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Chapter Nine takes us aside to describe how air medical crews cope with patients dying in flight. This particular anecdote deals with children, a far harder experience to deal with.
CHAPTER NINE – THREE CHILD TRAGEDIES IN ONE DAY
Arguing about whether or not we should accept a mission is part of life at a medevac base. It is how we deal with conflicting needs, the company’s drive for revenue, the pilot’s for avoiding dangerous weather and terrain, and the med crew’s for saving a patient. Such conflict flies in the face of accepted safety practices in aviation, but it is part of life in the medevac world. Crews have to walk through it and come to some sort of compromise they can all accept. Too often the crews pay with their lives, but we accept the risks as part of the job.
Other missions bring their own tragedy, patients whose terrible injuries or their death hits us hard, and tears flow despite our best efforts to remain clinical. It’s then that med crews’ irritation with pilots slips away and we draw together, sharing the pain. When you look at extremes of behavior like this, against the workplace cultural demands for equanimity and group love, you can only conclude that life at a medevac base is like no other.
It was a lovely, warm summer day, the beginning of a holiday weekend in 1992 in Michigan. I arrived at the hospital shortly before seven AM. With the start of shift tasks complete and coffee in hand, I found a lawn chair and sat down in the shade of the 412 to read the newspaper. I had no more than settled in when the radio clattered an alert. The nurses came trotting out of their quarters. The call was a possible drowning victim at a lake park twenty-five miles north.
The report Dispatch got from the requesting agency told us the story.
The Rogers - Bob, Nancy and their ten-year old son, Troy had driven to the lake earlier in the day. When they arrived at the beach Troy charged into the lake until he was shoulder deep then disappeared. Bob ran in and dived to the bottom but couldn’t find him. After several attempts, he popped to the surface carrying Troy. He wasn’t breathing.
Someone at the lake had called 911 and a sheriff’s car and ambulance arrived as Bob emerged from the lake with Troy’s lifeless body. It was the ambulance crew who called us.
Starting the 412’s engines I heard the nurses’ helmets clatter as they strapped them on, then their voices with a whispered communications check. We were in the air and headed north within minutes of getting the call.
We flew along at 500 feet and I slid open the pilot’s window letting the warm summer air flow through the cockpit. The lake came into sight, its parking lot jammed with cars. The ambulance nestled close to the trees surrounding the lake, doors thrown open and emergency lights flashing. The EMTs had set up a landing zone in a grassy meadow close to the park. A fence marked its border with the farmer who owned the meadow. As we flew in low over the fence I wondered how we were going to push a gurney across the deep grass and through the fence. Surveying it as it passed close underneath us, it looked like we could cut just the top wire then pick up the gurney and carry it over the lower ones. Someone would have to pay the property owner to repair what we’d done.
As we settled into the grass Pat, one of the nurses came up on the intercom. “Woody, could you shut down and join us at the scene? There’s bound to be crowds and confusion. We’ll need help getting through them with the patient.”
I nodded in agreement as she pulled off her helmet and stepped out of the helicopter. She turned and waved at me as she and Kate, the other nurse walked toward the scene. I waved back as the 412’s engines spooled down.
The ambulance crews and deputies were supposed to manage people congestion but holiday crowds were usually more than they could handle. The nurses didn’t ask that of all of the pilots, but I’d always made it clear I was there to help if they needed an extra hand.
Completing the shutdown process, I jogged to the scene and slid through the crowd of onlookers. The ambulance crew was working on a young boy, administering chest compressions and clearing his airway. His patrician nose, sculpted cheek bones were unusual for such a young boy. It hit me that he would grow up to be strong and handsome. But his skin was pale, almost blue, and his eyes were closed in that stillness only seen in people under deep anesthetic, or near death.
Our nurses huddled over him checking his vitals and sticking him to start an IV line. Then the EMT stopped, looked up at them and shook his head. It had been too long. Troy’s mom wailed in anguish.
Pat and Kate stood to help comfort the parents. Mr. Rogers held his wife tightly, his sobs joining hers. She fell to her knees but he held her tight all the way to the ground as she collapsed in anguish.
The sheriff’s deputy began quietly asking questions for his report while doing his part to console them. There was nothing more we could do. The nurses packed up, nodded to the ambulance crew and we walked back through the crowd to the helicopter.
On the way home, we all seemed to be working on the same thought.
“What a hell of a way to start the day,” Kate said.
Pat sighed as she responded, “Definitely not good, but that’s probably it for us on this shift.”
I thought about all the people out celebrating the holiday in this fine, warm weather, yet here, suddenly, a child had died. In the ensuing silence, we were all hoping that Pat’s pronouncement would be the case for us today.
But it was not to be. A couple of hours later we got another call, another drowning. We flew to yet another lake park, this time, thirty miles east. The deputies on the scene, who provided us the background when we landed, had blocked off enough empty parking spots for us to land close by. I joined up with the nurses as they worked on a little girl.
According to the deputies, six-year old Susan Smith and her parents, Bill and Terry, drove to the lake where several of her friends would be with their parents. Bill had been heard admonishing her when they first arrived, that since she had not yet learned to swim she would need to stay close to him.
