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My Kind of Medicine: Real Lives of Practicing Internists: Kristin Mitchell, MD, FACP

Kristin Mitchell, MD, FACP

The view from Kristin Mitchell’s kitchen window is a 10,000 square-foot active volcano. It’s a rare vantage point, one she hadn’t planned on having for long when she first moved to the tiny town of Soldotna, Alaska—a place she once called “the edge of the world.” But as time passed, she found herself falling in love with the intimacy of rural medicine, and before she knew it Alaska started to stick. Today, nearly 12 years later, she is and has been internist to many, a job she considers an honor.

The International
At age ten, Dr. Mitchell read “The First Woman Doctor,” about Elizabeth Blackwell and the story sparked something inside her. “I didn’t know girls could grow up to be doctors,” she recalls, “and I remember thinking how independent and dedicated she was, and how steadfastly she pursued her goals.” Later, while living in West Berlin, Germany, while her father completed research for a book, she gained insight and maturity and grew to understand how the unifying presence of humanity outlasts politics. “I learned while I was there that even if individuals have a difference in perspective, at the end of the day, we’re all human,” she says. “The world became a bigger place to me and I wanted to stay connected to it.” These two childhood experiences would ultimately steer the direction of her life, but first she was off to medical school at the University of California at San Francisco. It was here that she chose internal medicine. “The internists I met possessed impressive depth and focus and often a true sense of altruism,” she says. “I also found internal medicine to be tremendously intellectually stimulating, and I still feel that way.”

The pull of her childhood experiences returned, and she began working her summers abroad, in Bolivia and Bangladesh, working with communities on health education. The work was rewarding, and also as Dr. Mitchell explains, badly needed. In Bolivia, illiteracy was a huge barrier to health care. “We planned to teach from a book developed for areas without formal medical care, but even the idea of a table of contents and an index were foreign to most people because there was so little formal education,” she remembers. “In addition to acting out innumerable health crisis scenarios, I literally taught them how to use a book as a reference.” In Bangladesh, the focus was on sexually transmitted diseases. Dr. Mitchell worked with rural family planning clinics, trying to reduce the incidence of HIV in women. The work had its usual frustrations, but was further complicated by the political atmosphere. “In an attempt to contain the epidemic through quarantine, everyone who was diagnosed with HIV was in jail,” she explains. “As a western-trained doctor, I didn’t have the skills to change what needed to be changed.”

Returning to her residency in Seattle at the University of Washington, she decided to focus on meeting the needs of underserved communities in the United States. She participated in the WWAMI program, which offered rotations in rural areas for residents to experience medical practice outside of the urban environment. (WWAMI is a partnership between the University of Washington School of Medicine and the states of Wyoming, Alaska, Montana, and Idaho; the WWAMI name is derived from the first letter of each of the five cooperating states). It would prove to be good preparation for her future career, which began in 1997 when she learned of a position at Peninsula Internal Medicine in Soldotna, a town of 4,200 located on the banks of the Kenai River in south central Alaska. She and her husband David decided to go for it; they thought it would be a good opportunity for a year or two.

Northern Exposure
“When I first arrived, I still had the typical perception of Alaska as somehow beyond the frontier. I had to get used to plugging in my car in the winter, stopping on the highway for moose to cross, bumping into my patients at the grocery store, and having the choice of five restaurants that all serve the same Greek, Mexican, and Italian fare,” she says, “but the longer I was here, the more the small community grew on me. In small places people band together,” she says, “If something is important to you, you get involved. Becoming part of this medical community happened quicker than I expected. I am fortunate to have an outstanding group of colleagues, and I enjoy teaching students and residents from the University of Washington for several months every year.”

She quickly learned that the dynamic of rural medicine provided her the chance to act as her patients’ advocate, a role in which she has flourished. “The rewarding part of medicine is being in a partnership with your patients all of the time,” she explains. For one of her patients, this was especially true. The patient was diagnosed with stage four breast cancer and had to make the choice whether to receive chemotherapy treatments from Dr. Mitchell in Soldotna or from an oncologist in Anchorage, where most specialists are located, over 145 miles away. The patient chose the first option, and received chemotherapy for over five years, a time that brought Dr. Mitchell some of her more poignant experiences as a physician. She admired the woman’s spirit, which she describes as tremendously upbeat. “Whenever she was scheduled to receive treatment, her friends would come to the oncology suite to laugh, play music, and hang out - it was very much a celebratory atmosphere,” she says. “I shared in her joy when her grandchild was born, and in the pain of her terminal diagnosis. I did a home visit the evening she died; her last words were about how much she loved her family. It was a tremendous privilege to be a part of her journey; it’s rare to share that with someone who’s not a relative. That’s the trust and honor of being a physician.”

Breaking the Ice
The satisfaction Dr. Mitchell finds in her professional life is mirrored in her personal life, something she says is made possible working as an internist. She and her husband, who is an environmental engineer, have a nine-year-old and a five-year-old, and their life is very full. “Work is intense, but I have the flexibility to schedule my time,” she says, “I spend a day a week volunteering at my kids’ school, and I enjoy photography and rowing.” She recently traveled to Boston for the Head of the Charles Regatta, the world’s largest regatta, with 8,000 participating athletes. “There’s something about working in perfect unison with eight other athletes that’s hard to describe, but tremendously satisfying.” She rows with a club on Mackey Lake, about 10 minutes from her office. The rowing season is short in Alaska, as the climate permits it only about four months out of the year. Sometimes she says, they have to break shore ice when starting out in the early mornings. The mere thought would send chills down many a spine, but for Dr. Mitchell it’s just the start of another beautiful day.

Check out previous articles as physicians share what motivated them to become physicians as well as why they chose their particular type of practice.

Back to December 2009 Issue of IMpact

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