International Stories

A Different Way to Practice Medicine

HMCS ALGONQUIN is deployed on OPERATION APOLLO, Canada’s contribution to the war against terrorism. For Lieutenant-Commander (LCdr) Dale Skanes, Canadian Naval Task Group Fleet Medical Officer, May 9 begins a typical day, but gets interesting just as supper is served.

ARABIAN SEA—May 9’s Wardroom supper on board HMCS ALGONQUIN is something extra. It’s good to be able to punctuate a day with something nice when each day seems the same as the one before.

I’m the Fleet Medical Officer, and I’m just sitting down for a well-deserved steak and lobster—spinney lobster, but lobster nonetheless—when the call comes. There is a casualty on a civilian vessel, no details.

“We will brief in my cabin,” says ALGONQUIN XO Lieutenant-Commander Doug Young. “You and the Physicians Assistant, in 15 minutes.”

A merchant vessel has a casualty with a possible leg injury. PA Warrant Officer Chris Moffatt, from Carroll’s Corner, N.S., and I will put on Red Cross epaulettes and take our flashlights. Boarding Team members will clear and inspect the ship to make sure it is safe.

“Look after yourselves,” the XO says.

We head back to sickbay, where WO Moffatt and Junior Medical Assistant Corporal Nancy Alleyne have readied the necessary equipment for our mission. Cpl Alleyne has some epaulette Red Cross slip-ons, and we replace our ranks with this international symbol of humanitarian assistance. Just before we head to the quarterdeck to wait for the Rigid Hull Inflatable Boat (RHIB), I get my camera.

The RHIB is lowered and eight Naval Boarding Party (NBP) members, carrying 9mm automatic weapons, ready themselves in SWAT team-like fashion. They are all business, and so are we. Over the side and down ALGONQUIN’s ladder we go. 

We get underway. The large merchant vessel in the distance, our target, looks like a rusting hulk. It has been adrift for a few days with a broken engine.

It’s getting dark as we approach the ship. Our boatswain points out a robust-looking steel gangway to the stern of the ship and a more tenuous-looking rope ladder amidships. We opt for the rope ladder—the bobbing RHIB, the steel gangway and our heads would not go well together. We have some difficulty attaining the desired position at the base of the ladder; the RHIB is moving up and down by two meters alongside the ship. Finally we are in position, and look at the wall of rust stretching nine meters up into darkness. The rope is frayed. Some NBP members are a muscular 113 kilos. I reckon this will be a good test for the rope.

In what must have been a world record for the tensile strength of hemp, the NBP climbs on board and inspects the ship. We can see unfamiliar faces looking down. Their teeth are notably white. WO Moffat and I are given the “okay” by a member of the NBP—the ship is safe; no threats on board.

WO Moffat humps his burly 104-kg frame up the rope ladder. I hear a whispered “They don’t pay me enough to…” Up and away, and I’m into the ship as well.

We gather our equipment and ready ourselves. Our armed escort takes us to the casualty at the bottom of a 20-rung ladderway. Some of the crew accompanies us, and my Arabic “hello” is well received. That’s good, because I know only one other phrase.

Our patient is prostrate in an engineering space about 4.5 m x 3 m. There are engine blocks, old locks, tools of all sorts, parts, and junk of all descriptions. Everything has a layer of grease and dirt. Two stretchers are near the casualty, evidence of a failed attempt by his shipmates to move him. He has been there for hours and it is very hot.

WO Moffatt and I ensure the space is clear of hazards and proceed to work doing our primary casualty survey. The NBP films everything.

Our patient is a 20-year-old male who has fallen down 10 of the ladder’s steps.  He is alert, breathing, and moving all limbs, and when we palpate his spine he feels no pain. We logroll him onto the stretcher, with WO Moffatt controlling the casualty’s cervical spine with in-line stabilisation, and NBP members and I assisting by turning the casualty.

It is obvious he has hurt his right hip region. His pelvis seems stable. Vitals are normal. There is no bleeding. I ready an IV solution for good measure as WO Moffatt applies the C spine collar.  I reassure the patient that “ this is not going to hurt.”

He cries a dramatic “ooh ahh”, and I begin to wonder. He seems very woebegone for his physical findings. Could he be someone who has been working around the clock for days trying fix this ship’s engine? Did he fall down the steps in sheer exhaustion? The IV drip works fine. I give the bag to one of the NBP members to hold.

We tie our patient into the stretcher for his trip up the ladderway, and secure the IV on the stretcher.  I realise all our muscle has left to go to the quarterdeck. I take one end of the stretcher, the remaining NBP member takes the other, and we negotiate the ladder. We get wedged between the handrails. A small laugh, and we proceed. We make it to the deck and smell fresh air, and feel a pleasant change in air temperature.

I explain the situation to the Master, who assures us he will make repairs and be in port in about 24 hours. While the Boarding Team, the Master and Algonquin make plans, WO Moffatt and I make like tourists and get a picture with the crew in the galley. The eating area is not very clean. We mingle and shake hands, with smiles everywhere. After seeking permission, we have our photo taken; I say “Shacron”, and the thank you is returned. We go back to the quarterdeck, where the patient is stable. The Master can check in with us if there are any problems. 

We are back in ALGONQUIN by 2000 hrs. The boarding team is debriefed on the medical management of the patient.

It’s a different way to practice medicine.

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