When the chips are down, the hospital calls the Coast Guard
By Nelson Sigelman - March 22, 2007
Wind and rain buffeted the Vineyard Saturday morning, the remnants of a slow moving northeaster. A Coast Guard Jayhawk helicopter banked sharply over Lagoon Pond and approached Martha's Vineyard Hospital.
The HH-60 helicopter with its distinctive Coast Guard red and white color scheme hovered over a tidal pond behind the hospital sending up a spray of water. The pilot moved his aircraft forward and touched down on the small landing pad at the edge of the back parking lot.
The storm provided a fitting backdrop. Inclement weather of all types has given Islanders a deep appreciation and respect for the men and women of Air Station Cape Cod.
An HH60 Jayhawk Coast Guard helicopter set down Saturday morning on the landing pad behind Martha's Vineyard Hospital. Photos by Ralph Stewart
When the ferries stop and civilian aircraft are grounded, the Coast Guard is sometimes the only link to the mainland. And when time is critical, Air Station Cape Cod may be called upon to transport a critically ill patient to a mainland hospital.
In general, the Martha's Vineyard Hospital and the Nantucket Cottage Hospital rely on Boston MedFlight, a private nonprofit air ambulance service, for the majority of medical transfers.
MedFlight aircraft are essentially flying ambulances staffed with a critical care nurse and a paramedic. They can transport a patient from the Vineyard emergency room to a Boston hospital emergency room within an hour, says Danny Thomas, MedFlight special projects coordinator.
The cost of a MedFlight is approximately $5,000 to $6,000. Because of the Island's geographical isolation, flights from the Vineyard are covered by insurance. For those without insurance, Mr. Thomas said, "We never put the patient's ability to pay above the need for service."
Pilot Nate Hudson gives Nick Pecararo of Oak Bluffs a lift.
When MedFlight is not available or weather conditions ground civilian aircraft, and the situation is serious, the Island hospitals turn to the Coast Guard for assistance.
The Coast Guard's role in providing medical evacuations and the relationship with both island hospitals and Med Flight were formalized in a recently signed memorandum of agreement (See related story on Page 1).
According to a Coast Guard press release, Coast Guard Air Station Cape Cod completes about 40 transports each year from the two islands. Martha's Vineyard chief executive officer Tim Walsh estimates that about 30 originate on the Vineyard, "and they are the tough ones."
"I don't think that people know how much we rely on them and use them," Mr. Walsh told The Times last week. "When push comes to shove, when we have bad weather, the Coast Guard is who we count on. They are the ones who are there."
There was no medical drama associated with Saturday's visit to Martha's Vineyard Hospital. The Coast Guard crew flew in to participate in a hospital-sponsored health fair, much to the delight of young and old eager to get a look inside the aircraft and ask the five crewmen questions.
The crew - pilot, co-pilot, flight surgeon, medic and aviation survival technician (rescue swimmer) - emerged from the Jayhawk helicopter wearing orange aviation dry suits. Although it was a social call, it was not a day off.
Pilot Ryan Tickell is a former Army pilot.
Telling the crowd gathered around the helicopter to take a look inside, pilot Nate Hudson warned that the visit would need to end quickly if the crew received a call.
Flight surgeon Sandra Bender, 34, a family practitioner, is one of two flight surgeons assigned to Air Station Cape Cod at Otis. Under normal circumstances Lt. Commander Bender would not accompany a helicopter crew.
The flight surgeon on duty reviews all cases and determines when a medevac is warranted.
Dr. Bender began her military career in the Navy. "I like what the Coast Guard does," she said about her reason for requesting an inter-service transfer.
Before he transferred to the Coast Guard, pilot Ryan Tickell, 32, of Springfield, Va., flew Blackhawk helicopters for the Army as a member of a medical evacuation unit that included a stint in Iraq in 2003 A more settled base life with fewer deployments was an important consideration for his wife and three boys. And he likes what he does. "I enjoy going out there and helping people out," he said. "I think it is very rewarding and I also enjoy flying."
Lieutenant Tickell said there is always a sense of urgency when a Medevac call is received, but the determining factor is always weather.
Wind is less of a factor than visibility and ceiling he said. The visibility must be at least a quarter of a mile, but that distance can be waived at the discretion of the commanding officer, depending on the severity of the case.
A normal helicopter crew is a pilot, co-pilot, flight mechanic and rescue swimmer. When the assignment is a medical transfer, a corpsman is added to assist the rescue swimmer, who is a trained EMT.
The interior of a Jayhawk cabin is Spartan. There is not a lot of room when a patient on a stretcher must be accommodated. "It gets full," said Mr. Tickell.
Lt. Commander Sandra Bender, Coast Guard flight surgeon, and corpsman Austin Williams must make important medical decisions.
A helicopter crew is expected to be off the ground within 30 minutes of a call. Mr. Tickell said crews try to be off within 20 minutes during daylight, but night flights in bad weather and search and rescue missions sometimes take a little longer to prepare for.
The Jayhawk is capable of traveling at a top speed of 180 knots, but 155 knots is the practical speed. According to the factory specifications, the aircraft can travel 300 miles, conduct a hoist mission for 45 minutes, and return.
Corpsman Austin Williams, 27, is a native of Montana. A five-year veteran of the Coast Guard, he joined the service because he needed money for college and saw it as a good avenue for entering the medical profession. He is a highly trained emergency medical specialist capable of providing basic and advanced life support to adults and children.
"I like helping people," he said about his Coast Guard service. "The fact that we are out there making a difference in our local community. It is a really exhilarating feeling to know at the end of the day that you have saved somebody or helped somebody's well being."
Pilot Nate Hudson, 31, comes from a military family and calls New Mexico home. In two and a half years on the Cape he has participated in quite a few medical transfers.
One consideration in Medevac flights is the need for haste. "If we are Medevacing them, usually they are pretty bad," he said. "So we need to get there quick, pick them up quick, and get them to the next level of care quick."
The nature of the patient's injury and the hospital destination are also considerations said Lieutenant Hudson. He said that in a profession where there is a lot of bad news, knowing that he helped save a person's life is very gratifying.
A graduate of the College of the Atlantic in Bar Harbor who grew up as a military brat, he said he wanted to be a part of the military and joined the Coast Guard because he wanted to fly and the Coast Guard mission fit his background in ecology.
Standing by the aircraft casual and confident, Jeff Slaczka, 21, a blond-haired Southern Californian, is a Coast Guard rescue swimmer. And what does he like about the Coast Guard? asked a reporter. The answer was typecast: "What other job can you have where you can jump in the water?" he answered nonchalantly about his hazardous career.
His "job" requires him to provide medical assistance to injured people and on occasion drop out of a hovering helicopter into a turbulent sea guided by a motto that defines much of what he and his fellow Coast Guardsmen do: "So others may live."
