Primary Care and Infectious Diseases

Seattle, Washington

At Sea - Cruising

Ketchikan, Alaska - Ketchikan is often the quintessential introduction to the Inside Passage, serving as a potent concentration of everything travelers seek in Alaska. Known as the "Salmon Capital of the World," the town balances a gritty industrial history of fishing and logging with the profound heritage of the Tlingit, Haida, and Tsimshian peoples. Visitors should be prepared for "liquid sunshine"—this sits squarely in a temperate rainforest, and the frequent rain is an atmospheric element of the destination, not a deterrent. For a relaxed day, the town is highly walkable. The centerpiece is Creek Street, a historic boardwalk built on pilings over the water. Formerly the city's notorious red-light district, it is now a charming, albeit busy, collection of galleries and local shops. In late summer, looking over the rails offers a front-row seat to thousands of salmon fighting their way upstream; the nearby fish ladder provides a fascinating, close-up view of this biological struggle. To engage with the region's history beyond the souvenir shops, we recommend the Totem Heritage Center. Located a short walk or quick taxi ride from the bustle of the port, it houses an unparalleled collection of original 19th-century totem poles retrieved from deserted villages. Unlike the brightly repainted replicas found in parks, these are preserved in their natural, weathered state, offering a somber and powerful insight into Native artistry. While the town is engaging, the true grandeur of this stop lies in the surrounding wilderness. If logistics and budget permit, a floatplane excursion to Misty Fjords National Monument is the definitive Ketchikan experience. Soaring past sheer granite cliffs and cascading waterfalls provides a perspective on Alaska’s scale that ground tours simply cannot match. Whether you explore the boardwalks or fly into the fjords, Ketchikan delivers a dense, accessible dose of the frontier.

Juneau, Alaska - Juneau is a paradox: a state capital accessible only by air or sea, where the wilderness doesn't just surround the city—it defines it. As a port of call, it offers perhaps the most accessible high-adventure opportunities in Alaska, though managing expectations regarding weather and crowds is essential for a quality experience. The Mendenhall Glacier is the undisputed centerpiece. While the Visitor Center offers a solid introduction, the glacier has receded significantly in recent years. To truly grasp the scale of the Juneau Icefield, we recommend a helicopter excursion. Landing on the glacier or dog sledding on the ice cap is a significant investment, but it provides a visceral connection to the landscape that a distant view from the visitor center cannot match. If you prefer to stay grounded, the hike to Nugget Falls offers a powerful view of the glacier's face and a roaring waterfall without the flight costs. Juneau’s waters are among the most productive feeding grounds for humpback whales in the world. Sightings in Auke Bay are exceptionally reliable during the cruise season. If you have not booked a wildlife excursion elsewhere on your itinerary, this is the place to do it. Downtown Juneau is compact and historic, though South Franklin Street can feel congested when multiple ships are in port. For a sophisticated cultural break, the Alaska State Museum is outstanding, housing world-class exhibits on Native Alaskan heritage and Russian history. The Mount Roberts Tramway, located right at the dock, offers sweeping views, but we advise purchasing tickets only after assessing the cloud cover; the view is spectacular, but non-existent in heavy fog. For a culinary finish, skip the generic tourist traps and visit Tracy’s King Crab Shack for genuine local flavor. Juneau is a wet city—it lies in a temperate rainforest—so dress in waterproof layers to enjoy this spectacular intersection of civilization and wild frontier.

Endicott Arm & Dawes Glacier - Endicott Arm offers a quintessential Alaskan experience, distinct from the commercial bustle of port towns. This is a day dedicated to scenic cruising, where the ship navigates a 30-mile fjord carved by ancient ice. The scale here is humbling; sheer granite cliffs rise thousands of feet directly from the emerald water, often decorated with vertical stripes of cascading waterfalls. Unlike the open ocean, the water here is usually calm, turning the fjord into a mirror for the scenery above. The destination is the Dawes Glacier, an active tidewater glacier standing over 600 feet tall. As you approach, the water becomes cluttered with floating ice sculptures—from small 'bergy bits' to massive, sapphire-blue chunks. The highlight is the 'white thunder' of calving, where massive slabs of ice fracture and crash into the sea. While the visual is stunning, the sound is equally memorable. Wildlife viewing is excellent here. Look for harbor seals hauling out on the ice floes near the glacier face—this is a primary breeding ground for them. Mountain goats appear as white specks on the high cliffs, and brown bears are occasionally spotted along the shoreline. We recommend spending this time on the open decks rather than behind glass; the sensory experience of the crisp air and the roar of the ice is lost indoors. If your itinerary offers a small boat excursion here, it is worth the investment to get closer to the water level and the glacier face.

