A Courageous Doctor

by Alison Roberts

  ‘Fantastic. I’m starting to learn where things are on station and how it all works. We took the four-wheel-drive vehicle up to Coronet Peak to get a skier with a broken leg. We didn’t get to go up in the chair lift, though.’ Maggie’s face creased with disappointment. ‘The mountain rescue team had already retrieved him and the doctor in the first-aid room had splinted the fracture and given him pain relief.’ She looked disgruntled now. ‘We were just a taxi service really. We delivered him to the fixed-wing aircraft for transfer to Invercargill.’

  ‘The ski slopes are pretty well covered for emergencies,’ Hugo nodded. ‘You’ll find a lot of people in the township use the twenty-four-hour emergency cover the medical centre provides as well.’

  ‘Do you do nights there as well?’

  ‘No. I’m employed by the hospital apart from Tuesdays when I have a day at the medical centre. When I’m not needed for medical duties I deal with the administrative side of things. I’m on call at nights for the hospital from Monday to Friday as well. Not that I get called in very often.’

  ‘I’m beginning to suspect I won’t get called very often either.’ Maggie shook her head as she smiled. ‘But, then, I knew I was heading for a quieter workload. I’ve had enough of big-city dramas and feeling exhausted by the end of every shift. The idea of working business hours and still having plenty of time out on the road was very appealing. And there’s lot of other things I can do here.’

  ‘Like what?’

  ‘Like training for the volunteer staff here and in the more remote areas. Improving some of the procedures and updating equipment. I think we can streamline our transfer service to take patients to Invercargill or Dunedin and that will give more people the opportunity to spend time with the emergency side of the service.’

  ‘Won’t the administrative stuff get boring? I find it a bit much at times.’

  ‘I’m hoping I’ll still get a reasonable case load to keep life interesting. Plus, I’ve done helicopter work before so I’ll be available to go out with the chopper crew they contract for rescue work here. That way they won’t have to wait for a GP to come out from the medical centre.’ Maggie gave Hugo an anxious glance. ‘They won’t mind, will they? I don’t want to start treading on toes by taking away an exciting part of their duties.’

  ‘I certainly won’t mind. It’s incredibly disruptive to get called for a helicopter job.’ Hugo grimaced. ‘Not to mention downright scary.’

  ‘Scary can be good,’ Maggie said. ‘It keeps life exciting.’

  ‘Life doesn’t have to be exciting to be good,’ Hugo countered.

  The unspoken reminder of the repercussions of seeking adventure in the past hung between them in a moment of silence. Was Hugo going to take the opportunity to talk about Felicity? Maggie wondered nervously. She poked the food on her plate, her appetite suddenly gone. Hugo’s tone was sombre when he spoke but his words did not invite any conflict.

  ‘Safe can be pretty satisfying as well.’ The glance Maggie received was unreadable. ‘Isn’t it about time you grew out of being so adventurous?’

  Maggie’s smile was tentative. ‘You sound like my mother.’

  ‘And mine,’ Hugo had to admit ruefully.

  ‘And I am settling down,’ Maggie added softly. ‘I’ve come here, haven’t I? I’m going to try a more peaceful lifestyle.’

  ‘Hmm.’ Hugo was unconvinced. ‘That remains to be seen, doesn’t it?’ The look in his eyes was one Maggie remembered well. Stern but affectionate. She held his gaze as she smiled back at him.

  ‘Watch this space.’

  CHAPTER FOUR

  MAYBE safe would be satisfying after all.

  The helicopter was flying low due to the bank of cloud threatening to dump a fluffy new layer of snow onto the peaks towering behind them. Maggie could see the ripples on the lake beneath, caused by the current the helicopter rotors generated, and she could almost make out the startled expressions on faces peering from the deck of the old steamship below. Maggie leaned forward in her seat to snatch another glimpse of the vessel.

  ‘What a cool boat!’

  ‘That’s the TSS Earnslaw.’ The voice of Graham Burgess, the pilot, crackled through the headphones built into Maggie’s helmet. ‘She’s been steaming around Lake Wakatipu for more than seventy years. Does a nice dinner cruise.’

  ‘I’ll put that on my list.’ Maggie sat back and tried to relax, letting the safety belt she was wearing take her weight as the helicopter turned sharply and left the flat expanse of the lake behind. The ride became rougher, which seemed appropriate given the wild terrain they were now flying over. And it would probably get worse.

