SAVING LIVES

Author's Note: I am currently writing a series of stories for the Ukiah Daily Journal about people who do good things. This story, my latest, is about a helicopter rescue team.

It is 9:30 on a Friday night. The July 4th Holiday weekend is about to begin. Most people are snug in their homes watching television or making plans for the holiday weekend. But for the crew of Calstar 4 rescue helicopter team, it is quite a different story. For them, it is business as usual in the small tan building that serves as their office and bunkhouse beside the runway at the Ukiah Airport. They know that what sometimes begins as a slow day often doesn’t end that way. So they take advantage of downtime in their "home away from home" cooking a meal of "steak tips" on an outdoor grill and boiling fresh corn on the cob from a local farm on a stove in the small galley kitchen.
Beneath the calm exterior of the pilots and flight nurses, there is a constant state of readiness. The voice coming over a Motorola Radio on a shelf can be an instant call for their help at any time—day or night.
Downtime is when a lot of chores get done. Tim Tatman the aircraft mechanic performs tests on the Bell 222U helicopter that has become the sole lifeline for so many people in Mendocino County—and beyond—for 18 years. When the chores are done, the crew takes time to rest knowing they can end up being awake and at work, for as many as twelve hours at a stretch. Flight nurse Rob LaCount is glued to the television watching the Pepsi 400 at Daytona Speedway, at times jumping up off the couch and hollering when another car cuts off his favorite "Junior" Ernhardt. His tee-shirt has Junior’s name emblazoned across the chest. During commercials, flight nurse Trent Waechter talks about his recent vacation in Maui. Pilot Dale Farr catches up on computer work in his office taking breaks to check on the steaks on the grill.
Then at about 8:00PM, after the dinner was eaten and the dishes done, Farr’s shift ends. It’s time for him to head home and turn the reigns over to Jennifer Prevost, a feisty redhead and a seasoned pilot who began with Calstar in 1986, the year it started.
Things remain quiet while the crew finishes their ice cream but oddly, the moment they’re done, the radio suddenly comes to life. They hear the familiar voice of the CDF dispatcher from Howard Forest in Willits, the place where all emergency calls are dispatched, coming from the radio speaker: "Calstar 4, Howard Forest. Scene call, Philo. 30 year-old female, unconscious." There is a hush in the room as all ears tune in, giving the message the gravity afforded matters of life and death. The urgency is palpable and immediate. Flight Nurse Rob LaCount yells to Jennifer down the hall in the back office. Jennifer appears, seconds later, zipping up her flight suit, Rob holds the door for her. Trent is already out at the helicopter pulling the cord that attaches it to the external generator. Then, within a matter of minutes, the red strobes on the helicopter are flashing, the crew is buckled into their seats and the blades are slowly picking up speed. It is obvious these four highly trained individuals have suddenly transformed into a rescue squad.

