You Snooze… and others Loose- as the phrase goes.
This blog, like an episode of House MD from television, is about medicine in Antarctica. It is about common sense. Its about thinking outside the box. Feel free to read on.. or not. But I understand if you are not interested. I hope you learn something. Let me know if you do!
A GOOD NIGHT’S SLEEP
I went to bed at 1am.. having watched Bob Dylan’s ‘Don’t Look Back’… after a day of unpacking shipping containers. This will all be explained in further blog.
I had meant to just use the Don’t Look Back DVD as a test for my DVD player, but ended up watching it all the way through. Brilliant.
I woke up at 8am after a good sleep… and was quickly presented with a conundrum.
DAY 1, LESSON 1, ANAESTHETICS SCHOOL
Here it is – a simply irrefutable fact – the human body needs 200-250mls of Oxygen per minute, at rest.
I thought Oxygen was crucial for life, having spent the recent period of my life pushing it in and out of people’s bodies.
And yet here we are… at 3800m equivalent altitude with an atmospheric pressure of oxygen – one third less than that at sea level. Adding to being the furthest away from the equator (drops Oxygen further) and being in minus 39.8 degrees Celcius (dropping the atmospheric pressure Oxygen even further), that doesn’t leave a lot of Oxygen to play with. In fact, none; we are ‘owed’ Oxygen.
So if any medical problem develops, it would make sense, that with infection, or otherwise, the Oxygen demand by the sick body would go up and we would need, for basic treatment, to provide additional oxygen. As the Meercats say on television – “Simples!”
This is true whether you are lucky enough to happen to be in the emergency department in the John Radcliffe Hospital in Oxford or (unlucky enough) to be sitting on 3200 metres of ice in Antarctica.
This would require forward planning – to have Oxygen cylinders and a Oxygen concentrator. We have these – Hurrah! But… read on. Its long and boring. But common sense triumphs!
Just after coming upstairs for a coffee, I was told, in passing, off the cuff- by one French colleague and two other italian programme employees, the latter holding not a day of medicine between them- about a little conundrum.
The pilots on the incoming flight would need Oxygen. Ok understood.. everyone needs it… especially here.
I knew the pilots personally- I had flown with them several times and were good friends. There was Jim, the captain. And co-pilot, Scott, aged 24, who was 1-0 down to me in games of Table Tennis – and on his flying visits to and from Concordia, we were expecting the best of three games before he left the continent, next week. Winner takes all. Remember this, it becomes important later on in the story. In fact, pivotal.
It would seem we are nearly all out of Oxygen – atmospheric and bottled. So we have two cylinders – one half full and another just touching reserve. Another tank had been full when I had arrived, so either someone has started a Woody Harrelson Oxygen bar (these featured in London and LA for a short time), or they left the valve open. I suspect the latter, having just today found it open. A spectacular display of accidental sabotage – worthy of my prepared prize – a great big bag of British Sarcasm, prepackaged, ready at the John Lewis collection bay drive-thru, waiting for pick up by the culprit.
Thank goodness my Concordia colleagues above all knew and remembered Lesson 1 above, when they made the decision to give away our remaining Oxygen cylinders for the pilots arriving today.
Martin Frobisher. I hope you know that name. I learnt it living in Iqaluit, Frobisher Bay, in the Canadian Arctic. ‘Iqaluit’ in Inuktitut, means the place of fish. Certainly we found a lot of Arctic char there.
Its not Frobisher’s story, but this episode reminds me of another old story of the man who carries a bar of gold, instead of water, into the desert. Only one exception to this, from my anaesthetics knowledge, the Oxygen Cylinders aren’t made out of gold, they are made out of Molybdenum Steel. Though it probably weighs the same and would be just as useless, in a dry, hypoxic desert, when its empty.
And Concordia sits on Dome C – the throne of the Antarctic Plateau, which happens to be the world’s LARGEST desert. Average humidity, provides a generous 6-8%. Around this time last year I was in the Amazon where humidity sails into the late 80s and early 90s as a percentage. Don’t get me started on Relative versus Absolute measurements… thats FRCA exam stuff and maybe around Lesson 39.
OLD FRIENDS; THE DECISION
Either you help out friends- the pilots – and give them your last Oxygen – or you don’t and you let them suffer.
There is a further pressure also. It seems me and Scott have unfinished business. When we last met we played Table Tennis. I am 1-0 up. So on the one hand, I want him Oxygen deprived so I can take an advantage, having acclimatised myself – like the Chinese in the Olympics, drinking Turtle Blood Soup. But on the other hand, he needs to fly out and get back to his family in Canada, and also I suppose I need him in a fit state to play, so I can win. There is no forefit. And I am not staying here all winter without knowing safe in the knowledge that I am CONCORDIA TABLE TENNIS CHAMPION. In medicine, you always have to take a step back and see the bigger picture. I think the old man, Prof Harold Ellis OBE taught me that. Him or House MD.
