Craig Thompson and Walter Kerr wasted no time getting their helicopter ready to leave the blue hangar at Martin State Airport. It was a recent Monday afternoon, and a few miles away was a man who had slashed his stomach in a fall from a 15-foot ladder. Now, with an injury that had torn his intestines and threatened infection, the man needed to get to the hospital as quickly as possible.
Thompson sat in the righthand driver's seat, flicking the switches that started the twin engines, as Kerr steered the small yellow car that would tow the helicopter from the hangar and onto the runway area. Once on the pavement, Thompson started the four metal blades that whirred overhead, throwing shadows on the two men's helmets.
As the blades in the tail whined, the black-and-green helicopter, blazoned with the Maryland flag, rose. The nearby grass rippled, and the helicopter, tilted like a speeding wasp, headed into the graying sky.
Seven minutes earlier, Thompson had answered the telephone, sat bolt upright in his chair, and asked a few terse questions. Now, Thompson, the helicopter pilot, and Kerr, paramedic and state police sergeant, were on their way to collect the injured man and rush him to the nearest trauma center.
For the pilots and paramedics of the state police's aviation division - the helicopters that fly patients from accidents to hospitals, conduct search-and-rescue efforts and back up law enforcement - those are the moments when the mission becomes clear, the race when a minute's delay might carry lethal results.
And that rapid response is typical for the division, which recently celebrated a major milestone: transporting its 100,000th MedEvac patient, a child from Cecil County.
In small counties such as Harford, the job is especially crucial: with no trauma center of its own and a rapidly growing population, the county has 250 to 300 patients annually who need the airborne ambulances - the second-highest total in Maryland, with Anne Arundel County as the highest, Kerr said.
"What you see here exists nowhere else," Kerr said. No other state program duplicates Maryland's three-pronged mission, and no other public program carries as many people to care centers. Last year, about 6,000 people were carried.
The program started in 1970, when the Maryland State Police became the nation's first public agency to use a helicopter to transfer an injured person in a nonmilitary situation. That airlift on a single-engine Bell Jet Ranger helicopter led to a fleet of the aircraft stationed around the state.
Today, there are eight bases, from Allegany County to Wicomico County; the base at Martin State Airport is the headquarters. Trooper One, the helicopter there, covers Harford, Baltimore and Cecil counties, and backs up local law enforcement in Harford - checking, for example, potential terrorist targets such as the Conowingo Dam.
Besides the eight bases, the division has four more helicopters, to ensure that counties still have coverage when a helicopter is in the shop for repairs or the strict regimen of maintenance and inspections the vehicles must undergo after set numbers of hours of flight time.
"Safety in the air is our No. 1 issue," said aviation mechanic Steve Gumbel of Havre de Grace. "We want our people to go home at night."
The high pressure of the job is a factor that everyone in the program has to deal with. Many of the people in the division are divorced, Thompson said. He is still on his first marriage - "very rare" in the program, he said. "My wife has been a total support for what I do," Thompson said.
As a peer counselor, Kerr has seen the stress take a toll on others, too, getting his share of 3 a.m. phone calls from people dealing with the accumulated stress.
But the high pressure of the job is balanced out by the high reward, said Marc Cournoyer, a trainee pilot. The sense of public service bonds the people who work there, he said.
Cournoyer learned to fly in the military, where he became an Apache helicopter instructor and flew in the first Persian Gulf war, Panama and Somalia. He left the service after 23 years and flew emergency medical missions for a private company in California, but found he preferred working for a public group.
Pilots must have logged 2,000 hours by the time they apply for the position. That usually puts applicants in their early 40s, said Kerr. And the long time it takes to get those hours means that there are few women who qualify: All the pilots are male. However, these days, a lot more women are in aviation, said Thompson, and those new pilots are accruing the hours they'll need to get future jobs with the Maryland program.
Cournoyer got interested in the division after a friend met some people from the state program and pointed Cournoyer toward Maryland. Cournoyer called the division in April 2002, but he didn't interview until February.
Paramedics have a hard road, too. Unlike pilots, paramedics must be state troopers, which means they must go through the state police selection and six-month academy process before applying for a transfer to the aviation division. A typical transfer request can then take six to eight months, said Kerr, for a total of about a year and a half (or more) from police academy to final transfer.
Abroad the Trooper One helicopter that Monday evening, Kerr and Thompson were working to get the man injured from his ladder fall to a trauma center inside the "golden hour," the first hour after injury when care is most critical because of the mounting damage that shock does to the body.
For the man with the torn stomach, that meant getting him to a surgical team immediately.
When Thompson landed the helicopter in the parking lot of the Our Lady Queen of Peace church and school in Essex, Kerr slid out of his seat, opening the side door of the helicopter and taking out a metal stretcher. Local emergency responders had bandaged the man and provided on-the-spot care; now, it was up to Thompson and Kerr to take the man to Maryland Shock Trauma Center, where a medical team was suited up and waiting.
Once inside Trooper One, Kerr, belted into a "monkey harness" that tethered him to the helicopter's ceiling while letting him move about, checked the patient's vital signs. He hung a saline bag, keeping the man hydrated, and looked in on the wound. The man's feet, still in muddy white sneakers and socks, poked out of sheets covering him from shins to mid-chest. Occasionally, they twitched, some of the few movements that the lime green stretcher straps and neck brace afforded him.
Eight minutes later, the helicopter landed on the roof of Shock Trauma.
Hospital workers in pink scrubs moved in quickly as Kerr opened the helicopter doors; together, they transferred the man, still pale, onto a wheeled hospital bed, getting him through double doors and into a wide elevator. Emerging a few floors down, the bed was swarmed by nurses and doctors. Kerr, in his black flight suit, stood out as he briefed the doctors on the patient, who groaned faintly.
But Kerr's work here was done soon, and as the hospital workers took over, he headed back to the roof, where Thompson waited in the helicopter. The flight back to base was uneventful, the men sitting up front now, the only sign of the past half-hour's work a small streak of blood on the metal stretcher.
Thompson landed Trooper One and shut off the blades at 5:46 p.m., less than an hour after he took the call. He and Kerr may have saved a life - a few days later, the Shock Trauma patient's condition would improve from critical to serious - but they're modest about their role.
"We're just one link in the chain," Kerr said a few days later. "Without the other components [like ambulance crews and hospital staff], our part is pretty meaningless."