Snow Storm part 5

Jane and Cathy had just finished their tour of the clinic and Cathy had put the kettle on the stove when there was a knock on the door and a panicked voice called out, "Hello? Anyone there? We need some help, here!" The two women rushed to the front, where they found a young couple that had come in on skis towing a toboggan with a teenage girl on it. Belts were holding her in place on the sled. The girl was obviously in agony and kept moaning. When they saw the girl's left leg, they knew why. It was lying in an unnatural position.

"What happened?" asked Cathy.

"Bad fall off her skis while we were trying to get away from our cabin," said the young man.

The young woman looked very distressed and knelt down to take the girl's hand in her own. She looked up at Jane. "She's my little sister. We came up for the weekend to do some skiing. It was her first time. She didn't know how to fall." The woman looked sick. "We heard the crack when her leg broke."

The young man nodded, "It's really, really, bad. Her foot came up and hit her knee."

All four of them felt their stomachs turn, but then Cathy took charge again. "Did she hit her head at any time?" The couple shook their heads.

"No, it was just the break," answered her sister.

"But that's enough," added her husband.

"Right, well, let's get her into that first room, and see what we can do. I'm getting on the shortwave radio to see who can help us out. This is out of my league." She turned to the woman who had brought in her sister and said, "Why don't you stay with me? I'll show you how to use the radio – the basics – and you can relay messages for us in the surgery." She turned to the woman's companion, "Can you help carry her in here? And then will you be the one to carry the messages back and forth?" He nodded. Jane was grateful for Cathy's leadership.

Cathy sat down with the girl's sister after introductions had been made. "Okay, Laurie, watch what I do." She coached the girl, and then left her to make contact with someone while she returned to the girl with the broken leg. Jane and the young man, Peter, had placed the pale and sweating girl onto the examining table. Jane said softly to him. "It's a good thing she passed out again." He nodded.

Cathy shooed him out of the room to go to his wife's side and take messages. "Now we'll get her undressed, Jane. We need to be able to tell the doctors about her condition."

Jane said, "I felt her pulse. It seems very fast."

Cathy nodded over to the counter as she was unzipping the girl's jacket, and said, "Get a paper and pencil and start writing details down. Age, pulse, breathing rate, injury details, all that stuff. We'll need it to give to the professionals. Who I pray are going to be responding really soon," she added in an under-voice.

Johnny and his driver didn't see any more cars off the road as they headed to the clinic, but they did see a cabin with smoke coming out the chimney…and around the door frame. "We'd better check that out!" he called. The man nodded, and turned the snowmobile from the road and up the lane towards the cabin. "Sheriff's office!" they yelled as they banged on the doors. They could hear someone moving around inside, and coughing. Johnny frowned and banged on the door again. "Hello! Are you all right in there?" This time they heard stumbling and something falling. Johnny looked at his companion who nodded, and then he called out, "We're coming in!" There was no further noise, so they kicked at the door and it flew open.

The room was filled with smoke. Johnny ran in and grabbed a man who was on his hands and knees near the door, coughing. He passed him to his driver, and pulled his scarf over his face to do a quick sweep of the room for other victims. He couldn't see anyone else and ran outside. "Is there anyone else in there?" he asked the man, who shook his head. John told his companion, "C'mon, we need to get him away from here," and they carried the man towards the snowmobile. "If we sandwich him between us, can we get him to the clinic that way?" The driver nodded.

Johnny ran back inside the cabin and grabbed a coat for their passenger from just inside the door. When he got back, he finally asked, "What are you burning in there, man?"

The man shrugged on his coat with John's help, and sputtered, "Ch-ch- charcoal."

"Oh, man, that stuff's toxic! You nearly killed yourself with that!" He bade the driver grab a bucket and fill it with snow to cover and put out the fire in the fireplace. It took several goes, but then they were ready to leave the cabin without worrying that it might burn down.

Johnny gripped onto his driver's coat with the man supported between them and they started on their way again to the clinic. He hoped that they wouldn't need to stop for any other victims on the way. He didn't see how they could manage anyone else right now.

Soon they pulled up in front of the clinic and Jane met them at the door, as she had heard the engine before they arrived. Johnny and his driver helped the man inside and Jane directed them to the second examining room, where Johnny found an oxygen tank, and started getting the man set up. His driver asked if it was okay if he headed back out or if he was still needed. Johnny looked at Jane. She said, "We have another patient – a teenage girl with a terrible leg break. Cathy is working on her next door, but we really need some help."

