I am going to start numbering my flights by triple digits with the hope of breaking 100 before I graduate. Today was flight #5 if I’m counting correctly. It was a busy day in the ED, but with our new renovations, busy days are not as hectic and scattered. There is room for charts. There is an extra computer console. The doctors area now consumes twice the space that it did previously with both a deep low counter (and chairs that push under the counter out of the way), and a higher shelf for overflow or old charts.

Anyway, I had four active and interesting patients when I was called to the roof for a scene call, about 35 miles away as the crow flies, probably an hours drive or more. It was a beautifuly sunny late summer day. Visibility must have been almost unlimited. The mountains were bursting with shades of green from all the rain we’ve had, and the rivers were shimmering and blue as they snaked along the folded basin and ridge landscape (geographers will be able to localize me a little with that clue). We flew from our moderately rural landscape to “the middle of nowhere” which is where the medic told me we were when I could see nothing but trees and hills. WE floew over a ridge to a small farming area where a landing zone had been set up next to a big white country farm house. Next door was a stable with a horse that ran to greet us, but was blocked in by a fence. On the porch of the faded red log cabins inbetween was a country family watching us from their porch. It was like landing in a miniature toy railroad set.

When we got to the patient, I was shocked by a sight that I have almost never seen here in our rural parts–two well-muscled, trim, athletic looking men in biking tights and lycra shirts, tanned and sweaty. (As opposed to the pale, chubby, puffers and bloaters I see at the grocery store). One got tangled in a guard rail when he misjuged the bottom of the windy mountain road right in front of the country white house.

He had an open femur fracture. When I got him into the ED and cut off his biking shorts, the little clot over the break let loose and blood and fat (bone marrow) started streaming out of his leg. Ick. That grossed me out a little bit. Off he went to the operating room within about 2 hours of his arrival.