Pilot Maxime Proulx flies an “ICU in the air” for Montreal-based Skyservice Air Ambulance, transporting severely injured and gravely ill travelers to hospitals close to home.
Maxime Proulx’s Learjet 45XR air ambulance is packed with enough monitoring, respiratory, pharmaceutical, and laboratory testing equipment to fill a small hospital emergency room. The great majority of his emergency passengers, who receive in-flight care from a three-person medical team, are fully utilizing the terms of their travel insurance policies—a good thing, because a medical evacuation flight costs in the tens of thousands of dollars. We took to the skies to chat with Proulx about his lifesaving work.
How long have you been flying, and how did you begin flying air ambulances?
“I’ve been flying commercially—getting paid to fly—for eight years now and counting my training almost 10 years total. My first job out of school was two years of bush flying floatplanes and ski planes, and landing in small gravel runways in northern Canada. My following gig was flying business charters for an outfit in Montreal in northeastern U.S. and Canada. I’ve been with Skyservice Air Ambulance for four years now. There was no push for an air ambulance career on my side; it was just another flying job. But it happens to be an awesome one.”
What special skills do you need to fly an air ambulance, other than the obvious?
“I am fully bilingual in French and English because I grew up in Montreal. My first language is French, but to fly internationally you need to be able to speak English since it’s the official language of aviation. I think one special skill must be understanding accents from all around the world; hearing the English language being blabbered by a Japanese, an Italian, or Russian controller can all sound very different. And don’t even get me started on the New York accent or the good-old Southern one.
“Another skill good to have is to be resourceful. Stuff can go wrong with the patient or the plane when you’re halfway across the world or in flight, and all you have is the team on board to solve it. When I was first hired I was told that ‘we hire solution-finders.’ Skyservice hasn’t had an accident or incident in 30 years, so I guess we do OK.”
How do travelers find themselves aboard one of your flights?
“Any individual that requires medical attention for a flight will have to go on an air ambulance, but the circumstances that bring them on board can be very different. It can be a heart attack or a broken leg that requires immobilization, and anything from a fall from a camel to ‘that time you were too drunk and fell from the balcony at the resort in the Caribbean.’ And yes, those are real examples of patients we’ve had on board.”
What does a typical work week look like for you?
“I’ve flown 150 or 160 missions, I’d guess, and no week is typical. My monthly schedule consists of days off and days on. When we’re on, we are on call 24 hours a day. Once a flight is confirmed, our flight coordination department will call us, and if it’s a last-minute flight, we will have one hour to get to the airport and one hour to take-off. In any given week, I might be home for the whole week or flying the whole week.”
What’s the most difficult part of your job?
“My part of the operation is not the hard part; flying from point A to point B can be done by any pilot. But the whole operation is very complicated. A medical assessment will be done by our medical staff at the office, then quotes are sent, and when the client accepts it we get going. Our flight coordination department chooses the refueling stops along the route with the help of our dispatcher and chief pilot. These stops can be impacted by the weather (Iceland or the Azores are islands on the Atlantic, and weather can change whenever it wants) or by any other circumstances that make us change our itinerary at the last minute.
“Once we get to the hospital on the other side of the globe to pick up the patient, our medical team may encounter a very different story than the one they were told on the phone, and that can impact the flight on different levels. The hardest part is that every day is different, and we just have to adapt.”
Is there any place your service can’t reach?
“Remote islands—even Hawaii—are just a bit too far off the coast for planning with our type of aircraft. But we can pretty much reach the whole globe otherwise; it’s just a matter of how many fuel stops you want to do along the way! I’ve been on eight-day trips that started in Thailand to bring someone home to Canada. That involves multiple crew changes, with stops and changes in the U.K., Oman, Thailand, Bahrain, and Belgium. Once the patient is on board, the goal is to keep them moving forward to the destination as quickly as possible.”
What’s the most dangerous place you’ve ever flown?
“I would say Juba in South Sudan back in 2015, which was a quick drop-and-go kind of situation. It was the only time I ever was issued a kidnapping assessment briefing for one of my flights.”
How long are you typically in-country, and how do make the most of your time on the ground?
“We usually get about 24 hours of rest after we land before we take off again. That means sleep, but we also try to visit local landmarks and get into the local culture a bit. After coordination with the patient and hospital, the medical team joins the pilots, and we go exploring together. For that, Google is my best friend. We rarely know where we’re going ahead of time, so we have to make the call when we’re on the ground, and we often end up just searching for ‘what to see’ and ‘what to do’ wherever we happen to be. We are mostly winging it.”
Do you travel when you’re not working, and how do you get there?
“I grew up traveling with my parents, which is what got me interested in flying as a career. I’ve got a young family, which can make travel hard, but we try to travel a bit every year. I tend to like to go to places I haven’t been, and we’ve been to Costa Rica and up and down the North American west coast—whatever seems fun is what we’ll do. And when we go, we fly commercially. It’s nice having someone else do the flying for a change.”