corpuls on ice

It is pretty much a tradition: Every year an advertisement appears in the medical specialist newspaper “Das Deutsche Ärzteblatt”: The Alfred Wegener Institute Helmholtz Center for Polar and Marine Research (AWI) is looking for a doctor with a sense of adventure. With the will to go to one of the most hostile areas on this planet for 14 months – nine of them in absolute isolation. Six in the dark.
We are looking for a doctor as station manager and medical supervisor for the new winter team at the only German research station in Antarctica, the Neumayer Station.

"I've stumbled across the ad several times ... and at some point I thought to myself: "Just try it!" says Tim Heitland. He is a thoroughbred doctor, surgical consultant, specialist in visceral surgery and proctologist. Additionally the native of Munich also holds the qualification for emergency medicine. So technically very well qualified. “The nerves only came after the acceptance by the AWI and before going to Bremerhaven for preparation phase. From time to time I had doubts as to whether it was a smart decision..."

Dr. Tim Heitland, "Base Commander" der Neumayer-Forschungsstation
Dr. Tim Heitland, "Base Commander" of the Neumayer Research Station

The preparation phase. This is probably the most important thing for a stay near the South Pole, especially for winter. Antarctica is the driest and coldest continent on our planet. The temperatures only reach values around freezing point in the warmest month of January in the west and are otherwise far below the annual average of -55° C. The reason for this is the flat angle of the sun's rays. The little solar energy that arrives in Antarctica is also reflected by the snow – simply put: it's cold. Always.

Add to that raging strong winds. In some areas wind speeds of over 300 km/h were measured on 340 days of the year. For comparison: Hurricane Katrina, the storm that devastated large parts of the southern United States in 2005 and is considered one of the most devastating natural disasters in history, peaked at "only" 280 km/h.

Neumayer III, the third Neumayer station of the AWI, is located in a more temperate climate on the Ekström Ice Shelf. Nevertheless: “The memory of cold, extreme cold, really extreme cold, and again just really cold, remains," wrote Tim Heitland at the end of his last stay on Neumayer III in the (absolutely worth reading) blog "AtkaX-press.“ The training lasts four months. Based in the Bremerhaven-Reinkenheide Clinic. Here everything is organised that is required to live as a community for 9 months on roughly the size of a quarter of a football field. Without any outside help. “All planes and helicopters will be relocated at the beginning of the Antarctic winter – to the Arctic. That alone is a two-week flight. And even if we had an airplane, the weather conditions are so bad there in winter that flying is out of the question.“ In the event of an emergency, however, the doctor is not entirely on his own. “All team members received intensive training in Reinkenheide for two weeks before leaving. So everyone can lend a hand. In addition, the equipment on Neumayer III really is first class.“ A full operating theater, C-arm, dental x-ray, even a video laryngoscope, corpuls3 and corpuls. mission LIVE. “Out here, on the eternal ice, we depend on the possibilities of telemedicine. We have used this in the past with another system on corpuls 08/16, but corpuls.mission LIVE is in a different league. How elegantly the system from corpuls3 and corpuls.mission LIVE is integrated is great. If the worst comes to the worst, we have professional help on Neumayer III from the Reinkenheide Clinic within seconds. Our colleagues in Bremerhaven see exactly what we see and that helps a lot.“

Zur medizinischen Ausstattung der Foschungsstation Neumayer III gehört auch ein corpuls3 mit corpuls.mission-Anbindung.
It used to be a bit more complicated, says Heitland: “With the corpuls 08/16 we first had to start the program, then Bremerhaven had to start the program, then the programs had to set up communication with each other, and then you still had to hope that the radio link did not break down. Today: switch on, work.“ That is the advantage of the corpuls.mission LIVE server architecture. This is not only quick and safe, but also easy. “Our IT people are also happy about it, because corpuls.mission LIVE hardly needs any bandwidth from our valuable Internet access.“ The corpuls system has many advantages that the AWI also knows about: “I think we have 5 or 6 corpuls3 in use in the institute, plus a few corpuls 08/16 as backups. The Polarstern (the research and supply ship of the AWI, – editor's note) is also equipped with corpuls.mission LIVE, corpuls3 and corpuls 08/16. And the Kohnen station, our inland station, is also equipped with corpuls3 when it is occupied in summer.“ Nonetheless, to say that you are prepared for anything would be an exaggeration: “We are still isolated here. There is also a hospital in the base camp on Mount Everest – but if you fall on the mountain above 8,000 meters, within the death zone, and break your leg ... then it gets critical."
Hospital der Forschungsstation
The medical equipment only reaches its limits in extreme cases, says Heitland: “A comprehensive multiple trauma requiring a blood transfusion – that could cause problems. We have a “walking blood bank” here, which means that we know the blood types of all team members and could transfuse, but within limits. Fortunately, there are seldom really critical cases on Neumayer III.“ The training and those selected are too good for that. These are really top fit people with whom you spend the winter here. Everyone is checked down to the smallest detail.“ Heitland's worst case was therefore an injury that is dealt with several times a week in every emergency room in every hospital on the planet: a torn ligament in the knee. A doddle – if you're not sitting on hundreds of meters of ice in Antarctica. “We needed a knee brace with a joint and limited mobility. But we only had a stiff one. Our station engineer simply flexed them apart and installed a joint with a limiter. It worked great.“
Accident prevention is also extremely important: “We are trained in fire fighting. But we don't just spray a powder extinguisher around, we do it properly in the Navy's damage defence training centre.“ The training with the navy makes sense, as you can imagine Neumayer III like a ship. But Neumayer III is more like a spaceship on its way to Mars. Without the possibility of heading for a port and offloading a patient.
Brandschutzkurs in Neustadt

