Standing on the Devon coast, my phone rings.

“Hi James, we’d like you to look after Rothera for us. Are you happy to take the job?” 

“Yes, of course!”

Cue a moment of panic. After an hour-long interview only that morning, I have just signed up to work in Antarctica for eighteen months, providing medical cover for a research station of 27 people in the winter, 160 in summer. I would be the only doctor for at least half of that time, with only narrow windows for medical evacuation in case something goes wrong. My patch in the summer consists of an area the size of Europe, with deep-field teams scattered in some of the harshest environments on Earth.

But then again this is a job I’d been working towards for a decade. Starting as a medical student reading about the desert explorer, Wilfred Thesiger, I had slowly expanded my interest into other remote environment pioneers and had become enthralled with the exploits of Scott, Shackleton and the other expeditions of the Heroic Age of polar exploration. Sitting reading about them in a damp flat in Fulham, it suddenly struck me that I could be doing this myself rather than just reading about it. 

This journey culminated in me beating seventy other hopefuls to a place, and arriving in Plymouth to start training in all the skills that I might need in Antarctica. Whilst my six years of work in general and emergency medicine and anaesthesia put me in good stead for dealing with a sick patient, I might need to be able to take an x-ray, fill a tooth or recompress a diver with the bends if I was to effectively cover the needs of my fellow polar residents.

Six months later, I was packing my bags to fly south to start my tenure at Rothera Research Station, operated by the British Antarctic Survey (BAS). Positioned on a small isthmus on an island just off the Antarctic Peninsula, just inside the Antarctic Circle at 67°S, our station is not much to look at from the outside. But the location is spectacular. 

When I first arrived, sea ice covered the bay as far as the eye could see, only to break up and be replaced by icebergs providing an ever-changing backdrop to the activities on station. The glaciers start on our doorstep and open up into a wide ice piedmont, punctuated with nunataks and mountain ridges just waiting to be explored.

The British presence in Antarctica had a strong focus on scientific research from the outset. This has continued through from the inception of BAS in 1962 to the present day. Whilst the station is a research centre in its own right, with permanent marine biology, oceanography, meteorology, and upper atmosphere research projects and long-term continuous data collection, one of our main functions in the summer is to provide air access to the continent. 

This allows for BAS in-house and collaborative partner science teams to conduct world-leading research into glaciology and climate change, looking at how the climate has changed over the millennia and what effect the changes we are experiencing now are having on the vast ice sheets and glaciers that make up most of Antarctica. These can vary from small, highly mobile two-person parties up to the huge, multiyear, multinational collaborative projects currently in place on the Thwaites ice shelf.

My day-to-day work is generally straightforward general practice-style medicine, complicated by our location and remoteness. Our teams are all medically screened prior to departure but acute conditions and minor injuries can and do occur. With my background in anaesthesia and critical care, I am used to looking after some of the sickest patients with the resources of a large, modern hospital. Here, I really have to go back to basics and rely on my clinical skills and acumen to diagnose and treat the problems that present to me. I have to do my own x-rays and laboratory tests and, even then, the available options are limited. 

Fortunately, I am backed up by the British Antarctic Medical Unit (BASMU) based in Plymouth and can get expert advice within hours, if not minutes. Most of the environmental diseases that I encounter are disrupted sleep cycles due to the eccentric light patterns and dry skin from low humidity, rather than the expected frostbite or hypothermia.

The challenges I face vary from the expected; limited supplies and having to come up with imaginative solutions to illnesses that normally have clear referral pathways in the UK, to the more unusual; how to have a normal lunchtime chat with someone who you were minutes before counselling for a potentially embarrassing personal problem. In such a small community, medical confidentiality is both key and a challenge when someone is discussing their injury at the bar in the evening. 

This year has seen innovations in our practice, with our first use of high-definition videoconferencing to facilitate the examination of a wound by a plastic surgeon based in the UK, allowing for the rapid formulation of a time-critical treatment plan.

Life on an Antarctic research station is unique. Classified as an isolated, confined environment (isolated from the outside world, confined in that we can’t leave), it is no wonder that psychologists have studied research stations as proxies for long-term space travel. Despite our comfortable living conditions, we are heavily dependent on our life support systems. If the generators or water production plant break, we could suddenly be left in a tenuous situation, exposed to the harsh realities of our location. 