  ‘What’s the weather going to do?’

  ‘Should hold for an hour or so.’

  ‘That’s good.’

  Maggie succeeded in hiding her nervousness. She hadn’t worked with this crew before. Or in the kind of untamed wilderness offered by the bush-covered slopes beneath them. It had been a long time since she’d done any helicopter work at all, especially a winch job. Why had she remembered the adrenaline rush and excitement of such work and forgotten how mind-blowingly scary it could also be?

  And why had she been so eager to make her qualifications known to the team who manned the helicopter service when needed? The fact that her duties had been comparatively light for the first couple of weeks wasn’t really enough of a reason. Mind you, talking to the crew hadn’t prepared her for having her first call-out so soon and the excitement of having a break in a day of mostly administrative duties had worn off now.

  ‘It’s lucky we’ve got you in the area.’ The co-pilot, Sam, must have caught the direction Maggie’s thoughts had taken. ‘We haven’t had anyone trained in winch procedures until now. With the city choppers unavailable, this guy would have had to be stretchered out to a landing site and, by the sound of it, he wouldn’t have lasted that long.’

  ‘It doesn’t sound good,’ Maggie agreed. The call was for a gunshot wound to the chest, and the potential injuries had been ticking over in the back of her mind ever since she had been contacted. It was difficult to know what she’d be facing. A direct wound to any major arteries near the heart would have killed the victim swiftly. Lung tissue was relatively tolerant of a projectile injury but rib fractures with an associated pneumothorax would be high on her list of suspicions. A lot depended on whether the victim had been breathing in or out when the bullet had struck. If a bullet entered the lower chest during exhalation when the diaphragm was relaxed it was quite likely to cause an abdominal injury. Her patient could be bleeding out through a major injury to his liver or spleen. Whatever the possibilities, it was highly likely to be serious. Maggie shook her head slightly.

  ‘How often do deer hunters fail to identify their targets and shoot each other instead?’

  ‘Too often,’ Sam grunted. ‘Especially with the international, recreational hunters that get choppered into remote areas. They’ve got no experience of terrain like this and common sense goes out the window with the prospect of scoring a stag.’

  Maggie’s common sense was gathering with disturbing strength as the helicopter dropped and then tipped, following the precipitous mountain face. The spray from a spectacular waterfall billowed towards them. She had to be crazy, doing things like this for a living.

  ‘That’s the Homer tunnel to our right,’ Graham informed Maggie.

  Maggie spotted the narrow snake of road disappearing into the side of a mountain and then she looked up again. She had already lost count of the waterfalls, with their white foam brilliant against the dark grey of the rock faces and the deep green of the bush enveloping the slopes.

  ‘And this is the head of the Milford Sound coming up,’ Sam pointed out a short time later. ‘Been here before?’

  ‘No.’

  ‘It’s supposed to be the eighth wonder of the world.’

  Maggie simply nodded. The water of the sea beneath was so dark it appeared black. With the mountains crowding in to the sides and,
above them, the impenetrable-looking bush and the glowering bank of cloud as a ceiling, the overall effect was awe-inspiring but vaguely threatening. The helicopter was slowing now and losing height as it turned towards a valley.

  ‘We’re heading north again, now, into the Pembroke Wilderness area. Should reach our target in a minute or two.’

  ‘Roger.’ Maggie took a very deep breath. Sam was a trained winch operator and Graham a pilot of many years’ experience. It was time to step into her role as a helicopter paramedic and do this job without being distracted by any fears for her personal safety. It was an easy role to assume as they closed in on a target area that had been relayed with reasonable accuracy. The flare the victim’s companions had been instructed to set off pinpointed the area of bush-covered slope even more precisely.

  ‘Target sighted.’ Graham sounded satisfied. ‘Three hundred metres, nine o’clock. Turning downwind.’

  ‘Roger.’ Sam was peering through the Perspex panel of the side door. ‘I see them.’

  Maggie paused in her task of checking the contents of the trauma pack. She strained to catch sight of the target but could see nothing but the canopy of trees. Sam was reaching for the winch control panel.

  ‘Checking power,’ he advised.

