A Week in Wollaston

Kapur, Ankit

My sleep was rudely awoke by a robotic voice screaking throughout the cabin of our small plane; “PULL UP, PULL UP, TERRAIN, TERRAIN”. As a medical resident, working in the north, my training had ingrained in me a reflex response to all sudden and shocking situations, and so I instinctually applied it; like a well-used mantra I repeated to myself, “Stay calm, assess the situation – whatever you don’t appear panicked”.

I looked up at my attending physician and the two pilots to see their faces fixed in concentration, but no obvious distress. I looked out the window and saw nothing but clouds – my body sinking into the seat however, told me that we were pulling up quickly. And then all so gently, out of the fogs and mist that had cloaked our descent, I saw the dark blue waters of Lake Wollaston. We were no more then 100ft above the water.

After landing the pilots confidently reassured me that they had always knew where they where; I however as a pilot myself unfortunately realized just how close it had been – my flights would never again be quite so restful.

Sleep being a precious thing in residency, I had come to look forward to my days working in Wollaston Lake, a Dene First Nations community of about a 1,200 people located approximately 900 km north of Saskatoon. It has no overland connection and so twice a week the provincial government would chartered a private twin engine plane to ferry a resident and an attending up to run clinics in this community. The plane would wait for us for the day and take us back after 5pm. It was spectacular commute over virgin forest and untamed lakes; but to a chronically tired trainee it was also a guaranteed 1.5hrs of sleeping each way.

One of the downsides to this model of healthcare however was I never got to see the very community I served. We would always travel directly from the airport to the clinic, often work straight through lunch, and then rush back the plane - more commonly then not with a patient in tow. Detached from my surrounds, was to put it lightly; I would often hesitate to step outside the clinic’s fence, worried in some subconscious way that my presence was not permitted outside these narrowest of confines.

And so it was a welcome misadventure, that when we flew in that Monday morning our very first patient was a young woman who had had eight previous pregnancies and had presented to the clinic earlier that morning in active labour – her first sign that she was pregnant again. The patient was unsure of the dates of her last menstrual cycles, her previous history included significant complications with postpartum bleeding and preterm deliveries, and she was progressing quickly.

We consulted with provincial air ambulance, unfortunately they were unable to get to us as cloud cover had come even lower and closed the airport. My attending and I weighed our concerns around possibly delivering a baby in our unequipped plane, against the significant risks of managing obstetric complications in a resource limited nursing outpost. The decision was made to fly her out. My attending would leave with the plane, and all the obstetrical supplies we could muster, and I would stay and run the clinic solo. I recall seeing the plane leave, hoping the best for my patient, anxious about running the clinic solo, but foolishly not at all worried about how I would get home just eager to finally get a chance to see the town.

The rest of that day flew by, I saw patient as quickly and thoroughly as I could, diligently trying to make no mistakes while still getting everything done in a timely fashion. I was desperate to prove to myself that I could one day run a clinic on my own, and being only 4 months in residency, I was keen to develop my clinical confidence. I didn’t even realize that day just how isolated I was, the next nearest physician was almost 400km away, and for all intents and purposes I was now the most senior medical professional in town.

Being late fall, I would come to learn, the land and water having been warmed by the long summer sun now cooled with the approaching winter and produced huge banks of fog would cover all of Northern Saskatchewan for weeks at a time; a fact I wish I had perhaps been informed of beforehand! So that Tuesday, my second day in Wollaston, all flights were again cancelled.

I took this as occasion to cross great barrier, that clinic fence, which had so divided me from the town. I walked the streets, went to the one general store and perused the contents with great interest in the variety, cost, and nutritious value of each item, I went to the one restaurant in town, and I generally played tourist in a community that rarely has visits sightseers.

The high school invited me to talk to the students about hygiene and basic infection control measures - in the end they seemed most interested in learning about the epidemics of influenza and smallpox that had so ravaged their communities centuries ago. It seemed by the end of the day everywhere I went people knew who I was before I go there. All in all, I had the chance to introduce myself to the community and to learn something about their lives.

The next two days were again marked by heavy fog and no flights in or out. The doctors who were planning on coming up couldn’t make their clinics so I was tasked with running a solo practice - again. My preceptors were on the phone if I needed them and would review all my charts, but I was otherwise on my own.

As distant as I felt from other physicians, I had never felt closer to my patients; the difference in my clinic these last two days was drastic. Patients who had previously come in stoic and distant now wanted to chat with me, they found great humor in my situation stranded as I was, and they displayed a closeness with me that I had not felt in any of my previous visits to Wollaston. The medicine was more exciting as the patients became more engaged. The message was clear from everyone I saw; “you took the time to stay with us and learn about use; and now we will do the same for you”.

The plane never came for my in the end. I left six days later, hitching hiking a ride across the lake on the last barge for the season and then on a fish truck for 12 hours. My way home was coordinated by the community; the fish truck was borrowed from the restaurant, the barge ticket was given up by elder, my bag was stuffed full of fish and berries from the high school. I never had meant to spend a week in Wollaston, but as I napped on barge ride home, free of any alarm bells, I realized that my time in Wollaston would probably be the most rewarding week of my whole residency.

Theme: Community | Communauté
Theme: Relationships| Relations
Theme: Physicians | Médecins 
Theme: Teaching and Learning | Enseignement et apprentissage

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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