Muckdate 6: Hospital and a Helicopter Ride

One of the frequently asked questions we got before we moved to Muck was: what happens if someone gets ill? There’s no doctor on the island and the nearest surgery is the Small Isles Medical Practice on Eigg, three miles away. A nurse or doctor from the practice visit the island once a fortnight for non-emergency appointments, but what happens if you become suddenly unwell when they aren’t there? Well in the small hours of last Sunday morning we found out…

Earlier in the week our eldest daughter had been off nursery with a bug: snotty, coughing, tired, and generally not herself. After a couple of days at home watching Disney films and generally not doing or eating much, she was starting to feel a bit brighter - but on Saturday afternoon we noticed that her baby brother had also developed a cough. Nothing terrible at first, so we put them both to bed as usual and settled in for the night. Then at 3am I woke to hear the baby choking on his own phlegm. I got him upright but because of his age (4 months) he can’t yet cough voluntarily, so I was trying to help him clear his throat by patting his back and massaging his chest. Nothing was shifting and his breathing was ragged and noisy. When he did cough it came with a horrible rasp that didn’t clear the mucus, and all the time he was crying, a funny high-pitched mewl that I’d not heard him make before.

My husband and I took it in turns to hold the baby and Google his symptoms. Because of his ‘barking’-type cough I had suspected croup - I’d never seen a child with this illness, but I’d read about it in Anne of Green Gables and the baby’s choking coough seemed to fit the bill. Oh for some ipecac! Even with him upright the phlegm wouldn’t clear, so I did what you’re supposed to in these modern times and call NHS 24, the non-emergency medical helpline.

After half an hour on hold, during which time the baby had vomitted all over himself but at least didn’t seem to be choking any more, I got through to a call handler, who quickly put me through to the on-call GP. After going through his symptoms and a general medical history, she said that she thought it was croup - which should resolve on its own, but sometimes develops into a secondary infection like pneumonia in very young chidren. Because of his age, she wanted a doctor to see him straight away - and would send an ambulance. I had to tell her that although that would be appreciated, unless the ambulance included a ferry charter it wasn’t going to be much use to us!

Having explained to her about our island location, she then put the wheels in motion for a different pathway. We were handed to the emergency services coordinator in Glasgow, who explained that that the Coastguard would send a crew with a paediatric-trained paramedic to check the baby over before transferring him - and me - to hospital. It would take about forty minutes for them to assemble and prepare for the call-out, and then they would be with us about half an hour after that. I assumed that, because they said Coastguard, that they would be coming by boat. When the coordinator asked where was the nearest large, flat space to our house, I realised I was wrong. The paramedics would be coming by helicopter, and we should pack an overnight bag as we were now looking at a hospital admission.

By now it was 5am and the baby, though still coughing badly, was breathing more normally. He didn’t want to feed, presumably because his throat was so clogged, and though we thought about giving him Calpol we didn’t want to add to the sticky fluid in his throat. My husband packed our things whilst I did everything I could to try and calm the baby down enough to take a bit of milk. Eventually he became more settled and after a small feed, finally fell asleep. Now we just had to wait for the Coastguard - and before long three head torches came bobbing along the path to our house: Muck’s on-island Coastguard team, equipped with emergency first aid kit and VHS radios. Two of them went to take coordinates for two possible landing sites - the moor above the house and the field below us at the farm - and one stayed with us, keeping us calm by telling us how many of the island kids - and grown-ups - had been airlifted off before, for everything from broken ankles to high temperatues. ‘Because of where we are, they don’t take any risks’, she explained, and we were greatly reassured that, even though the baby was now much improved and the immediate crisis had largely passed, we were still doing the right thing by getting him seen by a doctor.

We all had a strengthening cup of tea, and then out in the darkness we saw bright lights in the sky and heard the thwack-thwack-thwack of the helicopter’s rotor blades. By now it was nearly dawn and I’d rung the farm to let our neighbours know that a helicopter would be landing nearby: the Coastguard had already been down and helped them move the tups off the allocated field. Then along the cliff path came the Coastguard winchman, dressed in an orange flying suit and carrying a huge rucksack full of kit. He did a quick check of the baby to make sure he wasn’t in any immediate danger, and then escorted us - dressed warmly as instructed by the emergency services coordinator - down from the house to the farm, stopping en route to swap my mucky wellies for more normal boots so that I wasn’t stuck in hospital in my wellies.

By now it was clear that we weren’t going to fly to either of the nearest hospitals - Belford in Fort William or Raigmore in Inverness, where island casualties usually find themselves. The wind was really picking up, and apparently its speed and direction, combined with the increased risk of turbulence from nearby mountains, would make it difficult to land at either mainland hospital. The Coastguard crew had come down from Stornoway on Lewis in the Outer Hebrides - over a 150 miles away - so that’s where we would be going. The island coastguard had told me that when her daughter was airlifted off the island, she had fallen asleep to the sound of the helicoper rotor blades, and that is exactly what our son did, sunggled on my chest in the papoose and zipped inside my jacket to keep him extra cosy.