  ‘Turning base leg,’ Graham responded.

  Maggie shut her eyes for a split second. These guys knew what they were doing.

  ‘Final two hundred metres to run.’

  ‘Roger.’

  ‘Speed back. Clear door,’ Graham instructed.

  Sam pushed the door open as the helicopter slowed again. ‘Door back and locked,’ he announced. ‘Hook coming in.’

  There was no time to think of anything other than adhering strictly to procedure now. Maggie clutched the large hook and fumbled a little as she attached it to her harness.

  ‘Check your pit pin,’ Sam ordered. ‘And then release your safety belt.’

  ‘One fifty metres,’ Graham told them.

  ‘Ready, Maggie?’ Sam’s gaze was steady but Maggie could detect an underlying concern. Her ability to do this job was as untested for them as their skills were for her. She could put them all in considerable danger if she wasn’t competent. Her nod was decisive and Sam’s face relaxed fractionally. ‘Moving to door,’ he said tersely. ‘Clear skids.’

  Maggie moved carefully, turning to face into the helicopter as she found her footing on the narrow skids. Sam faced in the opposite direction, leaning out to keep the target in sight. ‘Eighty metres,’ he reported. ‘Seventy…Clear to boom out.’

  ‘Clear,’ the pilot advised.

  Maggie stepped off the relative safety of the skids. Her stomach lurched as the harness took her weight and her legs dangled in the air. Sam attached the lightweight stretcher and the trauma pack to an extension on the winch hook.

  ‘Booming out,’ Sam said calmly. He was still calculating the distance to the target. ‘Minus forty…thirty-five…Clear to winch out.’

  ‘Clear.’

  Maggie was staring down as she steadied the stretcher and pack between her legs. The trees were too close together for comfort but there was enough space for a talented pilot and winch operator to get her safely to the ground provided the weather conditions co-operated. The helicopter was hovering now and Maggie was unperturbed by the fact she was now spinning in a slow circle herself.

  ‘I’ll keep you clear of the trees.’ Sam’s voice came through her helmet clearly as she felt herself being lowered. ‘What’s your distance, Maggie?’

  Her legs had just gone below the level of surrounding treetops. ‘Forty feet or so,’ she told Sam. She kept watching, concentrating on the ground coming up to meet her rather than the tree branches reaching out to try and snag her cable. ‘Minus twenty,’ she said, seconds later. ‘Fifteen…ten, nine, eight…’

  Her descent slowed and Maggie was impressed by the controlled touchdown Sam gave her.

  ‘Weight’s coming off,’ she heard him relay to Graham.

  Maggie unhooked the clips holding herself and the gear. She held the hook well clear of her body, now aware of her audience at ground level. Fortunately the two men were standing at a safe distance. After a hand signal to Sam, the hook moved up and away swiftly. Then the helicopter gained height, ready to hover as it waited for her to complete her part of the operation. The mixture of anxiety and relief on the faces turned towards Maggie made her all the more aware of her responsibility in this mission.

  ‘You take the stretcher,’ she shouted at the men over the noise from the climbing helicopter. ‘I’ll take my pack. Where is he?’

  ‘Just in the trees over here. Pete’s with him, keeping pressure on the wound to try and stop the bleeding.’

  ‘It’s bad,’ the other man warned. He looked at Maggie as though he hadn’t expected to see anyone of her age or sex arriving to try and save his mate. ‘Are you going to be able to help him?’

  Maggie was already moving. ‘I’m certainly going to do my best.’

  ‘So, how bad was he?’ Hugo was leaning forward in his leather chair, one hand resting on the head of the dog leaning against his legs. ‘And how did you start your assessment?’

  ‘He wasn’t in good shape.’ Maggie pulled her legs up onto the couch and leaned back. It was so good to be able to wind down finally. It was even better to relive the buzz the day had provided by sharing it with such an interested listener. ‘GCS of 7, responsive only to painful stimuli. His airway was patent but he was tachypnoeic with a respiration rate of 36. No radial pulse. Carotid was weak and he had a tachycardia of 130.’

  ‘Pretty shocked, then. What was his blood pressure?’

  ‘Seventy-five over 40 but I didn’t get that initially. I got some oxygen on and then cut his clothes to have a look at his chest.’ Maggie grinned wryly. ‘That was a job in itself. Have you got any idea how many layers a deer hunter has to wear in the middle of winter?’

