Saturday 15 October 2011

A day in the life of a Ski Patrol Doctor

The Office

It's 7am Sunday morning and I'm sat on the "fishy bus" on the way to Coronet Peak.  Forty minutes ago I dragged myself out from under several layers of duvets and blankets in our freezing cold Queenstown home. I could see my breath as I drank the first of the day's mugs of coffee. I still can't quite remember how I decided to apply for this job.  It seemed like a good idea in the heat of a Hawkes Bay summer. I couldn't even ski before I got here...


I stumble into the first aid room and look out through the window.  The clouds are clearing and the sun is begining to peek out.  Sweet.

Jess, the Ski Patrol Nurse, isn't here yet.  She went out first yesterday so that means I get to ski first today.  Skiing is why we're all here and so takes priority over all else.  Except over the patients, sorry, customers, of course. As long as either the doc or the nurse is in first aid then the other is free to ski.  I have to see virtually all the patients that come in the door, but usually the nurse can hold the fort with analgesia as I make my way back down the hill.

The best thing about skiing whilst "working" is that you don't have to queue.  Straight to the front and on to the lift whilst the masses scowl at you.  For this reason our uniforms are bright and the radio prominent and turned up loud.   It's a good talking point whilst riding the lifts with locals or tourists. I do my bit promoting the use of wrist guards and helmets with tales of serious injuries.

Most of the time I see the patients after they are brought to first aid by the patrollers.  The patrollers can really ski, and arrive pulling the "blood bath" with the patient wrapped in a tarp inside. Occasionally  I get to go out to the scene of the accident, sometimes on the back of a skidoo, or if I'm on the hill and above the injury I go directly there.  There always plenty of "walk-in patients" who have found their own way to the first aid room.  Sometimes they have pretty impressive injuries - completely munted wrists, or dislocations, even spinal injuries.

The snow is soft and fresh off piste and I feel indestructable as I cut some turns on the fresh snow.  Awesome. Back on the lift for another run.  This run I go a little faster and the off piste I had as fresh tracks has already been ridden by more people leaving me with fewer options for "freshies".  I run into a buried tussock as I go under the lift line.... double eject.... both skis are are off and I've face planted in the snow.  My poles are to the sides and my skis 40 metres back up the hill. Damn.  I hope no one saw that.  I'm thankful that the part of my uniform that says doctor is in small lettering on the front of my jacket, not emblazened on the back in huge writing.  I pick myself up, check that my radio is still working and somewhat more tentatively make my way back for another run. All good. A couple of runs later and I'm back at First Aid to tag Jess who is sitting with her boots on ready to go.  A quick handover of where the snow is best and she is out of the door. 

The patients always comment about "the office". The office is pretty sweet:


View from Coronet Peak First Aid Room towards The Remarkables.
I take off my boots, make a cup of coffee and fire up the computer. The door slams and boots can be heard behind me.  The first customer of the day is holding his arm and not looking happy.  Snowboard boots give it away.  I've learnt the patterns pretty quickly:  Snowboarders without wrist gaurds break their wrists, especially when it's icey and they are learning. Skiers tear ligaments in their knees, especially when the snow is soft, or when the ski binding doesn't release. Everybody breaks collarbones or sprains their AC joints.  The unlucky dislocate their shoulder or considerably worse.  The worst of the injuries we fly off in a helicopter - the unconscious or the truly munted, for example femoral fractures. Our main clinical activities are triage for helicopter or ambulance, triage for x-ray, and analgesia.  I've become a lot more familiar with injecting local anaesthetic into fractures and I've learnt the joys of nitrous (gas and air). Now I can even put a sling on a patient - previously a mysterious skill kept closely guarded by the nurses.

The day is going well.  It's mid afternoon, I've had a couple of hours of awesome skiing and it looks like I might be able to get another hour in before the end of the day.  I'm on the lift and I hear over the radio that there is a skier out wide and off piste with a shoulder injury.  As I get off the lift one of the patrollers is at the lift station and points me in the right direction.  I find the chap with JB, lifelong patroller from the States, already packaging the patient for the blood bath.  His shoulder is clearly out.  Its going to be an epic tow-out for JB as we are far away from the main runs, the snow is rotten, and the patient is in too much pain to be walking anywhere.  I put his shoulder back in.  No need for lots of analgesia when they are so freshly injured. Its all good now as he's in a sling and without screaming pain in his shoulder he can now walk out to a good place to be loaded in the sled.
"Working" during a night ski session.

 

The patrollers are an ecletic mix, but mostly ski guides, mountaineers, heli-ski guides and endless winter types.  All are good fun and red hot skiers.  Tonight is one of the infamous "Patrol Parties", with the theme being the circus.  Its a great opportunity to cut loose with patrol and catch up with the rest of the medical team.


Lion-tamer and the bloke who gets shot out of a cannon.

Ryan and Simon


Tomorrow I get to do it all again....  although I may not be ready to ski at 9am.

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