Author’s Note: The events of this story are true. I have done no research to embellish the tale. I will simply relate the events as I recall them. I was not personally involved in the care of the victim. Here goes!
It was not a dark and stormy night… but rather a sunny afternoon with a brisk wind out of the southwest. I was returning to the office from clinic at Fort Drum, New York. As a deputy EMS coordinator for our county, I was monitoring the emergency dispatch frequency on the car radio. The initial call was a dispatch for the Alexandria Bay fireboat to assist in managing a medical emergency that had occurred on a down-bound Salty” heading for the sea. Additional bulletins from dispatch indicated that a crewman on the ship was experiencing seizures and required evacuation to a hospital. This was before the days of paramedics, cell phones, and GPS. Pre-hospital care was provided by EMT’s and first-aiders.
The ship was in an area of the American Narrows where stopping, anchoring, or even turnings are not feasible. The ships had high free-board so that access to the ship would be possible only by climbing the rope Jacobs Ladder that is used when pilots are exchanged. Because of the following current and the trailing wind, the ship’s ability to even slow down was limited by its need to maintain steering. This meant that any transfer would have to take place while the ship and the fireboat are both proceeding at a faster than comfortable pace down the river. Reports from the ship indicated that the seizure activity was continuing. An attempt was made to transfer the man to the fireboat using a cargo net to support the stretcher, but this was terminated by an additional seizure. As the process continued, the ship left the protection of the Narrows and entered a more open section of the River. Here the seas were building making it difficult to hold the position of the fireboat against the ships quarter. With time passing quickly, and the likelihood of improvement of either the weather or the patient very remote, it was decided to request a helicopter evacuation.
Our nearest USCG helicopter resource at that time was Station Detroit, with a usual response time of about four hours. More commonly, air rescuer in our area is carried out by the Rescue Coordination Center in Trenton, Ontario. However, perhaps because the ship was in American waters at the time, the call went to a medevac helicopter crew stationed in training at Fort Drum, located only about 20 miles from the ships.
The Army crews were training for servicing the desert areas of Iraq and Afghanistan. They were discouraged by regulations from flying over water, partly because they were not equipped with personal floatation devices. Clearly someone looked the other way and bent a few rules in order to respond to this life-threatening emergency. Their task was complicated by the fact that the ship was equipped with masts and cargo-handling rigging that could easily ensnare anything dangling from a hovering helicopter. Furthermore, helicopter evacuations at sea were usually accomplished by turning the ship into the wind and slowing to a very slow bell, just enough forward motion to maintain steering in the seas. This is as close as you can come to a stationary target for the helicopter winch man. In this situation, as mentioned, the ship could not turn into the wind and had to maintain enough speed to keep control with a following wind and current. This amounted to a situation in which the flight crew had very little experience.
Reports from the ship indicated that the victim, a native of Ukraine, was deteriorating. His seizure activity increased in frequency. Care was hampered by the fact that the providers were not fluent in Russian. Two hours had passed, and it looked like there had been little progress toward a solution. I made a call to the Coast Guard to emphasize the urgency of getting him off to a hospital. They probably didn’t really need further persuasion.
So here’s the situation so far:
The man is getting worse, the weather is getting worse, the clock is running, the fireboat is unable to do much assistance, the language situation will not improve, and the helicopter crew is about to attempt something for which they are probably inadequately prepared.
The stage is set. World anyone like to finish writing the story? Anyone want to guess how this turns out?
At this point the pilot of the helicopter is in command. He gets to make the hard decisions. I don’t know exactly how it was accomplished, but the victim was hoisted off the deck of the ship and into the helicopter. I presume that a rescuer was lowered to the ship and the victim was secured in a “horse collar” devise for hoisting. In any event, it was accomplished. They headed for the hospital heliport; but the excitement was not over yet. Shortly after they were over land, the victim had another “grand-mal” - type seizure. This was sufficiently violent to cause the pilot to declare an in-flight emergency. They landed in a farm’s field. Details are sketchy at this point, but the likelihood is that once the seizure activity had stopped, the patient went into post-ictal state, which resembles a coma or a very deep sleep. It is not unusual for them to stop breathing for a short period at this point. Clearly here, short is a relative term. It never seems short to the care-giver and probably not to the patient either.
At this point the pilot could have easily justified calling an ambulance to complete the transfer and thereby relieve himself of further burden. But this aircrew was made up of professionals. They were given a mission, and they were not going to back away from it. With the patient apparently asleep and docile, they took off again and completed the trip to the hospital. He arrived alive and in relatively stable condition. At last things were starting to go his way.
Here the story turns into a “good news/bad news” routine.
Good new – he’s alive and stable in a hospital emergency room.
Bad news – he’s still having seizures
Good news – this moderate-sized hospital has a high-quality CT scanner.
Bad news –the scan suggests a brain tumor.
Good news – there is a neurosurgeon on the staff.
Better news – the Neurosurgeon speaks Russian, not necessarily Ukraine Russian, but at last they can communicate. It seems that the mass is treatable with immediate brain surgery.
