Dr. Kevin Patterson has been fascinated with the harsh, barren landscapes and lonely seascapes of the Arctic since he first travelled there to practice medicine more than a dozen years ago.

Since then he's made regular pilgrimages to the tiny, isolated communities perched on the edge of Hudson Bay, first as a family doctor, then as a specialist in internal medicine, treating illness and disease.

At the same time, he's learned about this remote, rugged corner of the globe through the stories of the people who live there.

Those tales, many consisting of the heartbreaking life experiences that have come to define the Inuit culture in many ways, help form the basis of Patterson's first novel, Consumption.

The drama centres on an event in the 1950s, when hundreds of children who developed tuberculosis were sent away from their families to sanitariums where they often remained for years.

Though very little of the book is autobiographical, Patterson tells CTV.ca he has treated countless patients who went through similar experiences to Victoria, the lead character in "Consumption." Like her, their scars still serve as reminders of their illness and often act as a jumping-off point for bedside conversations.

"The great privilege of practicing medicine is that stories occur, stories are told to you just in the course of the day, by happenstance, without any effort in chasing anyone down, all day long," he says.

"When you're taking care of the 60-year-old with the scar on her chest, and you ask her if she had TB, the answer is always yes, and the next 10 minutes are spent listening to her account of the train ride down to the sanitarium as a four-year-old, completely baffled by this world, and returning a couple of years later unable to speak the language, finding her family and making their re-acquaintance."

The tough reality of the situation, Patterson says, was that children who lived in communities and came down with TB were allowed to remain at home, so long as they paid their daily visit to the nurse's station to collect their medicine.

But it was impossible to offer the same treatment to nomadic family groups that still lived in igloos, travelled by dog sled and followed the migratory patterns of caribou and seals.

"I think something like a quarter or a third of the kids at one point were evacuated for treatment of tuberculosis. The tuberculosis epidemic in the Arctic played a pivotal role in the definitive de-culturation of the people. It really provoked the movement into the communities," Patterson says.

Countless families moved to communities on the shores of Hudson Bay, such as Chesterfield Inlet, Repulse Bay and Rankin Inlet in order to access treatment without having to send their children away. Others made the migration to find work in northern mines when the caribou became scarce and famine began to decimate the population.

Once they moved off of the land, they almost never went back, Patterson says.

"As a hunter-gatherer your skills start to erode and your dogs become hard to maintain, and you've made a fundamental rupture with your traditions, so it's a very consequential decision."

In tragic irony, Victoria's family doesn't move into town until after she is sent away for treatment. In the blink of an eye, the 10-year-old is diagnosed, put aboard a medical ship and is sent to the south, before her parents even have time to consider the ramifications of the decision. She doesn't return until years later, when the memory of her childhood on the land has faded to nothing more than a glimmer and her family is as strange to her as she is to them.

Though the first separation from her family was shocking and painful, her return to the North years later as a young woman of 16 is almost cataclysmic. She is forced to break strong bonds with friends, her first love, and a woman who has become like a mother to her, in order to return to a home, a family and a way of life she no longer knows.

"Consumption" is her story, filled with brooding storm-filled skies, vast panoramas, cold ocean seascapes, and a mental journey that traverses equally diverse geography as the reader looks out at the world through Victoria's eyes.

After the image of her childhood is established the scene changes. It jumps forward to the point when Victoria has married a foreigner, a Hudson's Bay Company man, and lives with him and their children in Rankin Inlet, the same small northern community as her parents.

Their life is a microcosm of the contradictions that exist in the North, where tradition battles with modernization. Her daughters are obsessed with Western pop culture and the music of Madonna, while her son seeks to return to the simpler ways of the past, hunting on the land and pining for the lifestyle his father and grandfather once lived.

Their home itself is another contradiction: two worlds colliding in their barge-delivered house filled with a mixture of store-bought items like boxed-cereals, alongside traditional seal and caribou meats.

Patterson wraps these elements up with love, passion, betrayal, the pain of the past and violence, in a gripping novel that shows how seemingly well-established bonds can shatter like thin ice when put under pressure. But also how, like the Inuit people themselves, the survivors can find the strength to pick up and carry on.

One of the most refreshing features of this story is the lack of social commentary buried in the plot, despite the plethora of opportunity to inspire guilt or expose historical wrongdoing. Instead, Patterson said his purpose was to do what any good piece of fiction should.

"It's a novel, and novels only have one job, and that's to break your heart," Patterson says. "Novels with agendas and messages are frequently bad novels, and certainly the more undisguised and obvious those agendas are, generally, the worse the novel is. So I want the reader to be moved and I want the reader's heart to be broken."

However, through the course of the book, and the years he has been connected to the Arctic, Patterson admits he has developed some ideas he wants to pass on, and Victoria's story provides the framework to do that.

"I think the path to telling the story involved trying to create some insight into the fact that when Western culture exports its pathologies to indigenous peoples, pathologies are usually amplified.

He lists the obvious examples, like smallpox and tuberculosis, suicide and alcoholism. But he adds to this social pathologies such as the disarray of families, the rise of obesity and disengagement between people and the land, noting that they have also shown up in dramatic ways in the North.

"So really I think the novel is not really about the problems of the Inuit, but it's about our problems, the problems of Western culture, viewed through the lens of the Inuit, because I think when you do that you de-familiarize our culture a little bit."

"If I have an ambition it gets back to this idea that I would like people to stop looking at and feeling sorry for and guilty about the problems of the Inuit and the problems of the First Nations people and start understanding that these are our problems, that these are the problems of our society, and it's not just that we have a responsibility for them, they are us and we are us and we are them and the reason they're sick is because they're like us and if we're honest, we're sick in exactly the same ways."

The ruggedness and intensity of the Arctic is one of the features that drew Patterson there in the first place.

