Being the ED doc at night in a small, rural Maine hospital usually means being the only ED doc for miles, and it’s a lonely job sometimes, probably what the Maytag repairman would be doing if he fixed people instead of washing machines. You work with great nurses and great docs, but you are all out on a medical limb when something rolls in that is so bad it can only be fixed at a bigger hospital a long way away.

In such emergency departments there are a few phrases which make the heart pound and the sphincters tighten. “He’s not breathing,” for example, when spoken in reference to a child, is one of the nightmare phrases of emergency medicine. There are other phrases, however, that help suck the tension back out of the moment; “I’ve got the tube in,” for example, meaning the breathing tube is in the windpipe and vital oxygen can be delivered. In Maine’s rural ED’s for the past five years, another such reassuring phase has been this one of five simple words: “LifeFlight is on its way.”

LifeFlight of Maine is the state’s critical care helicopter program, and this month it celebrated its fifth birthday. It is comprised of two helicopters and their critical care teams based at Eastern Maine Medical Center in Bangor and Central Maine Medical Center in Lewiston. Between them they cover the state like a warm blanket.

And what a difference that has made. In five short years “LifeFlight is on its way” has been said almost 2,700 times. Every flight has been a story. The teams have flown:

. pregnant moms to hospitals with neonatal intensive care units just in time for the moms to then deliver babies who would have died had the whole “package” not gotten there in time;

. more than 30 patients and their severed limbs to Boston hospitals to have those severed limbs reattached;

. patients needing organ transplants;

. critically injured patients from out of the woods and other places that would otherwise have been too far off the face of the earth for lifesaving help;

. (these kinds of flights LifeFlight does not get paid for) leeches to a rural hospital that emergently needed the blood-sucking creatures to help save a reattached ear; rare, life-saving medicines needed emergently by some patient in someplace otherwise too far away; blood to hospitals which suddenly needed extra blood for a patient on the operating room table. It once flew an injured child off of one of Maine’s islands to a state trauma center, then went back for the child’s mother and flew her there as well. LifeFlight would probably fly a load of pepperoni pizzas if that would save a life somewhere.

Beyond all of that LifeFlight has changed how rural Maine cares for its critically ill and injured. When communication is good, a local hospital can know it is going to need LifeFlight before the injured patient even arrives in its ED. It calls LifeFlight, does what has to be done to stabilize the patient while the helicopter is en route, and as soon as the LifeFlight team arrives flies the patient out to a state trauma center.

Doctors in rural hospital EDs can now save some patients we would never have saved, and get the kinds of care for patients in rural Maine which was previously unavailable because they were too far from the trauma centers and heart centers. We can also hope for better outcomes in some patients who, while they would have survived without LifeFlight, might now survive in much better shape.

But LifeFlight is not just about flying patients out of rural hospitals. Without the rural hospitals, and the ground ambulance crews which emergently transport more than 200,000 Mainers to them each year, prayers are all that many of the sickest and most injured Mainers could be offered. Rural Maine’s hospitals and ground ambulance emergency medical crews are partners with LifeFlight in a life-saving chain of survival, no one link more important than the others, and every link useless without the others.

It’s easy to see LifeFlight as just a pair of sleek, green and white helicopters but the truth is that when you see them flying you are seeing the hopes and efforts of an entire state “whup-whupping” by. Onboard every helicopter is a pilot, a critical care nurse and a critical care paramedic. Back on the ground, however, is a crew of mechanics, the communications staff, the administrative support staff; EMMC and CMMC which train and house LifeFlight’s staff; the parent corporations of Eastern Maine Healthcare and Central Maine Healthcare; other hospitals and communities across the state which have built helipads, trained staff to promote safe landings, installed navigation gear, and raised money to make it all possible. In Rockport there is even a group of volunteers who will drive families of LifeFlight patients to wherever the helicopter took their loved one. LifeFlight flies the helicopters, but Maine’s people are the air beneath its rotors.

Five years after LifeFlight of Maine was first launched as the fulfillment of a dream, it has saved hundreds of lives, many limbs, and countless hopes. That’s pretty good for a critical care air medical transport program so young that if it was a kid it would still need shots. That’s pretty good for Maine, too, where saving a life in the slow lane is easier to do these days because there are LifeFlight helicopters flying critical care crews at 160 mph in the fast lane.

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, and is on the staff of several hospital emergency rooms in the region.