It was the terrified look a frail and elderly woman gave those trying to help her that convinced Sheriff Bill Cumming that a better boat was needed to help with medical transport in bad weather.

With the entryway to small for a stretcher, the woman had been placed in an improvised carrier made of a sheet and was being jolted about as she was passed down into one of the smaller Sheriff’s boats. Cumming realized that they needed a boat with a larger entryway and more capabilities to take care of the medical needs of the people of the San Juan Islands.

“The fear in that woman’s face convinced me we needed to have better equipment,” Cumming said. “Three days being on scene in a search and rescue event further convinced me a better vessel was needed. On scene, there was no head, no water and no facilities to heat food for the crew.

The Sheriff’s Boat Guardian was put into service in August of 2005. Cumming is proud of the multiple capabilities of the boat, which he says has a replacement value of $350,000 and cost $252,000 when it was launched. The boat was purchased and outfitted with state and federal grants and with the Sheriff’s office portion of money seized in a drug case. San Juan EMS also provided financial support and guidance about what was needed to provide for patients with advanced medical needs.

Guardian responds to medical calls when the helicopters and flat-wing planes are unavailable. The two primary captains for the boat are Cumming, who holds a 100-ton master mariner Coast Guard license and Jim Ricks who holds a 50-ton master license and is a paramedic.

From Dec. 1 to Jan. 25, only one helicopter and one fixed-wing medical flight were able to respond to medical calls on the islands. Guardian braved the storms to answer 28 medical calls on Orcas, San Juan, Lopez and Shaw Islands. In all of 2008, Guardian transported 45 medical calls from the islands.

“I like doing this. I believe this boat is for public safety, and I am pleased it is in service,” Cumming said. “There were some eight and 10 hour days with multiple patients during December’s snowstorm that both Ricks and I worked. There were days when we would return Guardian to the dock at daylight just in time to go into the office, but we were providing a vital service.”

The weather may be rough, the seas choppy and the captain needing to focus all of his skills on navigating the voyage, but in many cases, the hour the patient spends onboard Guardian is the most peaceful part of a medical emergency.

The initial crisis is over and the patient is stabilized, the lights are dim and the hum of the powerful twin turbo powered 315 horsepower engines provides a comforting background sound. Many patients only barely remember the journey.

The 34-foot catamaran, provides a very stable platform for patients. It has a hydraulic door that is useful in loading and unloading patients and which gives “phenomenal versatility” to the boat. It is equipped with state-of-the-art radio, a global positioning system, radar and depth sounder. A thermal and multi-sensor imaging system was purchased with a grant from homeland security and San Juan EMS. Video records everything that happens.

The Sheriff’s Office works hard to keep the boat and the equipment in good shape. They have used the same mechanics to work on Guardian since its launch.

San Juan EMS has outfitted the boat with special overhead medical compartments and a wide variety of medical supplies. It has a powerful spotlight, sirens, blue lights and in the hull, it is equipped with aircraft landing lights. Guardian travels at 28 knots in the dark and in bad weather but is capable of almost 40 knots.

Usually the first call paramedics make is to Airlift Northwest. Even during bad weather, there can be a window when the planes are flying. If it is too dangerous for the planes to fly, then the next call is the to the Sheriff’s boat. It takes between 12 and 20 minutes for Guardian to reach Orcas and Lopez from the time the captain gets the call.

“We are always watching the weather in our line of work,” Cumming said. “Weather effects the Sheriff’s office all the time. The probability of accidents increases with bad weather so we are always aware of it. All boaters cast an eye to the sky.

“Very rarely is the boat unavailable.” As the captain of the ship we have to make the decision if it’s too dangerous to go. It’s very rare when we have been unable to respond.”

The Sheriff’s Office charges the medical emergency response agencies $400 for taking a patient to Anacortes and $450 to Bellingham to cover the basic costs of fuel and maintenance. In contrast a helicopter flight for a non Northwest Air member can range from $11,000 to $12,000 for those on Orcas and Shaw and a fixed-wing flight is $4,500. Bellingham presents more problems in windy weather but Anacortes can be a longer rougher trip.

“We take them wherever they want to go,” Cumming said. “It’s a medical decision but we discuss the options with them.”

There are three boats in the Sheriff’s fleet. A 19-foot boat on Lopez, a 27-foot boat on Orcas and Guardian is based on San Juan. All have as primary goal law enforcement, but Guardian also handles all the medical transport requests, performs search and rescue missions, helps with oil spills and assists with fires.

“In the case of search and rescue it most often turns out to be recovery,” Cumming said.

He remembers a plane that took off from Blakely and crashed on the east side of Orcas near the pea pod rocks. It took 45 minutes to get there and the young man was pulled from the water and saved just moments from death. The pilot had already died. In most cases, Cumming says people don’t last that long in the cold waters of the San Juans.

All three boats are used in law enforcement. Any crime that can be committed on land can be committed on the water.

It’s just a different environment,” Cumming said. “We have responded to domestics on water, thefts, boating while intoxicated and boating accidents and any case of drowning. Nationally, we have a comparatively high rate of drowning because of the water temperature and the weather. This is a particularly treacherous area for boating.”

All the operators who man the Sheriff’s boats have completed the San Juan County 40-hour Marine Safety School course and participate in safe boating activities. Orcas based Deputy Herb Crowe is responsible for making sure that the Sheriff’s office personnel and boats are meeting all the elements of the San Juan County Safe Boating Program which is adminsiterd by Washington State Parks.

From Dec. 1 to Jan. 25, only one helicopter and one fixed wing medical flight were able to respond to medical calls on the islands. Guardian braved the storms to answer 28 medical calls on Orcas, San Juan, Lopez and Shaw Islands. In all of 2008, Guardian transported 45 medical calls from the islands.

“I always hope that the call will come in the early evening but it always seems to be in the middle of the night, when its dark and forbidding outside and in the middle of a snowstorm, windy or heavy rain, “Cumming said. “We have saved a lot of lives on this boat.”