Other institutions have also noticed this. “As a doctor, I don't just sit around when there is nothing happening and nobody to cure. We are working on a study launched by the Ludwig Maximilian University in Munich, the Charité in Berlin, the University of Pennsylvania and NASA, supported by DLR and AWI. This involves longterm space travel, such as an expedition to Mars, and the following questions: What influence does isolation have on psychology and physiology? How does the immune system react in this low-stimulation environment, like the vegetative nervous system? Are the cognitive abilities, the ability to react, three-dimensional thinking and the ability to orientate oneself declining? And, of course, what is the dynamic within the group? For the study, we take blood, saliva and all kinds of other samples and freeze them. Cryopreservation is less of a problem here. We wear activity trackers and regularly have 24-hour ECGs. We even have the original NASA simulator for docking modules to the International Space Station ISS here. Which by the way is not that easy. There are also numerous psychological questionnaires as well as preparation and follow-up with examinations in Berlin. In its isolation and with our small team, Neumayer III is ideal for something like this. Much better than, for example, the USA stations. There are just too many people there in winter. Sure, you could just lock nine people in a container at the DLR in Oberpfaffenhofen and say: "We won't open the door for a few months now", but basically everyone knows that in an emergency, the door would be opened. We have no such door on Neumayer III.“

Comparing Neumayer III to a space station is not that far-fetched. “There are around 80 stations in Antarctica, less than half of which are occupied in winter.
Our closest neighbour, the South African station, is around 250 kilometres away. You can drive that in Germany in a few hours. For us it's a three-day trip in the Snowcat – in good weather. Nevertheless, we are all in contact, we send each other virtual postcards over the internet and we have the tradition of the "48-hour film festival.“ Here, a station is given five terms relating to the animal world – plants are not included – and then they have to make a film about it within 48 hours."

Pinguine
In addition to the study related work, the station manager and doctor has even more tasks. Medical technology, for example, needs to be tested. There is enough of it on board Neumayer III. “As in normal everyday hospital life, I check the corpuls3 and other devices every day. corpuls.mission and similar, important systems must also be checked regularly. These are the "doctor" tasks.
As the station manager, I am also responsible for the safety of the team and the station, for fire protection including exercises, the marking of the routes and even for monitoring the quality of the drinking water. There is also organisation and public relations work. The only thing I don't have to do is cook."
Catering is also a place where the similarities between the space stati-on and Neumayer III end. “Basically we have everything here that can be made durable in any way. As with the study samples previously mentioned: things freeze quickly here. Fresh vegetables, fruit and the like are particularly problematic. We recently had a greenhouse – ‘Project Eden’, but it wouldn't be Antarctica if it was that easy." Still: The alternative in space would be protein paste from a tube. For 416 days.
"Do you know what strikes you most when you come home after 14 months?"asks Heitland. “Smells. In Antarctica you have no smells, except in the station. But the smell of plants, nature, the sea or – on the other end of the spectrum – a city with its exhaust fumes. It doesn't exist there. And the colour green. The Antarctic has many variations of colours, it is a wonderful, unique place – but there is no green. And very few people. You notice that when you get off the plane at home. And it hits you like a slap in the face. But after two weeks you acclimatise again."
Am Nordanleger
Despite all difficulties – the fascination of Antarctica is undisputed. The AWI has been operating research stations on the icy continent for 36 ye-ars. Over and over again the magical landscape casts a spell over people. The namesake of the AWI, the polar explorer Alfred Wegener, is said to have once said about this place “...life gains content here. May weaklings stay at home and learn all the theories of the world by heart, stand face to face with nature out here and test your acumen on their riddles, that gives life a completely unexpected content.“ Tim Heitland wrote on the AtkaXpress blog: “He was right. Well, I wouldn't say that those who stayed at home are weaklings. We also wouldn't have enough space for all of them in the station. But I agree with the subject matter. Life still finds content here today. Meaningful, important, enriching content."
Interested? Then check out the advert in the Deutsches Ärzteblatt. Even if you work as a carpenter, cook or in another skilled trade and work emergency services on the side, your chances are good. Take a look at www.awi.de.

Photos: Tim Heitland, S. Christmann, AWI

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