Icebreakers

Bethel is starting to freeze over.  I snagged this shot of water under the boardwalk on my evening run.  I thought it looked nice and peaceful.  Then I came in to work this morning to hear a tale that made me shake in my clogs and think differently about the rapidly freezing rivers in these parts.

Let me start from the beginning.  As a ward doctor, every other night I am "on call".  Now, there is a night float doctor at the hospital from 6 pm until 8 am who takes all calls, admissions, ob triage and laboring patients, and RMT calls.  The only reason I would be paged in the middle of the night would be to go on a medevac for an ob patient (the EMTs don't need doc escorts for regular medical patients needing to be flown in at night, only ob patients).  The only ob patients who need to come in this way are pretermers, as all ob patients have to be in Bethel at 36 weeks (they all stay in a dorm together until they deliver).  And if a woman decides not to come to Bethel by her "be in Bethel date" at 36 weeks, then she has to deliver in the village.

I of course know these rules of the game here.  Yet, I'd always pushed it out of my head since I've never been paged in the middle of the night and like to delude myself into thinking that this sort of thing ever happens.  But people, this is Bethel.  Everything happens here.  Often.  It's just a matter of time.

Last night, my fellow ward doctor (a local doc who has been doing this gig for over 15 years, and is therefore worlds more prepared/appropriate for the job of midnight medevac to a village than I am) was paged to board the medevac to get a 27 weeker in labor.  The on call pediatrician also comes along for the ride for baby resuscitation purposes (thankfully).

Both the pediatrician and my fellow family doctor giddily (lack of sleep and sub zero temps will do that I suppose) told me their tale.  Apparently, the airport (more like strip of flat land where the medevac can land) in the village is on the other side of the river from the clinic.  After getting off the plane, the two docs and the EMTs on board had to board a boat (captained by a local villager just helping out and his son holding a torch at the front of the boat to see in the pitch blackness) to cross the river (which sounded more like a 10 min boat ride up river then just ferrying across).  Now, this would not be so exciting were it not for the fact that the river has started to freeze.  So before starting their boat ride, they had to help break up the ice.  Then it was discovered that they were one life jacket short (uhhh, Titanic anyone??).  They managed to traverse the river safely, then had to get on an ATV pulling a sled (for the patient - a stretcher of sorts) that brought them to the clinic.

Luckily, once they arrived, delivery was not imminent.  The pediatrician told me she's had plenty of village visits where the premie is born there and the logistics of getting the incubator on an ATV and into the boat, then on a plane are mind-boggling.  What usually has to be done is the baby has to go skin to skin with the doc, under the doc's parka, on the ATV, then the boat, then plane.

This particular patient was able to be transported via the sled, with baby in utero, who thankfully stayed put there in time to get on a morning flight to Anchorage.

The family and peds docs said aside from fleeting thoughts of drowning in a semi frozen river on route to possible medical badness, the adventure was nothing short of fantastic and picturesque.  Apparently the crisp, cloudless sky was strewn with enough stars to make you catch your breath.

I am more than relieved to be relaying this tale second-hand.  I sit here, though, tremulously watching my pager sitting oh so innocently next to me, knowing full well my time is coming.