A family nurse practitioner living in the Chilcotin who suffered a pelvic fracture after she was accidentally stepped on by her 2,600 pound horse said her experience put rural emergency health care services to the test and came up glowing.
“It made me think a lot about how we do emergency health care out here,” Patrice Gordon said of being on the receiving end of health care for a change. “I’ve been on the delivering end of getting a call from B.C. ambulance that somebody’s down a bank. It’s -20C and the car is 10 kilometres this side of Chilanko Forks and we go out looking for them. Or there is a call to the clinic saying someone’s been brought in or that someone has had a cardiac arrest and successfully resuscitated.”
Gordon’s husband, Dr. Rob Coetzee who also works in the West Chilcotin, witnessed the whole thing and told Gordon the horse was in mid-run when he landed and pushed off.
“It was certainly a case of everything can change in an instant,” Gordon told the Tribune. “One second I was walking and the next second I had been stepped on by my biggest horse. He was frolicking with the other horse, he hit me with his shoulder as he spun and I fell right under where his foot was going to land.”
For the past several years, the West Chilcotin Health Care Society and a medical emergency response planning committee have been working together to acquire equipment and personnel training to improve services for their rural area.
“We had someone come up to do trauma training,” Gordon said, noting they have tried to increase awareness that even though they have got a few strikes against them that they cannot change, such as the fact they are quite far from anything and there is no hospital right there, there are some things they can fix.
Admitting she’s “awfully lucky to be married to a doctor,” Gordon said Coatzee was able to set the plan in motion to make her medical evacuation work.
Normally, one of the biggest challenges is communication because there is no cell service near their home at Horn Lake.
If someone is in medical distress in the area and if someone else does come along in a vehicle, they may have a satellite phone, but if not they will have to drive to the nearest place where there is a telephone and that could be miles away.
“I was frozen by the time we got to the clinic and it was not even that cold out,” Gordon said. “I lay there while they made a plan and got the spine board and Rob assessed me at the scene, which took about 20 minutes.”
From there she travelled in the back of a truck and for another 20 minutes of bumping down the road on the spine board to the clinic in Tatla Lake.
“I was shaking so violently and every movement killed my hip, but they had wrapped me in a blanket and done everything right. It was about an hour from when it happened to when I got to the clinic.”
Once she arrived at the clinic she began to see the fruits of their labours to improve local emergency response efforts.
“Right away the nurse was there and she had grabbed a portable ultrasound machine. We each have our own which were purchased with funds raised by the West Chilcotin Health Care Society. Little did I ever think that was going to make a difference to me.”
The ultrasound showed where the pelvic fracture was and also determined she had no internal bleeding.
“We could then dial back the anxiety because if there was bleeding the chances are slim I would have even survived.”
From Tatla Lake Gordon was transported by ambulance an hour and half later to meet the critical care transport plane at the Williams Lake Airport.
“What was great was the Alexis Creek Station is now up 24/7 and fully staffed. They are doing the community paramedic thing and are busy and getting some hours in working with Williams Lake to increase their experience,” Gordon said. “I had been meeting with them previously because of some of the emergency planning we’d be doing.”
After the three-hour drive to the airport she was flown to Royal Inland Hospital in Kamloops where the orthopedic surgeon who assessed her decided she did not need surgery because her pelvis was stable, but she would need to stay in the hospital for a couple of days and not move and gradually get her mobile.
“The piece that broke off, broke into a bunch of pieces. I can feel where the spot is.”
When Gordon arrived at Royal Inland, she had already been taking pain medication.
”I was in a fair bit of pain, but I was quite coherent and I heard this male voice I’d never heard before say, ‘I finally get to know Patrice. Do you know how many years I’ve been e-mailing with this woman?’”
It turned out to be emergency doctor, Alan Vukisic, who Gordon had sent an e-mail to 11 years ago where she talked about working in the Chilcotin.
“I had attended a virtual lecture he put on about minimal standards for emergency services in B.C. and I told him if it had been in person I would have jumped up and down in the audience because that is not all of B.C. but that is big hospitals.”
She described services in Alexis Creek where she was working and said the services he was mentioning were not available in some parts of Interior Health.
“We don’t have an emergency department, but we have people who present with burns, pediatric airway problems — everything under the sun — including massive trauma and we are one person that has to run the whole show. We get family members to help manage the airway and we do what we have to do to make it work.”
Responding, Dr. Vukisic helped Gordon link Alexis Creek and Tatla Lake with people in the province that could help her.
“I didn’t talk to him for about eight years and then I sent him another e-mail and we’ve communicated off and on and then he was my doctor that day in Kamloops.”
Gordon returned to working from her home on Monday, Dec. 2 and said she has hit the ground running.
“I love it, connecting with people again.”