Alaska Inside Passage - The Inside Passage is not merely a route between ports; for most travelers, navigating this protected waterway is the definitive Alaskan experience. Unlike open ocean crossings, this journey takes you through a narrow, calm corridor flanked by the massive Tongass National Forest—the largest temperate rainforest on earth. The scale here is humbling, with thousand-foot granite cliffs plunging into deep fjords and mist clinging to the hemlock and spruce canopy. This is a day for active observation. We strongly advise securing a position on deck or a private balcony well before approaching major highlights like Glacier Bay, Hubbard Glacier, or Tracy Arm Fjord. The silence here is profound, often broken only by the 'white thunder' of tidewater glaciers calving into the sea. The visual impact of the 'glacial blue'—created by dense ice absorbing red light spectrums—is startlingly vivid against the grey skies. Wildlife viewing requires patience but offers high rewards. The nutrient-rich waters are prime feeding grounds for humpback whales; look for the telltale mist of a spout or the fluke raising before a dive. Orcas, Dall’s porpoises, and harbor seals are common sights, while bald eagles are nearly ubiquitous on passing ice floes. On the shoreline, keep a sharp eye out for coastal brown bears at low tide. Practical preparation is key to enjoying this passage. The weather is notoriously changeable; expect rain and mist, which actually enhances the dramatic, moody atmosphere of the fjords. Dress in waterproof layers and, most importantly, bring high-quality binoculars. Relying solely on the naked eye or a camera lens means missing the intricate details of this untamed wilderness. This is a time to disconnect from shipboard distractions and immerse yourself in one of the planet's most magnificent natural corridors.

Skagway, Alaska - Skagway operates as a living museum of the 1898 Klondike Gold Rush, situated at the northern terminus of the Inside Passage. While the town’s year-round population is small, its historical footprint is massive. The downtown district is part of the Klondike Gold Rush National Historical Park, featuring meticulously restored false-front buildings and wooden boardwalks. It is undeniably tourist-centric, yet the preservation is authentic enough to transport you back to the era of prospectors and con artists. You can easily explore the core of Broadway Street in an hour or two, perhaps stopping at the Red Onion Saloon or the National Park Service visitor center for context. However, we advise viewing Skagway primarily as a staging ground for the wilderness beyond. The town sits in a narrow, wind-swept valley, and the most dramatic scenery requires leaving the immediate port area. The definitive experience here is the White Pass & Yukon Route Railroad. This narrow-gauge railway is an engineering masterpiece that climbs nearly 3,000 feet in just 20 miles, offering vertiginous views of gorges, waterfalls, and the Sawtooth Mountains. It is not merely a train ride; it is the most efficient and spectacular way to understand the geography that challenged gold seekers. For a different perspective, Skagway is the premier port for flightseeing. Helicopter excursions to nearby glaciers—often combined with dog sledding—provide a sense of scale that ground-based tours cannot match. For those preferring to stay closer to sea level, a float down the Taiya River or a hike to Lower Reid Falls offers serenity away from the busy boardwalks. Ultimately, Skagway rewards those who book a specific adventure rather than wandering aimlessly.

Victoria, British Columbia - Victoria is arguably the most civilized port of call in the Pacific Northwest, blending British colonial heritage with West Coast vitality. Ships dock at Ogden Point, a pleasant 20-minute coastal walk or short shuttle ride from the Inner Harbour. This central hub is the city’s beating heart, framed by the ivy-covered Fairmont Empress and the neo-baroque Parliament Buildings. It is compact, safe, and exceptionally walkable. For many, the headline attraction is Butchart Gardens. While truly a horticultural masterpiece, we advise caution regarding logistics: the gardens are located 35-45 minutes from the port. Visiting requires a dedicated block of four hours, leaving little time for the city itself. If you are a devoted gardener, it is worth the journey; if you prefer a relaxed pace, the city center offers ample rewards without the commute. The Royal BC Museum is a standout recommendation for this demographic. It is one of North America's finest museums, featuring immersive exhibits on First Nations history and the region's natural evolution that are intellectually satisfying without being dry. Nearby, Government Street offers sophisticated strolling; look for Munro’s Books—set in a magnificent neoclassical building—and Rogers’ Chocolates for local heritage. For a casual interlude, a short walk leads to Fisherman’s Wharf, where colorful houseboats and fresh halibut and chips offer a looser vibe. Whether you opt for High Tea at the Empress or a quiet walk through Beacon Hill Park to see the world’s tallest free-standing totem pole, Victoria delivers a polished, high-quality experience that respects your time.