What can go wrong on a ski-trip?
Over Easter this year – with my friends B and A – I did a 9 day hut-to-hut ski-tour running roughly North to South across Hardangervidda, the huge high wild roadless plateau of central Norway, that is bounded to the North by the Hardanger glacier, and to the North and West by the innermost lobes of Hardangerfjord. (At one point the glacier and the sea are less than 10 km apart.)
I did a similar trip in completely different weather and snow conditions in 2008 with B and daughter M (from Haugestøl go Haukeliseter). This year we started at Hallingskeid on the Oslo to Bergen railway a little East of Finse and a bit before the trains begin their steep decent towards Bergen. For me the trip finished about 2 km short of the road at Haukeliseter after nearly 200 km. (For aficionados our route was Hallingskeid – Rembesdalseter – Kjeldebu – Dyranut – Hadlaskard – Torehytten – Tyssevasbu – Litlos – Hellevasbu – Haukeliseter.)
This Easter, central Norway was blessed with high pressure, leading to sunny, cloudless, cold and largely windless conditions. Lack of snow and previous strong winds meant that there was plenty of lumpy and grooved sastrugi to contend with, and a lot of hard and quite smooth unforgiving and sometimes shiny icy surfaces. And it was exceptionally cold, with -30C on some nights and daytime temperatures of between -23 and -5C.
In the continuation post below are a few pictures from the wonderful trip. But the purpose of this long post is to record what happened when things went wrong. I’m doing this partly to help others better to understand the anatomy of an accident, and partly to get what happened out of my system. What follows is a slightly edited version of something I wrote in Oslo on 1 April on the way home.
The final descent to Haukelister is hard and icy, and to my shame at one point I stupidly let myself rush on a schuss across hard icy snow to reach my friends B and A, who are waiting. At 12.35 I fall and injure my left shoulder – badly enough to know I’ll not be skiing further [Signs: almost fainting, almost vomiting]. B and a passer-by ski to find a mobile signal so as to summon the rescue service. Meanwhile A gets me semi-comfortable on a sleeping mat with, eventually, two sleeping bags, another mat, my duvet jacket, and a windsac. The pain in my arm and shoulder is shoutingly intense, and despite the amount of down clothing, mats etc I gradually chill enough to be shivering uncontrollably. The Red Cross skidoo is slow to arrive (we're only 2 or 3 km from the base) and B has to ski a second time to call them, to discover that the first time they’ve left without having been given our GPS coordinates, and fail to find us.
Just short of two hours after falling, the skidoo arrives, by which time I’ve got myself lying on my back rather than side, and though I do not think I'm hypothermic, I'm uncomfortably cold. [Lessons: assume the wait may be a long one; remove the injured person’s boots (assuming safe to do so); get them right into a sleeping bag; put them on the two thickest sleeping mats you can get hold of; wrap them in a wind sac; people hanging about may also need to use sleeping bags and wind sacs; lying flat is probably best.]
And now I begin to experience the Norwegian emergency services directly. The skidoo driver and his “rescue guy” introduce themselves by first name and shake hands with me. This is strangely comforting. After some basic diagnostics (can you feel your fingers? is the pain constant?) and a discussion about the fact that my left shoulder-blade seems to be overhanging my upper arm by about 3 cm, we conclude that I've dislocated my shoulder, if not also broken my upper arm. I help them get me onto a rigid stretcher and they and B lift me onto and zip me into a pulk (sledge) to be towed by the skidoo, lacing me up tightly in a wool-lined bag with a transparent window at the head (trailing end). B & A say goodbye at this point: very odd and sudden – even poignant. [Lesson: the injured person will most likely become substantially separated from their skiing partners or other helpers, since the rescuers cannot wait for them to catch up – therefore each person should always carry independently money, tickets, ID etc.]
The 25 minute skidoo trip is noisy, bumpy, and very uncomfortable. The rescue guy rides sort of “reverse shotgun” astride me and the sledge – partly to be able to stabilise the sledge if it tries to capsize on the rough terrain, and partly to be able to talk to me steadily (this is extremely comforting because you cannot see where you are going and because a long bumpy sledge ride is very trying for an injured person). The only compensation is that zipped up in the body bag I am warming up quite a lot, and stop shivering.
