Sunday, April 15, 2007

The day we'll all never forget

Susan and Marcus are very different people.

They’re different ages, they have different hobbies, and live in different cities.

They have likely never met each other before, and they probably never will.

But today, suddenly, they both had a few things in common.

They both woke up thinking it was going to be like any other normal day. They both soon realized how wrong that was – instead, they both had a day they’ll never forget.

As well, they both sat inside an air ambulance beside a first-year medical student as they were airlifted to a downtown hospital.

That’s right, I finally had another chance to shadow air paramedics again, and this time, it was unbelievable. We took calls from the moment we began our shift until the very end. It more than made up for the last time I shadowed, which involved sitting in the station for twelve hours straight and was just about as exciting as watching the Montreal Canadiens stumbling attempts to set up a defensive hockey play.

Susan woke up with the back pain that she had felt since New Year’s, but for some reason today it just wouldn’t go away. She took some more of her prescription pain meds. Nothing. More pills. Nothing. “Honey,” she said to her husband, “can you drive me to the hospital?” The nurses there realized quickly that no matter what they threw at Susan, her pain wasn’t going away. They checked on her throughout the morning, and faithfully charted her pain levels: six out of ten…9/10…8/10…20/10, defying the constellation of pain medications that were being pumped pretty much non-stop into the veins in her arm. When the doctor came to see Susan, he thought she could be suffering from a crushed vertebrae, a tumour pressing on a nerve in her mediastinum, or perhaps even the rare possibility of an aortic aneurism or dissection. It was past time for Susan to get some medical imaging done. In the big smoke, no big deal. Out here, though, well…impossible. In a rural centre like this, a CT scan wasn’t an option. Susan had to be sent somewhere where it was. The doctor picked up the phone and called for a helicopter, and we came and took her to the imaging machine that so many people, unlike Susan, have such ready access to. I felt bad as the paramedics resisted Susan’s husband as he begged to join her on the helicopter. I knew I was taking his seat.

Marcus woke up sad that the first camping trip of the summer, an early one, was coming to an end. The weekend had been perfect – great fishing, canoeing, beer drinking and quality time with his four best friends in the whole world - they’d grown up together, and did everything together. As they were driving home together, though, the driver lost control, destroyed a van carrying a young family, flipped over and over and ended up in a ravine. Three of his friends joined two little girls in the minivan who went straight up to heaven the instant the vehicles hit. When the ambulance got there, they paged the helicopter right away, as well as the community’s only trauma doc, a board-certified general practitioner and an experience-certified specialist in everything. The doctor struggled to get Marcus intubated as the ambulance raced to the soccer field at the edge of town, where a police officer had put out some orange pylons to set up a crude landing site, and radioed the coordinates to the incoming helicopter. We touched down, blowing over the little pylons, and quickly got the patient transferred into the chopper.

As the helicopter blades sliced through the air and we quickly gained altitude, I looked out the window and watched the two fire trucks and two ambulances, representing most of this small town’s emergency resources, form a convoy back into the town. The smell of the patient’s vomit quickly filled the back of the helicopter. The paramedics worked to start an IV and keep his vitals stable, and when we finally landed, we went from the helipad down the elevator to the emergency room where I watched the waiting trauma team spring into action. The flight paramedic called out the details of the crash, then the resident went through a full-body assessment of the naked victim, surrounded by a respiratory therapist setting up the ventilator, the X-ray techs setting up films, a lab tech taking blood, a medical student ogling, an attending doctor overseeing, a nurse hooking up monitors, and another nurse writing down the details the doctors shouted out.
I stood, my back against the wall, for the first time realizing what “fingers and tubes in every orifice” actually meant as a foley went in, a doctor checked for bleeding from the ears and prostate, and vomit and air fought for the right to use the mouth or nose as an entry and exit point. The last I saw of the patient was when they took him to get his head CTd, apparently something doctors like to do when the side of the head looks like a giant bruise and feels like mush.

These were just two of the cases that I saw first hand today. Overall, we flew four separate patients – two transfers, two traumas – went to five hospitals, worked two hours extra beyond what should have been a 12-hour shift, and spent more than four hours in flight. For me, it was a dream come true. All the money in the world couldn’t have bought a non-stop action-packed day like that. The experience was outstanding, the paramedics were so hospitable and so glad to have me join them. It was a day I would never forget, and I’m going to spend a some time this summer once school settles down not only accepting the paramedic’s invitation to come back, but also looking for places in North America that train and hire helicopter physicians.

As fantastic as an experience as I had, it was bittersweet. Sitting right beside these patients whose lives have been immeasurably affected was sobering. It’s likely that two – possibly all four – of the patients I met today will be dead within a week. Even if they make it, though, today will be a day they’ll never forget, either.


Couz said...

Dude. I can't believe you dissed the Habs.

Anonymous said...

High-five for needless Habs bashing.

Philosophy needs emergency helicopters.

Pseudo_Doctor said...

great job on describing your day shadowing these guys...didnt even know there was a job for an helicopter physicians, interesting....

Anonymous said...

Just be careful about actually considering a career on a helicopter. They have VERY bad track records for accidents and deaths. I mean, VERY VERY bad track records. BC Ambulance doesn't seem to be as bad, but talk to some people in the US about how often these birds go down.