The Coastguard walked me to the helicopter and gestured to me to duck and wrap my arms around the baby as we got closer. The helicoper was huge - a Sikorsky S-92 I believe, for those who like to know these things - and the noise and wind coming from the blades was incredible. The grass around the helicopter was pushed flat to the ground and in the early morning half-light, the whole scene felt utterly unreal, like something from a Hollywood film. Before long we were being strapped in to our seat, yellow eardefenders in place to block the noise, and after a few minutes waiting for the all-clear, slowly rose into the sky. One of Muck’s coastguard took the following video of our take-off:

I had never been in a helicopter before, though I knew a little about them as my husband has occasionally used them to get to remote spots on the Greenland ice sheet as part of his research into glacial melting. This one, though, was quite different from the small commercial aircraft he’d experienced. For a start it was enormous: the call handler had checked my weight in advance of the flight and we were sat towards the back, but there was space for at least 15 more people. Inside was quite bare, with fold-down seats rowed along the sides and headsets dangling from the ceiling, and the centre was a field-medicine stretcher bed, complete with spinal board and canisters of what I assume were oxygen and/or nitrous oxide. Stornoway Coastguard provide a 24-hour year-round Search and Rescue service for the north and west of Scotland, so they have to be prepared not just to transfer croupy babies from tiny islands (in their capacity as secondary Air Ambulance for the Western Isles), but also to find and assist climbers during accidents in the mountains, as well as recover and treat sailors taken ill at sea. To them, this was probably a very easy and straightforward mission - though it felt rather different to me!

As we left the island I felt the wind buffetting the helicopter, and as we came above the cliff that backs our house I felt the whole aircraft lurch to one side. I knew that it was likely that we’d keep fairly close to the ground as that’s what the island Coastguard had told me usually happens in strong winds, but as the winchman showed me the route on his iPad it was clear that we’d be flying over the sea, tracking between the West Coast and the Outer Hebrides. It was too loud for conversation, so we communicated by gesture and writing on a tiny whiteboard: at one point the winchman wrote ‘170 mph’ on the board, before adjusting it to 175mph and adding the epithet ‘the fastest I’ve flown’!

I could feel my heart thundering in my chest and my head was swimming with half-formed worries, but I knew that the best - indeed, only - thing I could do was sit tight and trust the people who had climbed out of their beds before dawn on a Sunday morning to help my baby and get us safely to hospital. From the windows most of what I could see was the sea, tinged a weird purple colour by the sunrise as it filtered through low cloud. Waves crashed on rocks and, far to the west, I could see them lapping on the shores of the southern-most Outer Hebrides. When the wind caught the aircraft and the sea was suddenly replaced by the sky and scudding clouds, I changed my focus and kept my eyes on the shoulder of the winchman. A large fabric patch on his sleeve told me his name was Norman ‘Nam’ MacLeod, and that seemed like a good Hebridean name, belonging to someone who would know this part of the world and its weather better than most. (I later found out he is a very experienced paramedic who has been involved in some pretty tricky rescues - read here for more: https://www.cicerone.co.uk/helicopter-rescue-in-the-hebrides)

Thirty-five minutes after leaving Muck we were touching down on the helipad at Stornoway. I was helped down from the aircraft and lead straight to a waiting ambulance which drove us the short distance to the hospital. The baby, who had slept through all the excitement, now woke up and, clearly refreshed by his nap, bestowed all of his best smiles on the A&E team as they assessed his condition. Throat swabs were taken and he was given a full health check; they confirmed that a viral infection in his chest was behind it all, and we were to stay in hospital overnight in case it developed into brochiolitis or pneumonia. Swabs for Covid and RSV came back negative, so the precise nature of the virus remains a mystery. After receiving excellent care in our own en suite room in the hospital, we were discharged the following afternoon. And there began the next stage of the adventure: getting back to Muck…

Without a helicopter or even a car, it was clearly going to take some time: we needed two ferries (Stornoway-Ullapool and Mallaig-Muck), two buses (Ullapool-Inverness and Inverness-Fort William), and one train (Fort William-Mallaig), plus at least two nights’ accommodation along the way. Fortunately there were plenty of spaces on public transport and options for places to stay as almost no one comes to holiday in the Highlands in January, but I can’t imagine how difficult - not to say expensive - this journey would be in the summer. So five days after we left the island in dramatic fashion, we finally came back to Muck as foot passengers on the MV Lochnevis and were reunited with the other half of our family - along with most of the island - at the pier. Now let’s hope we get through the rest of our stay here without further high jinks!

I would like to say a huge thank you to everyone who helped make sure our little boy stayed safe and received the best medical care possible. The Coastguard provides a lifeline service for island communities and I am hugely grateful to Muck’s team (Sandy, Vicky and Barnaby) and the Stornoway Search and Rescue crew (Norman MacLeod and colleagues) for everything they did that morning. Thanks too to our neighbours Colin and Ruth for the loan of their field and to the wonderful nurses and doctors at Stornoway (particularly Rebecca, Doreen, and Dr Mallick) who ensured we had the best care and medical support during our stay.