Dr. Saul Pytka is an anesthesiologist, caring for patients in a busy urban hospital. He’s also cared for the critically ill and injured in ditches, on ski hills and at rural ranches, in his 22 years as a transport physician.

“Working with STARS has been the highlight of my medical career,” said Dr. Pytka, as the sun sets on his time with STARS. “That might sound surprising since I spend 85 per cent of my time in operating rooms. But I was privileged to work with an organization that truly believes in delivering outstanding patient care and doing everything possible to optimize that.”

Dr. Pytka, one of several transport physicians retiring from STARS this year, characterizes his journey as a time of significant changes in health-care delivery. For instance, it is often said that when STARS arrives on scene, it’s as though we’ve brought an intensive care unit, in part because our medical equipment is state-of-the-art. But it wasn’t always this way, said Dr. Pytka.

“In the early days, we often had basic equipment, including a rudimentary ventilator that had difficulty doing the job at times,” he said, listing on-board ultrasound, access to timely patient health information, ability to analyze blood work and increasingly sophisticated communication as some of the game-changers in pre-hospital care.

“Not infrequently we went with our gut and experience because that’s all we had,” said Dr. Pytka, who has treated many critically ill and injured patients over the years and remembers with pride how hard the medical crew has always worked to provide the best possible care.

One mission stands out of a young snowboarder who ended up on a difficult run she couldn’t navigate. Rather than snowboard down, she opted to traverse the hill and slipped.

“She went flying off the hill and became airborne, smashing into a tree with her back and landing on a pile of rocks,” said Dr. Pytka. The patient was close to dying, comatose, with a collapsed lung and fractured spine and pelvis. She had broken her neck, which led to a stroke and required a lot of intervention before STARS could fly her to hospital. While he’s proud of the care she received, what stands out for Dr. Pytka was her recovery.

“I went to see her a couple times and it was wonderful to see her rehabilitating so well,” he said. “She had a deficit, but there is no way she would have survived if STARS hadn’t been there in a timely manner to resuscitate her.”

For retiring transport physician Dr. Rob Hall, one of his first tasks after starting as Calgary base medical director, was to create an airway training course and textbook.

“The crews were already at a very impressive skill level, but I felt that airway training could be more standardized,” said Dr. Hall, noting that managing an airway on a helicopter or in a scene call environment means time is of the essence for patients. Most airway management training available at that time was designed for in-hospital care where there is support available.

In 2010, Hall reached out to experts across Canada to help build the textbook, which is updated regularly and widely used across the country today. Ultimately, it became a full-fledged airway training course, taught by STARS and regarded as one of the best in the country.

STARS was the first air medical transport group in the country to put on a course like that,” said Dr. Hall. “Intubation is one of the most difficult procedures we do and requires a lot of confidence, so helping medical professionals do it well is one of the highlights of my career.”

Other physicians retiring after storied careers at STARS include Dr. Andy Anton, one of STARS’ longest serving transport physicians and a former Calgary base associate medical director, and Dr. Ian Walker, site chief of the Foothills Medical Centre emergency department.

“These doctors were brought to STARS for their skills, knowledge and experience in critical care,” said Dr. Mike Betzner, noting that whether it is for training hundreds of residents, working with rural physicians facing a tough medical case, or teaching STARS medical crews to become better, their expertise and bedside manner will be missed.

“They are great, calm communicators who have always shown great leadership and mentorship to our crews. They are smart, quick and the people you want in the room for sick patients. Even though they’ve left a significant legacy, they are not doctors who look for accolades,” he said. “We were extremely fortunate to have had access to their time and expertise.”

Drs. Hall and Pytka agree it will be difficult to say goodbye.

“I would like to stay at STARS until they have to lift me into the helicopter, but there are a lot of keen, young physicians out there who deserve a chance to work for this organization,” said Dr. Pytka.

“I will miss it, but it’s time for someone else to have the chance.”