Is There a Doctor Here? A Plane Crash on Vacation

An emergency can happen anywhere, at any time. Doctors may sometimes find themselves the only person able to help. Dr. Todd Dorfman was the only person who could help in just such an emergency. He describes what happened:

The night before, we had arrived at a house on Lake Kezar to spend a week with my spouse's siblings and family. That night, I was asleep in an upstairs bedroom when I suddenly woke to someone shouting my name. I jumped out of bed and ran downstairs. My children were watching a plane that had crashed into the lake. It had hit the water and flipped over. One of my in-laws and I immediately jumped into a small boat nearby and rushed to the scene.

Everything was underwater except for floating pieces of wreckage. A woman had surfaced, screaming, then dived back down. I immediately dived in. She was trying to rescue her husband and three-year-old son from the crushed front of the plane. Eventually, her husband and son also got free and surfaced.

The pilot had died; a piece of the left wing had pierced his chest.

Lauren, whose name I learned later, was about 5-6 years old. She was unconscious and trapped upside down, strapped into her seat. The water was murky, but I could still see her. Her mother and I repeatedly dived down, pulling at the door to try to open it. Unfortunately, we could only bend it a little. I could reach inside but could not release the seat belt. I wondered whether to go in through the windshield, but I could feel fuel in the water. I did not want to drown inside the plane. So I surfaced and shouted, “Does anyone have a knife?” My in-law was heading to shore, and I shouted, “Bring a knife when you come back!”

I was on a piece of the plane. My nephew was calling, “Uncle Todd! Uncle Todd! A knife!” He threw the knife toward me, but it went far too high and fell into the water. I dived down, but finding a black knife underwater was very difficult. By sheer chance, it had landed on a white piece of the plane. It could have sunk much deeper.

Fortunately, I retrieved the knife and handed it to the mother. She managed to cut the seat belt, and we pulled Lauren to the surface. I laid her on a piece of the plane floating on the water. She had no pulse, and her pupils were wide and fixed. Her mother was shouting, “Is she dead?” I began performing CPR . My skin and eyes were burning and stinging from the fuel in the water. Lauren began to breathe, and her heartbeat returned. She started vomiting. I tried to keep her airway open. With her pulse restored, we carried her to shore. She was now having anoxic seizures because her brain had been deprived of oxygen. Her brain was receiving oxygen again after the deprivation, causing epileptic seizures. I was still giving rescue breaths, but her seizures were severe and I could not control her. Her mother, Beth, was crying. She wanted to hold her daughter while I treated her.

The ambulance finally arrived. It was like a scene from World War II. There was a single oxygen mask, old and cracked, that was too big for Lauren but somehow fit me. So I inhaled oxygen and breathed it into Lauren. I was doing everything I could, but I had no equipment. I had nothing to establish an IV line, no IV fluids, nothing. I told someone to call Maine Medical Center, where I had trained in emergency medicine, and ask for a Life Flight helicopter.

We needed to reach a place where the helicopter could land, so we drove the ambulance to a nearby store's parking lot. The helicopter arrived, and as soon as its door opened, a woman inside called out, “Todd!” It was Heather, an emergency flight nurse I had trained with years earlier.

They had all the proper equipment. Lauren was immediately given an oxygen mask, an IV line was established, and her seizures were stopped. Soon her condition stabilized. There was an extra seat in the helicopter, so I told her mother, Beth, to go. They took off.

Suddenly, I began questioning my decision. I knew Lauren had been underwater for at least 15 minutes, but I did not know exactly how long. Had I done the right thing? Had I brought back a child who was brain-dead? I had not been able to think about that in the moment. Honestly, though, I am not sure what I would have done if this patient had been brought to the emergency department.

I heard nothing more about the little girl that night. The next day, I asked around but could not get any information. Finally, I reached a doctor in the pediatric intensive care unit where I had trained and got news about Lauren. She had woken up completely and said, “I need to go to the bathroom.” That was it: she was 100% normal. I could not believe it.

Children have something called a glottic reflex. I think hers kicked in when she hit the water and closed her airway. So when she lost consciousness, her lungs did not take in much water. There was enough air in them to keep her alive. Later, I received a call from Lauren's uncle. He was in tears, so I could not understand much of what he said, but as far as I could make out, he said Lauren was doing wonderfully.

Three days later, my spouse, our children, and I went to Lauren's house. I asked her to read something to me. I watched her play to assess her motor skills. I paid attention to everything, and she was completely normal.

Lauren's mother, Beth, said that before the accident, her own mother had given her a bracelet that the family called a “miracle bracelet.” It was supposed to grant one miracle in a lifetime. She said she had been wearing it that night, but it was now lost. “Saving Lauren's life was my miracle”, she said.

Interestingly, in Boulder, Colorado, where I lived for 20 years, I directed all the emergency service, police, fire, and ambulance operations. I wrote all the protocols. I would never recommend that any paramedic dive into aviation fuel to rescue someone. It was dangerous, but in that moment it was entirely instinctive.

I think this experience taught me not to give up in certain situations, because we really do not know what will happen.

*

The text above is a translation of Dr. Todd Dorfman's story, written by Medscape editor and writer Sarah Tucker.