When I was two, my parents began construction on a house about two blocks from the local hospital. My father's logic was that in really bad weather, he could walk up there to make his daily rounds...something that proved on the prophetic side about four years later during some of the only true blizzard conditions Kentucky has ever experienced.
I'm old enough to remember the very first flight ambulances: Huey Medevacs from Ireland Army Hospital in Fort Knox. If you are unfamiliar with a Huey configured for this purpose, you must never have seen any movies about the Vietnam War...especially not "Apocalypse Now", famous for the cluster of Hueys emerging at the horizon to 'Ride of the Valkyries'. They really were military green, and Medevacs really had the big white box on the bottom with an enormous red cross inscribed in it. Like Radar O'Reilly, I can hear a helicopter coming in from miles away, before anyone else notices. My family is still spooked by that.
Sunday night, as I was taking leave of my parents, I suddenly froze and said to my mother, "The helicopter's coming." She looked puzzled, and about a minute later, she heard the blades beating against the air. It's a distinctive sound; in Smalltownland, it's a bad omen.
Our tiny hospital is unequipped to handle major trauma. The Hueys used to take trauma victims to the base hospital at Knox, where experienced field surgeons who'd seen the battle carnage of a jungle war or two would make their valiant headlong charge against gruesome death. These days, a private commercial flight ambulance takes patients to a trauma ward at one of the city hospitals about ninety miles away. They will set down at the nearest hospital if the patient codes- my father's medical partner coded minutes after takeoff and died on the helipad of the neighboring town's hospital (he had already been resuscitated from a massive heart attack).
I made it as far as the intersection before a city police officer whipped out in front of me to block the street directly in front of the hospital. Traditionally, law enforcement and rescue blockade so that the helipad is free from interference. For some reason, I had a really bad feeling about this one- the helicopter was just touching down as I turned the car to leave by the only other means of egress.
I was right. I know the family. It ended badly.
I'm sure to most city-dwellers, a helicopter generally means some wealthy industrialist zipping around, or a news crew hovering overhead. Where I come from, it's a harbinger of death. I don't think I'll ever outgrow it; it's been difficult working next to an airport that incorporates a helipad. I also live in the flight path to the local hospital, something I didn't realize until I was out walking my dog a few weeks after I moved into my house. I thought I heard the faint beat of rotor blades...it grew clearer, and I saw the landing light illuminating the belly of the ship. Great.
The hospital here is much larger and more complex than the one back home, with a staff of several specialists and surgeons ranging from general practice to neurosurgery. There are still some things outside their purview, though. They, like the Smalltownland hospital, send the trauma patients out, in this case to the SFU hospital.
One quick aside: your health insurance and automobile insurance (if you are involved in a car accident) may not cover airlift, or a significant portion of the cost of an airlift. In the South, there are various regional subscription air ambulance services- subscription can defray a great deal of that cost. In rural areas, this was also common practice for ground ambulance services for many years; ours was self-supporting on a subscription basis before the county government picked up the bill. For both Smalltownland and Lake Redneckville, the air ambulance service is Air Evac Lifeteam.