Bartlett Regional Hospital emergency room physician Nathan Piemann took his first ever helicopter ride last Valentine's Day. It wasn't romantic. About two in the morning, he realized he was the only trained medical professional available to escort out of Juneau a man with severe neck injuries sustained after being thrown from a vehicle.
No planes were flying in or out of Juneau because of fog and he was told it would be six to nine hours before they could leave.
"When you have a broken neck and it is unstable, that's too much time - a person can become paralyzed just from the amount of inflammation that can happen without stabilization procedures," Dr. Piemann said.
He persuaded the U.S. Coast Guard to transport the man via helicopter to Sitka where the weather was better. From Sitka, an Airlift Northwest plane took the patient to Seattle for care.
Dr. Piemann said the Juneau man has almost fully recovered. He said without Airlift Northwest, lives would be lost.
Before the founding of Airlift Northwest, very ill patients usually ended up on a stretcher via an Alaska Airlines flight. The commercial airliner would clear nine seats to make room for the patient, medical equipment, nurse and doctor.
In the 1970s, Dr. George Longenbaugh worked as a physician in Sitka. His wife Dee Longenbaugh said her late husband faced very difficult cases, and sometimes lacked equipment or staff to adequately treat them.
"At that time we had a lot of logging around Sitka and that was a very dangerous job. Loggers would get hurt and they would bring them in by small plane. We had an old hospital, you'd just hope you could save them or get them out," she said.
Longenbaugh said her husband invited specialists to Sitka from other parts of the country to talk about new procedures. Dr. Copass came to discuss emergency medicine. At the time he headed the emergency department at Seattle's Harborview Medical Center. During his visit, several children were badly burned in a house fire.
Dr. Longenbaugh asked Dr. Copass to help treat them. After a day of surgery, only one child had survived. Dr. Copass knew he couldn't save her in Sitka but thought she had a chance at a Seattle burn center. It took four hours to find a pilot in Oregon willing to pick up two burn nurses in Seattle and fly to Sitka to help the girl. The terrain was unfamiliar and weather was bad. The plane finally arrived in Sitka, picked up the child and Dr. Copass and took off for Seattle. The child died en route.
"I thought to myself the whole way back what a tragedy it is that a surgeon's time would be consumed trying to find transportation," the non-profit founder said.
Three years later Airlift flew its first patient. Today, it operates six helicopters, three jets and a turboprop airplane out of stations in Juneau and Ketchikan as well as five bases in Washington. Its Juneau based lear jet looks like an airborne intensive care unit. It carries a stretcher, IV drugs, a defibrillator and oxygen masks. It has room for two medical personnel.
In Alaska, Airlift's busiest season comes between Memorial and Labor Day. In the summer it averages two flights out of Alaska per day, and in winter its flights go out about every three days.
Patients' conditions have changed over the years. As logging has declined so have serious trauma injuries. They've been replaced by chronic conditions such as heart disease.
"Travelers who arrive here don't always arrive in the best of health. They're given a bad prognosis and come here and get awfully sick. The phenomena (to) see Alaska and die is something we're trying hard to prevent," Dr. Copass said.
A flight from Juneau to Seattle costs about 25 thousand dollars and insurance companies usually pick up the tab. Dr. Copass said the non-profit also accepts Medicare and Medicaid. Most of the Alaska flights go to Seattle but some take patients to Oregon, Texas and New York.
Dr. Bill Palmer has practiced medicine in Juneau since 1973. He said three decades have brought advances but the air ambulance service remains vital.
Juneau lacks specialists and those who are here don't perform certain high-risk procedures. Palmer said critically ill patients also create a drain on the hospital.
"We have a big nursing problem as does the whole nation. So even though we might have the technology to do some things now that we didn't have had 20 years ago, sometimes we don't have the nursing personnel to cover it," he said.
Dr. Palmer said a day will come when emergency airlift services are no longer needed but probably not in his lifetime.
Juneau is served by other air ambulances including LifeGuard Alaska, which takes patients to Providence Alaska Medical Center in Anchorage.