The Big Chill 5 - Misunderstanding and Misadventure in the High Arctic

Close to the Arctic Circle, small mistakes have big consequences

Resolute Bay is named for one of the ships of the ill-fated Franklin Expedition that became trapped in the ice while searching for the famed North-West Passage in 1848. Resolute is 850 miles from Frobisher Bay on Baffin Island. 125 years later I was in Frobisher Bay working as a pediatric resident on rotation from the Children’s Hospital in Montreal.

One mid-July afternoon, Aussie Medical Officer, Frank Timmermans sent instructions for me to “saddle up” for an emergency evacuation of a child from Cape Dorset, a smaller community about 150 miles away.

Timmermans loaded me up with a battered green oxygen tank and a couple of bags of fresh blood in a transport cooler. “Take this fella down to the airstrip. Put him on the plane at the airstrip would ya.’” he barked to Joey, the hospital driver. The hospital’s big Yukon truck bounced us down the rutted roads down to the town’s airstrip.

Jerry jumped out to file the flight manifest, then drove me out to the plane waiting on the tarmac. I hustled up the steps of the Nordair 737. I had barely settled in the back, when the plane backed away from the small terminal. “This seems like an awfully big plane for a 150-mile trip”. The thought flitted through my head as the plane barreled down the runway.

The jets roared to full throttle as the plane gained altitude and wheeled over above the town. Something about the situation didn’t seem right. Coming on the PA, the pilot invited us to settle in the 4-hour flight to our destination, Resolute Bay! I looked at my supplies. The oxygen bottle would last 45 minutes at the most. I was sure that the community of Cape Dorset was not that far away, possibly 150 miles down the coast. “What the hell was I doing on jet flying 850 miles due north to Resolute Bay? “. It never occurred to me to flag the stewardess down and ask to explain my concerns to the pilot. A shroud of nauseating anxiety washed down and smothered me for the duration of the flight.

When the 737 finally landed, I raced to the front of the plane and stepped out onto the platform. The snow and the wind were blowing so hard and so loud, that I could barely make out a figure at the bottom of the steps. The outpost nurse dressed in a full-length parka was yelling” Go back, go back! You were supposed to go to Cape Dorset.” This was completely out of the question. Even if I found the authority to commandeer the aircraft for departure, the Arctic storm that had chased us all the way from Frobisher Bay had closed the airport down as well.

The station nurse immediately contacted Timmermans at the base hospital who identified the source of confusion. Back at Frobisher airfield, the storm had shut the airport for small aircraft. The Twin Otter having been pushed to the hanger, the dispatcher had put me on the 737, the only aircraft remaining on the tarmac. The explanation would be of little consolation to the patient in Cape Dorset who was now “storm stayed” and beyond rescue.

The nurse in Resolute introduced herself as Juanita and outlined a more immediate problem. A young Inuit girl had just arrived on an RCMP plane from Grise Fjord. Juanita asked if I would examine the patient still lying on a stretcher in the plane which was lashed down against the blasts of wind now gusting to 80 km per hour.

I climbed into the RCMP bare bones Twin Otter. In the dim light, I could barely see the outline of Elizabethee. Her stretcher was strapped to metal tracks on the floor. Pulling back the covers, I felt the heat of her fever roll off her. Her heart was racing. Her abdomen was rigid. With every gust of wind, the aircraft would rise a few feet and fall back to the tarmac. The young girl groaned in pain with each jolt. Elizabethee had peritonitis or worse.

As nothing could fly in the storm, we loaded Elizabethee’s stretcher into the back of an army truck Juanita had commandeered and headed for the nursing station a few miles from the airfield. Resolute had a military base and burgeoning mining industry. It became clear that the 500 soldiers and miners would fall over themselves to help Juanita, a strikingly attractive Bajan woman, evidently the Queen of Resolute and the informal commander of the island base.

Juanita was relieved that fate had delivered a doctor to share her anxiety over the young patient. Down south, we would have started IV antibiotics, taken blood and abdominal x-rays. With its receiver plate bolted to the wall, the antique x-ray machine was only designed to obtain chest x-rays. Out of desperation, I unbolted it from the wall and took an abdominal x-ray by laying the receiver plate under the stretcher. I then developed the x-ray which demonstrated free fluid in the peritoneal cavity confirming my fear of peritonitis.

McMaster Medical School had taught a minimum of anatomy or anything beyond superficial surgical skills. Upon reflection, I realized that even a skilled surgeon would have taken a “conservative” approach rather than attempt to do an appendectomy without the aid of an anesthetist and a surgical assistant. Apart from administering morphine, intravenous fluids and antibiotics, there was all little we could do except worry. Juanita proposed 6 hour overnight shifts watches.

To our alarm, Elizabethee was no better the next day. Then a miracle happened. A transpolar British Airways jet en route from London to Winnipeg had landed at Resolute Airport for refueling. Juanita called Timmermans back in Frobisher, who enlisted the help of the BA airline pilot.

The pilot informed five British businessmen that a medical emergency temporarily required their seats. To their enormous surprise, these pinstriped Fleet Street bankers were escorted off the aircraft and conveyed by army truck to the nursing station where they were each assigned a bunk. Their commandeered seats were removed to make space for Elizabethee’s stretcher and a companion. Shockingly, I learned that Juanita was flying Elizabethee to Winnipeg. I was to remain in charge of the nursing station including a few patients and five slightly disoriented Fleet Street Bankers.

Juanita arrived back at the nursing station a few days later. Elizabethee had survived the flight to Winnipeg where they confirmed that she had peritonitis. The hospital physicians never identified the original source of the infection, but it eventually responded to the antibiotics. I was delighted that Elizabethee had survived and equally relieved that I hadn’t done anything stupid. Meanwhile Timmermans instructed Juanita to take me down to the airstrip, “write the destination on his forehead and make sure that he’s on the right plane back to Frobisher.”