Johnny asked, "Who's Cathy and what's her training?"

"She's a former nurse's aide, and she's really good at the basics."

"Okay, great. This fellow's all right for now. I'll come and see the girl." He asked his driver, "Can you stick around for another couple of minutes until I see what we've got next door?" The man nodded and held open the door for Johnny.

Jane asked, "Should I stay or come with you?"

"Stay here for now; I'll call you if I need you." Jane nodded and turned to get some information from the smoke inhalation victim.

Johnny walked into the examination room and found that Cathy and Jane had managed to take off the girl's outer clothing. She was on the examining table in a sweater and jeans. He grimaced when he saw her leg, and then turned to the woman who was working on the girl. "Hi, Cathy, I'm Johnny."

"I am so glad to meet you! Especially in this kind of situation. Jane told me all about you."

"Tell me what we've got. But first, do we have any way to speak with a doctor?"

Cathy nodded. "There's a shortwave in the reception area and I gave some basics to Laurie, this girl's sister, about how to work it. We've almost got somebody available to help us."

Johnny pursed his lips together and looked worried as he began his examination of the girl. "What's her name?"

"Marie Hebert. 16 years old. Hadn't been skiing before and didn't know how to fall. Brother-in-law said they heard the break and saw her foot come up to her knee." Johnny's face said it all. "Yeah, that's how we felt too, when we heard."

"How long has she been unconscious?"

"She comes and goes. Few minutes this time. Every time we move her, and I just finished taking off her snow pants. I had to cut them up. We were very careful to move her as little as possible."

"You did the right thing. Now help me get these jeans cut open so we can see how bad that leg really is. Any head trauma?"

"Not that I know of. Her family said no, and I checked her head for any bumps but I didn't feel anything."

Johnny let his hands run over the girl's head himself, and Marie gave a groan. "It's going to be okay, Marie. Just take it easy." He didn't know if the girl was conscious enough to understand him, but he said it just in case. "Head seems fine. When she comes to, we're going to need some MS. Do you know where it is?"

"Morphine?" Cathy pointed to the glass fronted cabinet. "I have the key in my pocket – someone from the sheriff's office gave it to me."

"At least that's something. Now we just need to get someone to give it to her."

"I know."

"What about IV bottles or bags?"

"I haven't seen any, but that doesn't mean they're not around. Do you want me to take a look?"

"Yeah."

Johnny called for Jane from the next room, so they would have an extra pair of hands. "Jane, I need you to write down the girl's vitals and relay them as soon as we get someone qualified on the radio. Do you have the vitals for the smoke victim?"

"Yes, John, I gave them to Laurie." Jane looked over at Marie's leg, which was now exposed as her jeans had been cut up to her thigh. She felt queasy, and Johnny noticed, telling her to look away.

Johnny ran his hands expertly over Marie's limbs, checking for other injuries. "She needs surgery right now – we really need a doctor, damn it!" He looked back at the dark bruising, swelling and distortion of Marie's leg and a sudden flashback hit him of what he had felt when he had a complex fracture of his own leg.

"Johnny, are you all right?" Jane's voice sounded like it was coming from far away. He pulled himself together. He could do this. He knew what this was and why it was happening. He breathed deeply, closed his eyes tight, opened them, and then he was in control again.

"Yeah, I'm fine." He called to Cathy, "Get me a doctor on the air, and do it now." He turned to his wife. "Jane, get me splints, dressings, compresses, bandages, whatever; just pull it all out and put it on the counter, so I can see what we've got." He turned back to Marie, and started to re-take her vitals.

"We've got someone from Barton on the air, Johnny," called Cathy.

"What's Barton?" he asked as he walked into the reception area.

"It's the nearest hospital – just opened a few years ago – state of the art for the area. They even have air ambulance, so if we can find a place that's big enough and clear enough of snow, we will be able to transport some of our victims."

"That would be great!"

"But those are big 'ifs', Johnny," commented Cathy.

He sighed, "Yeah, I know."

Peter looked up from where he was hovering over his wife, who had the headset on, and was talking with someone on the air. "Is there something I can do? I'm feeling like a third wheel here."

Johnny sized up the young man. "Is your stomach good?"

