Several years after becoming a physician assistant, Heidi Lim, PA-C, decided she didn't want to settle in just one location. After working in Georgia upon receiving her degree from Emory University in Atlanta, she provided care at a Navajo reservation in Chinle, Ariz., then moved on to multiple locations in Alaska, including Dutch Harbor, St. George Island, Emmonak and Unalakleet.

"The more I worked out in the bush, the more I loved the remoteness and the challenges of the unconventional settings and populations," she says. "I loved the adventure of working in a remote area with a population in great need of medical care, and decided to do more."

So in October 2002, Lim headed to Antarctica-the South Pole, to be exact. For a full year on her first visit, and then for winters (February through October) in 2005, 2006 and 2007, she has worked at Amundsen-Scott South Pole Station, a U.S. research station.

Lim, who chronicles her experiences as "Homeless Heidi" at http://homelessheidi.blogspot.com , is one of only five PAs who have worked at the South Pole, and with four winters under her belt, she holds the record for most number of winters spent at the station for a woman. In the winter, temperatures can drop to minus 100 degrees Fahrenheit at the Amundsen-Scott South Pole Station, which consists of the Elevated Station and the Dome.

During her winter stays, Lim works in conjunction with the one physician at the station and says her tasks are 50% medical and 50% "other." Lim says there's not enough to do to keep two medical providers busy all the time in the winter, so that's why there are added duties for the PA.

On the medical side, Lim provides care to the crew (54 people on her last winter stay), typically walk-ins for minor injuries or prescription refills. She performs procedures such as removing skin lesions or draining abscesses, as well as provides physical therapy.

The station clinic's main treatment room also serves as a trauma bay, a radio communications room and dental exam room. "We have to be dentists here, too, and be able to fix things like a chipped tooth," Lim says.

There's also a two-bed patient ward and a lab, which houses the pharmacy. Among the station's medical equipment are an X-ray machine with a digital imager, an ultrasound machine, a fully-stocked crash cart, defibrillators, ventilators, patient monitors and IV pumps.

A standard work day is 7:30 a.m. to 5:30 p.m., six days a week, with Sunday off, although Lim alternates on-call time with her supervising physician. In the winter, Lim also gets one Saturday off a month.

"We stick to these hours for the most part, although oftentimes, you do end up doing things outside the hours," Lim says. For example, there is an eight-hour satellite window at the station that slowly shifts forward. Although the window may fall in the middle of the night, Lim still has to send digital X-rays to a radiologist in the United States.

Lim also frequently treats the altitude sickness that crew members exhibit when they fly in from McMurdo Station, the largest station in Antarctica, about a 3 ½-hour plane ride away from the South Pole. McMurdo is at sea level, a great change from the South Pole, which has an altitude of 9,300 feet and a physiological altitude usually over 10,000 feet.

When she's not with patients, Lim says "the rest of the (medical) time is used to maintain equipment, inventory, charting or other data requirements, cleaning or organizing." She also meets with her "trauma team"-crew members who act as emergency responders.

Lim also is responsible for maintaining the station's emergency medical cache. "It contains some medications and supplies that we have to keep in a location separate from our clinic, (so that) in the event that we have a catastrophe and lose Medical, we would still have some supplies to use," she says. "It's a grim thought, but we have to be prepared for emergencies like that."

As for the "other" side of her job, Lim is the station's resident manager of Polemart, a small store that sells items such as souvenirs, snacks and beverages and toiletries. She's the winter finance manager, reconciling funds on the station and acting as a human ATM. She also monitors flights to and from the South Pole.

In addition, Lim spends time acting as recreation coordinator, doing weekend power plant checks, washing dishes and making homemade bagels that are served three times a week (check out her March 30, 2007, blog entry for all the details).

Lim says there are pros and cons to having so many duties at the station. "I like the variety of jobs and like to stay busy, but the downside is I feel like some skills get rusty without seeing 20 patients a day like I've done in other more conventional settings," she says.

As for daily life at the station, "It's all communal living down here," Lim says. Most crew members have an 8-by-10 foot berthing room, although Lim has a double room as a benefit of seniority.

And bathrooms are shared, so it's a bit like dorm living, Lim says. "Because we have to melt ice to get our water, and fuel (costs make it) very expensive to fly down here, we are allowed two two-minute showers a week," she says. "I know that sounds horrifying, but it's really not that bad!"

The travel is one of the best parts of being part of the U.S. Antarctic Program, Lim says. "We spend a lot of time dreaming about warm tropical places that we'll be visiting when we get out of here, and that's another great reason for doing seasons on the ice-you get a free trip to New Zealand, and it's easy to vacation there or in places such as Australia, Fiji and Thailand afterward."

In fact, at the time of publication, Lim was vacationing in Thailand with her boyfriend, who is one of the chefs at the station, before she is to return to the South Pole in late January. Lim also was able to spend some off time visiting her family in Tucson, Ariz., where she grew up.

"The best part of my job is living the adventure that is Antarctica," Lim says. "We become a big family, and I've made lots of friends over the seasons, so in a way, it feels like home."

Visit Heidi Lim's blog at http://homelessheidi.blogspot.com .

See next page for an album of Heidi Lim's South Pole photos.