NARVIK, Norway (CNN) - Fresh from medical school, Anna Bågenholm chose to do her residency in the Norwegian city of Narvik because of its spectacular mountain slopes. An expert skier, Bågenholm had gone off the trail with two other young doctors on a warm spring afternoon when she fell.
[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/HEALTH/10/12/cheating.death.bagenholm/art.bagenholm.rescue.jpg caption="Rescuers worked frantically to save Anna Bagenholm from a hole in the ice of a mountain stream."]
What happened that day in 1999 changed her life and has redefined what is possible in cases of accidental hypothermia.
Bågenholm slid down a steep, icy gully and ended up submerged head first in a hole in the ice in a mostly frozen stream. Only her skis and Telemark boots and bindings protruded from the thick, opaque ice. As the 29-year-old struggled, her friends Marie Falkenberg and Torvind Næsheim began a frantic effort to free her, made impossible by a torrent of frigid spring runoff pouring over them into the hole where their friend was submerged.
They called for help, starting a chain of events that is now part of medical literature and local lore.
Bård Mikkalsen, a police lieutenant in Narvik at the time, took the call.
"I realized this was really a serious case," said Mikkalsen, who has since retired. He scrambled a pair of rescue teams in Narvik, one from the top of the mountain, the other from the bottom. He also contacted the nearest rescue team in Bodø, nearly 200 miles away, but the Sea King helicopter had already left to transport a sick child. Read the full story »
North of the Arctic Circle, the weather is unforgiving, the population is scattered and the distances are immense. At the University Hospital of North Norway in Tromsø, the northernmost teaching hospital in the world, doctors routinely use a helicopter ambulance and fixed-wing plane to transport the most serious cases for care – or to bring emergency care to the patient. It’s all about buying time.
During a visit Tromsø, we shadowed Dr. Mads Gilbert, who heads the Department of Emergency Medical Services at the hospital, a small city surrounded by water and mountains. He describes trauma care in this part of the world as “cold, dark, distance and dangerous.” The cold poses its own challenges, and Dr. Gilbert and the team see a lot of hypothermia from ski accidents and people who’ve fallen out of fishing boats falling into the water.
Dr. Gilbert was on call 24 hours a day all week when we were there. He is 62, a rangy man with the energy and enthusiasm of someone half his age.
“What we do with emergency medicine — be it airway breathing, chest compressions, bleeding control, treating hypothermia — is to slow or even stop the death process. So it’s really the struggle between life and death and I always feel like we’re standing on the shore with the tide coming up. We’re trying to pull people from the tide of death and onto the dry land of life,” Gilbert said with a flourish.
Hours after we arrived, his team scrambled in the middle of the night, putting on jumpsuits and helmets and climbing aboard the helicopter ambulance. The temperature was just a degree or two above freezing as the helicopter lifted off and a chilling rain soon began to fall. A young man was suffering from an uncontrollable seizure, and the local doctor wasn’t sure whether it was an allergic reaction or something more serious. The helicopter ambulance team brought the patient back to the hospital.
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