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Chapter Four diverts from the helicopter story to tell about jets used in air medical roles. One of the most important has always been flying organ harvest teams.
CHAPTER FOUR – THE ROLE OF JETS IN MEDEVAC
Helicopters are the stars of the medevac business, but once they’ve done their job of bringing victims out of the wilderness some patients need long-term care, surgeries using the latest high tech tools, or limb therapy and replacement, to name a few. These require trips to hospitals sometimes hundreds of miles away, too long for a helicopter.
That’s when airplanes are the transport of choice. Flying patients decades before helicopters came into the picture, airplanes operated from war zones to military hospitals continents away and domestically flew patients too sick to travel by ground.
In the early days of hospital aviation charter companies provided the planes for air ambulance flights as a sideline to their regular businesses. Rented patient care equipment from medical companies and nurses hired from personnel agencies was standard fare. Patchwork operations like this made for some bad patient outcomes.
We witnessed a particularly sad case while I was at UCLA. It involved a patient at our hospital who had chronic pulmonary disease requiring advanced care for the rest of his life. He was to be flown to his home in Denver and placed in a facility with full time specialty nurses and respiratory support.
We were planning on chartering a plane for the flight when, a day or so before we thought we needed it, I happened to be at the airport when this small, piston-engine twin, with a big medical cross on its tail, landed and taxied to the ramp. An ambulance drove up to it and the drivers brought out the patient, one of them lugging the pack of breathing equipment that was attached to him, keeping him alive. It had to be the same person we were planning to transport.
The ambulance crew loaded him into the tiny plane, the 20-year-old pilot scurrying around, helping as best he could, while the nurse plugged a portable oxygen bottle into the patient’s breathing support pack. As they loaded the patient and all the gear into the small plane its tail sank down and the nosewheel raised up until it was barely touching the ramp. I wondered if the plane’s center of gravity had shifted dangerously aft, out of limits. That could affect the way the plane flew and, if the pilot wasn’t paying attention, cause the nose to veer up out of control and the plane to crash.
Watching all this, I was dumbfounded. On top of the center of gravity problem, this small airplane wasn’t pressurized, so this poor patient was going to be taken as high as 12,000 feet on his way to Denver. The thin air at that altitude would kill him. As the plane taxied away, lurching right and left as the pilot struggled to steer it with the lightened nosewheel, I watched, knowing full well this patient was going to suffer terribly.
Driving back to the office I called my friend Dr. Marshall Morgan, whose realm was the ER and all that went with it, including our helicopter program and chartered airplanes. We were the best of friends and shared much wine together over the years.
I told him what was going on and asked him to check whether this was the same patient. Meeting him a little while later at a café, he confirmed our worst fears. The patient’s insurance company had shopped the flight. They’d booked the cheapest plane they could find, yet another grim example of how far insurance companies would go to save money.
He did inquire a few days later on how the patient was doing. He had suffered some permanent lung damage from the hours at high altitude, dashing any hopes his family had that he might one day be recover to a normal life. Marshall also checked with our own transfer coordinators, who confirmed that our bid to fly this trip was rejected because of the cheaper one from the company who owned the piston plane.
As we talked about how this had happened and the bad outcome for the patient, Marshall asked, “Why can’t we do these flights, Woody?”
“We could, Marshall,” I replied and gave him the bullet points: what kind of plane we’d need, its cost, and how we’d operate it. It wasn’t long until we began finalizing plans for a jet. I was called to meetings with hospital senior management to answer their questions, one of them: could this plane transport organ harvest teams? I explained we could do those missions more efficiently than the charter companies we were currently booking for them. That seemed to push things along. Little did I know at that point how much power and influence harvest teams wielded within the medical center. They could’ve had a plane of their own if they’d asked for it.
A few weeks later our newly acquired Learjet was put into service. We hired four pilots, giving us 24/7 coverage. The Lear could fly at Mach 0.8, well over 500 mph, for over 2,000 miles. We could pick up critical patients in the remotest parts of the Midwest and, with its Advanced Level of Care (ALS) medical system, administer the best of care on the way back to California.
