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Four physicians - four stories of resilience, one year after the Humboldt Broncos tragedy

 

By Girard Hengen
SMA

Dr. Pierre Hanekom, a pilot, is often drawn to the intersection of highways 35 and 335 northeast of his hometown of Melfort.

What happened on the ground at that intersection late in the afternoon of April 6, 2018, still haunts him one year later. A family physician, he was wrapping up work for the day in Melfort when he heard about a developing tragedy. At first he didn’t know what had happened, but headed with other Melfort physicians to nearby Tisdale to help in any way he could at the hospital.

Sixteen people affiliated with the Humboldt Broncos hockey team, including 10 players, coaches, the trainer, radio station employees and the bus driver, died when their bus collided with a semi that afternoon. Another 13 players were injured.

From the air, in the confines of his cockpit a year later, Dr. Hanekom has time to reflect. Like a province that is still reeling from the losses suffered, he has many questions and harbours many thoughts, but has few answers.

“I’m a recreational pilot so I fly a lot, and I find myself frequently flying over that site and circling around and looking at the memorial that is there,” Dr. Hanekom told the SMA. “That brings back all the memories of what happened that dreadful day. Being an older physician, it touches me a lot on the youth that’s gone, the potential in the guys that passed away, and also being so grateful for the guys that did survive.

“The first picture I saw of the scene was while we were still in Tisdale. I couldn’t believe the extent of it. That site was from the very first, and even up to today remains - can I call it a sacred site?”

 

“The care and support we, and all the Bronco families received, was unbelievable....I cannot begin to put into words how touching it was, and how helpful it was for us.”

What follows are the stories of four physicians who are connected by fate and tragedy. Each were touched by the Broncos bus crash, and during the past year each has shown resilience in his or her own way, returning to work in their emergency rooms, operating rooms, clinics and offices.

At the Tisdale Hospital, Dr. Hanekom and several physicians from Melfort joined their Tisdale colleagues and attended to the injured who were transported from the crash scene 30 kilometres to the north. Once stabilized, the injured were taken to Royal University Hospital in Saskatoon.

There, a neurology resident waited in the intensive care unit. Dr. Cassie Fehr, who had started her shift at 7 a.m. on April 6, worked under extreme conditions admitting and monitoring patients until 7 a.m. the following day. She broke down and cried when the next shift came in. Her husband took her home because she couldn’t drive.

The neurosurgeon on call at RUH - Dr. Daryl Fourney – asked his colleagues to come in and help attend to brain and spinal column injuries. And they did - all of them. Dr. Fourney credits their teamwork for helping all of them cope in the days and months that followed.

These three physicians were care providers that night. Dr. Paul LaBelle, an emergency room physician in Saskatoon, has a different perspective – that of a parent of a Bronco player. His son, 18-year-old Xavier LaBelle, was on the bus. Dr. LaBelle, his wife, Tanya, and their nine-year-old daughter, Viviana, were travelling to Nipawin for the playoff game the night of the crash. Five minutes after being notified of some sort of bus accident from their 20-year-old son, Isaac, Paul, Tanya and Viviana, drove up to the tragic scene about an hour after it had happened. 

After initially being misidentified, and being declared deceased, it was discovered a few days later that Xavier LaBelle survived the crash – “A miracle in itself,” said Dr. LaBelle. 

The year that followed has seen progress and setbacks, but the LaBelle family has persevered by leaning on each other, on friends and family, on the families of other Broncos, on the community and their faith community, on co-workers, people from across the province and indeed, Canadians from coast to coast. Dr. LaBelle has returned to work in Saskatoon’s three emergency departments. It hasn’t been easy.

“One year has passed. It seems like it was yesterday, other times it seems like it’s been a very, very long time, but we’re certainly continuing to heal as a family and get back into a new normal, which is good,” Dr. LaBelle said during a break recently at City Hospital.

“The care and support we, and all the Bronco families received, was unbelievable. In addition to my emergency department colleagues and nursing staff, we felt support from the whole health-care community, reaching out in different ways and encouraging us. I cannot begin to put into words how touching it was, and how helpful it was for us. We are so grateful.”

