navy, Public Health Service, and Project Hope (private clinicians volunteering their services from the United States) provided care for victims of the 7thmost powerful earthquake ever recorded, just 3 months after the 4thlargest had resulted in the devastating Tsunami of 2004. After providing relief service following the tsunami, USNS Mercy was heading home after months of serving as a floating hospital off Sumatra, the closest inhabited land mass to the epicenter and most devastated from the tsunami. Then in March, about 100 miles south of the epicenter of the tsunami earthquake, the second earthquake struck, mercifully without a tsunami, but devastating the island of Nias only a few miles west of Sumatra. The Mercy turned around and resumed its service for the people of this island. I served as physician and epidemiologist for the Public Health Service, residing on the Mercy and arriving on land by helicopter or inflatable watercraft daily to assess injuries, provide medical care, and collect data on illnesses that required public health intervention (such as outbreaks of diarrhea, respiratory disease, etc.). Our engineers assessed building and water safety, and we forwarded information daily to Naval and public health officials and the World Health Organization so that specific needs could be addressed by the multiple relief organizations. The incredibly gracious and personable Indonesians met us in throngs, sometimes making it difficult to land helicopters, and then followed us around like some sort of pied pipers. As the month of April came to a close, I was called back to the US along with some of the Project Hope clinicians. We boarded the Blackhawk helicopter that had reliably taken us between ship and land daily for the previous month. Along with us was a retired Navy admiral, also heading back to the states. As we headed across the Indian Ocean towards Sumatra, the pilots apparently felt an overwhelming sense of boredom and perhaps a duty towards the admiral. Without warning, the helicopter jolted upwards toward the sky, thrusting all of us into or out of our seats, until we reached some predetermined pinnacle. The helicopter leveled, and like a rollercoaster without a track, shot straight down toward the ocean. Although I had faith that the pilots would be able to pull the aircraft out of this terrifying maneuver, I could not keep the thought of the deadly Australian helicopter crash just a few weeks earlier out of my mind. Proudly and smugly, our pilots pulled the craft out of its dive shortly before meeting certain death at the surface of the ocean. The remainder of the flight was fairly uneventful, sprinkled with only occasional flirtatious drops, spins, turns, and flying vomit. I returned home intact and thankful for the solid ground below my feet, free of earthquakes, tsunamis and most other natural disasters. What an opportunity to help out where the need was so great.