One might presume that our operations in the Learjet were less dangerous than those in helicopters. That was not the case. We faced the same pressures to save patients as in the helicopter and found ourselves, at times, pushed to the limits of the jet’s capabilities. A whole different set of fears - running low on fuel, bad weather forcing us to land at an alternate airport, and the occasional inflight mechanical mishap - could pop up hours into a trip that, at the start, looked to be just another long ride.
We were soon flying lots of trips for the organ teams, most of them tough, demanding experiences for the pilots. They stretched our duty day to its legal and physical extremes as we flew thousands of miles across the U.S. retrieving organs vital to their patients’ survival.
My first experience with transplant teams was a late-night flight in 1989, the first in what would be a long series of surreal journeys through the netherworld of human organs traveling from one life to another. When the call came in that day alerting us to a possible flight, I asked our dispatcher to page my copilot (this was before cell phones, when we carried pagers and phone credit cards) and let him know about the flight. The evening dragged on, with the team at one point telling us there were complications and they didn’t think it would go. Heading home, I settled in for the night. My pager went off about eleven PM, waking me out of a dead sleep.
“Looks like they got it together, and they want to leave as soon as possible,” Charles, the duty dispatcher said when I called in. They had not told us the destination up to that point, so I asked.
“Good news, it’s just to Palm Springs,” Charles said.
“Wonder why they don’t just drive?” I asked.
“They want to fly, Woody, and you know these guys get whatever they want.”
We shared a laugh at that and I asked him to inform the team we’d be ready to take off in forty-five minutes.
It was a beautiful night with just a sliver of a moon. That late in the evening, air traffic had thinned out to freighters and overseas departures, so L.A. Center cleared us direct to Palm Springs and offered us any altitude we wanted. I chose 14,000 ft. to keep us clear of the surrounding mountains. Twenty minutes after takeoff, we started our descent into Palm Springs Airport, nestled at the base of 11,000-ft. Mt. San Jacinto. The tower was closed, so the Center said they’d clear us for a visual approach as soon as we had the airport in sight.
The pattern of runway lights splashed across the black terrain made it easy to spot the airport. We bade goodnight to the Center controllers and descended toward the runway. The radio was quiet after that and, throttles at idle, our two jet engines whispered as we flew tight spirals to get down to the field. An eerie thought came to me: we were a monster-size vulture swooping in silently in the dark to attend a death. Late night flying does that to you, creating strange visions and creepy thoughts.
As we taxied in to where the airport operator would park us I expected the ramp to be dark and quiet. The rich and famous do not travel at this hour of the night. Occasionally, movie stars and hedge fund guys would swoop into Palm Springs on an evening, attend a jet set function but then fly out late that night, back to their pursuit of fame and fortune.
But there were three other jets on the ramp, all with lights on, ground power units hooked up and busy copilots in their cockpits.
“Wow, wonder what’s going on in Palm Springs tonight?” I asked Todd, the copilot. “Must be a big party or a concert.”
A limo slid up to the airplane as I shut down the engines. The transplant team stepped out and were whisked off to the hospital. We secured the plane and walked into the lobby. The Captains of the jet crews were there, some of them talking quietly on pay phones and others stretched out on couches catching a nap.
As I paid the landing fee, I asked the counter person what was going on.
“Oh, all of these planes are here for the same reason as you,” she said. “They brought teams of doctors who are at the hospital.”
I went over and spoke to one of the pilots who was sprawled in front of a television. Turned out he was from St. Louis and had flown in a kidney team. He pointed to a pilot who was snoring on the next couch and said his plane had brought a heart team from Denver.
I thanked him and, too wired to sleep, walked back out to the ramp. I leaned on the wing of my plane and looked up at the moon, clear and bright against a still desert sky. The planes around me were now shut down and their pilots departed for the lounge. Their polished metal surfaces were bathed in soft rays of moonlight. The airport lay quiet in the deep silence of early morning.
