The Last Frontier

The Last Frontier

Through twists and turns, a Creighton alumna falls in love with Homer, Alaska, and a unique form of therapy

By Emily Rust

The “elephant in the room” was a massive steel aerial rig. And there was the book: The Aerial Circus Training and Safety Manual.

Melissa Gagnon, OTD’13, had moved into a cabin in Homer, Alaska, with a friend, and the rig was there, in the living room — intriguing and inviting.

She began practicing with it, every day, following along with photos from the book. She eventually got good — carefully contorting her body on the rig’s trapeze bar, her flips and spins mimicking those of the otters she watched from her cabin window. She taught herself moves with names such as “bird’s nest” and “gazelle.”

This wasn’t your traditional circus trapeze, upon which a performer flies through the air. This static trapeze hangs about four feet off the ground, attached to the steel rigging, allowing for a variety of acrobatic moves.  

After time, all the flipping, twisting and contorting became Gagnon’s life’s work and an effective therapy tool for children visiting her occupational therapy clinic in Homer — aptly named Cirque Therapy.

There, Gagnon has her own steel rig, but now she teaches children the secrets behind aerial acrobatics using a trapeze and a long piece of fabric called a silk, all while improving her patients’ spatial awareness, social skills and quality of life.

It’s not an ordinary approach to pediatric occupational therapy, but nothing about Gagnon’s life has ever been ordinary.

A native of New Jersey, Gagnon lived in Phila­delphia, Orlando, Florida, and Miami, before buying a bus ticket as far west as her last few dollars would take her — Reno, Nevada.

Eager to relocate, Gagnon, with $10 in her pocket, hitchhiked from Reno to work on a sustainable farm in a small Russian village on the Kenai Peninsula of Alaska, relying on the kindness of strangers who took her from the deserts of Nevada, through the Canadian Rockies until she reached the Last Frontier.

“Money is not going to stop me from doing something,” Gagnon says.

She only intended to stay in Alaska for the summer months, but 13 years later, the once nomad has settled here.

With the shortened Alaskan winter days — when sunlight can be fleeting — Gagnon enrolled in courses at a satellite campus of the University of Alaska Anchorage as a way to keep busy. She mainly stayed in Homer, earning a degree in biological sciences. A few courses required her to move to Fairbanks with her then-infant daughter Zayda, where she lived in a house in which a trek to the bathroom meant going outside in minus-65 degree weather.

“If you don’t have an outhouse in Fairbanks, you don’t see the Northern Lights,” Gagnon says.

Realizing many of her co-workers on the sus­tain­able farm had science degrees and were only earning $12 per hour, she knew she needed more education.

A frequent traveler, Gagnon had met a German couple while visiting Laos who were both occupational therapists, a profession she had always considered.

“They were like, ‘You should do it,’ ” Gagnon says. “‘We love our jobs, it’s satisfying.’ They totally sold me on it.”

As she finished her undergraduate degree in Fairbanks, she volunteered at an occupational therapy clinic in town, remembering her German friends. A co-worker mentioned a new occupational therapy program administered by Creighton University at the University of Alaska Anchorage.

“There are so many scientists fighting for jobs in Alaska,” Gagnon says. “Occupational therapy is the complete opposite. There are so many jobs and so few occupational therapists. So it made a lot of sense.”

Forging a Pathway

Meanwhile, Creighton leaders had come to the same realization about the state of occupational therapy in Alaska a few years earlier. Al Bracciano, EdD, an occupational therapy professor at Creighton, was an early proponent of the Alaska program.

“Our primary goal is to provide occupational therapists who stay and practice in Alaska,” Bracciano says.

In 2008, Creighton established the Alaska Pathway Program, the first occupational therapy program in Alaska. It was designed for Alaska residents to study occupational therapy and eventually work in their home state — where there was a dire need for therapists.

Before, Alaska residents wanting to study occupational therapy had to leave the state and move far away.