Peter looked a bit scared. "Um, I hope so?"

"That's gotta do. Come with me – I need you to help me with Marie while we immobilize her leg to get her ready for transport. And Cathy?" She looked up from where she was giving vitals to Laurie to pass onto the person at Barton. "See if they can bring in a nurse or doctor to set up a couple of IVs and some medication for Marie when they come." She nodded and relayed the request to Laurie.

Jane acted as assistant while Johnny and Peter stabilized her leg. Marie didn't know anything except for her pain, so it was very hard on her, and on her helpers who were taking care of her. Johnny then turned to Jane and asked her to check on the man in the other room. She walked in and found him sitting up. He had been listening to Marie moaning and crying out in the other room, and was pretty upset, so Jane talked with him and helped him to calm down.

Cathy called out to Johnny again, "They're going to land an air ambulance at the garage; the guys were able to get an area cleared in front that would work. We just need to get our patients there."

He came to the radio. "Well, we're not going to do it on skis and a toboggan, that's for sure. Can you get me the fire chief on that thing? We need some alternatives."

Peter had stayed with Jane by Marie's side. He asked Jane if she knew what would be happening now. Marie's face was ashen grey. She did not look good. Jane put her hand on Peter's shoulder. "We're doing everything we can. It will work out."

He nodded, distracted, and looked down at his sister-in-law. "I just don't know how she's gonna cope if she can't use her leg." He looked at Jane with fear in his eyes. "Do you think they'll have to cut it off?" Jane reassured him as best she could, but she really didn't have any answers. From what she had learned from Johnny and working at the hospital, the girl was in shock, and shock could kill. It might be that losing her leg was the least of her worries.

While waiting for the chief to get back to them, the crew in the clinic assessed the situation. It was another twenty minutes drive by snowmobile from the clinic to the garage. How were they going to transport Marie that distance and keep her stable?

Just then Laurie called out, "They have a doctor from Barton on site at the garage – just landed in the air ambulance!" Cathy and Johnny looked at each other and smiled with relief, then looked down at Marie, and instantly became serious.

The unnamed man with whom John had ridden to the clinic came back inside from where he had been shovelling. He was carrying his walkie-talkie. "We've got Bob James arriving in a few minutes. Chief wants to know if you've figured out what to do at this end."

"We have her leg immobilized, ready for transport. But she's not looking good right now, and time is really important here. She really needs an IV like yesterday, and some MS."

The radio crackled, and Laurie answered whoever was calling. "The doctor wants to know if you have access to any medications."

"I've got the key right here," replied Cathy.

"He says to take all the medications you can spare and bring them with you when you transport the victims, so he can use them at the command centre. He says that for now he's going to set up his base there, rather than try to get up to us here. He also says that the chief says clearing a road to us is the number one priority, but it may take several hours because of the volume of snow to be moved. He's asking to speak to you, Johnny."

"All right – Cathy, you can unlock that cabinet and start unloading some meds into a bag, but leave most of it here. Just keep track of how much you take and leave – write it down. Peter, check on our breathing victim and Jane, do the same for Marie. Then bring the info to me." He turned to the radio and took the headset from Laurie.

Johnny told the doctor that the only thing he could see to do for Marie was an air lift from the parking lot area beside the clinic. "We need to use a Stokes – I really don't think she can handle any rough transport, Doc." After some discussion, it was arranged that Johnny and the doctor from Barton would accompany Marie in the air ambulance right to the hospital, while the snow mobiles would drive her sister and brother-in-law and the smoke inhalation victim to the garage, where other transportation would be arranged for them.

While they were waiting for the air ambulance, they all took turns working on shovelling an area clear to the parking lot so they could walk through and carry Marie out on a stretcher, which they would slide along the snow on top of the toboggan. Soon they heard chopper blades and a helicopter was hovering over the lot. Someone opened the door and began slowly lowering the Stokes, which spun and twisted as it descended. The snow was blown up from the blades and began swirling high into the air as the clinic team carried Marie out to the Stokes, which was being steadied by Johnny. She was covered completely with several blankets that encased her like a cocoon. Jane was amazed at how quickly and efficiently Marie was loaded into the chopper and Johnny was hitched to the hoist and lifted into the aircraft after her. The snow from the ground resembled the earlier blizzard as the rotors picked up speed and the air ambulance flew away.