MONTREAL — Last Friday night, a few hours after a bus crashed in rural Saskatchewan killing 15 people, a prominent Montreal doctor who is also chief surgeon of the Montreal Canadiens hockey team couldn't sleep.
What kept David Mulder awake was his belief that if the same tragedy occurred in a small town in Quebec, the province would be unprepared.
Quebec is the sole province in Canada and Montreal the only urban centre in North America without a helicopter program that can quickly transport seriously injured people to trauma care, Mulder told The Canadian Press on Wednesday.
He gave the hypothetical example of a truck hitting a school bus in Victoriaville, 165 kilometres east of one of Montreal's Level 1 trauma centres, and said, "what do you think would happen?"
"I think there would be a high mortality and there would be difficulty getting people to Level 1 trauma centres," said the director of thoracic surgery at the McGill University Health Centre.
Shortly after the bus crash north of Tisdale, Sask., three helicopters from the province's STARS program played an important role in transporting the critically injured to trauma care.
STARS is a charitable, non-profit organization that is funded partly by government as well as by corporate and community donations and has bases in Alberta, Saskatchewan and Manitoba.
The crash between a semi truck carrying a load of peat moss and a bus carrying the Humboldt Broncos junior hockey team killed 16 people.
Mulder, who grew up in Saskatchewan, worked in a family medicine practice in Watson, 40 kilometres west of Humboldt.
"I played junior hockey in Saskatchewan," Mulder said. "I travelled on (team) buses — it really hit me in the heart."
Mulder called Quebec Health Minister Gaetan Barrette soon after the tragedy but couldn't reach him and therefore decided to write an open letter to the politician.
In the letter, he said the helicopters at the scene of Friday's crash "clearly reduced the time from the grievous injuries to definitive care at the level 1 trauma unit."
Mulder said in the interview there is a so-called "golden hour" in trauma care.
"The shorter the time interval from injury to definitive care is the most important variable in terms of survival," he added.
His letter says "our measured times (in Quebec) on patients transferred from rural areas are unacceptably long and well beyond the 'golden hour' in trauma care."
Mulder says Barrette still hasn't responded.
A spokesperson for the minister said in an email that work is being done to advance a pre-hospital helicopter program.
"The health network has a first responder system, efficient ground ambulances, a hospital plane and a relief device that allows for extensive medical interventions in flight, and ambulance aircraft," said Catherine Audet.
Despite being one of the most prominent doctors in the province, Mulder said he's been unsuccessful for years in trying to get the Quebec government to start a helicopter program.
Mulder, who has been with the Canadiens hockey organization since 1969, said he's "failed" on that front.
"Somehow I've failed to convince people it's important and I feel sort of guilty about that," he said.
He suspects Quebec has been lucky it hasn't had to deal with a similar crash in a rural area because, if one occurs, the province would be in trouble.
"I wrote the letter so we can avoid that," Mulder said. "So we can have a plan before that happens."