Teamwork at its best

What one notices about the crew of Calstar 4 is that they act as a team in the best sense of the word. They talk to each other constantly, the microphones on their white helmets, pressed against their lips. Jennifer asks if the "box handler" a UPS truck has left the tarmac on one side of the chopper, Trent, who is sitting in the left front seat has a better view. "He’s outta there," he reports. "Thanks," says Jennifer, voicing each of the steps she takes as she coaxes the sleek helicopter off the ground. She tilts the nose down and the chopper picks up forward momentum. "Gaining altitude," she says. "We’ll be making a slow right turn southwest then we’re over the mountains." Each step brings the life-saving nurses closer to their call.
In the seat in back, which holds the life-saving equipment and the litter, Rob tears off a six-inch strip of white medical tape and sticks it to the top of his leg. As the radio dispatcher from Howard Forest calls in the co-ordinates, Rob copies them onto the tape with a ball point pen. "Rob, please confirm," Jennifer asks, as she climbs the helicopter into the dark sky where the mountains to the west appear jet black suddenly taking on an ominous feeling. During the day in the light of the sun the mountains seem like beautiful objects; now they are transformed into obstacles the chopper must climb over.
As Rob reads the co-ordinates, pronouncing each number clearly, Jennifer punches them into the Garwin GPS navigation system where they appear on the screen miraculously transformed onto a screen giving her time, distance and bearing to the location. The dispatcher from Howard Forest finally turns the radio over to a Boonville Fire Department dispatcher who has arrived on the scene. Fireman and EMT Don Gowan is assessing the patient. The 30 year-old woman, still unconscious, lies on a litter in an ambulance. She has had a history of heart failure.
In route the Calstar team is already mentally preparing for the situation they will encounter on the ground. In a matter of minutes, the scene comes into view 4,500 feet below: The flashing red strobe lights of an ambulance parked beside a house with two other visible sets of red lights speeding along roads towards the scene. Within minutes, the powerful white helicopter over flies the landing zone while the ground coordinator warns the pilot of the danger of wires and a pole at the edge of a field. These inanimate objects, non-threatening on the ground, present a real danger to a helicopter attempting a landing. "There are a lot of trees in this place!" Jennifer reports, her powerful searchlight illuminating a grove of tall firs. "There’s a big field behind the barn," the voice from the ground informs Jennifer who finds the center of the field and expertly settles the chopper down.
Once the chopper is on the ground the ambulance speeds to the field and Trent Waekler and Rob LaCount are ready to meet it. They find the patient strapped to a litter in the ambulance, which becomes an emergency room for the flight nurses. Trent and Rob assess the patient. They determine her respiration is ineffective. In essence, she is not breathing. Immediately they start an I.V. then Rob injects a sedative to relax the patient’s mouth while Don Gowan, a Boonville Fireman who was first on the scene, assists Trent in intubating the patient—opening her airway with a curved metal bar—a laryngoscope. Trent sends a plastic tube down the windpipe and Gowan attaches and pumps an airbag until he is effectively breathing for the patient. Trent takes the vital signs reading them aloud to Rob who copies them down. Gowan tells them what he knows of her history.
Not until the nurses are confident the woman’s condition has stabilized do they transport her on the litter to the waiting helicopter. Jennifer has never stopped the engine; the blades continue to revolve slowly. But once the patient and the nurses are aboard, she eases back the throttle and the chopper seems to comes alive—the rotors increasing their revolutions, lights flashing in the cockpit. "Please tell Don to close the doors on the ambulance," she says to the ground coordinator. "Or I’ll close them for him!" She jokes. In this business of life and death, the professionals involved all seem to maintain a sense of humor. What she means, of course, is that the powerful prop-wash from the helicopter blades will slam the ambulance doors shut if Gowan doesn’t do it first.
Everything happens quickly in the business of saving lives. In a few more seconds the powerful chopper has once again climbed above the mountains—this time flying northeast. "Take a moment to look out the windows on the right side," Jennifer says. And there, like a huge Sunkist orange sitting on a pitch-black shelf, is a full moon on the top of the mountains—a singular sight and a pay-off for these late-night workers who quietly, thoughtfully, systematically go about business while the city sleeps.