 

‘We grew as a community, we grew as physicians together, we have camaraderie that helps us push forward.”

Dr. Pierre Hanekom had one thought as he headed to Tisdale in the first moments after the crash.

“I said, ‘I don’t know what to expect but I just hope it’s not kids,’ ” said Dr. Hanekom. “Not too long ago we had a tragedy in Melfort where a mom and five kids were involved in an accident where they drove off the road into a little slough. That kind of brought back some memories of that experience.”

At about 9:30 on the night of April 6, while attending to one critically injured patient and helping out where he could with others, Dr. Hanekom phoned his wife to tell her where he was. Things were a blur; he had no time to process the magnitude of the situation. His wife had yet to hear of the crash.

“The immediate feelings were that of - I just hope the ones that I personally saw and managed, that they were better off with the first care that we provided,” he said.

He also thought of the first responders at the scene. He served with the South African military in the South African Border War at Angola and witnessed the atrocities of war - this before any medical training. Later as a physician, he spent a year dealing with severe traumas at a hospital that served about six million people. He says that background helped him at the Tisdale Hospital, but he knew in the weeks that followed he would have to get back into the routine of clinics and rounds and surgeries.

“As a physician you’ve been trained, and having gone through shall I say the emotions of being involved in early trauma and then working machine-like in a place like the trauma unit in a huge provincial hospital in South Africa, it gives you a stronger ability to work through things and just go on.

“The exposure to people that you see in a huge trauma unit is minimal. But it’s different here when you live in a community that you’re close to the people around you. You work in an environment where anybody that you come across has some sort of a connection to the tragedy, either by passing through that area, living close to it, knowing somebody who had a person involved in that accident or lost a family member in that accident.

“It’s way different, but the thing is it still doesn’t take away your responsibilities of what you have to do tomorrow. You find yourself back at work and you work and you have to do this and you have to do that.”

As the year progressed after the crash, various events in the news served as reminders. What helped was talking about it - during debriefings, with other staff and especially among physicians and nurses. They talk about how the survivors are doing when they hear updates. 

“We talk frequently and I think that helps you carry the extent of the trauma that lurks in the back of your mind all the time,” Dr. Hanekom said.

He understands a physician can’t escape trauma, whether in pastoral, quiet Melfort or a major hospital in a city of six million. As much as his mind turns to April 6, 2018, he also reflects on how his community has been touched and affected – and changed.

“We have to go on, and I don’t think something like that night necessarily weakens you. We’ve had strong things that happened. We grew as a community, we grew as physicians together, we have camaraderie that helps us push forward. I think it was a good year, in terms of the support we had from the community. People are happy to say that our physicians from Melfort went to Tisdale and gave a hand where they could.”

 

“I just broke down and everything kind of hit me at once.”

Neurology resident Dr. Cassie Fehr, who was into the second year of her five-year program on April 6, 2018, had a quiet first half of a 24-hour call shift. She was the only resident scheduled for the evening in the ICU. She expected a quiet night to follow the day.

Soon, though, the ICU would – in her words – turn into “organized chaos.” Extra staff was called into the emergency and operating rooms under a Code Orange, but not the ICU. A staff physician handled the overall scene and a member of the day staff stayed until midnight, while Dr. Fehr admitted every patient to the ICU.

“You just have to think logically and scientifically and try to do your best for these kids, and you know there’s a factor of exhaustion because you’re going all night from patient to patient, getting them admitted and trying to make sure they’re stable,” she said. She felt confident in her training and medical skills, but was unprepared emotionally.

In the moment she had a job to do, and was “almost numb” to what was going on around her. But once the morning crew arrived to take over, “I just broke down and everything kind of hit me at once,” she said. “I ended up having to get my husband to come pick me up, I couldn’t drive. I didn’t get a lot of time to process it.”

She was on call Sunday, Tuesday and Thursday the following week, and says she struggled at times with her feelings.

“First of all you’re horrified and you’re traumatized, but then you also feel guilty for feeling that way because what you went through is nothing compared to what the patients and their families have gone through. I also had this feeling of obligation to the kids and their families, because I know the ICU team switched over that Monday and I was one of the only faces that was familiar to all of them so I felt an obligation to them as well. I found that relying on my family and my co-workers was really, really important.”

