After a traumatic event earlier this year, I’m feeling ready to tell the story (as far as I remember it), so hopefully getting it out of my head will help me with moving on since these events are at the forefront of my thoughts pretty much all the time and also while trying to sleep. I’m doing much better than I was several months ago:) I broke the story up into 4 parts: the background, the discovery, the aid, and the aftermath. (Part 2 was published at http://www.josharch.com/blog/tragic-event-part-2)
[PART 3] The Aid.
After we moved the ladies out of the cabin and into a shaded area outside, we needed to decide what to do next. Step one was to call for help, and it was clear we needed helicopters. David was on the phone with rescue personnel as we tried to convey the vital signs to 911. He looked for the pace of breathing by watching the subtle movements of their stomachs. In. Out. In. Out. In. Out. This helped 911 understand the severity of the situation and gave them the clues needed to explain to us how to be helpful until help could arrive. They were also trying to assess the likelihood of survival to determine if they should send helicopters or not.
This made me consider the regretful feelings of potentially “saving” a future “vegetable.” If these ladies were already brain dead and potentially in a catatonic state that you cannot recover from, I thought about the possibility that they would be in a coma or wheelchair for the rest of their lives while their family would need to deal with some harsh realities. This was a brief thought at that moment that I quickly dismissed, but the same thought kept returning to haunt me.
During this time, I was kneeling next to one of the ladies as I propped her head back to keep her airway open and make it as easy as possible for her to breathe since oxygen was the essential need. We also held cool rags against their necks and foreheads to cool them down while also wetting their dry lips. Her breathing started to improve slightly now that we were in fresh air, but there was still no response to my shouting her name, asking her to squeeze my hand, or getting her eyes to track my finger. Occasionally she would dry heave, and this was so great to hear since it represented a sign of life. Coughing is something that living humans do, so this made me so hopeful. As she dry heaved, I tilted her head to the side to ensure any liquid would exit and not block her airway. The other lady was not responsive either, and she was not making any apparent signs of improvement such as deeper breathing or dry heaving.
At this time, we had a good crew of caregivers. The woman who found the ladies and a few others were able to help one lady stay as comfortable as possible while I helped the other. She also found their wallets with ID, so we could talk to them by name. It seemed more humane to say their names over and over and to reassure them that we were doing everything we could do to help. David stayed on the phone with 911 and figured out a location where a helicopter could land. This became my hope. Just knowing a helicopter would come with medics and oxygen was so reassuring. Time kept passing, and we kept hoping.
After about an hour and a half to two hours of kneeling, bending over, and holding a fragile life in my arms, we heard helicopter blades beating the wind in the distance. The joy was overwhelming to hear this.
The helicopter circled to spot the landing place, and returned as it floated nearly sideways above the beach as it landed into a grassy field in front of another cabin a couple hundred yards away. It seemed to take a long time for the medics to arrive from the landing spot. I expected urgency and running, but this was not the case. Were the medics expecting it to be too late? Was coming to the island just a formality? I was told that helicopters are only sent if there’s a good chance of survival, so this kept my hopes high although the slow moving medics were somewhat deflating to that hope.
When the 2 medics arrived on site, I gave them a summary of the events. It became clear to them that the other lady was in worse condition, and they devoted their attention to her. They asked me if I had any medical training. I said, “no. I have only taken a first aid course for coaching soccer.” Their response was, “good! Here you go.” They shared me some medical equipment that I’ve never seen or used before. I repeated to them: “I said no. I don’t have medical training.” Their response was, “it ideally takes 3 people to resuscitate a person, so we need you.” This was not what I was mentally prepared to hear. I thought helicopter medics meant everything was going to be all better. That’s when I realized that this was just the beginning.
They gave me a breather bag which is a plastic bubble that you put over the mouth and nose to squeeze air into someone’s body. They said, “we only have 2 medical kits in the chopper, and this one is a pediatric kit. You take this one and watch us as we help the other one. You will need to try and pinch her nose while you breathe for her because this bag is too small for her.”
I watched them pump air into the other lady, and I tried to match their pace as I pumped air into “my patient.” They said, “bag… bag… bag…” each time I needed to squeeze, but they were too preoccupied to give clear directions to me. Although I barely knew what to do, I realized that it wasn’t so much about a pace, but rather to try and match the natural flow of inhaling and exhaling of the patient. When she started to breathe in, I slowly but firmly squeezed the bag, and as she exhaled, I released the bag so the air could be removed from her lungs. I was controlling her lungs. The two medics were doing the same thing to the other patient, but they had an oxygen tank hooked up to their breather bag. They also started hooking up an electronic monitor to their patient while I pumped and pumped and hoped I was doing it right. With the pediatric sized breather bag, it was tricky to prop her head back to keep a straight airway while also pinching her nose and fitting the small plastic pediatric-sized cover over her adult-sized mouth. That cover should cover the nose and mouth if it was properly sized. Occasionally one of the medics would come over to help me by hooking up the only oxygen tank we had for a few minutes.
