By Henry Ehrlich
Here at Asthma Allergies Children world headquarters, we keep a constant eye out for unusual voices in the world of atopy. Thus, it was with great excitement when a new Twitter follower showed up, Melinda Rathkopf, MD (@mrathkopf), who practices in Alaska. We reached out to her to write something for us about her practice, and now we are rewarded.
For those of us whose ideas about Alaska were shaped by Jack London, Melinda’s wonderful piece is both amusing and sobering. I haven’t read “To Build a Fire” in decades, but it’s an account of a man struggling to keep wolves away and simultaneously avoid freezing to death. Now I have to conjure with the image of him developing asthma from the smoke, and if he survives by some miracle, sneezing and itching all summer, such as it is.
Dr. Rathkopf’s report is also an object lesson for those who speak glibly about allergies and our being “too clean.” It’s possible, I suppose, that her patients were all born by Caesarian section, bottle fed, and dosed heavily with antibiotics before they felt the call of the wild. I only know a few people who have moved to Alaska, including one whose mother used to tell my mother about his subsisting through the winter by shooting a moose, putting the carcass on the roof of his cabin to protect it from scavengers, and going up with a chain saw when he was hungry to cut off a few frozen steaks and chops. His sinuses were always congested in high school as I recall. But it strikes me that anyone who is now allergic to seal and whale meat might not be a poster child for the hygiene hypothesis. Allergies may constitute an immune response to “progress” but even if you try to get away from civilization, your immune system can’t.
And finally, the answer to a burning question. When I asked Dr. Rathkopf whether she can see Russia from her office in Wasilla, she said, “I can’t see Russia but I can see Sarah’s house.”