ALL AROUND HER WAS THE ROAR OF THE helicopter and the smell of her own lost blood. Fourteen-year-old Patricia Bowen focused her frightened eyes on the flight nurse crouched over her head. “Am I going to die?” she asked. Patricia had been stabbed twelve times and was bleeding from her neck, chest, abdomen, and hands. As the helicopter flew at 130 miles per hour toward Houston’s Hermann Hospital, nurse Georgie Brown grabbed IV’s and began pumping fluids into Patricia. “No, honey,” replied Georgie. She carefully locked eyes with her patient. “Hang in there. Don’t give up.”
Slightly more than half an hour earlier, Patricia had answered the door of her middle-class home amid tall pine trees in northwest Houston. A fifteen-year-old boy stood before her. He asked her for a cold drink. Reluctantly, she agreed. Once they were in the house, the boy grabbed her, held her to his chest, and slit her throat with a knife. Again and again he stabbed her. Twice she felt the knife rip into her chest. When she held up her hands to protect herself, he slashed her fingers. Then he fled through the front door. Patricia stumbled after him, collapsing on the front lawn. A neighbor ran over, took one look at Patricia’s bloodstained body, and telephoned 911 for help.
Georgie Brown’s pager went off with a high-pitched whine at 2:19 p.m. on December 10. Within five minutes, Georgie, paramedic Guy Stevenson, and pilot Taylor Jordan converged on the helipad of Hermann Hospital and were soon lifting off. In flight, Georgie and Guy checked their equipment, popped their fingers into rubber gloves, and listened to information via radio about Patricia’s condition from an Emergency Medical Service ground crew. What they heard from the para-medics wasn’t good. Patricia’s blood pressure was dangerously low, between fifty and sixty, and there were decreased breath sounds in her left lung. She was bleeding to death. Inside the helicopter, Georgie’s and Guy’s adrenaline levels soared like those of a couple of runners trapped behind the starting line. Nothing focuses the mind and heightens the physical senses as does the battle with death.
It took only sixteen minutes by air to reach Patricia. The helicopter floated over her neighborhood, dodging pine trees and electrical wires, until it came to rest in the middle of her street. Patricia was rolled on a stretcher through the rear of the helicopter, and soon she was en route to Hermann Hospital. A chorus of beepers signaled her arrival to a team of trauma surgeons, surgical and emergency room residents, respiratory therapists, nurses, and x-ray employees. Suddenly the room filled with all kinds of noise. The electric door swung open. Georgie and Guy rolled Patricia in; heavy machinery was being pushed around. Over the roar came the authoritative sound of Georgie’s voice: “I have here a fourteen-year-old white female who has been stabbed approximately twelve times.”
The trickiest part of the surgery was repairing two punctures near Patricia’s heart. Two surgeons worked side by side. One of them was Dr. James H. “Red” Duke, the director of emergency services and the medical director of Life Flight at Hermann Hospital whose health messages have been syndicated on television and have made him a celebrity. “The principle at work here is for everybody to hold their hosses,” said Duke, as he reached into Patricia’s chest, rolled her heart over, and then held his finger on a wound beneath her heart to stop the flow of blood. He looked like a highly skilled plumber plugging a leak. Dr. Neel Ware, the other trauma surgeon, stitched up a nearby hole. Together they worked on closing the other ten.
The next morning, Duke dropped by the intensive care unit. “How ya feelin’, Patricia?” he drawled. “Pretty good,” she replied. Duke peered at her through thick bifocals and twirled his heavy moustache. “That’s good, honey, because ya sure got a hell of an airing out yesterday.”
Patricia Bowen looked at Duke blankly. She had no idea how lucky she was to be alive. She was lucky to be among the 40 percent of Texans who have access to a 911 system. She was lucky to live near a fully staffed trauma hospital. Most of all, she was lucky to have gotten a ride on the $1.7 million helicopter that saved her life.
“IT’S AN ABSOLUTE TRAGEDY THAT THE PUBLIC continues to deny the presence of the epidemic called trauma,” fumed Red Duke. “We are in mass de- NI-al, and believe me, de- NI-al ain’t no river in Egypt.” Duke was seated near the coffeepot at the Life Flight offices at Hermann Hospital, haranguing on his favorite subject—the crisis of trauma-related injuries in Texas. To judge by the state budget, trauma doesn’t even exist. No state money goes to pay for treating trauma. By comparison, about $10 million of state and federal money is spent on AIDS. “Trauma in Texas is sort of like the elephant in the living room,” said Duke. “Everybody talks about the elephant, feeds it, and cleans up after it, but nobody really sees it or does anything about it.”
What has Duke worried is that trauma is the number one killer of people under 44. Not only are trauma injuries increasing, but the number of hospitals in which trauma patients can be treated is dwindling. So many Texas hospitals have closed that in effect we have a hub-and-spoke system of hospital care: Patients who were once treated near the scene of accidents now have to be airlifted to larger, hub hospitals in big cities.
Helicopters can make the difference in such cases. In suburban Austin a teenage driver loses control of his car and suffers a head injury, a broken pelvis, and a broken leg when his car rolls down an embankment. A helicopter arrives within a few minutes, paramedics place a tube down his wind-pipe so he can breathe, and half an hour after the accident, he is in a hospital and on an operating table. Flight paramedics