Her program director, Dr. Gary Hunter, told her to take any time off that she needed, but she said she was fine. He insisted she go to a debriefing, which she said was a positive experience. As the week went on she realized she “wasn’t processing this well.” She took some time to be away – to talk.

“I found the ICU staff was wonderful, the ICU nurses were really wonderful. There’s something to be said for solidarity when going through a thing like this when other people have experienced it, too. I found it was really helpful talking to a lot of the nurses who were there that night and who took care of those patients over the following week.

“For the few weeks following I almost had this urge to talk about it,” Dr. Fehr continued. “I always just wanted to talk about it – to my husband, he’s great at listening. My mom’s a nurse, my sister’s a nurse, they were really helpful to talk about things, too, because they’ve seen their share of trauma in their work. I found that went away in time, but initially I had this drive to talk about. I found that really, really therapeutic.”

It’s true that time heals, she said. The crash and its aftermath have been the biggest story in Saskatchewan through the year. When people bring it up with no warning, or when confronted with it, she struggles. She cried while driving to work when people on the radio were talking about the Broncos on the day of their season-opening game. But she feels she learned much from the experience and has become a more resilient physician.

“I learned things about myself and how I deal with things and what’s helpful to me, and I learned how to lean on people a little bit more, which I think was a really good lesson,” she said.

“Time is really what did it. I don’t know if I can put it on anything else, honestly, and just taking time away from the hospital, taking time to do things that I like to do that doesn’t involve work.”

 

“I think we coped just by working together as a team, just letting it be known that we were there to support each other in the job.”

Dr. Daryl Fourney was the neurosurgeon on call on April 6, 2018, at RUH. He knew early he needed help from other neurosurgeons and staff.

“The details originally were quite sketchy, but it sounded like there were multiple traumas coming in and they were setting up a special triage system for this,” he said. “I’m the only neurosurgeon on call. There’s one neurosurgeon and one resident typically on call on a weekend like this.”

All of his colleagues agreed to help in whatever capacity they were needed. Five neurosurgeons were on site at RUH. Dr. Fourney stayed in emergency with a resident working with a trauma surgeon triaging patients. Dr. Fourney performed eight neurosurgery procedures that weekend, while neurosurgeons Drs. Lissa Peeling and Mike Kelly managed the ward and the ICU. The enormity of the tragedy didn’t really hit in those first few days. The surgeons were too busy.

“You are just going with what needs to be done through that weekend,” Dr. Fourney said. “It wasn’t, I think, until Sunday that I got to talk to most of the families after the initial trauma. All my discussions with families before that were when they came in and assessing the situation and giving immediate feedback about what we were going to do. By Sunday, much of the adrenaline rush was frankly still going on. It was hard to conceptualize the enormity of the situation when we were right in the middle of it in the beginning.

“Once time had passed and we had more time to kind of sit and talk to families more, that’s when it in some ways became harder, in terms of…,” Dr. Fourney said, pausing, “…in terms of seeing the pain that families were going through, not just in the short term, but in the long term too and in the follow-up after that.”

Teamwork became a key concept in the days and weeks that followed. The surviving Broncos players and their families had already shared bonds that only seemed to strengthen in the glare of the public spotlight. The neurosurgery group at RUH also coped by relying on each other.

“What was unique about this situation wasn’t just the numbers of people or the fact that they were all young, healthy people before this,” said Dr. Fourney. “It was that they were a team; that the families had a connection. They were all together, and that made it very different.

“In kind of the same way, I think we coped just by working together as a team, just letting it be known that we were there to support each other in the job,” he said.

He said the recent organization of trauma services within the Saskatchewan Health Authority added to the capabilities of dealing with a tragedy of the magnitude of the Broncos bus crash. And he singled out the actions of the other neurosurgeons “who for no reason other than a sense of moral obligation” pitched in during the first weekend and the weeks that followed.

“What we were able to do just wouldn’t have happened,” Dr. Fourney said. “That speaks to the quality of the people we have here. I am truly grateful for the help that I got.”