I thought back to our arrival, when we’d glided silently down out of the night sky. The image returned, large, metal vultures - these jets on the ramp - creatures who sensed a death nearby and slipped in to witness the passing of a spirit.
I’d flown many a late-night flight. It was easy, up there in the black sky, to sense mystery. That night though was surreal. These transplant teams were extracting organs from a person who had died tragically. Donors have to be healthy people, so their ending up on a donor gurney had to have happened suddenly, leaving their loved ones in shock with their loss. Dealing with the deceased’s decision to be an organ donor meant the bereaved had to live with visions of their departed loved one being cut open. How much more anguish would that cause? I thought about the counselors who would be near them, whispering that this was what their loved one had wanted, and that others would live because of it. That couldn’t be much consolation in their moment of grief.
Out here on the ramp I sensed their agony, and it took me to an emotional place I’d never been before. I’d witnessed violence and death when I was a cop, but in those situations, my feelings were more clinical. The dead were either criminals who created their own demise, or victims whose unhappy situation I was there simply to clean up and document, all of which I’d learned to compartmentalize.
This was different. I was now part of a mysterious process, the vital organs of one person being transplanted into others so they might live on. We are born, grow up, maintain our health as long as we can, then ultimately succumb to one deadly circumstance or another. By taking an organ from one who died before their time and sewing it into another, was this cheating the grand scheme? Were doctors tampering with the natural inevitability of things and extending the life of someone who, in the order of the universe, was meant to pass on?
At times like this it was easy to spin off into such contorted, scary thoughts. Yet, I needed to maintain a sound grip on reality and fly airplanes so, there was a point where all this had to be shelved to be considered in more grounded circumstances.
I stared into the darkness at the stars and the nearby mountains, stark and forbidding in their grandeur. I would do my part this early morning hour. When the team raced across the ramp and clamored into the airplane I would be ready to deliver a perfect, smooth flight home. Bounding out of the plane when we landed they would bolt into the ambulance for the lights-and-siren ride to their operating room. I would finish my duties for the night and be left with my thoughts about mortality, and even immortality.
I would go on many more harvest flights after that night. On most of them, I accompanied the team to the hospital. Their pace was so unpredictable that the only way we could stay ahead of them was for one of the duty pilots to be there, close enough to get a sense of when they’d be ready to go. Once they began to pack up I’d call the copilot at the plane and alert him. He’d get the prep work done so when we rolled up we could get the team and their precious organ on the way. That was the best we could do for them.
***
The image from all the harvest missions that is forever burned into my mind started with a call on an otherwise quiet Saturday night in 1990. The coordinator said this was going to be a peds harvest. I asked what that meant. He replied the donor was a two-year-old child who had fallen and sustained a fatal head injury. The instant I heard this the thought crossed my mind: how devastating would it be seeing an infant passed from this life, lying cold and still in death?
We landed at a small-town airport and, because arranging a separate car for me wasn’t possible on a weekend night in rural America, I rode to the hospital with the harvest team. They were silent as we drove, unusual in that normally they chatted noisily, venting their manic state of mind.
I hung back as they got out of the ambulance and trotted into the ER. I did need to keep an eye on their progress, so I walked to the operating room where the donor lay, planning to watch them work from an observation window. The team was still scrubbing for the harvest procedure. Through the window into the OR I saw the small, still form lying there, it’s perfect little face profiled under the sheet that covered the body.
Lurching away from it I stumbled back to the lobby, desperate to shake the image. I got through the rest of the night on mental autopilot.
I didn’t share my nightmare with anyone until I could talk to my friend, Marshall Morgan. A few days after the flight, I told him about my encounter. He listened like the true friend he was, then said that treating patients could, on occasion, be a harrowing, emotional experience. After years of caring for trauma victims in his ER he said he still had images of patient tragedies that stuck in his mind. So, mine might never go away. It never has.
