Emergencies happen anywhere, anytime — and sometimes physicians find themselves in situations where they are the only ones who can help.
Is There a Doctor in the House? is a new Medscape series telling these stories.
When the plane crashed, I was asleep. I had arrived the evening before with my wife and three sons at a house on Kezar Lake on the Maine-New Hampshire border. We were going to spend a week there with my wife's four brothers and their families. I was woken by people screaming my name. I jumped out of bed and ran downstairs. My kids had been watching a float plane circling and gliding along the lake. It had crashed into the water and flipped upside down. My oldest brother-in-law jumped into his ski boat and we sped out to the scene.
All we can see are the plane's pontoons. The rest is underwater. A woman has already surfaced, screaming. I dive in.
I find the woman's husband and three-year-old son struggling to get free from the plane through the smashed windshield. They manage to get to the surface. The pilot is dead, impaled through the chest by the left wing strut.
The big problem: A little girl, whom I would learn later is named Lauren, remained trapped. The water is murky but I can see her, a 5 or 6-year-old girl with this long hair, strapped in upside down and unconscious.
The mom and I dive down over and over, pulling and ripping at the door. We cannot get it open. Finally, I'm able to bend the door open enough where I can reach in, but I can't undo the seatbelt. In my mind, I'm debating, should I try and go through the front windshield? I'm getting really tired, I can tell there's fuel in the water, and I don't want to drown in the plane. So I pop up to the surface and yell, "Does anyone have a knife?"
My brother-in-law shoots back to shore in the boat, screaming, "Get a knife!" My niece gets in the boat with one. I'm standing on the pontoon, and my niece is in the front of the boat calling, "Uncle Todd! Uncle Todd!" and she throws the knife. It goes way over my head. I can't even jump for it, it's so high.
I have to get the knife. So, I dive into the water to try and find it. Somehow, the black knife has landed on the white wing, four or five feet under the water. Pure luck. It could have sunk down a hundred feet into the lake. I grab the knife and hand it to the mom, Beth. She's able to cut the seatbelt, and we both pull Lauren to the surface.
I lay her out on the pontoon. She has no pulse and her pupils are fixed and dilated. Her mom is yelling, "She's dead, isn't she?" I start CPR. My skin and eyes are burning from the airplane fuel in the water. I get her breathing, and her heart comes back very quickly. Lauren starts to vomit and I'm trying to keep her airway clear. She's breathing spontaneously and she has a pulse, so I decide it's time to move her to shore.
We pull the boat up to the dock and Lauren's now having anoxic seizures. Her brain has been without oxygen, and now she's getting perfused again. We get her to shore and lay her on the lawn. I'm still doing mouth-to-mouth, but she's seizing like crazy, and I don't have any way to control that. Beth is crying and wants to hold her daughter gently while I'm working.
Someone had called 911, and finally this dude shows up with an ambulance, and it's like something out of World War II. All he has is an oxygen tank, but the mask is old and cracked. It's too big for Lauren, but it sort of fits me, so I'm sucking in oxygen and blowing it into the girl's mouth. I'm doing whatever I can, but I don't have an IV to start. I have no fluids. I got nothing.
As it happens, I'd done my emergency medicine training at Maine Medical Center, so I tell someone to call them and get a Life Flight chopper. We have to drive somewhere where the chopper can land, so we take the ambulance to the parking lot of the closest store called the Wicked Good Store. That's a common thing in Maine. Everything is "wicked good."
The whole town is there by that point. The chopper arrives. The ambulance doors pop open and a woman says, "Todd?" And I say, "Heather?"
Heather is an emergency flight nurse who I'd trained with many years ago. There's immediate trust. She has all the right equipment. We put in breathing tubes and IVs. We stop Lauren from seizing. The kid is soon stable.
There is only one extra seat in the chopper, so I tell Beth to go. They take off.
Suddenly, I begin to doubt my decision. Lauren had been underwater for 15 minutes at minimum. I know how long that is. Did I do the right thing? Did I resuscitate a brain-dead child? I didn't think about it at the time, but if that patient had come to me in the emergency department, I'm not honestly sure what I would have done.
So, I go home. And I don't get a call. The FAA and sheriff arrive to take statements from us. I don't hear from anyone.
The next day I start calling. No one will tell me anything, so I finally get to one of the pediatric ICU attendings who had trained me. He says Lauren literally woke up and said, "I have to go pee." And that was it. She was 100% normal. I couldn't believe it.
Here's a theory: In kids, there's something called the glottic reflex. I think her glottic reflex went off as soon as she hit the water, which basically closed her airway. So when she passed out, she could never get enough water in her lungs and still had enough air in there to keep her alive. Later, I got a call from her uncle. He could barely get the words out because he was in tears. He said Lauren was doing beautifully.
Three days later, I drove to Lauren's house with my wife and kids. I had her read to me. I watched her play on the jungle gym for motor function. All sorts of stuff. She was totally normal.
Beth told us that the night before the accident, her mother had given the women in her family what she called a "miracle bracelet," a bracelet that is supposed to give you one miracle in your life. Beth said she had the bracelet on her wrist the day of the accident, and now it's gone. "Saving Lauren's life was my miracle," she said.
Funny thing: For 20 years, I ran all the EMS, police, fire, ambulance, in Boulder, Colorado, where I live. I wrote all the protocols, and I would never advise any of my paramedics to dive into jet fuel to save someone. That was risky. But at the time, it was totally automatic. I think it taught me not to give up in certain situations, because you really don't know.
Todd Dorfman, MD, is an emergency medicine physician in Boulder, Colorado and medical director at Cedalion Health.
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Cite this: A Plane Crash Interrupts A Doctor's Vacation - Medscape - Nov 16, 2022.