Bad news – it is hard to get an informed consent for surgery from someone with a language barrier and impaired mental functions.
A little more good news - a lady in the dietary (food serve) department of the adjacent nursing home speaks Ukrainian, and her services are enlisted to help the patient understand the risks of surgery.
A little bad news - her Russian is fine, but her familiarity with English, particularly in regards to neurosurgery leaves a little bit to be desired.
At this point my daughter called from New York for an evening chat. In relating the events to her, she became concerned for his welfare and wondered if there was any way to help. She was employed in the broadcast industry at that time. She said, “Guess what! There is a guy who works just down the hall from me who is Ukrainian. He does translating for the United Nations. Let me put him on the line. All of a sudden you could feel the tide turning in George’s (not his real name) favor.
It was now well into the afternoon. I chatted with a very pleasant young man and explained the situation to him. His approach was, “If he’s Ukraine, and in this serious trouble, then he is a brother of mine. Where are you? I will be right up. Give me the directions.” He got on his motorcycle and followed simple instructions. “Take the Thruway to Route 12 Utica, and then stay on Route 12 until you can put your hand in the St. Lawrence River in Clayton”. It is a six-hour drive; he was there in about four hours. I met him at the dock and took him to our island home for the night. I remember the night well. I told my wife, “This is what our home is for; most of our family, my Polish-American Catholic mother-in-law and our new-found friend, a Russian-American Jew, all together under the same roof.” The happiness I felt was just like Christmas Eve.
Next day he went to the hospital and met with George. Informed consent was obtained, and we learned more about “George.” He had no relatives in the US, and was estranged from his wife. He had left his 14-year-old daughter home to care for the family. He had promised to bring her a pretty dress upon his return. He was not an officer, but was trying to upgrade his ticket by sailing as an AB (Able-bodied seaman). He had gone to sea like many of his ancestors, to find a better life for himself and his family. He was trying to learn English.
His luck held. His surgery was successful, and the tumor was benign. There is no question that his life was saved by the surgery. Had the seizures come a few days later, he would have been in the North Atlantic, and the likelihood of his receiving surgery to relieve the pressure in his skull in time to save him is very small. The tumor was benign, but its size was causing pressure inside the skull and causing the seizures. Without surgical intervention, the mass would have increased in size, squeezing the brain and eventually resulting in death.
Awakening from surgery can be scary. Finding that you are in a foreign county with no friends or relatives, and a big bandage where your hair used to be, must be terrifying. Of course, all his friends were still on the ship heading to sea. At first he could not talk at all; then only a few words in Russian. We were both trying to communicate, but it wasn't easy. Because I worked in the hospital and because of my interest in his care, I visited him daily during his stay. His employer made contact with a representative in New Jersey who took care of his legal matters and helped in contacting his daughter. He had a long, but uneventful, recovery and rehabilitation. The issue of where to go when hospitalization was no longer required, arose. Again his luck held. One of the pilots who takes ocean-going ships though the St. Lawrence Seaway stepped up and offered to take him into his home for a month or so until he was well enough to travel back to his home in Odessa. His English improved at a remarkable rate. He was something of a celebrity at our hospital, as we don’t see many Russian sailors. He was a hit with the nurses who cared for him, and prior to his discharge, they collected some money and took him to Wal-Mart to purchase a pretty dress for his daughter.
Neighbors of Russian background assisted with his care and rehabilitation while he was staying at the pilot’s home. After about a month, the representative in New Jersey was able to make arrangements for him and he flew home to his daughter.
As you can tell, this was a moving experience for me. This is more than a story of a man with a bad headache. It reflects the brotherhood of the sea. In a tradition that goes back centuries, seamen have come to the aid of their brothers in peril. Perhaps the most telling aspect is the fact that no one apparently thought that what they had done was extraordinary. Nevertheless, many of the circumstances of this case defy the laws of probability. The timing of the onset of his symptoms can be attributed to “dumb luck." But then what are the chances of finding an Army helicopter willing to do a maritime rescue that stretched the regulations? Then there is the likelihood of finding a small hospital in this area with a neurosurgeon on staff... and one who speaks Russian... and then to have the tumor treatable with surgery and not malignant. And finally, finding a pilot whose only connection is being a fellow seaman... taking you into his home for a month, and finding neighbors who are from a Russian background. None of these unlikely events is miraculous, but taken together, I think the case can be made. I’m sure he went home knowing that he had fallen into the hands of people who cared. These days maybe that’s the miracle. One final irony... the hospital where he received his care is the House of the Good Samaritan... think about that.
By Richard Withington, Round Island, NY.
Richard L. Withington, M.D. is a retired Orthopedic Surgeon and lives year-round at “Rivercroft” on Round Island. TI Life subscribers always enjoy Dr. Withington’s articles. He has a way of making his life on the island, no matter what season, exciting. The “Miracle on the St. Lawrence” took place several years ago. The event was one he always wanted to share. This winter the story was published in part in the popular magazine, Lakeland Boating. We are honored to have the opportunity to present this version it in our May issue.