True Yankee Ingenuity a Must for Antarctica Doctors : Medicine: Performing an appendectomy on oneself comes with the territory. There has never been a winter medical evacuation from the U.S. base at the South Pole, and only two from McMurdo Station.

The utter isolation of Antarctic bases during the long winter sometimes forces tough choices on doctors--such as the Russian physician who decided to remove his own appendix.

Russia’s Vostok station, up on the polar plateau at the geomagnetic pole, is completely cut off from the outside world from February to November by gales and drifting snow that closes the runways.

About five years ago, the only doctor at the base came down with appendicitis. He had to turn his scalpel on himself, using local anesthetic.

He survived, and has become part of Antarctic medical lore among doctors who spend the winter at the bottom of the world--along with the Australian diesel mechanic who helped save a man’s life.

In the early 1960s, a worker at an Australian station suffered a head injury in an accident, and the mechanic was called in to fashion a piece of fuel line into a large catheter, which the base doctor used to drain a brain hemorrhage.

Again, the patient survived.

Antarctic doctors are proud of their skills, but they hope they are never tested in a situation as dire as that.

There has never been a winter medical evacuation from the U.S. base at the South Pole, and there have been only two from McMurdo, which is 2,500 miles and a nine-hour flight from a major hospital. Even in summer, planes that land at the South Pole keep the engines running so they do not freeze up.

The U.S. program has been fairly lucky not to face any disasters, or to have to improvise emergency care. Its worst casualty last year was a heavy machine-shop worker at McMurdo who had his jaw shattered when a hydraulic press buckled.

“Those teeth were floating around,” said Dr. Randall Hyer. The man’s jaw was wired and he was flown to Christchurch, New Zealand.

The U.S. Antarctic Program stresses prevention to minimize problems. Everyone who works on “The Ice” has been thoroughly screened to guarantee they do not have any lurking medical problems.

That includes pregnancy, which disqualifies a woman from working in the U.S. program, or gets her a flight out if her condition is diagnosed in Antarctica. The U.S. program does not attempt to deliver babies--or perform abortions.

“I receive a lot of criticism, but I can shrug it off. I can sleep at night,” said the chief physician at McMurdo, Dr. Joe Swartz.

As part of the diagnostic screening, everyone at the U.S. bases is also part of the “walking blood bank.” They are required to donate blood for a transfusion if their type is needed. So all must be free of hepatitis, the AIDS virus and other infectious diseases.

Staffers who winter-over are subjected to yet another hurdle, a psychological test and screening for antisocial and behavioral problems and alcohol abuse.

“You don’t have enough personal space, you don’t have enough varieties of personalities” at the South Pole station, said Dr. Eileen Sverdrup, the base’s only doctor this winter. “It is definitely not the sort of place to run from problems.”

Those who have been screened say the U.S. Navy psychologist or psychiatrist in charge also asks whether a person has any elderly or ill relatives who might die while the staffer is isolated over the winter, and how they feel about that possibility.

But no screening program is foolproof. A distraught support staff worker came in on the first relief flight this spring intent on committing suicide in Antarctica and had to be put under observation.

Officials and doctors at McMurdo and the South Pole declined to talk about the incident, which was common knowledge at both bases. The worker was evacuated on the next flight out.