Dark Water, Wild Winds: Notes of a Flight Nurse

I must see new things
And investigate them.
I want to taste dark water
And see crackling trees and wild winds.
—Egon Schiele

IMG_2650Repatriation

I’m standing on the tarmac in Manaus, Brazil, where there is indeed a wild wind; it blows debris across the runway yet does nothing to stave off the nearly intolerable heat. Sweat soaks my back and drips down the center of my chest. My limbs are heavy with lethargy. The heat index is 110 but it feels much hotter—even the Learjet fails to provide a haven from the equatorial sun.

We’d come to Brazil to repatriate an Englishman who’d been visiting family and was struck down by sudden and severe seizures. He’d spent weeks in the hospital, sustaining scans and diagnostics to pinpoint the cause, and endured the addition of one antiepileptic medication after another.

While the seizures finally ceased, he was left disquieted and uncomfortable, unsure which symptoms were due to the 7 cm brain mass that had been discovered and which were side effects of the myriad of antidotes. By the time we were dispatched for this mission, he was medically stable and ready to go home to deal with the ominous findings. Biopsies awaited and treatments would be considered. Plans could be made.

Conversations in the In-Between

His long flight was one that seemed to serve a purpose far greater than physical transport. Away from the confines of the hospital and the doting attention of his family, he had time to process the implications of a brain mass. He pondered aloud the best- and worst-case scenarios and all of the “what ifs” in between. He napped often, awakening to ask my partner and myself a series of questions of which we never tired. (“What if it’s malignant?” “Will they operate?” “How will they operate?” “What if they can’t operate?” “What if I have no time left…?”)

By the time we reached the hospital near his home, his questions had slowed and nearly ceased. The flight was cathartic, I think. Our patient seemed at peace.

A week later, we received an email from the gentleman with a somewhat cryptic message of thanks. It said that we gave him peace of mind with our “deep knowledge,” and that our mental support meant a lot to him. “Subtle assurances,” he called it, “indiscriminately conveyed”.

I knew what he meant. On this trip, in particular, the medicine was rote. Wrapping his mind around the potentials of his situation—and the implications for his young daughter and wife—had been more painful than any seizures, and I think we were able to quell such painful thoughts, for a time.

Staying Afloat

I often travel with the same crew. We’re a small group and mostly like-minded; we grow close on the long trips, thriving on the “goodness” we can do, the success of missions gone well, the thrills of the unexpected situations we find ourselves in and the pleasures of traveling to distant lands.

On this trip, I was fortunate to be traveling with a medic who is as adventurous and competitive as I am. After a bit of rest, we set off with the pilots to explore our patient’s hometown before heading back to the US. Confronted with the English Channel, and despite a damp, gray day and frigid wind, we hurled ourselves into the water, effectively adding it to the running list we compile titled, simply, “Bodies of Water Swum In.”

And in the moment of total-body shock, in the freezing pain that felt almost electric, I didn’t think of how bad an idea it was to swim in the English Channel in the early spring, when the water churned and sucked my feet out from under me on the pebble beach and the undertow felt like a force I shouldn’t have reckoned with. I thought of our patient, amidst his own dark water, just staying afloat.

(Editor’s note: Details have been change to protect the privacy of the patient described in this blog post.)

 

 

Chief flight nurse at Global Jetcare. Regular author on this blog.

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