“There was hardship on the student, hard­ship on the family,” Bracciano says. “What usually happens is where you do clinical rotations, internships, that’s where therapists will stay.”

Without these rotations happening in Alaska, there were not near the number of therapists in the state to fill the need. And those who were there were aging quickly — 42 percent of therapists in Alaska are 45 or older.

“Alaska was the one state that did not have an occupational therapy program,” Bracciano says. “The national professional occupational therapy organization, the American Occupa­tional Therapy Association (AOTA), knew there was a need. Nobody would take a risk to do it. Creighton was really progressive.”

Five to 12 students — each of whom must be a resident of Alaska — are accepted annually into the program, which features both online classes and on-campus professors in Anchorage. Each year, members of Creighton’s Omaha-based faculty travel to Anchorage for Welcome Week and other events, and many Alaska students travel to Omaha for graduation.

“I didn’t want to leave my house and my family,” Gagnon says. “We are so lucky that the Creighton program did develop here.”

Life in Alaska

Homer residents are ruggedly independent yet quick to come to a neighbor’s aid.

“You can’t afford to not help someone with a flat tire, because one day, that’ll be you,” says Dylan Smith, a native of Homer and one of Gagnon’s friends. “I can’t leave someone to the elements. With a greater population density, you think someone else can help them. Here, someone else might not come along.”

And along Alaska Route 1, which ends in Homer, that someone might indeed not come along. It’s where the land ends and the sea begins.

Alaska Route 1 starts in Tok, weaving through Anchorage and down through the Kenai Peninsula until it blends into the Kachemak Bay at the end of a long strip of land called the Homer Spit. Snow-capped mountains, dotted with glaciers, line the coast, a natural beauty that continues to draw inspired artists. The town of 5,515 is known both for its commercial fishing industry and arts scene.

Like a lot of Alaska residents, the towns­people in Homer have a hardy self-sufficiency. There is a general “distrust of ‘The Man,’ ” partic­ularly when it comes to traditional medicine, Smith says.

Once, the highway into town was just a single-lane dirt road, but as word traveled of easy money from halibut and salmon fishing, the town grew.

Hippies and artists also flocked to Homer, delighting in its natural beauty. It is also the hometown of Jewel, the Grammy-nominated singer-songwriter.

It’s the perfect place for a unique form of therapy.

“In Alaska, we have a lot of people who are very alternative and very hesitant about engag­ing in medical care,” Gagnon says. “Before I opened my clinic, the only place for pediatric occupational therapy was at the hospital in Homer. There’s a wait list and a lot of parents said, ‘I don’t want to take my kid to the hospital.’ ”

Cirque Therapy

So Gagnon combined the artistic, holistic spirit of her town with clinical treatments that have proven to be successful. It might look like her therapy is more play than work, but she has found a way to tap into these children’s lives.

Consider Ryan, an 11-year-old, who Gagnon puts on the trapeze. A little wobbly, Ryan looks nervous as he balances himself on the bar. After a misstep, Ryan falls down on the mat below.

“Well, that is not the preferred exit,” Gagnon says. “Don’t forget, I can always do it after tons of tries,” Ryan says.

After a successful “bird’s nest” (a trapeze move), Ryan has earned a game of foosball, something Gagnon uses to motivate her patients.

“They will do things they hate just to do foosball,” Gagnon says. “I really want everybody to enjoy what they’re doing, but I have to challenge them all the time.”

Gagnon sees about 25 patients from one to three times a week. She works with patients ages 2 to 19, and with a contractor for any infants. Homer’s service area is about 40 miles or 13,000 people, so some patients travel an hour for sessions. Her patients have often been diagnosed with autism, attention deficit hyperactivity disorder (ADHD) and fetal alcohol syndrome.

Ryan may have fetal alcohol syndrome, Gagnon says, but the disease is difficult to diagnose. A lot is unknown of the trauma he experienced in the womb, but Gagnon says his birth mother consumed various drugs and alcohol while pregnant. Alcohol abuse is a major problem across Alaska.

