In this post, guest blogger Dimitra Lavrakas gives a personal account of Skagway's journey to modern healthcare.

Guest post by Dimitra Lavrakas for Rasmuson Foundation

It was the X-ray machine that was the big problem. To this day, I swear the medical assistant at clinic took a shot six times and nothing registered after the film was run through the developing fluid.

Even if the film had come out, it would still have had to be mailed to Juneau for an X-ray technician to read. That took days.

That was in 1998, when I first came to Skagway, and dang if I can’t remember what I thought I broke. The machine was a true relic and so outdated that parts were hard to come by and had to be scavenged or jury-rigged. Still it was a testament to Alaska ingenuity.

When the clinic did get the money for a replacement, it was too big to fit in the room so walls had to be moved.

About a year later, as editor of the Skagway News, while covering a city council meeting I doubled over and started sweating. I thought “heart attack.” The pain in my gut was so bad it was all I could do to hobble from the meeting to home and into an intensely hot bath.

It didn’t really help.

Next morning, when I went to see my provider, Lynn Cameron, an advanced nurse practitioner, who said I needed an ultrasound.

There wasn’t one in town.

Lucky for me I was leaving the next day for Anchorage to go to the annual journalism conference. She gave me pain pills that I just couldn’t keep down.

I went straightaway from the plane to the doctor, where the ultrasound technician showed me the little white dots on the screen. Gall stones.

As good as the health care professionals at the clinic and the Emergency Medical Technicians in town are, my case was not unusual.

People had to fly out to Juneau or drive to Whitehorse for any extraordinary treatment. That could be problematic when the road north was closed or planes couldn’t fly because of severe weather or if no ferry was scheduled.

In those cases a medevac comes from the U.S. Coast Guard base in Sitka.

You can judge that huge Jayhawk’s landing when the windows in town start to rattle to the beating of the chopper’s rotor. When we hear that sound, we hold our breath and hope that whoever is going out will come back.

It was a certainty that a new clinic was needed to bring the town’s health care into the 21st century.

You know how sometimes in a small town there are always fiscal conservatives who rail against spending? That didn’t happen here — we were all in agreement.

And so began the laborious process to replace the over 40-year-old facility. Wells Fargo stepped up and donated six lots at 14th and State. While Alaska is geographically large, it is really a small circle of friends. National Bank of Alaska, founded by E.A. Rasmuson, who lived in Skagway, was sold to Wells Fargo.

When I was an EMT with the Skagway Volunteer Fire Department, you parked in the alley, out in the open weather and lugged the stretcher in through the double doors. The emergency room was small and if there were a lot of personnel it was cheek to jowl. Now it’s got its own drive-in bay and a portable X-ray machine that can be slid right under a patient. The X-rays are digital and can be sent via e-mail and read in a day if not hours.

There’s even an ultrasound.

During 2011’s Yuletide, the town’s three-week holiday celebration that includes open houses, clinic operations ceased for the day and residents were toured through the new facility to areas they usually might not get to see.

At the open house, I asked Lynne what she was grateful for at the new clinic.

“Privacy for the patients,” she said.

That’s true. You could hear everything that was being said through the walls in the old clinic.

“And the sliding fee scale,” she said. “Now people can afford health care.”

One of her clients, Bill Hunz, chimed in, “The personnel, and all the stuff they have. Back in 1930 we didn’t have that stuff.”

Well, we do now.

Dimitra Lavrakas is a photojournalist living in a neat little cabin she built in Skagway. She has worked across the state: Arctic Sounder in Barrow, Anchorage Daily News, Senior Voice, Alaska Business Monthly, Dutch Harbor Fisherman, The Skagway News and First Alaskans.