Part Deux

The syringe filled with blood. Evidence that the .22 cal bullet he had fired through his own chest had nicked his lung. I quickly finished numbing the incision site and the flight medic proceeded to place a chest tube. (I was disturbingly jealous that he did the procedure, but know that they need to keep their skills up as much as I do.) Our patient was surprisingly thick. One cut didn’t do the job. As the medic worked his way toward the chest wall he found his landmark (4th – 5th rib on the axilary line) and cut into the pleural cavity. With a wealth of experience behind me, I deftly stepped to the side (I was holding the patient down) and avoided the gush of blood that shot out of his chest. The chest tube was quickly worked into place and blood flowed readily into the reservoir attached past the 500ml mark. Lung sounds improved. Mildly. Oxygenation improved. Mildly. A call was made and our patient was going to head to Anchorage. Surgery was in his future.

We loaded him onto the trailer, behind our four wheeler. Two of us sat astride the rear wheels and two sat in the trailer with the patient for the short ride back to the airstrip. Our next stop was St. Mary’s, a village with an airstrip large enough to accommodate a small jet which would complete the transport to Anchorage. As our plane lifted off the runway, low on the horizon was the deepest blood-red moon I have ever seen, backed by the number of stars that only a location this remote and this dark could present (galaxies…I could see galaxies). The orb barely rose above the tundra, appearing as a warming fire in the distance on this cold night. Turning to look back the opposite direction, towards the village, I also noticed a thin blue vein dancing across the sky. My first sighting of the Northern Lights, this year. Fascinated, I watched the ever-so-slight dance as we headed south to St. Mary’s.

The story ends with a 3a.m. return, lack of sleep, and an appreciation for small caliber gun shot wounds. Sadly this is not the first time I have flown to pick up some one who managed to “wing” themselves with a rifle. Suicide and suicide attempts in the villages are far too common. Is this the result of western influence? The TV showing teenagers a lifestyle they can’t have? Simply (or not-so-simply) a substance abuse problem? A result of the lives that were spirited away to BIA schools, leaving their culture and family behind? Something that has always been present, but not acknowledged due to the lack of a written history and the color of oral tradition? I don’t know. Our patient is still alive. The family member who encouraged him to shoot himself, while they were both drinking heavily, has to live with his influence. I’m glad that our patient’s young son still has a father. That means a lot to me these days.