The unsung heroes

Every team has its unsung heroes. Calstar Base 4 has two: A helicopter, a Bell 222U and Tim Tatman, the aircraft mechanic who keeps it flying. Dale Farr, the pilot on duty, who is also Calstar’s Corporate Safety Manager, puts it simply, "we’re blessed to have him here. There’s never been a day when I’ve been uncomfortable to fly." A compliment not to be taken lightly from an ex-military pilot who flew for the Special Ops.
Tim is a tall lanky man with a mustache. In an older time, the type of man who might well have had a pipe in his mouth while he dotes over his obvious labor of love. Tatman’s answer to how he got in the business is straightforward. "My first helicopter job was when I was 18. I was a field support guy driving a fuel truck for a geological company so I got to travel all over the place."
Tim’s office is in a corner of the base’s living quarters. Above his desk a bookshelf reaches the ceiling, every inch packed with manuals, not only for the resident Bell 222, but for a GermanBO-105 another helicopter Calstar uses. But the Bell is Tim’s true love. "There’s nothing she can’t do—no other like her." And there’s nothing Tim Tatman doesn’t know about what’s under her hood. "The Bell 222U can carry 8250 pounds of gross weight—that means," he explains patiently, "the weight of the bird including the medical equipment she carries and the passengers. The pilot, two nurses and the patient. She cruises at 145 knots and her range is 300 miles."
Tim’s point makes it evident that what makes helicopter rescue so effective is speed. Given the topography and remoteness of many areas in Mendocino County, often an hour’s drive time for an ambulance is cut to only fifteen minutes with a helicopter.
Weight is crucial element, right down to the last pound of fuel. Load weight must be carefully calculated, with the outside temperature making the crucial difference. On a cool evening, any aircraft can carry far more weight than on a hot day. So everything aboard becomes a consideration, the amount of fuel in the tanks and the weight of the patient is considered.
Tim easily gets on a roll when he’s talking about his aircraft. He removes a cowling to reveal one of the two Lycoming jet engines and the intricate mechanics of transferring torque to the huge twin blades. Next, he removes the fiberglass nose which covers a radar system, a powerful 24 volt battery connected by a sea of wires snaking between high-tech black boxes, hiding things like gyroscopes, all of which he is on intimate terms with. Complicated is not a good enough word to describe—intricate is better.
Tim says he feels a great sense of accomplishment being part of the life saving process. But like all the Calstar team members, he modestly defers the word hero to those who directly do the business of saving lives.

