He was Spider-man. Three-year-old Sam would leap from his favorite points of ambush, using super strength and invisible webs to subdue his giant rival, the villain played by his dad. These were epic contests in which Dad would sometimes plead for mercy. “You win Spider-Man. Please, no more,” he would say, and finally the fight would end with giggles and playful salutes to Spidey’s general awesomeness.
Now Spider-Man was outside, ready to attack again. The giant steel beast and its formidable rider approached with a fearsome roar of metal teeth. Spider-Man crouched low in the tall grass, ready to pounce on the evil chopping machine his rival had commandeered. He cocked his legs and readied his tongue to make the whooshing sound of his spidery webs. He was well-hidden, so obscured that his dad would be completely surprised as he came across the grass with his big machine. Spider-Man sprung his trap…
It was Oct. 4, 2008, a couple months after Sam had been brought to the United States by his adopted parents, Marty and Carole Phillipson. The Phillipsons had plucked Sam and his older brother from an orphanage in Addis Ababa, Ethiopia. The two adopted boys joined a family with two other children (one biological and one also adopted) and were soaking up American culture like the parched earth absorbed rain in their birth land. Before the adoption, Sam was named Teklab, and his 5-year-old brother, now called Paul, was known as Abel. Like their names, their lives had been transformed: Everything was different at the Phillipsons’ home on its 6 acres near Sullivan, Wis.
Much of their property, including a marshy tract, grows wild, sprouting a mix of coarse weeds, indigenous flowers and 6-foot-high prairie grass. Marty Phillipson maintains walking paths through the thick growth with an industrial-grade riding mower.
This was the machine Marty was using to mow the paths while Carole removed garden overgrowth with a brush cutter. The children were playing around the property and all seemed well.
But suddenly, the riding mower jolted and groaned. Its blades fought to cut through something of far greater mass than grass or sticks. Marty didn’t know what was happening until he saw little Sam’s tiny shoe come out from underneath the carriage.
The mower’s blades had been sharpened just the day before, and the damage to little Spider-Man was devastating. Both of his legs were chopped off, one of his arms was barely hanging on, and his back and buttocks were deeply lacerated. Sam was dying.
Remarkably, Sam never lost consciousness as his father yelled desperately for his wife. Carole pulled the other children toward the house to shield them from the grizzly sight and called 911 from the land line. Marty stayed with Sam and tried reaching 911 on his cell.
Richard Heine, the head of Sullivan Emergency Medical Services, has more than 18 years of experience in the field. He received the dispatch seconds after the calls came in. He knew immediately that the quickest, highest-level care needed to be dispatched. He called Flight for Life.
As soon as Heine’s call came into the Flight for Life communications center at the Waukesha County Airport – even without all of the details of the accident and its location – the dispatcher hit an alert button, a “get ready” tone for the flight crew.
Upon hearing the alarm, pilot Charlie McCall, who has been with Flight for Life since 1984, began preflight preparations, checking updated weather conditions. Flight nurse Rebecca Schwuchow and flight paramedic Leif Erickson loaded two units of Type O-negative blood, double-checked relevant medical equipment and medications, and donned their helmets. More information about Sam and their destination was sent to their pagers as it became available. The goal, as always: to be airborne within 10 minutes of getting the call.
The Waukesha-based crew was soon speeding at over 150 mph toward the mutilated child whose life was slipping fast in a field 40 miles away. En route, Erickson and Schwuchow were in continuous communication with their dispatcher to gain more details about the injured boy. Once they had confirmed Sam’s approximate weight, they began making dosage calculations for medications they might use.
Heine, meanwhile, had arrived at the accident scene within minutes of the Phillipsons’ 911 calls. The first medical professional to see Sam, Heine couldn’t believe what he encountered.
“In 18 years of doing this, I’ve seen a lot of crap. But I’ve never seen someone this mangled and still breathing,” Heine says. “Yet the boy never passed out, he just kept looking up with these big dark eyes that said, ‘Hold me.’ But we couldn’t.”
Heine didn’t expect Sam to survive a half-hour, let alone a rough transfer to a hospital. The helicopter’s speed and the skills of its highly trained medical crew were Sam’s only hope.
“We could have bounced him down the road in an ambulance, but he would have never have made it,” says Heine. “He needed that helicopter to get to a Level One trauma center.”
Trees and power lines are dangerous obstacles for an emergency helicopter. The BK 117 helicopters used by Flight for Life require landing zones free of such hazards over an area that’s at least 100 feet by 100 feet during the day and 150 by 150 at night. The land must be relatively flat, with no more than a 5-degree slope. Still, Flight for Life’s skilled pilots have been known to skirt such requirements to reach desperate people.
