Saturday, June 02, 2007

Bush Pilots – One of the Seven Wonders of Canada

Our national radio, the Canadian Brodcasting Corporation, is having a contest to select the seven wonders of Canada. There is talk about having a human wonder. One listener suggests that bush pilots are as quintessentially Canadian as it gets, so interviews are arranged with a couple of bush pilots who speak about mining exploration and air lifting sportmen to remote northern camps. This is one of my stories.

Grenfell's bright red Turbo Beaver, referred to in Labrador by its call numbers, CF-OEL, or just OEL shuttles back and forth between the base hospital in North West River in the south and the six aboriginal communities on the edge of the Labrador sea, moving patients, supplies and staff. CF-OEL and indeed most planes on the coast use the sea ice as a landing strip in winter and open water in summer. Annual periods of Break Up and Freeze Up bracket the long winter as times when travel in and out of the communities if possible is difficult.

During Break Up, the ice isn't thick enough for a plane to land on its skis and there is not enough open water for the Beaver to switch to pontoons. Most of us when we can hunker down and wait for it to pass. But Break Up can extend up to six weeks so bush pilots have to be knowledgeable and experienced in the many factors that affect travel during that time.

As the traveling doctor on the north Labrador coast in the early eighties, I was waiting one Saturday to be picked up in the hamlet of Makkovik, about midway up the coast and returned to my home further north in the Inuit community of Nain. A nurse calls me from the Hopedale nursing station, which was on our route to Nain, about a woman had just come in with abdominal pain but not much tenderness. It is break up and the nurse doesn't think it is anything serious but since the plane is on the coast and there is a seat and just to be sure.... I think, but don't say, and because it is the weekend.

I ask the nurse to finish getting the woman’s vitals; the blood pressure, pulse, temperature and hemoglobin. As Hopedale’s radio phone isn't working, I offer to call the pilot and arrange for us to pick her up on our way north.

Coming into Hopedale, our pilot, Tony, flys low to buzz the nursing station, letting them know we have arrived. CF-OEL drops down about a mile from the Hopedale nursing station where the ice is a bit thicker. Before the plane has come to a halt, John, Hopedale’s maintenance man, is out on the ice racing towards us on his skidoo, pulling a komatik (sled) in which our patient, Salome, sits in a wooden box.

It is a beautiful, clear sunny day as we take off from Hopedale with Salome, who will travel to Nain with me and the two women who are being returned home before the plane heads back to North West River. From my window, the view takes in the mountains behind Hopedale, the sea ice to the east and the community nestled on the sea edge. It is a fine day for having tea in the country, what is called a boil-up on the coast. We can make out several groups on skidoos moving out from the community below us. As I turn from the window, I notice Salome making odd movements with her fingers as if to catch something in the air. She seems oblivious to the rest of us. When I call her name, she doesn't respond. I extract from her parka pocket, the brown envelope containing the medical referral letter written by the nurse, to see if there is any further info on her. Salome's vitals haven't been recorded. Abdominal pain is all her notes say.

Salome continues to pluck at the air in front of her. What is going on? She had climbed into the plane without assistance. She seemed OK. By this time we had reached altitude and the plane isn't pressurized, so I wonder if she is short of oxygen. But why? What is going on? The interior of the plane is cold and crowded and we are all in parkas, so an examination is not possible.

I unbuckle my seat belt and move up to the cockpit. Tony slides the earphone off on one side of his head.

“How long to Nain,” I hollar over the roar of the engine, knowing full well it is too long since we have just reached altitude outside of Hopedale.

“About 45 minutes,” he responds.

“Then we have to go back down.”

“Back to Hopedale?” he queries in surprise, as if I have really lost it.

His eyes follow my backward glance to Salome who is still picking at the air distractedly. I don't even know what to say to him.

“Yes”, I nod, not sure what Hopedale holds in store for any of us. Since the radio is down, we can't even let them know we are coming back. We might end up sitting on the ice for a very long time.

Tony flies in low over the nursing station roof, buzzing them in the hopes that someone will hear the plane return and respond. We set down not far from the spot we had just left.

For the second time, John comes racing across the ice, the komatik swinging wildly from side to side behind the skidoo. By the time he reaches the plane, I have written up a list of what we need--oxygen, IVs, cannulas, and antibiotics, a stretcher, BP cuff and blankets.

"Are any of the nurses still in the station?" I ask, as I hand him the list. Hopedale has two nurses, but the one who referred Salome has already gone off.