***
Transplant teams are by their very nature intense and driven. The presiding physician is the boss, guru and the leader of the pack. Since ours was a teaching hospital, the teams included residents who’d demonstrated the requisite intelligence, skill, and fanatic dedication.
Working around the clock, the teams often went days without sleep as they prepped recipients, then flew off to harvest the organ. Rushing home in the jet, they’d spend long hours in the implantation procedure. Their patient’s recovery in an Intensive Care Unit took days as the team monitored the healing process and, with complex drug cocktails managed their immune systems, hoping their bodies didn’t reject the new organ.
One of the weird things about harvest operations: they were late night missions. I asked one of the doctors why, and he said it was operating room availability. Hospitals scheduled operating rooms to the max during daytime hours, so the only time left for a pop-up event like a harvest was late at night. That might have been the case, but to me, it was just part and parcel of the dark mystery of human organs in transit.
One afternoon in 1990 we learned a team would need to fly to a hospital in western Florida. Their patient, Mr. Chapman was in an ICU bed. If he didn’t get a transplant in the next twenty-four hours he would die.
The harvest team coordinator told us Mr. Chapman had developed organ failure while working in a small fiberglass shop where chemicals in the resins were known, deadly poisons. I knew from my experience with airplane manufacturers who worked with fiberglass that protective clothing and breathing gear were mandatory for those working with it, but Mr. Chapman’s employer was a small business that probably kept the shop doors and windows open hoping the constant breeze would keep them safe. Mr. Chapman started feeling tired and achy and began losing weight, then his condition worsened until finally he was admitted to a hospital. His body was polluted with toxins from the resins and was shutting down. Only a transplant would save him.
I could see how this trip was going to play out. From western Florida back to California was at the extreme range of the Learjet. I was the duty pilot that night, and, on the trip home, under pressure from the team for the fastest possible flight, it was going to take all my skills to create the precise balance between fuel load, performance and airplane weight so we could make it in the least amount of time - nonstop.
Pilots contending with head winds have to put on more fuel, but then the airplane weighs more and can’t climb to higher altitudes. Jet engines burn much less fuel at higher altitudes but the plane needs to be at a lighter weight to get up there. Therein lies the balancing act pilots had to play. Luckily, we had flight planning software that optimized altitude and airplane weight against forecast winds aloft, then printed out the altitude profile that would make the trip work. That data gave us a good planning base from which to start the trip, then we could tweak the profile enroute and extract even more miles out of the jet.
The organ team came racing up to the plane about six that evening. Four hours later we were in Florida, and the team was harvesting their organ. I’d shadowed them to the hospital. About two AM, they’d placed their harvested organ in a Styrofoam beer cooler, just like the ones people use for picnics, and were ready to charge out of the operating room.
We’d reported for duty an hour earlier than was customary for the night shift to prep for the trip, so, by then, we’d already been at it for almost eight hours, and we had a four and half hour flight ahead of us back to the West Coast.
A long trip like this wasn’t unusual for jet pilots, but flying an organ team, well, that made it a different game. Flying high-net-worth types was demanding, but organ teams were over the top. Obsessed with their task, always fighting the clock as their patients lay at death’s door, they drove through life at a dead run and demanded the same from everyone around them.
So, as soon as I saw that cooler I called the airport and asked for Fred, my copilot.
“They’ll be in the ambulance in a few minutes,” I said. “I’m leaving now for the airport.”
“OK, I’ll get the clearance and be ready,” he replied. He would trot out to the plane, turn on the ground power, then call Air Traffic Control on the radio and copy down our flight clearance to the West Coast.
I’d hired a car to take me to the hospital and wait so that I could be back at the airplane ready for takeoff before the team arrived in the ambulance.
We were ready when they came through the gate, ambulance lights flashing. Less than five minutes after they pulled up to the plane, we were taxiing for takeoff. As we neared the runway, one of the nurses stuck his head in the cockpit.
“How long’s the flight?” he said. He was breathing hard, amped up, cranking full speed.
“Four hours and twenty-two minutes,” I said.