And he's setting out on his next adventure for similar reasons -- travelling to Afghanistan for a stint practice medicine with the Canadian military -- treating some of the people who have the least, need the most, and live in one of the harshest parts of the world.

"There's an intensity I think, yeah. There's nothing soporific about the Arctic, there's nothing numbing about it. The Arctic peels away all your covered-up nerve endings and exposes them, and I imagine that kind of starkness exists just as intensely in Afghanistan."

Patterson grew up in Manitoba, and now lives on Saltspring Island in British Columbia. His first book, a memoir called "The Water in Between", was a Globe Best Book and an international bestseller. "Country of Cold", his debut short fiction collection, won the Rogers Writers' Trust Fiction Prize in 2003, as well as the inaugural City of Victoria Butler Book Prize.

Excerpt from "Consumption" by Kevin Patterson

Eskimo Poetry

Here I stand,

Humble, with outstretched arms.

For the spirit of the air

Lets glorious food sink down to me.

Here I stand

Surrounded with great joy.

And this time it was an old dog seal

Starting to blow through his blowing hole.

I, little man,

Stood upright above it,

And with excitement became

Quite long of body,

Until I drove my harpoon in the beast

And tethered it to

My harpoon line!

-Recorded and translated from the Inuktitut by Danish ethno¬grapher and explorer Knud Rasmussen in Report of the Fifth Thule Expedition, 1921¬24

One

Storms are sex. They exist alongside and are indifferent to words and description and dissection. It had been blizzarding for five days and Victoria had no words to describe her restlessness. Motion everywhere, even the floors vibrated, and such motion as was impossible to ignore, just as it was impossible not to notice the squeaking walls, the relentless shuddering of the wind. Robertson was in Yellow knife, and she and the kids had been stuck in this rattling house for almost a week, the tundra trying to get inside, snow drifting higher than the windows, and everyone in the house longing to be outside.

It was morning, again, and she was awake and so were the kids, but they had all stayed in bed and listened to the walls shake. Nine, or something like that, and still perfectly black. She had been dreaming that she had been having sex with Robertson. She was glad she had woken up. Even the unreal picture of it had left her feeling alarmed-though that eased as the image of the two of them, entwined, had faded. In another conscious moment she was able to blink the topic away and out of her thoughts. As it had been.

She could hear her girls, Marie and Justine, whispering to each other in their bedroom. She couldn't tell what they were saying. She heard the word potato. Pauloosie, her son, her oldest child, was silent. She listened carefully and thought she could hear him turning in his bed. And then the wind wound up and just howled.

As a girl she had not been this restless, waiting out storms with her parents on the land in a little iglu, drinking sweet tea and lying on caribou skins. It had been more dangerous then but less frightening. Storms make an iglu feel more substantial somehow. This house, on the other hand, felt as if it were about to become airborne, and it would have if not for the bolts tethering it to its pilings. It had been made in Montreal, of particleboard and aluminum siding, before being shipped by barge to Hudson Bay, sagging from square with each surge of the sea. Where the door frame gapped away from the kitchen door, snow sprayed through in parabolas. These wee drifts persisted as long as the door stayed closed. After five days they seemed as permanent as furniture. The wind whistling under the house kept the kitchen floor nearly as cold as the stone beneath it.

That stone slid, in its turn, through the town, to the shore, and then under the ice of Hudson Bay, angling shallowly out into the sea basin like a knife slipping between skin and meat. And on top of that water was ice, a quarter-million square miles of it, arid and flat and sucking in the frigid air from the High Arctic like a bellows-blowing it down through Rankin Inlet and into the rest of the unmindful continent. Chicago would be Rome but for this frozen ocean, not that its significance is known to anyone who doesn't live alongside it.

Rankin Inlet, Repulse Bay, Baker Lake, Coral Harbour, Whale Cove: variations on the theme of shelter from the sea, each of these hamlets lies on the west coast of Hudson Bay, named by whalers seeking safety in the nineteenth century. The smallest is a couple hundred people and the largest of these, Rankin Inlet, is two thousand, almost all Inuit, with a handful of southerners, Kablunauks, among them.

The people exist along this coast against a backdrop of a half-million square miles of tundra, gently rolling treeless plains. In the summer, this land is boggy and moss-bound; in the winter-frozen and blasted lowlands: eskers of rock protruding through shallow snow. The Inuit lived here for ten thousand years, pulling their living from this meagre forage until the 1960s, when they accreted in the little government towns built along the coast and left the tundra empty of human inhabitants for the first time since the glacial ice melted.

Victoria and Robertson had been married a year when Robertson paid to have this house shipped here, for his new family to live in. It was twice the size of the housing department shacks offered to the rest of the community; this benefit of marrying a Kablunauk had been observed and remarked upon in Victoria's presence since the house had floated its way to the bay at the edge of the town. The other young families were crowded into the back rooms of their relatives' cramped houses, and privacy such as Victoria knew was held to be an uncommon luxury.

Robertson was not from here, and so no toothless and snuff-spitting aunts had been assigned to their family. The drawbacks of marrying a Hudson's Bay Company man had been explored by dozens of women in the town, but this single advantage held. She lay in her bed now and listened to her daughters squealing and whispering and calling out to each other. This was an intimacy, she thought, that could never be available to a family who shared its house with another. She was lucky, at least on that score. But then, she thought, there might be a different kind of intimacy available to the cousins and brothers who had grown up unencumbered by the rind of privacy.

She was thinking about that when the banging at the kitchen door began. Victoria thought the door had become unfastened, and she leapt out of bed to close it before it was torn from its hinges.

Excerpted from Consumption by Kevin Patterson Copyright © 2006 by Kevin Patterson. Excerpted by permission of Random House Canada, a division of Random House of Canada Limited. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.