John tells me that Anne is around, so I request that he ask her to help, thinking he will need help finding all the stuff on my list.

“We have only twenty-five minutes on this ice”, Tony warns John and me, checking his watch.
"The ice can’t hold the plane any longer so we will have to take off whether we are done or not."

While John tears off on the skidoo to collect the equipment needed, I try to examine Salome sitting up her in her parka without much success. At least she is breathing better and seems stable on the ground. I explain to her that we will have her sit up in a stretcher, start an IV and give her oxygen. I am not sure if she understands but she nods. But why is she short of breath in the air? What is going on? Is she bleeding? Does she have a fulminating infection somewhere? When was her last period?

In fifteen minutes John is back with Anne. Together we put in the IV and settle Salome onto the stretcher with oxygen. I open up the IV and start antibiotics. The blankets and pillows have been soaked by the snow flying in over the sides of the box, so John is sent back to get dry ones. He packs them in green plastic garbage bags so they don’t get wet in the komatik this time.

“Forget Nain" I tell Tony. "We will have to go back south to the hospital in Goose Bay where there is a surgeon. She has an acute abdomen and is in shock. Can you try to get an ambulance to meet us and ask them to notify the surgeon? Tell them It’s an emergency.”

"Sure," responds Tony, "No problem".

We are just finishing up, putting the pillows and blankets in place when Tony gives us the five minute warning. In the bustle I have forgotten completely about the two other passengers who were returning to Nain on the plane with us. They have been standing all this time quietly on the ice beside the plane in the sun where it is slightly warmer.

“Do they want to go back with us to Goose Bay or do they want to stay here?” I ask. This is translated by John and the women opt to stay in the community where they have relatives. Such arrangements don't always work out so Anne agrees to check later to be sure they find a suitable place to stay and if not to put them up in the nursing station. It's Break Up so we don't know when the plane may be back this way.

It’s a 4 hour flight back to Goose Bay and we arrive after dark. Tony has made radio contact once we are out of Hopedale and there is an ambulance waiting for us on the air strip in Goose Bay, blood is on hand and the Australian surgeon is standing by in the OR waiting for us. Within fifteen minutes Salome is out of the plane and in the OR.

She has almost exsanguinated from an ectopic pregnancy, traveled by single engine bush plane from Hopedale on the north Labrador coast and miraculously survived. As a result of emergency surgery, 6 litres of blood and the skilled efforts of bush pilot, she will be able to return home to her four children within a few days.

For our pilot, Tony, it was just another day. Lives were at stake and bush pilots are trained to take calculated risks. He navigated around the challenges of spring break up in the north, failure of the radio phone in Hopedale, dramatic turnarounds in destination and schedule with the attendant calculations of fuel and coordinates and has delivered us all safely, after dark, flying with visual flight instruments alone.

Bush pilots opened the Canadian north. Bush pilots linked isolated aboriginal communities to much needed medical services and ferried supplies, people and services to inaccessible outports. Bush pilots provided the glue that linked remote communities on the Labrador coast with the outside world. Bush pilots are the quintessential human wonders of Canada.

Photos: Hopedale, CF-OEL, Hopedale ambulance, CF-OEL in Hamilton Inlet, Nain from the air.



Blogger The Tundra PA said...

And how about the attentive physician who noticed subtle signs of a serious problem that could easily have been missed or dismissed as insignificant, and then made exactly the right call to get the patient the care she needed, without which she would have died? Certainly, the bush pilot's skill was crucial in saving her life. So was the physician's. Good work, Traveling Doc!

12:29 PM  
Blogger Shinga said...

I like the whole notion of having human wonders of the world.

Another thought-provoking piece.

Regards - Shinga

6:53 AM  
Anonymous Dean Moyer said...

This is my first visit to your blog. Excellent story. Very well written. Three cheers for the bush pilot and the Traveling Doc!

I'm looking forward to reading more.

11:52 AM  
Blogger Borneo Breezes said...

Thanks all for the comments and sorry I don't get in to respond quickly. Tundra -- I am liking your wonderful recent pieces- reminds me about botulism. Shinga -- your encouragement has kept the pediatric rounds going and alive and many of us are so happy about that.

Dean welcome and nice to have a first time visitor.

1:42 PM  
Anonymous thestoryofhealing said...

This is a wonderful blog piece. This is my first time to read you.

9:33 PM  
Anonymous Mary S said...

I was sooo interested to read your blog about Hopedale...especially as I was a nurse in Nain 1986-1988.
It took me back to the days of snow and ice.
Thank you so much.

12:08 PM  

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