Squatter Sam

On a cold winter afternoon in Fairbanks, Alaska, there was a slight air of expectation in our 2-doctor internal medicine office. After a hiatus of 5 years, Sam had made an appointment.

I had first met Sam some 15 years ago. Even in a place famous for colorful characters, he was a standout. Small and wiry, with rotten teeth and a nearly constant smile, he had come to me for care of his narcolepsy. His disease first manifested in his mid-twenties when he was working on the Trans-Alaska pipeline. Medication helped but did not fully overcome his profound fatigue and inappropriate sleep, and he was unable to maintain the 12-hour days and 7-day-a-week schedule demanded of the workers at the remote camps. Over the following 10 years, he tried a series of jobs closer to town and finally settled on logging. Although it was physically demanding, the hours were more flexible, and he could take the breaks he needed. Financially, however, he was never able to rise above the most basic survival level.

Food was always an issue, especially if hunting had been poor. One spring I noticed he was thinner than usual. “Yeah,” he answered with a smile, “I didn't get a moose last year.” Housing, however, seemed to be the area where Sam had to improvise the most. Since he was unable to afford even the most basic rental, he made do with a multitude of arrangements. He found a series of rural abandoned shacks to inhabit. For several years, he lived …