The sky was darkening by 4pm when the ice fog began to creep across the lake in a thickness that seemed as if you could reach into it and scoop out a handful. It left a layer of white ice crystals on everything it settled over and a cold crust that gave the appearance that the landscape might shatter if touched too hard. It made a wilderness that was was already deceivingly hard to navigate even more confusing as it swallowed small islands and hid miles of tree covered shoreline that even in clear conditions could trick you with the many inlets and peninsulas that made the abstract pattern of the shape of the large lake. It was after the darkness had embraced the entire sky and the ice fog had blanketed every surface that we received a call looking for a missing woman who had been riding her snow machine and had not been seen since the sky was still light from the setting sun.
At first there wasn't too much concern, the woman was from the area and had a cabin along the lake. It was possible she was still out riding or had stopped by somewhere to warm up in a cabin. By the time the man who had called looking for her arrived at the lodge his concern was apparent and an impromptu search team of friends who had gathered for the evening began layering on their warm arctic clothes and starting up their snow machines. It was around 7pm and already -10°F.
In teams of two, they followed the shorelines and cabins where her route might have taken her. Some searched the center of the large lake, but even the locals of over 25 years found themselves turned around and lost on the white surface with nothing but heavy fog in all directions. They used their own snow machine tracks, which could be seen for only a very short distance in their headlights, to follow their way back to the lodge an hour later. As they quickly warmed their fingers and faces indoors the search teams reassembled, discussed their next search plan and quickly headed back out. They had a full understanding that in this type of cold and dark every moment mattered, and in this remote location there was nobody who could be called to help in time, it was up to them.
Most of these men had been on searches like this before, searches for strangers and friends alike, and most of these searches had not ended well. It was hard to know what was going on in each of their minds, but we all knew the gravity of the situation. Together they headed back to her initial path of travel to look for her tracks in hopes of following them. As they circled in the fog they spotted a dim glow on the shoreline, but as they neared the glow they realized it was a neighbor who had come to his porch with a light. When they looped back around, not far from that neighbors cabin, one of them caught a glimmer of a helmet. Her snow machine was not found as it was buried in pieces in the trees where it had crashed, but somehow the woman had managed to crawl out onto the open lake and had been watching the search lights of the snow machines circling around her unable to hear her screams or see her in the thick ice fog. The men could not fully assess her injuries in the dark but found her partially clothed, a common occurrence as hypothermia sets in, and knew that after hours in negative temperatures the priority was to get her warm.
We had been anxiously watching for headlights returning in the fog to the lodge when we received the call that she had been found and was alive. We exhaled huge sighs of relief. We had been told that they were on their way back with her and that she was cold. We began to heat water and were prepared to get her warm sugary drinks and food to help heat her up, but we were not prepared mentally, at least I was not, for the extent of her injuries when they returned.
I left briefly to go to my cabin and when I came back to the lodge soon after I was surprised to see a line of snow machines out front indicating that they had already gotten back and I hurried inside. I entered a room with blood smears on the tile floor and several people removing wet clothing from a semi limp body near the woodstove while others were rushing to gather blankets and a medical kit. I quickly removed my coat and rushed to the back room for a pair of latex gloves while I began to review the steps of my medical training in my mind. I had taken several wilderness medical courses in the past and had been a certified wilderness first responder for almost three years, however I had never had to rely on my training for more than a minor cut. I had hoped that would be all I would ever need it for, however living where and how I live it was inevitable that I would eventually find myself in more serious situations. I knew my training was important for my lifestyle, but I often said I hoped I would never have to be a first responder in the field. I knew I had the most medical training in the group that evening and I was about to experience my first serious situation as a first responder. I took a deep breath as I approached the scene in the back room.
The men cleared aside to allow me full access to her body and were quick to assist with warming measures as I began to assess the extent of her injuries. It was easy to know she had a broken arm from the look of the swollen purple limb twisted at odd angles and I soon realized she had a compound fracture when I caught sight of a small piece of bone protruding the skin on her elbow. She was awake and coherent making eye contact with me and acknowledging that she knew me, the people around me and many of the details of the evening. She was also clearly in shock and suffering from hypothermia. As the others worked to warm her, called for an ambulance and gathered the local medical transport vehicle/litter I examined the rest of her body relieved that there did not appear to be any additional trauma. I struggled to find a heartbeat on both wrists and neck and was unable to do so after what seemed like a long time trying. I decided to move on as I knew at least her heart was beating since she was awake and responsive.
Preparing her for transport was the main objective and the process was a blur of teamwork which I tried to direct, as well as confusion as we struggled to familiarize ourselves with a gurney nobody had used before, move her body onto a backboard, carry her through narrow doorways, load her into the transport vehicle while unsuccessfully trying to lower and secure the wheeled gurney, and finally removing her from the vehicle to transfer her to a more stable litter before putting her back in the vehicle. I was frustrated with my inability to assist with the unfamiliar equipment, the additional movement that we had to do to the patient in order to get her secured, the in and out of the cold environment that was required to move and secure her a second time and the time in which all of this confusion was taking. As we fumbled to get going I envisioned an ambulance waiting for us at the highway, not knowing that at around 9pm they were still over an hour away.
Once I was in the back of the transport vehicle I searched for a way to turn on the overhead lights. I had never seen this vehicle and didn't even know it existed in our community. The only other person with rescue medical training was driving the vehicle while her grown son helped me in the back by providing light from his phone, as we never figured out how to turn on the interior lights, and assisting me with medical supplies from the well stocked compartments. My main concern was keeping her comfortable on the bumpy ride down our long ice covered sixteen mile dirt road and ensuring that she stay awake while I continued to examine her and run over and over the medical checklists swirling in my brain. I took her temperature with a thermometer multiple times to confirm a reading of under 95°F. We rolled her to her side while she vomited the water that she had been begging for on the floor and on me. I had tried to avoid giving her too many liquids knowing this would be the outcome, but her begging was intense and persistent so we had been slowly giving her some warm liquids throughout the rescue knowing that while she might vomit they would also help with the warming process. She was coherent, intelligent, and responsive throughout the entire transport and she was also dangerously close to death.
When we finally reached the highway after what seemed like an excruciatingly long ride we were all crushed to realized the ambulance was still over 30 miles away. We spent that time comforting the woman, while also gathering as much information as we could to pass onto the emergency personnel when they arrived. We were so relieved when our windows were filled with the glow of the approaching ambulance lights and we were able to transfer her to the vehicle that would take her to the hospital which was still over 120 miles away.
The three of us returned to the lodge down the long bumpy road under a sky illuminated by the green glow of the northern lights. We still had much to discuss and needed some major time to decompress, but for now we just needed to get back home.
I fell asleep after a long time of running the night's events over and over in my mind. The realization of how very removed we are in our remote community and how truly alone we are in the face of an emergency had hit me in the face hard that night. The following day I woke with my first thoughts being of the night prior and the need to know that the woman had survived. We were all thankful to learn that while she suffered a shattered elbow and multiple breaks of her arm, including the compound fracture, and had a long road of surgeries and recovery ahead of her, she was going to be okay.
She told me while we were waiting for the ambulance that she thought she was going to die that night out on the ice. I have no doubt that without the quick response and teamwork of her community that she would have. Unfortunately the rescues out here often become body recoveries, but not this time, this time we will all be able to hug her when she returns and tell her how glad we are that she survived.