When Jackie Greenham's brother suffered a heart attack on July 21, he needed far more complex treatment than the family could find in Labrador City.
"He was in a bad way. He was critical," Greenham recalls.
"We didn't know if he was going to make it or not. His heart had stopped twice. So we were really, really counting on the air ambulance to come in and get him out to St. John's."
Greenham says the attending doctor ordered the ambulance that evening, hoping for a rapid medical evacuation to save his life.
It would be nearly 24 hours before an aircraft arrived.
"They didn't show up that night," Greenham said. "We learned that there were two flights on the ground, and no pilot for either flight."
Other Labrador residents echo Greenham's experience with the province's air ambulance service, which they say has left them dissatisfied, shaken and, in some cases, grieving.
CBC News has spoken to several patients who say long airlift delays have negatively impacted their wellbeing. Their stories paint a picture of a complex system that sometimes strikes its patients as troubled or ineffective.
Dawn Volpatti says her trust in the service can't be repaired after a traumatizing wait time in 2008.
That year, Volpatti went to hospital in Labrador City while pregnant, with vomiting and seizures. As her condition worsened, she was told the province had no aircraft at its disposal that could fly through the wintry weather that day.
Instead, an aircraft in Quebec, which she understands could withstand those conditions, transported her to hospital in that province, where she delivered the baby. Her daughter did not survive.
During two subsequent pregnancies, Volpatti uprooted her life and family to Ontario until after her daughters were born to avoid relying on medevac services in Labrador.
Since then, the province has upgraded its fleet and moved one base to Happy Valley-Goose Bay.
Volpatti remains shaken, however, by recent stories outlining continued delays.
"I know that an air ambulance is not a guarantee of life," Volpatti said.
"But we deserve a fighting chance. And I don't think that the air ambulance situation that we have now is really giving us a fighting chance."
Greenham, a cancer survivor who in 2018 also experienced a delay that caused her to miss a surgery in St. John's, won't accept the reason her brother nearly didn't make it.
"It's not that there was a medical or mechanical problem with the flight. It wasn't a weather issue. It wasn't the fact that there was an emergent case, a more emergent case," she said.
"It was staffing. And that should never be."
She's now collecting stories from other Labrador patients, hoping to jumpstart a conversation about improvement to the system. Greenham notes that she's heard from people still wondering why they had been left in limbo. In one case, she said, a man waited 11 days for a medical evacuation in 2019 after going to the doctor with chest pain.
Dr. Brian Metcalfe, the provincial medical director under Eastern Health, said staffing gaps have sometimes led to delays, as well as weather, geography, and maintenance.
"We've managed to solve some of the staffing issues that we have faced over time. But staffing can be a challenge for us," he said.
A total of 857 flights to and from Labrador were conducted in 2019, according to data provided by Eastern Health, the overseeing authority for the province's air ambulance agency, MedFlight NL.
Eastern Health could not immediately say how many of those flights were classified as delayed.
Although Metcalfe noted staffing gaps have recently improved, he said the behind-the-scenes work is sometimes hampered by conditions outside the agency's control, such as weather, resources and geography.
"There is a very busy, very dedicated team whose entire job is to ensure that we have this service available to the province," Metcalfe said. "It's a very complex system, but we're a very dedicated group of people who are constantly doing our best."
That includes bringing a small hospital directly to the patient. To combat long flight times, the medical staff on air ambulance flights "don't just move patients," Metcalfe said.
"Instead of a patient coming to a critical care team, we bring it to them, so that we can get the specialized care to them quicker, stabilize the patients in a more timely fashion. We have better outcomes because of that."
For Greenham, who's still collecting information volunteered by other patients, that reassurance can't help her brother.
"There needs to be a contingency plan if people call in sick," Greenham said. "Any improvements that can be made should be made.
"If you stop talking about it, you can rest assured that nothing's going to be done. So we need to keep this fresh and talked about and advocated for."