A 2012 graduate of Touro’s Physician Assistant (PA) program, Brewer, now 34, lives in Anchorage and specializes in inpatient and outpatient orthopedics at Alaska Native Medical Center, which serves Native Americans from all over. the state.
“One of the great things about Touro’s program is that the professors have made it clear that there’s no one way to be a physician assistant,” she says. “It’s great to work in a doctor’s office, but you’re limited by nothing but your imagination and skills in shaping your own career.”
Her job is neither easy nor frustration-free, but the work is challenging and rewarding. “What makes this job unique is the logistics involved in providing care to people in remote villages,” says Brewer. “We need to develop care plans for people who don’t have access to running water, heating, food and regular health care. Third World conditions.
This is rural health care at its finest – winters are 40 below zero, cases of frostbite are frequent and severe, transportation hundreds of miles can take days, not hours. “We had patients with broken femurs who came in from the Arctic seven days later,” she says. “It’s not like most of us think, that they get here quickly, get treated and go out for physical therapy three times a week for six months. They return to their remote villages.
“These patients are resilient,” she says. “If the tough 80-year-old can go back to her village and start picking berries again like she does every summer, that’s quality of life. If a man can still hunt caribou to feed his family in the winter, that’s the quality of life. If we can get them to enough functional capacity to do what they’ve been doing all their life, that’s a success.
She sees up to 40 patients in her 10-hour workday. “I can see a range of orthopedic issues from knee arthritis and rotator cuff tears to more acute and serious issues including open fractures, polytrauma from snowmobile accidents to traumatic amputations,” she explains.
And these are the easy days. Traveling to remote clinics often requires an airplane, ATV, and sometimes a seaplane. Brewer and his colleagues are housed in the clinic’s accommodation and during their three to four day stays see some 80 to 100 patients. These patients have arthritis and are evaluated for total joint replacement, or they have follow-up appointments at the field clinic instead of traveling to Anchorage. They also have knee, shoulder, and back pain that requires attention and injections. “Most of these clinics only have one x-ray machine,” Brewer says, “so if they need additional imaging, we coordinate the trip to Anchorage.” These field clinics serve as a service center for small villages, so most patients travel by snowmobile, ATV or small plane to their appointments.
Now married with two little girls under the age of two, Brewer loves winter sports, including ice fishing, high-speed biking on frozen rivers to glaciers, and extreme skiing and backcountry skiing. Alaska’s abundance of spectacular natural beauty is a balm for one’s psyche. “You’re very isolated here and it’s also isolated in Anchorage,” she laughs. She came to understand the burdens of poverty and lack of access to medical care that plague Alaska Natives. Although his loans have long been repaid in return for his years of work at the Alaska Native Medical Center, Brewer has purchased a home and has no plans to return with his family to the lower 48s. we do,” she explains. “It can be frustrating, even depressing at times, there is no typical day. It is never, ever boring.