“We’re making it nonstop, right?”
Our flight plan had us landing with slim fuel reserves. If the winds were even five knots higher than forecast we were going to have to stop for fuel. I wasn’t about to bring that up while we were taxiing for takeoff.
“Yeah, we’ll be fine,” I said.
His head disappeared as quickly as it popped in. That was good. He needed to be strapped in for takeoff and out of our hair.
We pushed the throttles up to takeoff power, streaked down the runway and were accelerating to our enroute climb speed less than a minute after brake release.
“Lifeguard Lear four two alpha, contact Departure Control. Have a good flight,” the tower operator said.
“Thanks, sir, good morning,” Fred replied as he selected the Departure Control frequency.
“Departure, Lifeguard Lear six five four two alpha, out of two thousand feet for eight thousand,” he said.
The lifeguard call sign, when we had a patient aboard, gave us priority ATC handling, helping us cut vital minutes off our flight time. We used it when we were flying an organ as well, since the same urgency applied.
“Lifeguard Lear four two alpha, good morning,” the controller replied. “Radar contact, climb and maintain Flight Level Two Nine Zero.” Higher altitudes are designated as Flight Levels rather than by feet. There wasn’t much traffic at that hour and getting cleared that high right after takeoff was a good sign. In the middle of the day with all the traffic, we’d have been held down to a lower initial altitude, probably ruining our already stretched fuel plan. Fred and I breathed a collective sigh of relief as we climbed high into the dark sky.
The cabin lights came on and the organ team began laughing loudly. They had demanded plates of lobster and crab to eat on the way home and the paper containers were opened. The tangy scent of fresh seafood wafted through the cabin.
The cabin lights glared into the cockpit, blinding our view out the windshield and obscuring the instruments. We needed it dark so we could watch for air traffic and maintain our night vision should we have an emergency. I pulled the cockpit curtain closed, restoring the darkness and muffling the noise.
Our flight management computers continuously updated our arrival time, as well as how much fuel we’d have on board when we landed. After leveling off at our cruise altitude we ran a check of our status. The winds were as forecast and our fuel plan was holding. We would land with the reserves we wanted. But we had a long way to go.
Later, as we streaked along at Flight Level 390, we could see the weather fronts below us that were dumping rain on the middle part of America. Up where we were, it was quiet and smooth, the noise level in the cockpit a mere whisper while the air roared by our stout, metal cocoon at eight-tenths the speed of sound. The boundary with space was only a few thousand feet above us, the stars crystal clear, and America spread out around us for a hundred miles in all directions.
Our routine, hour after hour, called for constant checks of the jet’s systems and monitoring our fuel, the flight management computers’ green numbers glowing against a soft, grey background telling us how we were doing. The one we worried over was labeled Landing Fuel, our precious reserves. At that moment, it was showing 1,300 lbs., pounds the unit of measure because, in flying, it’s more useful than gallons.
We didn’t want to land with less than 900 lbs. If we had to do a go-around we’d need that fuel to fly back around and land. So, if it dropped below our minimum, we’d have to stop. I didn’t want to think about how the harvest team would take that bit of news should it come to that. The good news of the moment: having finishing their sumptuous banquet they were snoring loudly in a darkened cabin.
The number labeled Wind in the flight management computer glowed a minus 22, a 22-knot headwind. The winds would be less the further west we flew, so, our odds of making it nonstop grew better with each hour. But then, they started to pick up, 24 then 28 knots, not enough to ruin our night but certainly a disturbing trend. Hopefully it was just a passing wrinkle in the air mass.
Over the next hour our 1,100-pound reserve shrank to 1,000.
Fred and I exchanged worried glances.
“What do you think?” he asked.
“It’s not the end of the world yet,” I replied. Our options were limited. We could climb to Flight Level 410 or even 430, which would bring down the fuel burn. But our cruise speed would be less and the climb itself would suck up precious extra gas. Better to stay here and hope the winds didn’t pick up.