“We’ll land Flight for Life pretty much anywhere. These are the best of the best pilots,” says Heine. But the trees and hilly contour of the Phillipsons’ yard made landing there impossible. Sam had to be taken a quarter-mile in the ambulance to a baseball field where the helicopter could land.
Emergency Medical Services around the region have set up predetermined landing zones in their areas in anticipation of such problems. A standardized FFL document provides pilots with information about a given area’s hazards, topography and coordinates. Some of the more commonly used landing zones have been programmed into the helicopters’ navigation systems
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The chopper touched down on the baseball diamond within 20 minutes of the accident. Schwuchow and Erickson quickly unloaded a stretcher and bags of medical supplies and raced to the ambulance that held the injured boy.
Sam was in bad shape. His left leg was severed below the knee, his right leg was severed at the ankle, and his left arm, while still attached, was badly maimed. He also had a deep cut on his lower back, and one of his butt cheeks had been sliced down to the rectum.
Heine and the EMS workers from Sullivan had arrived first and had wrapped Sam’s missing legs in saline gauze, placed them in plastic bags and packed them in cold packs for transport. They had tried, unsuccessfully, to start an IV in his right arm, the only viable spot left on his body.
Sam was in shock. The FFL team also made some attempts to start the IV, but could not do so. Somehow, despite his serious lacerations, Sam hadn’t lost a dangerous amount of blood. The state of shock had pulled his blood supply away from his limbs and toward his vital organs.
Sam needed to get to a hospital, and fast. Erickson and Schwuchow finished dressing his wounds, hooked him up to oxygen, and with the pilot’s help, loaded him onto the helicopter. Sam was carefully secured inside the aircraft, face up on a dedicated cot on the port side of the aircraft, with his head pointed toward the front.
The helicopter took off and raced for Children’s Hospital. In the air, the team got an IV started and began giving Sam fluids. The worry with pediatric patients is that there is often no warning before catastrophic system failure. Their vital signs will go from looking OK to crashing in seconds.
Flight for Life’s dispatcher had alerted Children’s of the situation and given them an estimated time of arrival. A trauma team began assembling at the hospital.
During the flight, Sam’s eyes sometimes opened; he seemed aware of the frightening situation. Schwuchow has worked as a volunteer in impoverished areas of Africa and has come to love the indomitable spirit and open hearts of the people she has met there. Looking into the eyes of Sam, she felt an immediate bond, and empathized with how scared and confused he must have been. Barely removed from the more familiar culture of Ethiopia, Sam had been mutilated by an awesome machine and was now strapped into another one with strangers who were doing things to him that hurt. It must have been terrifying.
The nurse gently stroked his head and reassured him. “Your mom and dad are coming to see you,” she told him. “Your mom and dad love you.”
The helicopter landed 16 minutes after takeoff on the helipad above the emergency department at Children’s Hospital. Sam was unloaded and taken by elevator to Children’s Hospital’s trauma center. The Phillipsons, Sam’s parents, were anxiously waiting for him. Sam kissed them goodbye. The trauma team wheeled him into the operating room.
As Milwaukee Magazine began trying to find people aided by Flight for Life who would tell their stories, one thing soon became clear: The degree of separation between many in the area and someone aided by FFL is shockingly small. Once word got out that we were searching for such stories, the magazine was flooded with e-mails and calls from people who were either part of a rescue or had a friend or relative that was.
In the last 25 years, Wisconsin Flight for Life has served some 26,000 patients, many as horribly injured as Sam. The program’s origins go back to the early 1980s, when area medical professionals began discussing the need for it. By then, a number of flight-based medical transport programs had proven themselves in other American cities. And so, in 1983, the Milwaukee Regional Medical Center applied for approval from the state Department of Health and Human Services to create a one-year demonstration program. The project was approved and took its name from the first such program nationally, Flight for Life in Denver.
Six nurses from the Milwaukee County Medical Complex were hand-picked to become FFL’s first medical personnel and began flight training. A Bell LongRanger helicopter was outfitted, and in January 1984, Flight for Life transported its first patient from Eagle River Memorial Hospital to the Milwaukee County Medical Complex. By year’s end, the program had transported 283 patients. That nearly doubled to 503 patients the next year.
A new era had arrived in Milwaukee. Patients who might otherwise have died – due to longer travel times on the ground, the inability of emergency vehicles to reach them or inadequate emergency care while en route to the hospital – were now being saved. FFL also began serving patients in need of tertiary care, but who might not survive a long and bumpy ambulance ride, by moving them between medical facilities.
Demand for FFL quickly grew. In 1987, Flight for Life opened a satellite helicopter service at the Northern Illinois Medical Center in McHenry, Ill. Between its two operations, Flight for Life was able to provide aid to 697 patients that year.
