When physician Dale Mole stepped off the C-130 turboprop plane that had landed at the South Pole in January 2012, he felt a twinge of disappointment. It was only minus 25 degrees Fahrenheit. Granted, it was summer—but he had expected worse.

"The average winter temperature is minus 85," he says. As the weeks and months passed, however, the thermostat dropped as low as minus 107. Mole's exhaled breath would freeze in mid-air; no one dared leave bare flesh exposed more than 10 or 15 seconds; teeth would ache for hours after exposure.

Once, as Mole was cresting a snow bank, his face mask froze. "I had to remove my mask to breathe and the super-cooled air felt like ice daggers in my throat," he says. "I was afraid my windpipe was going to freeze, which could prove fatal."

When physician Dale Mole stepped off the C-130 turboprop plane that had landed at the South Pole in January 2012, he felt a twinge of disappointment. It was only minus 25 degrees Fahrenheit. Granted, it was summer—but he had expected worse.

"The average winter temperature is minus 85," he says. As the weeks and months passed, however, the thermostat dropped as low as minus 107. Mole's exhaled breath would freeze in mid-air; no one dared leave bare flesh exposed more than 10 or 15 seconds; teeth would ache for hours after exposure.

Once, as Mole was cresting a snow bank, his face mask froze. "I had to remove my mask to breathe and the super-cooled air felt like ice daggers in my throat," he says. "I was afraid my windpipe was going to freeze, which could prove fatal."

Scott Parazynski, M.D., had spent 16 years in NASA's astronaut corps and was an experienced mountaineer when the offer came to become Chief Medical Officer overseeing healthcare for the National Science Foundation's U.S. Antarctic Program (USAP). Having tended to climbers all the way to the summit of Mount Everest, he was familiar with the psychological and physical demands of practicing medicine without a net.

"It takes a really broad skill set," he says. "I call it MacGyver medicine. What can you do to diagnose and treat conditions in a really remote environment when the chips are down? You have to invent solutions on the fly."

Physicians who volunteer typically have backgrounds as surgeons or emergency room veterans. When Parazynski selected former submarine medical officer Mole to go to the South Pole, the 63-year-old underwent a rigorous screening: an EKG to assess cardiovascular health, an ultrasound of the gallbladder to rule out any simmering problems, and a psychological test.

Once approved, Mole left Denver for New Zealand, which connected him to McMurdo Station. There, a dentist gave him a crash course on fillings and root canals. After a week, he boarded a flight to the South Pole, where his patient base of 49 scientists and researchers studied everything from geophysics to astronomy in a fuel-powered compound; the dry air (the area averages seven percent humidity) forces residents to guzzle four to six liters of water a day. Mole was careful not to touch any metal with his bare hands—it can take the skin right off—and investigated his professional tools, a mixture of modern and museum-worthy.

"Some of the items I remember from visiting the doctor in the 1950s," he says. There was a World War II embalming kit, a straitjacket, and glass syringes with reusable needles. "Some of our lab equipment was also designed for use on animals, but was perfectly suitable for humans. The x-ray unit was the portable kind used by veterinarians, but it worked."

Ventilators, ultrasound, and critical life support devices are also present, though luxuries like an MRI device would be cost-prohibitive owing to the small population. "You're relying upon clinical judgment and your resourcefulness," Parazynski says.

Because the Antarctic workers are carefully screened for any major conditions, Mole and other physicians frequently find themselves treating conditions common to any industrial environment: slips, common colds, and lacerations. The plummeting temperatures and non-existent humidity also give rise to dry skin conditions and respiratory ailments. One, "the McMurdo crud," is a hacking cough that tends to nag at patients.

Despite the cold, frostbite is not as common as one might expect. Mole saw only a few cases, albeit one that resulted in a patient losing part of an ear. Most injuries, he says, "were sports related, as many played basketball, volleyball and dodge ball on their off-duty time."

Sean Roden, M.D., who stayed during the comparatively warmer summer months prior to Mole's arrival, recalls that altitude sickness was a problem for many: Antarctic stations are 9500 feet above sea level. Staff and crew take Diamox, a drug that helps adjust the body's chemistry to the environment, but it isn't always effective. "I had a headache for over two months," Roden says. "Everyone was just constantly short of breath, had a headache, had a hard time sleeping. You get winded just brushing your teeth."

Summer also invites a scourge of insomniacs, with the sun refusing to go away and inhabitants putting up blackout shutters to try and cope with the irregular seasons. "People were walking up and down hallways, not really awake, not asleep," Roden says, "like zombies."

When Doctors Get Sick

The modest inpatient ward. Courtesy Dale Mole.

It's a hypochondriac's worst nightmare: alone in the Antarctic, with the lone physician too ill to care for anyone else. Modern screenings have reduced that possibility, but the area has been home to a series of legendary crises.

Some countries require their doctors undergo an appendectomy to ward off the potential for appendicitis. If that seems excessive, consider the case of Leonid Rogozov, a Russian physician who diagnosed himself with a swollen appendix during a 1961 expedition. Trapped in the Austral winter with no flights in or out—the harsh weather can prevent aircraft from functioning properly—he deputized a few researchers to be his surgical assistants and cut out his own organ using only local anesthesia. He recovered in just two weeks.

In 1999, Jerri Nielsen discovered a lump in her breast. She performed a biopsy using only an ice cube to numb the area; upon discovering a cancerous growth, she had drugs air-dropped to her until she was able fly out for treatment.

If anything similar were to occur today, physicians would have the benefit of teleconferencing with colleagues. "We can look remotely in someone's ear, eyes, listen to their heart, share views of ultrasound or EKG tracing," Parazynski says. "We can look over their shoulder and be part of the decision making process."

That assumes, however, communications are working. Mole says Internet access was available only a few hours at a stretch. Without it, "You rely upon textbooks you either brought with you or were available in the small South Pole medical library."

Dental concerns are treated here. Note the armrests for ease of gripping and writhing. Courtesy Dale Mole.

Much of a physician's time is spent in preventative preparation, training staff in the event of an emergency. During his stay, Roden orchestrated the medical evacuation of a crew member who had fallen ill with a neurological issue more than 400 kilometers from base. "We had rehearsed it in a drill, so we were prepped for it." (The patient recovered and returned to work.)

Off-duty, Roden says numerous groups were devoted to salsa dancing, knitting, or Doctor Who viewing parties; Mole read, ran four to six miles a day on the treadmill, and ventured outside sporting at least six layers of insulation—anything to stretch out from his cramped 6 x 10-foot living quarters. He says he experienced none of the depression that can result from a lack of sunlight for months at a time.

"Being at the South Pole was like living on another planet, one with only one day and one night per year," he says. "There was always something unique to experience, so I was never bored or felt an overwhelming desire to leave."