But that morning, with all of the kids and parents milling around in the water, Bob lost track of his daughter. Yelling her name attracted the attention of other parents, and minutes later one of them lifted her still body out of the water.
Blue from lack of oxygen, Susan barely reacted to Pat and Kate’s CPR, her face still, lips frozen in place. Her blond hair, still wet, matted across her face, a disturbing messy element adding to the fear that was palpable around us.
Kate injected a stimulant into her chest, hoping it would jolt her back to life. But it was not to be. And once again, they comforted a distraught, sobbing mom and dad.
Walking back to the helicopter, Kate, Pat and I were silent as we each processed the second death of the day. Arriving back at the hospital, as I was shutting the helicopter down I suggested an early lunch in the hospital cafeteria. Kate and Pat agreed.
We picked at our food in silence. Friends stopped by our table to talk to Kate and Pat. That helped, I think. We finished lunch and headed back to our quarters. Emotional exhaustion was starting to settle in, and then the radio went off. This time the incident was forty miles west of us.
A report from the police that were onsite gave us the victim’s story.
Six-year-old Amanda Morton and her parents, Ron and Patty were walking along a narrow, twisted path around a lake. The shore dropped off steeply into the water. They stopped while Ron pointed at something on the other side of the lake. Then, as he turned back, Amanda slipped on the path, fell into the water and disappeared.
Ron dove into the lake, searching for his daughter. He slid into a sink hole well over his head but managed to pull her to the surface. Other dads helped him carry her to shore and begin CPR. An ambulance arrived only minutes after Amanda was found.
After we landed in the parking lot the nurses jogged off as I was shutting down the aircraft. I had no more than stepped down to the ground when they came trotting back, pushing the gurney along, Mary pressing on a breathing bag covering the small victim’s mouth while Pat steered the gurney.
I climbed back in and got the helicopter running while they loaded the child. We took off as Kate and Pat worked on her, exchanging rapid comments back and forth over the intercom.
“Kate, you want to do the adrenaline?” Pat asked through heavy breaths as she kept up the compressions.
“Yes, but I think we’re losing her,” Kate replied. The steady siren tone of the heart monitor as the little girl’s heart stopped echoed throughout the cabin. Kate leaned over the bulkhead, her face close to mine, her blue eyes blinking with the sweat running off her brow.
“Woody, can we go any faster?” she gasped.
How many times had I been asked that? The answer was always the same.
“We’re at red line now, Kate,” I replied, pointing at the engine torque and temperature gauges, their vertical tape displays touching the bright red limit lines. She looked at them, held my eyes for a moment, her mouth a grim line in quiet desperation. Then she ducked back into the main cabin.
The nurses called the hospital over the radio and asked for a crash cart to meet them. Five minutes out, I heard Kate tell Pat the little girl was gone. They called the hospital to advise the crash crew to stand down. As we descended into the helipad though, they were still there, off to the side, waiting in hopes they might still be needed.
As soon as we landed, Kate slid the door open and stepped out to talk to them. They all nodded their heads in sorrow, then loaded the small, still body onto their gurney and returned to the ER. Hardened to sudden tragedy as they were, a child’s death was still a cause for sadness and a moment of pause.
Once we were back inside, instead of heading off to our separate quarters, we stayed together, somehow better off in each other’s company, and headed to the comm center. We slouched into chairs that were there for observers. Rob, the duty dispatcher, sensed the impact of the moment and didn’t ask questions. Then I heard a sniffle. It was Kate, blinking her eyes, trying to control herself. She put her hand over her eyes, then sobbed quietly.
“How could we lose three patients in one day?” she said. “I’ve never lost three patients in one day.”
Pat leaned forward in her chair, covered her face with her hands and cried, the only evidence of it, her shaking shoulders. Then she looked up at us, her face red, wet with tears. She stood up, straightening her flight suit.
“We have to move on, guys. It’s still the holiday and we could get another call,” she said.
Kate stood up and they hugged each other briefly, then blinked their eyes and blew their noses. “Yes, we do.”
She looked at me critically, like nurses do. “Woody, are you OK? Your face is wet.”
I stood up and swiped at my face. “I’m fine,” I replied, more abrupt than I intended it to be.
“I think some coffee would be a good idea. I’m buying,” I said. “Rob, can we bring you something from downstairs?”
He shook his head and waved us on our way. I patted Rob on the shoulder and we departed for the cafeteria. Kate put her hand on my shoulder, her quiet thanks for the prescription.
In the ensuing months, when we worked together we made a point of starting our shift with a quick hug, silently sharing the bond from that long, tragic day that would be ours forever.
Working close to tragedy carves grooves in your soul. Professionals who have to perform in the face of trauma and death learn to keep it together, to suppress their sorrow and take care of the victims. Later, though, when the victims have been handed off to trauma teams, or they’ve passed away, the moments come when it crashes in. It’s then we mourn for them and ponder their fate. It’s then we see the world in a different light, and the path of life itself more clearly. Being close in touch with mortality brings with it a profound sense of the world - life and death - the two states of existence, in a kind of harmony. The pain that comes with it lights the way, and we treasure it.
Copyright © 2021 Woody McClendon. All rights reserved.
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