As we did this, the medics were in communication with 911 trying to get a second helicopter since the chopper could only take one patient. At this point, we were over two hours into the ordeal, and about everyone on the island (about 10 people) came in to help. For awhile, someone helped me squeeze the breather bag, while I focused on stabilizing the head, keeping the airway open, and pinching the nose shut. At no time during this ordeal did I feel confident in my ability to help, and I just wanted the medics to take over. They insisted that I kept going.
We eventually heard the sound of the second helicopter in the distance, and there was discussion as to where the helicopters would take the ladies since a bariatric chamber large enough for both of them would be essential since their condition was too fragile for them to take turns in the chamber which uses pressure to force oxygen back into their bloodstreams.
When the second helicopter landed, the medics actually rushed over. It was a different sort of urgency with this group. As they came in, they checked in with the other medics to get a status check, and I stood up as I was relieved to let them get to work. As I stood up, three sensations rushed through my body. I was more relieved than I had ever been just knowing that this ordeal was done for me since the actual medics were taking over. It was such a relief to know that someone’s life was not in my hands. Also, after being on my knees, crouched over, on the ground, with extreme adrenaline-fueled focus for over 2.5 hours, pulsating pains starting shooting up my back. It made it tricky to stand up straight after being hunched down for so long. I bent over with hands on my knees and face looking down which caused suppressed tears to gush out of my eyes. As the pain rushed up my back, my mind had the first chance to realize what had just happened, and what we did. It was also the first chance I had to look around. I looked over at the woman who first discovered the ladies, we locked eyes, and I broke down into full tears knowing her vigilance and bravery of finding them made this whole situation possible. She gave me one of the best hugs I’ve ever had right when I really needed it most. It was also an awkward time to be hugging since I hadn’t hugged someone outside my household in over a year due to COVID. This sense of care kept me going.
Just seconds after I started to collect my thoughts again, the new medics called me back in to help. It was the last thing I expected to hear. I had already mentally checked out and prepared myself to be finished. The hug already sealed my stopping point. The medic said he needed me to continue with the breather bag while he hooked up the electronic monitor and proceeded with next steps. He also had an oxygen tank. Reluctantly, yet willingly, I got out of my own head, I got focused again, and I crouched back down on the ground and ignored the back pains which I knew were just a selfish inconvenience given the circumstances.
Once he got the monitor hooked up, he could get a reading on the vital signs, and the metric he was most focused on was the oxygen level in the blood. I recall it being around 29%, and he said we needed to get it up to around 70% hopefully to be stable enough to get her in the helicopter. He tried various things including shots of medications to get the vitals to change, and he explained how I could pace the breathing to benefit that process. He also shoved some sort of rubber nasal hoses into her nose to keep that airway open since the larger breather bag he had did properly fit over the nose and mouth. Part of my job was to push those hoses back into her nose each time they worked their way out since her mucous worked as a lubricant.
The next step was to intubate the patient. This is the process of sticking a breathing tube down the throat and into the lung to get the oxygenated air directly to that vital region. He asked me to prop her head in a certain way and hold things in certain places as he carefully guided a video scope, clamp, and breathing tube down past her vocal chords and into her lung. It was not easy to find the right path, I noticed. He warned me that when the intubation was complete, her vital signs on the monitor would drop substantially, but not to worry because they would quickly recover. He was right. That exact thing happened, but I still panicked inside when the vitals dropped. He reattached the breather bag to the breather tube, and I was now pumping oxygenated air directly into her lungs. His partner bounced back and forth between helping me and helping the other medics. Their professionalism kept me calm, and I knew we were in good hands. The blood oxygen level was starting to increase, and the discussion shifted to figuring out a departure strategy.
They were still going back and forth with 911 on where the ladies would be transported, but eventually they had a plan. The ladies were eventually in a stable enough condition to be lifted out of there. I didn’t have anything left in me to carry the ladies to the choppers a few hundred yards away, but at that time, a police boat with 1 cop and 2 off duty firefighters had arrived. Between them, the medics, and the other people around, there was enough help to safely carry the ladies away while hooked up to their life support apparatuses.
As I watched them get carried away and the helicopters take off, the last phase of this ordeal started. The aftermath was the longest phase and is described in Part 4 of the story: http://www.josharch.com/blog/tragic-event-part-4