During its first 11 years of operation, Flight for Life partially relied on the support of sponsors like Froedtert and Children’s Hospital to meet its expenses. But in 1995, it became self-sustaining, operating on revenues gained from the services it provides to patients. Transports are billed to patients (which insurance often reimburses), and average from $6,000 to $10,000, depending on miles covered.
To increase FFL’s efficiency and range, a third helicopter was added in 2008 in Fond du Lac. The addition gives FFL three operating zones and a wide area of coverage. Each helicopter generally covers a 60- to 75-mile radius, but can fly up to 200 miles from its base.
At the end of 2007, Flight for Life moved its main operations from a hanger on top of a building at the Milwaukee Regional Medical Center to Waukesha County Airport’s Crites Field. The new location features spacious offices, hanger facilities and a state-of-the art operations center to handle dispatches.
Ericka Fricker is one of FFL’s air medical communications specialists. She sits behind a large desk packed with computers and telecommunications equipment. On the wall in front of her, monitors displaying a computerized map of the region pinpoint the locations of FFL’s three helicopters and provide data on airspeed, heading, altitude and destination. The northern Illinois helicopter covers FFL’s southernmost zone; the Waukesha helicopter covers the center zone and the Fond du Lac helicopter services the northern zone. But the helicopters can be called outside of their zone if another one is unable to operate, or if multiple transports are necessary at an accident.
Flight for Life crew are constantly updating their training and learning cutting-edge prehospital medical techniques. This helps them save lives directly and indirectly, as they often train others on the latest resuscitation and life-support methods. Between 1995 and 2007, FFL put on 2,700 educational and community events, providing training to some 262,000 people. They included EMS personnel, law enforcement officials, firefighters, hospital workers and community members.
One key discussion point in these seminars is when it’s appropriate to call Flight for Life.
Emergency personnel must decide whether ground transport to a hospital might pose a threat to a patient’s survival; whether traffic or other obstructions might delay the arrival for too long; and whether FFL’s cutting-edge skills and equipment may be critical to the patient’s survival en route to a hospital. This can sometimes be a tough call to make.
On Feb. 13, 2008, 18-year-old Shauna Holmes was snowmobiling with her brother and father in northern Waukesha County. Upon crossing Highway 83 to pick up a trail, she was struck by a fast-moving car. The girl flew 50 feet and landed hard on the road. It was a dramatic collision, yet she lacked obvious signs of a major injury.
The EMS responders suspected head trauma. They worried that a slower, rough transit by land could result in Shauna suffering catastrophic internal bleeding. They called in Flight for Life, which was able to land at the scene and whisk Holmes to Froedtert. There, she was assessed and released within hours. It was a rarity for FFL: Nothing was wrong with the patient.
More commonly, calling FFL is a clear life-or-death decision. As it was for Sullivan resident Dean Galusha – twice.
In 1987, Galusha and a few friends had been drinking heavily at his cabin near Crivitz, Wis., (not far from Michigan’s Upper Peninsula) when they decided to fire up some ATVs and go for a ride. Galusha was faster than his friends and left them in the dust. He’d always been a jokester, so his friends thought Galusha was pulling a prank when they caught up and found him face down in the dirt on the trail. It wasn’t until someone lifted his head and saw he was bleeding profusely that it became clear: This was an emergency.
Galusha had lost control and flown off his three-wheeler. The vehicle hit him in the head after he landed. He wasn’t wearing a helmet. Paramedics took Galusha to a hospital in Marinette, where it was quickly determined he had suffered a severe head injury and needed transport to Froedtert for Level One trauma care. Though Marinette was beyond the normal coverage zone of Flight for Life, it handled the job.
Typically, patients transported by FFL remember nothing about the experience. That’s how traumatic the usual medical situation is.
Galusha was in a coma for three weeks and re-emerged with major memory loss and without the ability to handle simple tasks like feeding himself. He spent three and a half months in the hospital learning how to function again.
Doctors told Galusha he should never again use alcohol, as it would affect him badly due to his brain injury. Resisting the coaxing of his friends and co-workers, Galusha remained alcohol-free for almost three years. In 1990, however, Galusha went out dancing at a bar with friends and made a fateful decision.
“I don’t know why, but I ordered a mixed drink,” says Galusha. The booze left him feeling woozy and extremely tired. He said goodbye to his friends and got in his brand-new pickup truck to head home.
Galusha blacked out near Pewaukee Lake and slammed his car into a large oak tree at high speed. A nearby resident heard the crash and called an ambulance. First responders found Galusha on the floor on the passenger side of the truck. He hadn’t been wearing a seat belt and his face was smashed beyond recognition. It took rescuers two and a half hours to cut him from the crumpled wreckage. He had lost five and a half pints of blood and was barely hanging on to life. He needed Flight for Life.
