Sunday, November 6, 2011

An Unexpected Test--Part III

And then I remembered…I was supposed to phone Paul when I got down. What if he heard about the rescue or saw the helicopter and thought it was me. He knew I was heading up alone…and my bike! (Now I know it might sound like a crass thought to have in an emergency but that bike is worth more than my car and heaven knows I’d never be able to afford a replacement.)

I asked one of Tina’s friends to take over c-spine for me while I called Paul and checked on Maggie again. Paul was stunned when I told him the situation, and said he had started to wonder what had happened to me. He offered to help in any way he could. I wasn’t sure how long the elderly Irishman was going to be selling walking sticks and watching my bike, so I asked Paul if he’d pick it up for me and then collect me later once the ordeal was over. He was happy to do so and I could breathe a little easier.

I resumed my post after a short jog on unsteady legs in an effort to get my body temperature up again. Tina was oscillating between drowsy silence and angry outbursts directed at the cold. We were all starting to shiver. I couldn’t remember a time when I’d been that cold. I’ve been outside during winter in the Arctic circle but I was always appropriately dressed for that. My cold sweat and thin jacket were a bad combination and at times my hands and body started shaking to the point where I wondered how effective my c-spine stabilization was.

Finally we heard the reassuring buzz of the approaching helicopter. The fog was so thick that only the sound alerted us to its descent nearby. Tina began to cry out with relief. Our huddle, which consisted of Father Henry, two teens, the Swiss couple, and myself, looked around at each other with relief on our faces. Relief that soon turned to concern as we heard the noise change and then grow quieter and quieter. Tina soon realized the helicopter was gone and started to cry.

Twice more our rescuers tried to land unsuccessfully. Each time our hopes rose with the crescendo of its approach and fell further as it drifted away again. I was getting genuinely worried now about hypothermia, for all of us. How cold did it have to get before the injured ones really started getting into trouble? Our little circle got tighter and tighter. After the helicopters 3rd failed attempt to land, another hiker coming down the mountain stopped to offer help. She immediately started pulling out extra pieces of clothing, hot coffee, and chocolate. She threw an extra coat over my shoulders and then sat behind me rubbing my back and arms in an effort to stop the shakes which were starting to take intermittent control of my body. As she pressed up against me she said, “I know I am getting into your personal space here, if I am annoying just tell me to go, but you really look like you need warming up…” I told her she was the farthest thing from annoying and that I was extremely grateful for the warmth she brought down with her.

Finally, the helicopter was able to drop a rescuer down nearby. Keith was a tall, stocky flight paramedic and he had with him two large bags filled with emergency medical supplies and outdoor protection gear. I gave him the best report I could from my initial surveys, and helped place a collar on Tina. We were able to wrap her in a thick, warm, bright orange emergency sack.  Soon many other rescuers were on the scene. I didn’t ever find out if they had arrived on foot or along with Keith when he was dropped off.  Someone, who I think was a doctor taking direction from Keith, took over c-spine. I asked the Swiss guy to pull my bent leg straight for me so I could stand.  My leg muscles had seized up and fallen asleep during the nearly three hours that I’d stayed almost motionless. It was a strange combination of sensations as I tried to negotiate the rocky terrain over to Maggie and the swarm of rescuers who surrounded her.  I knew the patients were in good hands and I suddenly felt like a supernumerary gawker. Where had all those bystanders come from? I approached Keith and told him I was planning to head down. He offered to give me a lift in the helicopter to the hospital. I thought for a moment how much I would love a spin down in the whirly bird but I felt like I needed to go sooner rather than later. He didn’t know how long the refueling would take and I didn’t know how much longer I could stay on the rocks. Not to mention that I’d long ago called Paul and told him ‘the helicopter is landing’ and then forgotten to update him with ‘and now it is gone’. He’d probably been waiting at the bottom for well over an hour.

I said goodbye to the rag-tag gang who I’d spent the afternoon with, wished the patients my best, and gave Keith my contact information.  Leaving the scene I took one last look at Maggie, getting rolled into the bright orange rescue blankets. The bruising on her face had started to look like raccoon eyes and I stiffened with the thought that maybe she did have a skull fracture after all…and that I hadn’t observed her close enough.  My next thought of course, was what could I have done differently if she was a skull fracture?

I started running down the mountain.

It felt so good to get moving again. My legs were rubbery and sore. Soon my body temperature started rising and the sweat started pouring. By the time I reached the bottom I was pulling off the extra layers and soaked again. I pulled open the door to the café at the bottom and spotted Paul reading at a table near the window. The teapot in front of him was empty. I sat down and began a litany of apologies for my lack of communication and keeping him waiting. He too apologized for the crazy afternoon of training that turned into a rescue off the mountain. He got up to buy me some tea and I went to the bathroom to wash my hands and face.

I looked like I’d been through the wars. Clothes damp from fog and perspiration, hair and eyes wild from the wind, lip cracked from nervous chewing. My attempts to make myself presentable to the café crowd were futile. I dried my face and hands with some toilet paper and went out to enjoy the hot tea and padded chair.


That evening, while I was driving home, Keith called to tell me they’d successfully airlifted one patient after the other, off Croagh Patrick. Maggie had gone second, and they’d left with her just after 1730h. He said both were stable and expected to do well. I thanked him for the call.

The next day Father Henry called me to say that Maggie had been released with a few stitches, and that Tina was expected to go home the next day. She had no broken bones, just a bad sprain, concussion, and a few head and facial cuts that required stitches. He thanked me profusely for my help. I felt somewhat sheepish because I didn’t really feel like I had done anything except stay with them. He told me that just being there and my reassurance that they weren’t doing anything to make the situation worse had been invaluable and extremely helpful.   

Two days ago I received a series of text messages from Tina, thanking me for my help, telling me how scared she was, and how she had been convinced that she was going to die.

I was very touched by the fact that all three people had endeavored to make contact with me and that they were so appreciative. It didn’t change the fact that I had felt helpless and useless during most of that afternoon on the mountain. But it was nice to think that in their eyes I’d made a difference.

I’d spent the 4h drive home going over the scenario in my head and thinking about all of the things that I should have done differently. I berated myself for things like not having thought of getting both of them off the cold ground right away, and not showing one of the people in Maggie’s group how to hold c-spine. All told, it was a very good learning experience. It showed me the power of reassurance, reminded me of my love for emergency situations, and reiterated the importance of never, ever, going out without a headlamp and an emergency blanket.


Frazzled-Razzle-RN said...

Praise God for both of those people not dying. Thank the Lord you were there trying to keep your cool and helping ease the emotional outbursts of others. You are a gifted caregiver. Thanks for the story of inspiration!

Kitt said...

Wow. Kudos to you. Even if you are second-guessing yourself, you still provided more help and reassurance than anyone else there could. They were very lucky to have you. I'm so glad everyone will be OK.

Anonymous said...

Best blog story I've read in a long time. Strong work on the mountain.

Anonymous said...

Glad to hear everything worked out alright.

And I agree with Father Henry: just showing up and being reassuring has a lot more value than you'd think, especially in a group like that, panic can spread like wlidfire.

Reconsidering ditching ER?

Elizabeth Shouldice said...

What a wonderful story. You never know when you'll be needed. I know for sure that these folks were so lucky to have you there. One for your residency applications!

PGYx said...

Strong work, ABB! You're clearly on the right path!

On a related note, I think berating oneself for things one could/should have done differently/better is universal among medical professionals.

Susan Green said...

Well done really interesting reading. The cold in Ireland is really insidious isn't it, we don't expect it.