Strange Sunday

So I headed back to the Rez with a group of 8 from Bethel. Well, 6 from Bethel, Dad and me.  That makes 8.  I was a little anxious on the drive out, excited to see the friends I had made out there again, nervous about the group I was with - hoping they would have a great experience.

When we arrived on Saturday, I was a little overwhelmed.  The staff changes periodically through the summer, and I knew that.  But everyone I knew was away from camp.  A whole new staff was there to greet us.  It was OK though, as they were all great.  Eventually I did get to reconnect with my "old" friends, and it was great. We settled in on Saturday and I slept well, knowing that Sunday would be quite an adventure.

After the Sunday morning sunrise (pictured above), the decision was made to go to the Badlands first instead of Wounded Knee, since the heat was supposed to be rather extreme. We stopped first at the South Unit visitor center, which was open this time.  It was very cool, both in displays that they had, and the air conditioning as well.  Some people stayed behind for the cool air, but everyone on our bus ventured forth.

When we reached the Badlands, we set out across the trail, Dad and Erika and I bringing up the rear.  I carried along a camp chair for Dad to sit in, in case he got tired.  But we managed the hike out to the climbing point without difficulty.  As everyone climbed, Dad, Erika and I set out once more to get a lead on the group.  I'm rather glad he was there, because it was hot enough that I didn't want to move very fast.

Eventually the group passed us.  Dad decided to head back to the buses, as the heat and altitude were bugging him.  He started back with Erika and I went on a bit.  I found eviddence that this area was once used as a gunnery range...

(That's a machine gun belt link.)
and had a little quiet time. But I eventually decided I'd rather stick with Dad and Erika.  The heat and altitude were getting to me, too.  I got a shot of them as I was headed back to them...

See?

Anyway, when I caught up to them they were at the climbing spot again, and I found this really neat rib bone from some mammal.  It turned out to be a great back scratcher, as demonstrated by Erika...

We walked on a little and when we stopped to rest again, Dad pointed out a small orange circle in the dirt.  We excavated a little and discovered that it was an intact fossil turtle shell!

We decided to see how much of it we could uncover before the group came back.  After only a couple of minutes, one of the staff members came back to find us.

"Uhh, we have a bit of a problem." She said. "Somebody fell and broke their leg."

Immediately I worried that it might be one from my group.  But it was not.  It was a guy from Lincoln, NE.  After talking it over with Dad and Erika, we decided I'd better go back and see if they needed any help from a former medic, and to take the chair in case it would make transporting him out easier.

Erika and Dad headed for the buses again, and I headed for the Sanctuary.  As I walked, people from the group came trickling out.

"You're going the wrong way!" I heard many times.

I saw one of the people from my group and told her to send back my backpack.  Before I left for the trip, I had noticed that I had a little extra room in the front pouch of my pack.  I packed a few bandages in it, some cloth triangle slings and some trauma shears.  As an afterthought I tossed in the SAM splint, a foam covered strip of aluminium that can be formed into a splint for broken bones.  I didn't think I'd eed it, as I'd been carrying it for ten years having never used it.  Like I said, an afterthought.  I had even considered leaving my pack back at the camp that day, but decided last minute to bring it along.

Then two more staff members came running by. I asked them what was happening.

"Some lady just broke her leg."

Lady? I thought it was a guy?

"It is." They said.  "It's both."

Oh crap. I thought to myself.  The medic in me awakened and I went into EMS mode.  Two broken legs. Severity unknown. In the Badlands, medical resources are distant.  This had the potential to suck.

As I came up over a rise I saw two staff members halping one of the women from my group along, one under each arm.  She appeared to be putting weight on it.  Good.  Maybe just twisted or a sprain.  Then I caught sight of a group of guys carrying a body like Christ coming off the cross.  His head was lolling back and I couldn't tell if he was conscious or not.

Well, that's not good. Thought I.

I reached them as they were setting him down to take a break.  His right ankle was wrapped in an ace bandage with a cold pack tucked in it.  But his foot was at an odd angle compared to his leg.

"Tib/fib" I thought.  I walked up to his head and introduced myself.  There was a woman kneeling with him.

"Hi, I'm John.  I'm a paramedic. Can I help you out?"

His response was a weak "OK". He looked pale and shockey.  Complained of nausea and wanting to pass out. 

"Yeah" I thought, "This is not good."

