Charles Cotton , contributor to Izaak Walton’s classic treatise, “The Compleat Angler”, advised sportsmen to “fish fine and far off”. Sandy Point, on the southern shores of Abaco Island, may not necessarily qualify as an exotic destination, but for a southern boy of very humble beginnings, it is close enough. Over the years, I have come to appreciate that the actual fishing at such distant places may not, in and of itself, constitute the “fine” part of the experience recommended by Mr. Cotton. Broadening one’s horizons by experiencing firsthand the lives and cultures of other peoples is, for me, an essential part of travel fishing. Some observers feel that Americans remain, despite the mind boggling advances in recent years of communication and transportation, far too provincial in their thinking and outlook. Well, I am an American, and some people say that I am ugly, so perhaps this observation does hold true in my own case. My recent trip to the Bahamas serves to illustrate the importance of the social aspect of travelling, fly rod in hand, to some foreign country.
Saturday evening, our group of bonefishing diehards had returned from the flats, washed the salt from our gear and ourselves, and settled at the dinner table. A wonderful, but curious meal had been prepared by the lovely ladies in Stanley’s employ, consisting of a combination of local fresh caught lobster and plain old diner style meat loaf. The usual combination of “mildly” exaggerated fishing stories from the day and not to be taken seriously ribbing about poor fishing skills filled the air along with the aromas of shellfish, hot sauce, and Kaliks. A general atmosphere of lighthearted revelry settled over us as we enjoyed just doing what we all love so dearly.
The mood was suddenly interrupted when Stanley limped into the room on his impossibly bowed legs and announced that there was a medical emergency at the small clinic in town and that our assistance was urgently required. I was surprised to learn that Sandy Point has its very own physician, though she is shared with both Crossing Rock and the island community of Moore’s Island. One doctor for some two thousand persons, available 24/7 to handle any and all medical issues, emergent or chronic. She is a native Bahamaian ,who after medical school, chose to settle in this remote village to serve her people, rather to seek riches in a large city. She is yet another in a long list of unsung heroes around the world. We frequently hear about movie stars and athletes, but rarely do stories of real heroes, such as this physican, make the papers or tv news shows. A sad statement about our values and priorities.
Three among us were physicians and we immediately arose from our repast and headed out the door while Stanley explained the situation. It seem that one of the village’s older inhabitants was in distress. She faced the triple threat of being diabetic, living alone, and having early Alzheimer’s disease. On this particular afternoon, she had taken her insulin injection as normal, but mistakenly thought she had already taken her meal. Unfortunately, she had not. Her blood sugar plummeted predictably, rendering her semi- comatose and combative. The local doctor was struggling to raise the patient’s blood sugar by injecting a concentrated form of glucose into her veins. What should have been a simple problem became life threatening when no veins for establishing an IV line could be found, a common problem for diabetics. Her dangerously low blood sugar combined with her combativeness and inability to cooperate spelled disaster.
We piled out of Stanley’s pickup and hurried into the clinic. The physician was struggling to help her patient, but had little in the way of medical equipment. The doctor hit upon the idea of inserting a plastic tube through the patient’s nose and into her stomach, whereupon the glucose could be delivered without IV access. She had no NG tube ( nasogatric tube, a commonly used device taken for granted in American hospitals), so she cleverly cut off a piece of oxygen tubing and attempted to use it instead. Unfortunately, a combination of thrashing about by the patient and the stiffness and size of the oxygen tube made this effort unfruitful.
By now, the patient’s glucometer blood sugar reading was 20, dangerous indeed. The three of us searched frantically for a vein. Two of us are highly experienced surgeons but despite our expertise, no suitable vein could be found. We contemplated inserting an IV line into the jugular vein, but we had neither the equipment nor a cooperative patient. The situation was becoming desperate and I asked that the helicopter be called in to transport the patient to Nassau, a mere ninety miles away. I was informed by the doctor’s assistant that unless the patient or her family could come up with thousand of dollars to pay for it, the helo would not come. That is the stark reality of life in many places. No money, no treatment.
Ultimately, we came up with the idea of just bypassing the need for intravenous access by injecting the glucose under the skin into the fatty layer. Despite a lack of veins, this patient had no shortage of subcutaneous fat, so we injected a couple of vials of concentrated glucose into the fat in the abdominal area. We maintained her airway and prevented her from injuring herself by flailing about on the table and falling to the concrete floor of the exam room.
Though not as rapid in its onset of action, this route of administration offered us our best hope. Indeed, within a few minutes, we witnessed that almost miraculous recovery diabetics experience when their blood sugar is restored to normal levels. Suddenly, the patient ceased struggling, sat up and asked what had happened. She was able to drink a small cup of orange juice and seemed no worse for the wear and back to her normal state of health.
I was immensely grateful for her recovery, as I had feared for her life initially. After it had become apparent that she had made a complete recovery, I could not help but make the fishing analogy of the modern practice of catch and release. Just as the many bonefish we caught had been released unharmed after a ferocious struggle, to continue their lives on the nearby flats, this lady was returned home to live out her life in the idyllic village of Sandy Point. Our hope is that increased vigilence on the part of her neighbors and family might prevent simlar episodes in the future.
The intense frustration I had experienced earlier that day after being unable to entice a large permit into taking my fly was now replaced with the very deep satisfaction of helping save a life. Although people in other countries may have a differing culture than our own, every person is precious, and are no different from ourselves. These kinds of events help bring that truth more sharply into focus and help me ensure that my priorities are in order.