By the time we reach the Haukili Red Cross base a Red Cross ambulance has arrived, to which I am transferred, seated, after more first name introductions and hand-shaking. The volunteer driver is an ambulance driver in his day job. The other ambulance man a trucker. We set off. Almost immediately the driver gets a call to a more pressing emergency – a man with heart-trouble – to which we are diverted. I’m sat hunched uncomfortably in the ambulance chatting to the trucker while the man with heart-trouble is given oxygen by our driver. After a while a state-run rescue helicopter arrives nearby: it seems to hold a pilot, a doctor, and an anaesthetic nurse. The latter two come over – more introductions and hand-shaking – to look at me and to confirm the diagnosis of dislocated shoulder. The nurse is authorised to dispense morphine. Twice they fail to catheterize my hand because I am so cold. Eventually they get a catheter into the “blood-doning” vein in my elbow, and then, after saline and an anti-nausea drug – oh joy – 5gm (?) of morphine is fed in, with another dollop a bit later on. Gradually the pain, which has been extreme, begins to subside.
Next, at the direction of the air-ambulance doctor, I’m transferred, following more introductions and hand-shaking, on a stretcher into a state-run ambulance that had also arrived for the man with heart-trouble. The latter is taken away by helicopter. A two hour morphine-hazed journey to the nearest hospital then ensues during which I chat with ambulance-man Hallgeir – about telemark skiing, Hardanger fiddles, privatisation, and shift patterns. I arrive at Norway’s smallest hospital, in Rjukan – where the Nazi Vemork heavy water plant was blown up by the Norwegian Resistance (the "Heroes of Telemark") in February 1943. It is about 17.00, 4.5 hours after the accident.
More handshaking introductions – to a Norwegian nurse, a Ugandan radiologist, a Moldovan doctor, a Swedish anaesthetist, a Norwegian orthopaedic surgeon. All are calmly busy on a quiet Easter Sunday evening. X-rays confirm the earlier (obvious) diagnosis and reveal a small break to the ball-joint in my upper arm. I’m put to bed with a saline drip to ease my thirst. Some hours later (19.30?) the Swedish anaesthetist tells me they are going to resocket my arm that evening, on the basis that the quicker you do this the better it heals, and that a post-procedure X-ray will show if the broken bit is held by the socket (in which case good), or not (in which case surgery will be needed). Later on I’m taken down to the operating theatre and introduced (more handshaking) to an anaesthetic nurse (Mette) and an operating theatre assistant. I’m given oxygen by nose and mask, diazepam and a morphine derivative described by the anaesthetist as, "in effect heroin", with the warning that I might remember very little. The orthopaedic surgeon does some confident and entirely painless pushing of my arm into my shoulder, and my body assumed its normal shape. After 8 or so hours with a ghastly feeling of being in a “stretched spasm”, I suddenly feel wonderfully normal, in a sort of happy-clappy euphoric way. No doubt this feeling is partly drug induced.
The follow-up X-ray shows that the break seems to be held in place by my shoulder socket. I am now moved to a two bed room (other bed unoccupied), given food from the staff canteen, and left for the night, during which various interruptions occur for things like my passport number, and for discussions about whether it will be OK for me to leave the next morning, and with the Moldovan doctor about the big differences between Norway and Moldova. At some time well after midnight, answering a call of nature, I bump into the anaesthetic nurse Mette and the Swedish anaesthetist. Mette has a plate full of sandwiches. She quips that it has been all go since I’d last seen her, and that she just had to eat.
Over the 18 hours from accident to leaving hospital I've had direct, personal help through a complicated web of paid staff and volunteers (as well of course from my two skiing partners and a passer-by). I've been introduced to about 20 people with different roles from at least 5 different nationalities. I've shaken a lot of hands! Every one of the interconnections has worked (eventually or immediately), despite it being in the middle of the major Easter public holiday. I’ve been exceptionally well-cared for throughout.
But alongside this I know that despite my misfortune, I got off pretty lightly.
Postscript. The next day I go by taxi into Rjukan, and get the 07.22 bus to Oslo, changing en route at Nottoden, and managing to get my planned flight to Manchester on Easter Tuesday. Carrying my pack and skis is just about feasible using my undamaged arm and shoulder. By Wednesday - though trussed up like a chicken - I am fully, if one-handedly, preoccupied by Maths MOOCs i.e. the normal things of life. But recovery will take many months, it seems, with biking ruled out for at least three.