A half hour later the headwinds had increased to 30 knots and our reserve had ticked down past 1,000 lbs. We’d be down to less than 900 lbs. within the hour.
“Think we ought to stop?” Fred asked.
“Nah, not yet, but it wouldn’t hurt to look out ahead and figure out where we could stop for a quick turnaround.”
Thirty minutes later, we were at 1,000 lbs. Our fuel on arrival would be dangerously low.
“That’s it, Fred,” I said. “We have to stop. I’m going to go tell the team. Stand by for howls of anger.”
“OK, Woody,” he replied, his large brown eyes following me as I climbed out of my seat.
Fred had flown for a charter company all over the US at odd hours of the night. During his interview, I liked him instantly. He radiated a quiet confidence that I knew would be an asset in our high-pressure unit. When we put him in the Learjet for his validation flight, I was amazed at his almost uncanny, smooth touch on the controls, rare for pilots that young. His resume said he had worked hard to perfect it.
After he joined us, we saw another good side to him, his meticulous attention to detail, another asset in flying jets. I was glad he was with me, because the harvest team was taking a lot of my time and energy. I knew I could depend on Fred to take care of things while I dealt with them.
Heading back in the cabin, in the glow from the cockpit lights I could pick out the bodies strewn around the cabin, all snoring in deep sleep. I found our contact guy whose name was Jay. I touched his shoulder. He lurched up and stared at me in fright. Then he woke up enough to recognize me. He shook his head, fatigue tormenting him. He probably hadn’t had a night’s sleep in a week.
“What’s wrong?”
“We’re going to have to stop for fuel, Jay,” I said, gently. “The winds have picked up and our reserves are gone. Remember we talked about this last night, that we might not be able to make it nonstop.”
He shook his head trying to comprehend what I was saying while he stared at me.
“You don’t understand. This organ won’t make it if we have to stop, and our patient will die. He has no time left. You have to keep going.” Exhausted, he fell back onto his seat and stared at the ceiling.
I’d expected pushback but his fixation stunned me. How do you work with obsessive, manic behavior within what’s supposed to be a civilized, professional setting?
Jay rolled over and woke the doctor. He sprang straight up, looked around, blinking, trying to orient himself. Jay put his hand on the guy’s arm and spoke to him quietly.
“Our pilot ...” He knew my name, but chose not to use it. I wasn’t a real person in their world. “Our pilot says we have to stop for fuel. He can’t make it to L.A.”
This was getting crazier by the minute. I couldn’t make it to L.A.?
The doctor sat straight up and glared at me. “What do you mean, you can’t make it? This organ won’t survive, my patient won’t survive, if we’re not on the ground right on schedule!” As he spoke, his face moved closer to mine, penetrating my personal space.
“I understand the urgency, Doctor, but we do not have the fuel to safely make L.A.,” I said, with practiced patience. “Jay and I had this conversation yesterday. The flight plans last night indicated that we’d make it, and now the winds ...”
“I don’t care about wind!” he shrieked. “I am saving a man’s life and, if I don’t get this organ to the hospital within the next three hours, it won’t be viable and he will die. Can you comprehend that?”
I held up my hand, trying to calm him, then turned and headed back for the cockpit. “Pick the best airport up ahead,” I said to Fred, “then call them and arrange for fuel. Ask ATC to help us with a priority arrival.”
He looked at me, his eyes wide. He’d heard the shouting and was terrified. I think he was afraid they might beat me up or something. But he nodded dutifully, then turned and set to work.
I went back to where the doctor and Jay were hunched over, staring at me.
“Here’s the deal, Doctor,” I said. “We’re going to make a stop. It’ll add about a half an hour to the trip.”
He opened his mouth to start in on me. I held up my hand again and looked him straight in the eyes.
“Hold on. The stop will take about fifteen minutes. Then we’ll fly fast at a lower altitude the rest of the way. The total delay will be thirty minutes max, probably less.” I took a deep breath. They stared. “That is the absolute best we can do without jeopardizing your lives.”
