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The San Juan Mountains are like a riverbed – at least that’s how Matt Hansen, lead pilot for Mercy Regional Medical Center’s Flight for Life, describes it.

The wind breaks over the peaks like water over boulders, leaving turbulent zones, like invisible rapids, in the mountains that make this part of Colorado one of the most dangerous to fly, he said.

Hansen has been flying helicopters for two decades, starting his career with the U.S. Army flying in Iraq. He joined Flight for Life about six or seven years ago, as one of three pilots who fly about 600 patient flights a year.

“This is the most challenging flying I’ve had in my career,” Hansen said. “You’re always on your toes.”

Flight for Life flies rescue missions to save people who are injured in the high country where typical emergency vehicles cannot go.

What makes this flying so challenging is the terrain and the altitude, he said. Winds whip over the mountains from different directions each day, making the skies a turbulent and unforgiving place, he said. And this region doesn’t have the weather forecasting other Flight for Life regions do, so sometimes the only way for pilots to know what is going on in the sky is to fly it. Pilots use indicators on the ground, like trees or water, to determine which direction the wind is pushing, Hansen said.

Helicopters are also precise aircraft, and every pound of weight on it matters. The aircraft Flight for Life uses out of Mercy Regional Medical Center – a 20-year-old AS350 B3 – is light and maneuverable, making it the most capable kind of aircraft for the mountains, Hansen said. It is the same kind of helicopter used by heli-skiers, he said, although the Flight for Life helicopter carries a much heavier payload.

That’s because the helicopter is essentially a flying intensive care unit, said Katy Watson, flight nurse with Flight for Life. Inside the helicopter is an AED defibrillator, pharmaceuticals designed to stabilize trauma patients, a stretcher and a mechanical ventilator to help people who cannot breathe on their own. Then there are fuel and people in the aircraft that also add weight, making it difficult for the helicopter to climb up to 12,000 feet, where it sometimes needs to go.

Heat is also a factor for the aircraft – if it is too hot, the helicopter cannot reach some of the higher regions. It just does not have enough power.

These factors can lead to situations where the helicopter may weigh too much to get to a patient high up in the mountains, Hansen said. That is when the crew finds a lower landing zone, dumps some of its equipment that is not needed and even a crew member, if necessary, before flying to a higher altitude.

“It becomes this refined juggling act,” Hansen said of balancing the weight of the aircraft. “Fifty to 100 pounds at 10,000 feet makes a big difference.”

Then there are times when a patient is too deep into the mountains for the helicopter to reach, and the Flight for Life aircraft must land hundreds of yards, if not miles, away from a wounded individual.

Matt Sullivan, a flight paramedic with Flight for Life, said he once flew on a mission where the helicopter had to land a mile away from a patient, and because the terrain was so difficult, it took crews hours to get to the person.

The job can be challenging, Sullivan said, but it’s also rewarding. “It keeps things fresh,” he said.

Crews are experienced; they are required to have at least five years of experience before they can fly with Flight for Life. While the job seems like it would be adrenaline-filled, Sullivan said his experience keeps him calm in intense situations.

“It’s super exciting from the outside, but from the inside it’s pretty routine,” he said.

The helicopter is just one of the aircraft Flight for Life has at its disposal in Durango. It also has a fixed-wing airplane – a Beechcraft KingAir 200 – that is really the “unsung hero” of Flight for Life, Watson said. The fixed-wing aircraft flies patients from Mercy to other hospitals in the region, such as St. Mary’s Medical Center in Grand Junction or Saint Joseph Hospital in Denver.

The majority of the people Flight for Life transports get injured in the summer months, Hansen said. And most of the people who get injured are not locals, he said. Flight for Life works with other agencies in the area, such as La Plata County Sheriff’s Office and La Plata Search and Rescue, when flying many of its missions. Hansen said these agencies often train together so that in the event of an emergency, everyone is on the same page.

But Watson said there is no competition between agencies – they are all working together for the same cause.

“There’s no pride of ownership,” Watson said. “Really, it’s about getting a patient the care they need.”

Even with some 600 flights each year, the scenery from 1,000 feet above Durango is still stunning, Sullivan said.

“We’re constantly flying, but we’re constantly taking photos,” he said.