By the time he was removed from the car, the helicopter was there. The crew began life-support protocols and flew him to Froedtert. While he was spared injury to his brain this time, the damage to his face was extreme. Surgeons rebuilt it meticulously. “My entire face is fake,” says Galusha.
He spent five and a half months in the hospital recovering. The accidents have given Galusha a new outlook on life. He is overjoyed just to be alive and his positive energy is immediately evident. “I thank God for Flight for Life,” says Galusha. “There’s no way I’d be alive without them.”
Rebecca Schwuchow, 48, has been working with Flight for Life for more than a year. It seemed like the natural culmination of her professional evolution. She became a nurse in her 20s and has since worked in high-intensity situations in emergency rooms and intensive care units around the country. In 2007, Schwuchow learned a nurse position was open at Flight for Life and jumped at the chance. Her experience and personality set her apart from other candidates and she was chosen. After intense flight, survival and medical training, Schwuchow started work in November of 2007. She now splits her time between the Waukesha and northern Illinois bases.
Flight for Life uses a rigorous selection process for its crew. Most flights carry a medical team consisting of a nurse and either a paramedic or a physician resident from the Medical College of Wisconsin. Nurses and paramedics must have five years of experience to be considered for a job. The current FFL nurses average 24 years in the field and 12 years with Flight for Life; flight paramedics average 15 years in the field and seven with FFL. Many of the 13 pilots flying for FFL have military backgrounds. On average, they have 28 years experience and 10 years with Flight For Life.
Schwuchow has the look of a mountain guide. Her biscuit-blonde hair spills down her back. Her chiseled face, angular and determined, projects decisiveness. It’s her eyes, though, that convey the humanitarian, the mother, the nurse. She’s the Flight for Life ideal: well-trained, rigidly professional, yet tender and caring, an unflinching technician with a heart like a flower.
Flight for Life crews work in high-stress, fluid situations that often involve people who have been killed or injured in gruesome ways. Trauma makes up most of their workload. They commonly arrive at scenes with multiple fatalities. Sometimes the casualties are children (20 percent of transports are pediatric). What keeps psychological trauma from overtaking staff is an extreme focus on the task at hand and a never-quit approach to life support and resuscitation, say several crew members.
“No one dies in the back of our helicopter,” says pilot Vince Freeborn, who flew Cobra helicopters in the military. Freeborn remembers the only occasion when the medical team ceased resuscitation efforts in flight. “We were on a long flight and they had gone through every last bit of medicine and equipment on the aircraft,” he says.
Inevitably, people do die aboard Flight for Life, but the crew never stops trying.
After every transport, there is a debriefing. When something has disturbed the crew, they say, this helps get things out in the open. There’s a familial bond between FFL team members; they rely on each other for understanding and emotional support.
“You see some pretty horrific things and bad outcomes,” says flight nurse Dave Mason. “But if you did the best you could, then you can sleep that night.”
Even so, every crew member has seen disturbing things that stick with them. “I have a mental filing cabinet that I don’t like to open very often,” says Mason.
And even the most intense focus on the task at hand sometimes isn’t enough to keep personal feelings at bay. “It pops up in funny little areas here and there. A victim might look like the kid down the street to one of us and suddenly it’s like ‘I’m not so good with this one,’ ” says flight paramedic John Emerson. “But there’s an unbelievable amount of support and caring between us that allows us to keep going.”
Seldom will a team follow up on a transport’s progress after delivering him or her into appropriate care. It’s all about professionalism and sticking to the task – and the next trauma or transport – at hand.
There was something about Sam, though. The team that helped him continued to stay involved in his life. They visited him during his two-month stay in the hospital and followed his recovery on the Web site his parents set up to keep people informed as Sam underwent multiple surgeries and learned to function with only one remaining limb.
On Dec. 14, a pancake breakfast benefit was held for Sam Phillipson at a gym in Sullivan. He had been released from the hospital just two days earlier. Flight for Life members drove to the event to see their little patient, and the helicopter flew in as well. Flight nurse Rebecca Schwuchow watched in delight as Sam raced all over the gymnasium in his little wheelchair. It was an extremely cold morning, but Sam made his mom take him out to watch the helicopter land. The crew lifted him into the aircraft.
“He was so excited,” says Schwuchow, the tender side of the flight warrior showing though.
“It’s things like this that make my job so wonderful.”
Mario Quadracci is an associate editor with Milwaukee Magazine. Write to him at mario.quadracci@milwaukeemagazine.com.