The rest of the harvest team was awake now, lying on one shoulder or another and listening. The doctor and Jay just glared at me.
“Now, why don’t you try and get some rest? We’ll have you home as soon as we possibly can.” I turned and went back to the cockpit before the doctor could yell at me again, but I felt the glares of the team burning into my back.
We landed at an airport in Kansas, perfectly placed mid-continent as a fuel stop for those corporate jets that couldn’t make it coast to coast. These mid-US operations were renowned for their quick turnarounds. The fuel trucks drove up to the plane as we taxied in. I told the organ team we’d be on the ground no more than fifteen minutes and they were welcome to make a quick lobby visit. They piled out, glad for the respite. The doctor stayed in the plane. There was some regulatory question of refueling with passengers aboard, but at three o’clock in the morning with a freaked-out transplant doc I wasn’t going there.
We were airborne eighteen minutes after we landed. Climbing to the mid-thirties we pushed the power to the top of the green. Instead of our usual cruise of Mach 0.76, we were doing Mach 0.81, almost fifty knots faster than before, right on the redline.
Starting our descent at four-thirty AM, I asked ATC for priority handling into Van Nuys, California, our base airport. They were great, clearing us direct to the airport. Planning for a 6,000 foot per minute descent we could keep our speed at the max all the way to the airport, a Shuttle One arrival, named after the space shuttle’s screaming, steep flight path to Earth.
We taxied in to the ramp twenty-eight minutes later than our original planned arrival. As we stopped right next to the ambulance, Fred stepped back into the cabin and opened the door. The organ team stormed out. The doctor passed the door and leaned into the cockpit. “I’m speaking to the director tomorrow. He’ll have your job.”
What a guy. The ambulance clambered out the gate, lights ablaze and sirens howling, heading for the hospital.
I climbed out of the plane and stretched. God, what a night.
“What did he say to you?” Fred asked.
“He told me how much he enjoyed the flight,” I said.
The next day, I called my boss, the director.
“Hi, sir. I understand our passengers last night were angry at our poor service.”
He chuckled. “Yeah, I heard something about that. Sounds like you had a long night.”
“We did,” I replied.
“If we fired everyone that pissed those guys off there wouldn’t be many of us left. That was good judgment, though, not allowing the doc to crowd you into a bad situation.”
I thanked him for his support.
We heard that Mr. Chapman survived the operation and was able to resume his life. I saw the good doctor around the hospital now and then. He was never cordial, but then he wasn’t with anyone. The other pilots had high-pressure trips with him in the days and weeks afterward, and we all got through life together, one day at a time.
The spat with the doctor was a new experience. Our flights in the 222 had been pleasant, for the most part, the few disagreements we had solved with friendly dialogue. There was always a certain air about nurses and doctors, a pre-occupation with patient care that we found it better not to interfere in. There were always a few of them who were distant to us, a certain arrogance that, over the years of flying with them, we got used to, but then, you only had to watch them lord it over the ER staff to realize we weren’t the only ones.
Could we change this, prevail on them to recognize that we, like them, were highly trained professionals? Too many instances over the years showed us that would never be.
Over the years flying medevac I did become friends with some of the nurses. In the dangerous scrapes we experienced I think they came to respect my pilot skills that got us safely through the mission. Most of the pilots I worked with were able to build that same kind of respect for themselves. As a group, though, we knew we would always be looked down on by them, their varying levels of contempt implanted in our collective memories.
One day, as the science of growing organs from animal tissue and donor cells eventually replaces the organ harvest process, doctors will look back on the transplant process as a necessary but gruesome step in the evolution of medicine. And history will show that all its uncertainties and tragedy drove those medical teams to the manic states we witnessed. They meant only the best for their patients, but too often the organs didn’t work or something else happened to ruin the process. Their patients’ tragedy became theirs, and for those of us who worked closely with them, ours. We can only hope that with progress the pressure on those teams will be lessened, and there will be no more all night, frantic flights.
Copyright © 2021 Woody McClendon. All rights reserved.
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