  ‘I can imagine.’ Actually, Hugo was having a hard job trying to imagine Maggie out there in the wild, fighting alone to save the life of a severely injured man. She’d been winched in from the chopper, for heaven’s sake! The idea of Maggie facing the kind of dangers such a feat presented gave Hugo an oddly mixed reaction of astonishment that she was capable of such work, admiration in hearing her sound as though she was as skilled as she was capable and sheer disapproval of her putting herself into such a risky situation. Admiration was winning hands down at present.

  ‘The entry wound was left-sided and quite low. It had fractured some ribs and left enough of a hole to bleed profusely but I suspect the lung damage was relatively minor and the bullet carried on to make a hole in the liver or spleen. Or both. The abdomen was pretty tense.’

  ‘Did you put more than one IV line in for fluids?’

  ‘Yes, but the second one was en route.’ Maggie grimaced. ‘It was lucky it wasn’t an arterial stab with the air pocket we hit.’ She caught Hugo’s questioning gaze. ‘I got a 16 gauge in on the ground and got one of the guys to squeeze a litre of saline in fast but that wasn’t before I dealt with the sucking chest wound.’

  Hugo whistled softly. ‘Pneumothorax?’

  ‘Yep. It tensioned within the first couple of minutes I was on scene. It was lucky we got there when we did.’

  ‘What did you do?’

  ‘Covered the open wound with an occlusive dressing and did a needle decompression.’

  Hugo shook his head. ‘You make it sound easy.’ He knew perfectly well how tense an emergency like that could be within the controlled environment of an A and E department. How much worse would it be as the sole medical officer, in a hostile environment, with limited supplies and equipment? His glance was frankly admiring. ‘How long did you spend on scene?’

  ‘Twelve minutes,’ Maggie said proudly. She was enjoying the new experience of impressing Hugo Patterson but she didn’t want to take all the credit. ‘I was glad of the other men being there. That made getting him into the stretcher and winched up much faster. And
Graham and Sam were just brilliant. They’re a great crew.’

  ‘Did you take him to Dunedin?’

  Maggie nodded. ‘He was as stable as we could hope to get him. What he needed was to get to Theatre as quickly as possible.’ Her smile was delighted. ‘We made it, too. He’s going to survive by the sound of it.’

  ‘Well done.’ Perversely, Hugo felt envious of the way Maggie had spent her afternoon. ‘I had a day full of toddlers with ear infections and old people with their chronic airways disease exacerbated by upper respiratory tract infections.’

  ‘Maybe you should do some winch training,’ Maggie suggested. ‘Then you could go instead of me next time.’

  ‘I could think of a lot of things I’d rather do,’ Hugo said drily. He eyed Maggie curiously. ‘Weren’t you scared at all?’

  ‘Terrified,’ Maggie admitted cheerfully. ‘But only briefly. Once you start thinking about your patient instead of yourself, it goes away. And I guess the danger is what makes it so exciting,’ she added. ‘Especially when it’s a difficult job and you get a successful result.’

  ‘And you said you were coming here for a quieter life,’ Hugo sighed. ‘What is it with you, Maggie Johnston? Are you going to keep flinging yourself into dangerous situations until your walking frame gets in the way?’

  ‘Oh, no.’ Maggie closed her eyes and rested her head on the back of the couch. ‘I’ll retire from any really active duty when I get pregnant.’

  Hugo’s jaw dropped. ‘You’re planning to get pregnant?’

  Maggie’s eyes opened again. ‘Of course. I’ve always wanted to have kids some time.’

  ‘When…precisely?’ Hugo still sounded horrified.

  Maggie grinned. ‘Don’t worry, I’m not planning on solo parenthood. I’ll wait until I find a suitable husband.’

  ‘So you haven’t got anyone in particular in mind?’

  ‘No.’ Maggie sighed sadly. ‘I thought I had a while back but it fizzled.’

  ‘Why was that?’

  ‘He was a bit older than me. Drop-dead gorgeous but…’ Maggie chewed her bottom lip thoughtfully. ‘He turned out to be drop-dead boring as well. No adventure in his soul.’ Maggie sighed again. ‘It was a shame but I guess you can’t have everything.’