Offering aid from the skies
It's been a tough day at the office for this intensive care paramedic [Johnny Mulheron] with two of his patients today dying.
I've been on standby for 12 days, with the Nelson Marlborough Rescue Helicopter pager system configured to text my cellphone.
It's a strange and slightly stressful way to live, knowing that, at any moment, the vibration from my phone in my chest pocket could mean I must drop everything and "go". To have any chance of leaving with the helicopter, I need to get to Nelson Airport from wherever I happen to be within 10 minutes.
With my first page on day three, I'm 90 seconds late and watch as the rescue chopper leaves without me. On subsequent days I either miss it because I can't escape meetings, or am "parked" in school traffic on Waimea Rd.
Weekends for the rescue helicopter are normally the busiest days for operations and last Saturday proves that point.
At 8.31am, my phone vibrates with the message, "Air 1 Nelson. Fall Kaiteriteri."
I'm on my way in less than 60 seconds, carrying my camera, flight suit and wearing my boots with the laces undone. Pilot Jarrod Colbourne and St John intensive care paramedic Johnny Mulheron welcome me briefly and we lift off.
The crew are briefed on the injured patient – a man in his 60s who's fallen in the shower, breaking a femur. Johnny says he'll be in a lot of pain and asks me to help by getting and holding the "sharps" container while he draws syringes of various pain killers.
There is little talk on the 14-minute flight to a grassed reserve at Little Kaiteriteri, apart from brief comments about the weather. A minute before landing, Jarrod asks us to check our seat belts. I simply reply "straps tight".
As Jarrod brings us into land, everyone – including me – is responsible for pointing out potential hazards – anything from power and telephone lines to people and animals.
We don't leave Kaiteriteri till 9.15am. It's taken 20 minutes to get 62-year old Duncan Gardiner stabilised and stretchered to the chopper by a Motueka ambulance, from the address in Kaiteriteri where he's had his fall.
I photograph Duncan's wife Jill Gardiner being comforted by a friend then climb back in the helicopter, where I see Mr Gardiner up close for the first time. He appears to be in shock and a lot of pain, but I'm amazed that, within a minute or two, he's stopped shaking and is answering Johnny's questions ... .
"Duncan, on a scale of 1 to 10 what would you score the pain?" He answers "5", which seems a low score to me. Johnny gives him some morphine, "Aw, I can feel that," he says as the drug flows through the tube and into his arm. On Monday I speak to his wife Jill to get consent to use his name and photograph. She says her husband can be "very stoic".
At 9.28am the skids of the rescue helicopter touch the large H on the heli-pad at Nelson Hospital and Mr Gardiner disappears out the back of the helicopter and past my side door with Johnny and a hospital orderly. It's been less than an hour since I received the phone text. I return home and take off my flight suit and boots.
At 12.59pm my chest pocket vibrates again, but the traffic is heavier – and one of the conditions of this assignment is "no speeding".
I arrive at the rescue helicopter pad just as Jarrod is about to shift the two engine control levers from "idle mode" to "flight mode". Johnny is in the front with Jarrod to help navigate to the location of a St John ambulance on Neudorf Rd in the Moutere. We land at 1.19pm in a paddock near the ambulance. Johnny heads off to check on the condition of 65-year old Richard Pomeroy, who is having chest pains, which turn out to be a heart attack.
An advantage of the larger BK 117 helicopter over the smaller Squirrel chopper, which the team also use, is easier patient transfer using the Stryker stretcher. With the help of Upper Moutere deputy fire chief Alan Rankin, who has stopped to help, four of us wheel the stretcher over the paddock into the back of the idling machine.
As we lift off for the 10-minute flight to Nelson Hospital, it's clear Mr Pomeroy is in a bad way and suffering major chest pain. He's having a heart attack and really needs to be on a cardiac operating table, right now!
The sweat is starting to show on Johnny's face as he works hard to keep his patient alive – the only sense of real urgency I see all day from him comes as he tells Jarrod: "This is definitely priority one".
I take a few scenic aerial photographs from the helicopter as we head towards the hospital at 225kmh and think it hasn't been a good day for 60-years-plus men. Unfortunately, the day is not yet over.
When we land at the helipad at 1.44pm I notice a group of people in the nearby garden area of the mortuary visiting room. It turns out they are with the body of Cain Adams, who died in an accident at Port Nelson earlier in the day. Johnny Mulheron was the intensive care paramedic who attended this incident, too. So the busy day being experienced by pilot Jarrod and me is nothing compared with his.
It's 1.52pm and I've moved to the front seat of the helicopter when my phone vibrates again. The message reads, "Air 1 Nelson chest pain difficulty speaking Lagoon St Torrent Bay", and within a minute another message, "Torrent Bay is now cardiac arrest".
Johnny has walked out of the hospital, ducking under the spinning blades of the aircraft and is simply told by Jarrod "we have another job".
The helicopter and its crew represent the patient's only real chance of survival, and Jarrod powers up the rescue helicopter's two 500 horsepower engines. Just 15 minutes later we land at the reserve at Torrent Bay, and I follow Johnny with equipment he has asked me to carry. I've already told the rescue helicopter people and the St John paramedics that I did a NZQA first-aid course in 2005 and have done the necessary refresher courses to maintain the qualification.
In first-aid training they teach you to look after yourself first, so I take a pair of rubber gloves from my flight suit pocket. As Johnny takes charge of trying to restart the heart of 68-year-old Gary Harman of Motueka, who has collapsed near the lagoon at Torrent Bay, Johnny calmly issues instructions to the two house surgeons who happen to be on holiday at Torrent Bay. They, along with Mr Harman's friend, have been performing CPR on him since he collapsed.
Johnny gives me several tasks, including using a suction pump to make sure there is a clear airway, as Jarrod sets up the oxygen. We try to revive Mr Harman for 45 minutes, but there is no sign of life. Johnny's heart monitor produces nothing but a straight line and the decision is made to stop resuscitation attempts.
The disappointment Johnny feels at losing a patient is obvious. He later tells me "we're supposed to save them".
It's been a tough day at the office for this intensive care paramedic with two of his patients today dying.
While he leaves to phone the police, Jarrod and I wait with Mr Harman's body. Johnny comes back with a police request that we fly Mr Harman's body to the Nelson Hospital mortuary.
In his death notice in Monday's Nelson Mail, his family ask, "In lieu of flowers would people please make a donation in Gary's memory to the Nelson Marlborough Rescue Helicopter Trust."