The Woman kneeling with him looked at me.
"Are you really a paramedic?" She asked.
"I actually am." I said.

Fortunately one of the staff members was driving the camp van up into the hills as far as he could get it.  I joined the group carrying him as the broken leg supporter.  Everybody else did the heavy lifting.  We manhandled him into the van and headed slowly for the road.  I was trying to keep his foot from flopping around, but it wasn't easy.  His toes were purple and I knew he was losing circulation in his foot.

As we bounced along a guy from my group came running up with my pack.  Here was the gear I needed.  The van driver hopped out and Jen, the program director, jumped in to take us to the hospital.

"How long is the drive?" I asked.

"Half hour or more." She said.

I looked at his leg again.  No circulation, no feeling in his foot, and he couldn't wiggle his toes.  So I made a quick choice to try and reduce the fracture there in the field.  I unwrapped the ace wrap and noted a nasty purple/black bruise where the bone was pressing against the skin.  Any more bouncing, I thought, and it would poke through.  I could see the broken tibia, but I couldn't tell if the fibula was broken.  It looked weird.  Usuallly they break near the same place, and you can really tell.  Not this time.  I wasn't going to sit and examine it too much though.

 David, one of the construction managers was helping me, so with a steady smooth pull, I pulled his foot away from his leg and set the bones in place as best as I could.  Mike, the guy who was now my patient, was not happy with this move, and grunted and yelled a bit in response.  But with David's help I managed to get the splint on and wrapped with the ace bandage. I propped his leg between a backpack and my jacket as best I could to stabilize it.  David hopped out and I had hoped to as well.  But they asked me to go along, so I did.

So, with Jen driving, Leslie - the woman from our group that fell moments after Mike and hurt her right leg as well - in the front seat, me straddling the middle seat with Mike's leg, and Mike and the woman that had been with him the whole time in the back seat, we headed for Pine Ridge, with the goal of getting him to the IHS hospital.

The other womans name was Kim.  She was the leader of the Lincoln group, and a reverend of the UCC church.  She was also a very comforting person to have along.

As we drove, I reassesed my patient.  His color looked better, and although he was a little nauseous he didn't look near as much like he was going to pass out.  His foot pinked up nicely as well, and he had good feeling throughout his foot.  He could also wiggle his toes now, which gave me some relief.

As we drove, Jen called her boss, Ted and told him what was going on.  He told us that at the IHS hospital they would just splint it, stabilize him and send him to Gordon, NE.  Since we had already splinted and stabilized, we decided to head right for Gordon.  The whole trip took a little less than an hour, and in that time Mike went from nearly passing out, pale, sweaty, nauseated, to alert, oriented, and even smiling a bit.

We got both of our broken ones into seperate rooms in the Emergency Department and let the staff take over.  While Jen, Kim and I waited, we went to find some lunch at a local eatery, the Antelope Cafe.  It was tastier than it sounds, and they even had fried green beans. Sort of like fried mushrooms or fried cheese sticks... again, tastier than it sounds.  Kim even bought us lunch.  It was very kind of her.

When we returned to the hospital, I was shocked to find that Leslie had actually broken her ankle bone!  She was none too pleased, and Jen very kindly told her that she now had many other options for a vacation like trip.  Reading, relaxing, that sort of thing.  I was also shocked to learn that Mike would be flown out to Lincoln for emergency surgery!  His tibia was indeed broken down low, but his fibula had broken mid way up his leg. It was a very flukey break indeed, and he was bummed not to be able to spend the week on the Rez.

We had to leave Mike just as the air crew was getting to him, as we had to drive 45 minutes to Chadron, NE to the Wal-Mart pharmacy to pick up meds for Leslie.  It was a crazy, crazy driving day indeed.

As we were at Wal Mart, Jen handed me her phone and said that Allie wanted to talk with me.

Allie is a friend I made the last time I was out.  She is a young Lakota woman and has a great family. 

Anyway, to make the day even more surreal, she invited me to go to a sweat with her and some of the staff that her dad was doing that night.  Of course I accepted, and spent the drive home nervously anticipating what it would be like, and trying to put the medic in me away for the day.

Jen gave me some helpful pointers for the sweat as we drove.  And as we approached the camp, I saw Allie, Erika, Bryan and a few others waiting for me.  I grabbed my running shorts and a towel and we headed off.  It was a very strange day, and I expected to go even farther out of my comfort zone in the evening.

More Later