We have to be self-reliant and self-contained, as resupply is intermittent at best, and impossible over the winter. We rely on each other in a way that isn’t always visible back in the real world, with everyone on station having a vital role to play, from scientists and engineering staff to the electricians, plumbers and mechanics that keep the lights on, water running and vehicles working, not to mention the chef that keep us fed and happy. 

The doctor, as a mostly reactive job, gets a plethora of ancillary roles attached to it; I am now a deputy subpostmaster, shopkeeper, binman and viral researcher on top of being on-call twenty-four hours per day, seven days per week. 

Our first summer season was a whirlwind of the flying program; routine maintenance, major construction projects including the wharf that will service the RRS Sir David Attenborough,  and the continual flux of personnel coming in and out the station. As such, the morning that the ship left with the last of the summer staff was a moment of relief for those who were staying behind. 

The Antarctic winter is a challenging but personally rewarding time that drew many of us down here in the first place. The wildlife, so plentiful and varied in the summer, slowly starts to vanish as the days shorten and the temperature drops. Slush, pancake ice and finally fixed sea ice forms over the bay and the silence becomes all-consuming. The moment when you realise that the only thing you can hear is your own blood pumping is bizarre and sublime. 

Likewise, smells fade and disappear as everything freezes, and the twilight gloom reduces the world to shades of white and grey. However, this canvas puts all the phenomena of Antarctica into vivid relief. The six weeks over midwinter, where the sun does not rise above the mountains, were punctuated by the most glorious displays of colour in the sky as the invisible sun highlighted the clouds. I’ll never forget the delicate nacreous clouds high in the stratosphere shining with pearlescent beauty; or the moment I felt the first rays of sunshine on my face after more than a month of darkness; or waking to hoarfrost coating every surface outside, only to disappear completely a day later.

Winter forces you to be creative as forced time indoors can quickly become stale and repetitive. Nothing is handed to you although we are lucky to have access to a supply of materials and talented people to keep us entertained. Music, art, sports and crafts have all had their moment, with everyone digging deep to make intricate and thoughtful gifts for Midwinter’s day, our proxy for the holiday season. We’ve made films, had old-school LAN parties, skied down the glacier dressed as dinosaurs, and spent weeks off station climbing mountains and exploring down crevasses whilst living in tents.

COVID-19 has had a huge effect on the organisation, as it has on everyone over the last year. We have been incredibly fortunate to escape the virus itself at Rothera. This has been through the sterling work of BAS, BASMU, the government of the Falkland Islands and the Antarctic community as a whole, leading to risk stratification and strict quarantine procedures for all staff coming south, and a complete rejigging of plans for the coming summer season. 

Our winter, originally scheduled for five months, has now expanded to almost double that. We have all felt incredibly lucky that we have been able to continue living relatively normally and have a lot of sympathy for those that have found themselves cooped up indoors, as we keep up to date with the ongoing situation through online news and communications with friends and family. 

Coming down to Antarctica, I knew I would have a lot to discover about living here. But now I realise that it is going to be my return home in March, after several weeks on a ship, that will be the real learning experience, as I adjust to social distancing, masks, and having to learn how to treat a now-common disease I have never seen before.

As I approach the end of my time down here, I’m looking around me at the amazing people who have supported me through this and whom I have got to know so well, at the elephant seals sitting obstinately on the runway, at the doorway that needs digging out yet again, at the time away from family and friends, to an uncertain future after such a landmark experience in my life. Would I advise someone else to seek out this opportunity? Absolutely. If you are willing to take up the challenge.

To read more about James’ time in Antarctica, head to  DiscoverInteresting.com

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James Bowyer is a doctor for the British Antarctic Survey. Since 2019, he has been based at the Rothera Research Station, a centre for biological research and a hub for supporting deep-field and air operations. 

Here he gives some insight into his remarkable daily life and responsibilities, along with his thoughts on being one of the world’s last remaining medics yet to gain first-hand experience of the Covid-19 pandemic…

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