 

“We’ve got an incredible group of physicians – not just physicians but human beings, too - who look out for each other and are incredibly empathetic.”

On behalf of his wife Tanya and family, Dr. Paul LaBelle spoke to the SMA because he wanted to say thank you.

Thank you to his emergency department colleagues for their patience and understanding, especially when he didn’t return to work as early as he planned. Thank you to all the health-care workers and all the specialists in all of the locations that Xavier received care. Thank you to people in communities near and far who have wrapped their arms around the Humboldt Broncos families and haven’t yet let go, one year later.

“Our lives were thrown upside-down in the total chaos of the tragic circumstances that we found ourselves right in the middle of,” Dr. LaBelle said. “It was incredibly overwhelming and incredibly challenging just navigating my own personal life and supporting my immediate family, our son who was severely injured and had a prolonged hospitalization, and of course, we were so very much connected to the other families on many different levels, because our son had been playing there for two years so we knew the coaching staff, support staff, the players and their families.”

“It was so incredibly tragic and gut-wrenching on so many different levels that even the thought of work was extremely overwhelming at the start.”

Dr. LaBelle says his colleagues immediately reached out to him, taking away any concerns or pressures he may have felt about needing to return to work. They gave him the time and space he and his family needed to recover.

The thought of returning to work was daunting. Trying to balance ongoing family needs while Xavier remained in the hospital, and during his transition home, was difficult. Dr. LaBelle said he was emotionally, physically and mentally exhausted, and the tears continued to flow easily. He sought out counselling to deal with the post-traumatic stress, and triggers he might encounter upon returning to the emergency room setting. With the help of his colleagues, Dr. LaBelle returned to work at the beginning of July. 

“We’ve got an incredible group of physicians – not just physicians but human beings, too - who look out for each other and are incredibly sympathetic to the situation that we were going through and wanting the best for my family as well,” Dr. LaBelle said, tears welling in his eyes.

Within emergency medicine there has been more awareness of physician wellness, making sure physicians have the right tools to lead long, productive and happy careers, he said. In the future he hopes he can help colleagues in their time of need, when they are in turmoil from a traumatic situation and are reaching out for help.

“As a department we were already well on our way to at least learn and use various tools that are available to help with physician wellness,” he said. “What I personally went through – as a physician and a person – certainly highlights just how vulnerable we all are.”

For the remainder of 2018, Dr. LaBelle worked on a reduced schedule. Although Xavier came home in June, he has had ongoing medical needs, surgery, physio, and out-of-province appointments. 

“Xavier has had some setbacks and obstacles over the year but he’s continuing to improve,” Dr. LaBelle said. “Obviously he had a life-changing event, but he’s a very strong young man who has shown a lot of determination and perseverance. He is determined to keep moving forward. He’s looking to his future and for all of us, we’re cheering him on, and we know it will be amazing.”

As the one-year anniversary of the crash approaches on April 6, 2019, the LaBelles plan to attend some of the memorial ceremonies and events. They feel the pull of the ties that bind the Bronco families together.

“We are affected by all the suffering and pain that everyone who was on that bus, along with their families, experienced. We are grateful that Xavier miraculously survived, but we’re always mindful of the others who are on a different journey. We keep connected and support each other as a Bronco family.”

(Photos top to bottom: Bus crash site and physicians Drs. Cassie Fehr, Daryl Fourney, Paul Labelle and Pierre Hanekom (SMA photos); crash site from the air (courtesy of Dr. Hanekom); crosses erected at crash site (SMA photo, May 2018); Xavier Labelle as a Bronco (courtesy of Dr. Labelle); Dr. Hanekom with his plane (courtesy of Dr. Hanekom); Dr. Hanekom (SMA photo); next two photos - Dr. Fehr at the U of S (SMA photos); next two photos - Dr. Fourney outside his office at RUH (SMA photos); Dr. Labelle at City Hospital emergency (SMA photo); Isaac, Viviana and Xavier LaBelle at Hockey Day in Canada in Saskatoon, March 30, 2019 (courtesy of Dr. Labelle); memorials at crash site (SMA photo, May 2018)

 

 

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