You Can Do Surgery Anywhere with Doc Sayer - TAS #23

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This week we sit down with surgeon Doc Sayer and gold miner Emily Riedel in Nome. Doc is 82 and has been performing general surgery across the state of Alaska for 50 years. He's a general surgeon from a bygone era - performing everything from brain surgery to heart surgery to cancer treatment - performing procedures in homes with his wife and nursing assistant Frankie and sometimes taking payment in the form of game meat instead of cash. In addition to being a medical pioneer in the state of Alaska, Doc has been a gold miner for 40 years and shares some insights on the business. Listen for a trove of great stories of mining and medicine in the bush.

Interview Notes

Doc has been in Alaska practicing medicine since 1968.

He was in Anchorage from 1968-1979. He was the deputy chief of surgery at the Native hospital.

Fairbanks didn’t have a lot of infrastructure for serious injuries, so they got sent to Doc Sayers.

In order to not go broke in gold mining you have to work extremely hard. It’s often costing you more money than you’re making. In the old days - 1800-1940s - people came here to make a fortune or make a living. 90% of them failed and today the percentage failing are the same.

Back in the day they didn’t have as much technology, but they didn’t have to buy all the petroleum products or deal with advanced machinery and repairs. It costs a phenomenal amount to buy machinery and maintain it. It didn’t cost them much to maintain their shovel, but might cost $100k a year to maintain a D10 Dozer.

The big thing in mining gold is you need good luck, you also have to work very hard and manage money. The other aspect is management.

On land the miners tend to help each other. If you get on a hot paystreak you’ll tell your neighbor. Doc’s commercial fishermen friends will help each other. It’s kind of like that.

Doc’s been mining 46 years. They were poor farmers growing up - his dad reminded him that he, during the 1929 and 1930 depression, was lucky making 50 cents a day driving a caterpillar pulling a grater. When he was farming he had to do a lot of land and pond work for environmental reasons and drainage and he taught Doc and his brother how to drive a dozer and a truck. Doc put himself through college driving heavy machinery building the pipeline. He made a lot of money during the summers doing that.

Then he climbed radio towers and put lights in them for pipeliine companies, FAA towers, and communication towers. He and his friend put a contract together with his buddy - figured in 1960 they’d make $10 an hour and climb towers and put bulbs in them 24 hours a day over weekends and holidays. They tripled that to $30 an hour and got the bid and they were making big money for that time. He went to vet school for a year and paid his way through medical school. Doc thinks vet school is harder than medical school.

Why did he change to medical school? Because only one person in his mother’s and father’s family who was in medicine. She was an anesthesia nurse. He did really well in grade school and didn’t know how much that meant and didn’t even think about medical school. He got in in two years which is the shortest time he could do. He switched to med school and realized they’re not all that smart.

Doc wanted to be a surgeon because he’s pretty aggressive and likes to do things his way. He decided he’d be a family practitioner at the beginning of med school. After the rotating internship he wanted to be in orthopedics or general surgery - at the end of the year narrowed to general surgery. He liked the surgeons he rubbed shoulders with. He got a full residency and got into American College of Surgeons immediately. He was in the public health service at the marine hospital in Seattle and made it easy for him to go into the Indian health service which is public health. He came to Anchorage at 30 and was immediately made deputy chief of surgery there.

3 years later he borrowed $5k to start his own office and paid it back in 3 months and has been at it ever since from 1971. He’s still doing endoscopies and hernia surgeries and colonoscopies at 82.

What was cutting edge surgery in the late 60s and early 70s? Now it’s all specialized. He was even taught to do brain surgery. He was taught heart surgery and did the first heart operation in the state of Alaska. At the Native Hospital in Anchorage the director of internal medicine had his residency with Doc Sayers in Seattle - that guy told him there’s a guy from Kodiak who’s got water around his heart and he’s going into coma. They had to take care of him because he’s Native. Doc Sayers thought he could do that.

Doc called a friend to come help him because the chief of surgery there hated him.

Back then anesthetic deaths weren’t uncommon, so they didn’t give him anestesia.

Doc did the first total urinary bladder excision. He’s done a lot of serious cancer operations. That was the chief in Barrow. It was a really radical surgery - 20 years later he saw his picture on the front of the ADN in his dozer pushing snow. 3 years ago in Nome Doc met a girl with his last name from Barrow. It was her great grandfather.

When he didn’t know how to do a surgery he would hit the books. The first brain surgery he did was out of Homer. In 1980 they had a good year mining and took the family fishing down in Panama. They got in an airplane to go to Anchorage - over Tustemena lake 40 miles out of Homer the pilot comes on and tells the plane he’s been requested to turn the plane around and land back in Homer. An 8 year old boy fell out of the swing at school.

He had to go cut into the boy’s skull and get it all tied up. The boy woke up and he gave him local anesthetic and got on the airplane in a Lear Jet and flew him to Anchorage.

Aneurysms are the trickiest surgeries because the bleeding can get away from you. The most stressful surgery is the kind where you know if you get it wrong you’ll be treating them for a long time. Pancreas is tricky - it will digest itself if you open it up and it likes to get infected. You have to really do the right thing and use the right drains and get it hooked up to the bowel right so it doesn’t eat the bowel up - or you’re going to kill the person or treat an infection for 6 months. Vascular surgery, pancreas surgery, and liver surgery were the toughest.

As a surgeon, the more you smoke and the more you drink and the more divorces you get - the more stress you get the more you lose. If you’re lucky or fortunate enough to do a good job with few complications it’s just a joy.

Doc is kind of like a tailor that makes house calls when you rip the seat of your pants. He’s done work in his office and his home - he doesn’t do surgery anymore at hospitals.

Doc has done surgery for beef, chickens, goat, pork, wild game, cheap or even free. Coming from a farm in midwest he wanted to grow up like that.

For the past 40 years every day of Doc’s life has been a vacation.

He was in Seattle in 1967 or 1968. This guy in Kodiak named Magnusson fell from 100-foot mast. He got gangrene and they had to find an iron lung and starve his leg from oxygen where the bone poked through. They killed the gangrene starving it of oxygen and giving it penicillin. Then his leg was infected with staph. It was still draining when they transferred to the marine hospital in Anchorage. Doc Sayers took his leg off they had to wait six weeks till the prosthetic came in. Bill Magnusson stayed in the hospital six weeks and married his physical therapist.

Bill invited Doc up north to check out his father’s gold mine near McGrath, where Doc bought a mine and got involved in the business. w

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