Flight Nurses—the best in the business

Rob LaCount is a burly guy with a short-cropped beard. He’s has spent the last six of his 36 years working for Calstar. And like all the team members, his resume is impressive. His eight certifications might be uncommon in the industry but they’re the norm at this company. He has his RN of course, but followed by that are CCRN: National Certification in Critical Care Nurses, CFRN—National Certification in Flight Nurses, MICH—Mobile Intensive Care, ACLS—Advanced Cardiac Life Support, NRP—Neo-natal resuscitation. In addition, Rob has passed the FNATC—Flight Nurse Advanced Training Course.
Rob thoughtfully says he does what he does because he likes the critical, challenging, nature of being a flight nurse. "It’s probably the most autonomous area of medicine," he says. "I like to fly and like to be in the field. It’s a greater challenge than being in a hospital which is a controlled environment."
"Sometimes were doing our job in the middle of Highway 101. The traffic is stopped in both directions. It could be raining, and we’re intubating someone in those conditions." The challenge," he smiles, "is to stay calm in a very critical situation."
He began in a cardiac, thoracic emergency room at the Good Samaritan Hospital in Phoenix 13 years ago. It was there that he talked to a flight nurse one day who was delivering a patient from the field. "I knew immediately that I wanted to do it."
When Rob explains what missions have been the most life changing for him, he mentions two calls, both involving children. One was an 8-year old drowning victim at Lake Pillsbury; the other was a 10-month old infant near Leggett. "We responded to a head on collision involving an 18-year old and found a baby in the back seat. She had stopped breathing. We intubated her and then flew her to Harmon Center at Mercy Hospital in Redding."
For saving the baby’s life, Rob was awarded the EMS nurse of the year by the Mendocino County Board of Supervisors. But what meant the most to him was meeting the little girl’s grandfather and the emotional thanks the man gave him.
Rob is not shy about saying, "I am good at what I do. If I can make the difference in the life of a child, I want to be there to do it. This business is about saving lives."
Trent Waechter is a good-natured 33-year old who commutes from Granite Bay near Sacramento. "I’ve got the greatest job in the world," he says simply. It was a catastrophic event in his own life that made him want to save the lives of others. He received a bad head injury in a motorcycle accident when he was eighteen. But that event gave him the impetus to enter a career in nursing. Interestingly, Trent had problems with motion sickness, which he thought would preclude his being a flight nurse. But it turned out that although he was uncomfortable working in fixed-wing aircraft, he had no problem in helicopters. Lucky for Mendocino County!
Like all the nurses employed by Calstar, Trent had years of critical care experience, in his case seven years at U.C. Davis Medical Center. Echoing his team member’s sentiment, what Trent likes most about his job is "You’re out there on your own without an ER physician. We are forced to make decisions that doctors would make if we were back in a hospital."
"We approach things very systematically—we have to, especially in an uncontrolled environment. We don’t want to get overwhelmed by adrenaline rush. It’s almost uneventful when you’re doing things right."
But Trent clearly revels in the adventure of his job. "We were on a call in Piercy where a car went off a bridge. We were the first responders, so we had to pull two people out of a car that had flipped into a river. We were doing what fireman would normally do. But sometimes, like that time, it’s just us on the scene so we do whatever we have to. No two calls are the same—we’re always improvising," Trent smiles.
Dale Farr at 45 is the senior man in the group. He’s one of the pilots who gets the nurses to the scene. Farr’s background in flying makes him a perfect candidate for his job here. He learned to fly Hueys in the Army in Germany. Then he was assigned to the Top Secret 160th Special Ops group flying Black Hawks equipped with the Army’s most sophisticated weapons and radar jamming devices. Farr was then sent to Alaska as a Chief Pilot in search and rescue. Stationed in Fairbanks, he encountered some of the harshest and coldest conditions on earth. "Then I was transferred to Fort Irwin near Barstow, California in the middle of the Mojove desert," he laughs. "Which was about a 100 degree temperature change."
Dale is happy to talk about filling his role as Corporate Safety Manager as well as IFR Captain—Instrument Flight Rules—for Calstar. "It’s one of the best MEDEVACS in the industry," he says. "We require at least 3,000 hours of flight time for our pilots. Plus, they must be EMS qualified. Doing what our pilots do is the most demanding mission for civilian pilots there is. We get a call, try to lift off within six minutes, often flying to a place we’ve never been before. Most of our flight planning happens when we’re flying with the ground contact on the scene giving us the longitude and latitude. We usually have to self-land, picking our own LZ."
Farr is proud of the fact that he flies with two nurses on board. "Two," he emphasizes, "amounts to a lot more. Our helicopters are really flying emergency rooms."
Talking about the area Calstar 4 flies in, Farr says, "we cover the largest area of any of our teams and we have the most varied terrain. Sometime, when it’s dry you can land in a ‘brown out’’’ he says. "The prop wash blows up so much dust it completely envelops the chopper and you can’t see a thing—you don’t know where the ground is."
"It gets very dark." Trent adds. "There’s no ambient light in this area. So unless the moon is out, you can’t see anything—it’s difficult to distinguish the mountains."
"This is the scariest flying I’ve ever done in my career," Farr says. "It’s much harder here than any place I’ve been. There’s a marine haze that comes off the ocean." But the pilot defers the hero status to others. "I’m just the pilot. I get the heroes to the scene."
Farr attributes Calstar’s excellent safety record to a simple company saying: "Three to say go—one to say no." If any one of the crew aboard the aircraft feels uncomfortable about a mission they can abort. Farr notes that because Calstar is a non-profit organization, they aren’t forced to take dangerous flights in order to make money. "I feel guilty whenever I turn down a call," he says, "but when I make that decision, I do it knowing the aircraft will still be here to save somebody else."
Gordon Gore, the Assistant Airport Manager for Ukiah, truly admires the Calstar team. "They are the most empathetic people I know," he beams. "I am impressed with their professionalism. They’re like fire fighters—they do all they can for people—anybody."

The journey’s end

The flight over the mountains from Boonville takes a quick six minutes from the field behind the barn to the heli-pad at the Ukiah Valley Medical Center. After the patient is rushed into the hospital, Pilot Jennifer Prevost shuts down the helicopter and heads across the pad through the doors which lead into the emergency room. She has the look of concern in her eye—the look seen on the faces of people who genuinely care about others.
"It’s more than a job," says the veteran captain of eighteen years. Asked to describe what she’s feeling, "satisfied," she says simply. And that says it all.