Exposure to these adverse child experiences, or ACES, has a great impact on a person’s life.

“Some days he’s thriving and doing so well,” Gagnon says. “Some days, he has serious regression and he’s at a developmental level at [age] 8 or so.

“He doesn’t have a lot of confidence, which is a very common thing in children, especially in my patients. They’ve struggled through life and they want to avoid those struggles.”

For families in Homer, there wasn’t always a ready solution for children who were in need of occupational therapy. One reason was because medical clinics in town were not sure how to help, until Gagnon took it upon herself to educate those health care providers.

“When I did talk to them, they said, ‘Great, because we didn’t know who to send these kids to before. We didn’t know what to do for them before,’ ” Gagnon says.

With new Medicaid laws in Alaska, parents no longer need referrals from a doctor to come to Gagnon’s clinic. Almost all of her clients are on Medicaid.

“Previously, parents would try to get a referral, and there’s a wait list just to see the doctor,” Gagnon says.

Now, Gagnon is able to focus on outreach and community education, directly presenting her practice to parents.

One educational seminar helped Izzy Scott realize her daughter Kelsey needed Gagnon’s help.

“She was hitting buttons with Kelsey that we were recognizing,” Scott says.

Kelsey, 5, may have autism, but has not been officially diagnosed. In her six months with Gagnon, she has worked on sensory processing with activities like cutting with scissors and pouring water.

When Kelsey went on a two-week vacation in Oregon with her family, her progress with occupational therapy did not pause, thanks to an activity kit Gagnon prepared.

“She goes above and beyond helping the kids as much as she can,” Scott says.

After just three months of working with Gagnon, Kelsey showed more confidence. At a local McDonald’s PlayPlace, for the first time, Kelsey went up the stairs and started climbing around. Before, she wouldn’t play at all.

“I don’t know what we would do without Melissa,” Scott says.

Gagnon says her practice is one of only three in the U.S. that combines circus arts and therapy. During her professional rotations, Gagnon studied with licensed clinical social worker Carrie Heller, the author of The Aerial Circus Training and Safety Manual (the same book Gagnon had found in her cabin) and founder of the Circus Arts Institute in Atlanta.

“Children tend to respond better to move­ment and play than just talking,” Heller says of her practice.

Gagnon remembers, during one rotation, working with a patient who was no longer able to participate in gym class because of a lack of “body awareness.” The patient’s academic performance was correspondingly plummeting.

“Once I got her on the trapeze, she started building up a lot of awareness,” Gagnon says. “It was just awesome. She’s now in gym class; she’s thriving.”

A Town Spectacle

Gagnon’s love for the circus extends beyond her clinic, into all aspects of her life. On the first Wednesday of every month, Gagnon and her husband, Mark, perform “acrobalance” at Alice’s Champagne Palace, one of Homer’s oldest bars.

Around 60 Homer residents gather for the First Wednesday Spectacle. It’s an eclectic assembly of people who sign up to do “weird human tricks,” Mark says, as he and his wife waited to perform this past August.

Singers, comedians and even a fisherman reciting rhyming poetry take the stage this particular night. Melissa and Mark are the final act. Mark lifts Melissa on his feet, her entire body-weight balanced carefully. Their performance is a little comedic. Falls are scripted. Mark shows off his muscles, and the audience loves it all.

“She’s really passionate about circus arts,” says Gagnon’s friend Dylan Smith. “That’s the dream, to combine two of your passions, right? And to help people.”

Melissa and Mark return to their table, where their daughter Zayda, now 9, has been watching patiently. Zayda is part of the next generation of circus performers, having started on the trapeze at age 4.

The next morning Gagnon is back at Cirque Therapy, the giant steel rig waiting for the next patient. It’s no longer the elephant in the room; it’s as important to her practice as her Cirque Therapy is to the town of Homer.

“It’s a little more rough and tumble,” Smith says. “A little more Alaskan.”