No planes available, and the nearest surgeon is 400 miles away.

Sometimes I come close to despair,

We won’t even talk about fair.

     Never mind where’s the pain,

     There simply isn’t a plane

The prop’s in the shop and the jet needs repairs.

The outpatient area of the Samuel Simmonds Memorial Hospital has six exam rooms and two Emergency Room beds.  There are no windows.  The six exam rooms extend along one wall.  The doctors, nurses and ward clerks work in a space that runs parallel to the exam rooms, separated by a corridor six feet wide. 

Each exam room has a unique character.  One is closest to the door through which the patients enter, and has a blocked up window. 

Two evidently was something else before it was an exam room; the door is very narrow and the heat is permanently on.  It is the only exam room configured so that the doctor can work on the computer without turning his or her back on the patient.

Three also has the heat stuck permanently on.  Four’s exam table sits against a wall.

Five is the designated orthopedic room and holds the casting materials; the exam table raises and lowers electrically.

Six is as narrow as two but the exam table raises and lowers manually.

A dry erase board hangs on the wall between two and three and gives the name and five status parameters for each patient.

Posted at the bottom of the board in its usual place today the Medevac status read “No Medevacs on slope today.”  Both planes were in need of repairs and it was too windy to risk the helicopter.

The first patient of the day needed a surgeon; because of the circumstances I called in one of the other docs, who concurred.  Nor could we wait till the commercial flight at 8:00 PM, which would have effectively put the patient on the operating table fifteen hours after presentation.

I talked with the accepting surgeon at Alaska Native Medical Center (ANMC) in Anchorage and he agreed to send a plane.  The patient in the meantime received IV fluids.  As the hours progressed the surgical problem grew more and more obvious.  When the ANMC crew arrived in the early afternoon, the patient looked better for the fluids

I spoke the Community Health Aide staffing an outlying clinic about a patient with chest pain.

I always take chest pain patients seriously.  With the available information, I had no doubt that if Medevac had been available I would have ordered one out.  The best that could be done was to put the patient on the commercial flight (which was held on the runway).

In the afternoon I had a short breathing space, while patients were coming into and out of the ER.  I attended a non-Native patient who had spent thirty-five years in Alaska, and was supremely happy with the decision to come to Barrow to retire.   We talked about what goes into a good retirement.  Where else but Barrow, we decided, can you hang out all day with subsistence hunters and still be able to walk down the street for a supper of good sushi or Thai?


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