We would need to provide oxygen for two people, not just one. Which means we cannot use our last oxygen from the cylinders and would need to use the concentrator. BUT, the concentrator only provides for one person.
A true conundrum. More so about the table tennis.
It seems common sense triumphs – a solution must always be found.
And so I sat down, like in the scene in Apollo 13, when they are running out of Oxygen in space and the NASA team had to improvise a solution to eliminate the building level of Carbon Dioxide, using only what is found on board, to save the lives of the crew.
I tried to configure a way to supply oxygen to two people from one supply.
And after a short time, looking like Jesus, who famously had turned water into wine and fish into more fish, behold, I turned one person’s oxygen into enough for two. I knew Sunday School would come in handy one day. And Hollywood movies… thank you Jesus, and thank you Dr Spielberg.
After 20 minutes a T piece was found, that belongs to a different machine for monitoring the weather, by our station leader, which happened to kind of fit and provide a solution to this problem. Team work pulled through.
And a bit of electrical tape and medical tape did the rest.
The italian’s coffee machine’s latte maker served to sterilise the container for the humidity. Hopefully we won’t have the first case of Brucellosis in Antarctica, in case the milk had been taken from a Camel in Algeria. Man, I really enjoyed my time in Prof Robin Bailey’s clinic in the Hospital for Tropical Diseases. And I obviously learnt something!
And I asked Glaciologist, Sebastien aka Frenchie II, for distilled water from the Glaciology lab.
A solution was created.
Also, I moved out of my room, to sleep outside in one of the summer tents – therefore allowing the pilots to sleep indoors. This was important, as one suggestion had been to carry the oxygen concentrator outside to the tent- which would have broken in the minus 40 or so conditions. Then we would have been stuffed, just two days before winter starts and we begin 8 months of isolation in Oxygen deprivation.
I threw my ipod and Rab 1200 Expedition Sleeping bag in the tent… good for Mount Everest. Rated to minus 60. Made in Sheffield. Home Sweet Home.
Tonight is gonna be a long, cold night. Oh well Shackleton, at least we won’t die over winter from a lack of Oxygen.
I recall during a previous anaesthetics interview I was told to provide a 10 minute presentation on, ‘whether my glass is half empty or half full?’ in relation to the UK anaesthetics training scheme.
I ended up giving a presentation on how travel broadens the mind. I didn’t get the job. That wasn’t my point though.
The lesson here is- it doesn’t matter if your Oxygen cylinder is half empty or half full, when you have pneumonia at 3800m in the world’s largest desert, you need oxygen if you want to live. You don’t go giving it away.
I feel like I learnt just as much, if not more, whilst working in clinics in Africa, Asia and South America than sitting in a stuffy lecture in UK. But that’s just me. You make do with what you have… which is never a lot in developing countries. You have to be creative and think outside the box.
There it is… common sense.
Lucky I didn’t sleep through that lecture at medical school. And lucky we didn’t give away our last Oxygen.
Though I still stand by my opinion about Dental School – it really can be compressed into a year (or 4 days).
Now, I can’t remember why I started writing this. Some would call this hypoxic-related-brain-damage (HRBD sounds better; though I must confess that I just made it up that abbreviation). So I’ll stop there.
Enjoy your Oxygen folks – take a deep breath – in and out – inspire and expire – hell, do it again and again- enjoy it for me – because we don’t have any here and I am beginning to miss it.
I look down and to my delight, I see the big bag of British Sarcasm has been taken, when I wasn’t looking… it’s a mystery.
I knew something important from drinking Whiskey with ‘Nico’ in Hobart… It turns out Nico is an Antarctic diver and told me all about the many bottles of Oxygen held in Dumont DuVille.
I send an email to request an order for new Oxygen – the last flight arrives tommorow from Dumont DuVille. Lucky for me I drink Whiskey. Lucky for the crew. A near miss in the Swiss Cheese Model of Human Factors, being responsible for every plane crash that ever took place. Humans aren’t gods and I am not Jesus. Though what happened today was a miracle.
A gift arrives on my desk, addressed to myself and Frenchie I (Stephane). A box. Heavy. Shaky. What could it be? Who could it be from?
Two bottles of Whiskey from Nico, sent for us for overwinter, just before he recently left Antarctica. One Irish bottle. One Scottish.
Nico, You Legend. This one’s for you.
At least we won’t run out of Whiskey.