Balmy, then...KABOOM!

For the past few days, it has been downright balmy, with temperatures in the mid-30s, ice melting, puddles forming on the side of the road.  Last night brought the emergence of the Supermoon (the largest full moon since 1993!), as the moon arrived at its perigee, the point in its orbit closest to the earth.

All was well until the spring equinox today brought gale force winds and a snow storm.  All flights between Bethel and the outlying villages have been canceled due to weather; even the medevac has been grounded.  The RMT calls from the villages were pouring in nonstop:
-A 61-yr-old male with blood intermittently oozing out of his penis but no recent injury or trauma...the health aide estimated a half cup of blood had dribbled out within the past hour.  I spoke with the on-call urologist in Anchorage who suggested attempting gentle insertion of a foley catheter for tamponade until the planes can bring the patient in for further evaluation.  Apparently urethral injury is not a urologic emergency.
-A pregnant multip in active labor at 39 weeks who had missed her "Be in Bethel" date, baby delivered by the health aide who gave us a blow-by-blow account over the phone as it was happening.
-A 6-month-old baby in respiratory distress: tachypnea, hypoxia, tachycardia, fever of 100.7.  The health aide was treating the baby with oxygen, albuterol nebulizer,  and ceftriaxone IM and checking in with us every 2 hours while waiting for the weather to improve so medevac could resume flights.

As Aurelie has mentioned, if medevac is grounded, a Blackhawk helicopter can be summoned in life & death situations...and it's nerve-racking to be the one who determines what constitutes "life & death".

Meanwhile I was attempting a massive diuresis of my service before the next set of ward docs start tomorrow.  My two loony-bin suicidal adolescent patients (one pregnant, the other withdrawing from an alcohol binge) on Title 47 (involuntary psychiatric hold for danger to self, danger to others, or grave disability) were awaiting transfer to the psychiatric facility in Anchorage.  My intoxicated 49-yr-old female with fractured ribs and a tiny pneumothorax not apparent on chest x-ray, but seen on chest CT: when would it be safe for her to fly home to her village?  I checked with the on-call pulmonologist in Anchorage who estimated 5 days after complete resolution of the pneumothorax.  My patient can't get home without flying...unless she goes on a several-hours-long ride via snow machine over the bumpy frozen river, which would be quite painful with cracked ribs...

At the end of a very hectic day, I walked home from the hospital in the middle of a blizzard.  At least all the waterproof gear I got at REI has proven to be truly waterproof.