ALISTAIR JEPSON
The Skiing Doctor
Ski Club Member and orthopaedic surgeon Alistair Jepson gives a first-hand account of how his professional skills were needed on a family ski holiday to Bansko, Bulgaria
Half-term February 2012 saw my family and me, together with two families from our village in Northamptonshire, visit Bansko for our first ever respective family ski holidays. Bulgaria may seem an unusual choice for a first ski holiday but it had been highly recommended to one of our party and, at the same time we were there, the resort was hosting the Men’s and Women’s Alpine World Cup Slalom and Giant Slalom events, which provided an opportunity for us to see the professionals in action.
The resort ticked all the right boxes – it was friendly, the quality of accommodation was exceptional, and there was a good mix of skiing for all abilities. What I never anticipated though, during what had otherwise been a quiet skiing trip, was for my orthopaedic skills to be required.
On our penultimate day, my friend and I were skiing down to rendezvous with the rest of the group for lunch. On the final run down we noted a stranded skier on the middle of the steep piste who looked in trouble. Unsure for how long he had been there, we felt obliged to stop and enquire as to whether all was well. At this point my ears pricked up when he said everything was not ok - “I think I have dislocated my shoulder – can you help me?” When I explained I was not only an orthopaedic surgeon, but one who specialised in shoulder surgery, he found that just too impossible to believe! In a resort with many nationalities, it was fortunate that we spoke English (he was an Israeli national) and I reassured him that I genuinely was, although unsurprisingly I had no identification to hand to show him! He explained how he had sustained his injury and that he was, as sure as he could be, that he had dislocated his shoulder.
Since no alert had yet been raised with any of the resort rescue staff, I felt it the right thing to offer my services, as my patient, as he had now become, was clearly in terrific pain. I knew too, that the longer a shoulder was dislocated, the harder it would be to put back in. At this point my friend became my nurse and we constructed a makeshift treatment area with our respective ski poles forming a barrier around the scene. My nurse and I cautiously removed our patient’s ski gloves and jacket and I was then able to make an assessment to confirm the diagnosis.
In the absence of gas and air or sedation, we needed to improvise on something to help relieve the pain, and the only available option seemed to be something to bite hard on, which is where our patient’s ski glove came in handy. When the time came, therefore, to reduce the shoulder I asked my patient to bite down hard on the glove; this technique actually worked well and with slow traction on the arm, a gentle twisting motion and firm pressure on the front of the shoulder, the shoulder reduced with relative ease. The relief as soon as the shoulder was back in joint was incredible and then we were able to enjoy a more light-hearted conversation amongst ourselves about the amazing fortune of a English-speaking shoulder surgeon being the one to stop and help. A little while later the medical team arrived and my patient was stretchered down the slope to the medical centre, but not before we had exchanged phone numbers.
Needless to say, this led to us being very late for our lunchtime rendezvous and none of our party seemed believing of our heroics, and in truth we were somewhat castigated for being late for lunch! Fortunately, though, I was able to prove our exploits that evening when my patient messaged me to say that all was well, that no fractures has been identified, and he was planning on returning home the following day.
As doctors, we all expect the possibility of being called to help on an aeroplane, but this story tells the tale of a more unusual place to be called upon to help.
