• U.S.

Saving Jessie Arbogast

9 minute read
Timothy Roche

At dusk, two days after the fourth of July, Jessie Arbogast was having a Kodak moment on the beach in Pensacola, Fla. The Gulf waves were mild, no higher than a foot and a half. His sister and the other girls had ventured out much farther, but Jessie, 8, his brothers and some cousins stayed 15 ft. from shore, crouched in the shallow surf. Then, one brother felt something swish by his leg, and Jessie saw the sharp fins of a bull shark protruding 2 ft. above the water. The shark took an exploratory bite of his arm and a chunk of his thigh. “He’s got me!” Jessie yelled. “Get him off! Get him off me!”

On shore, his uncle Vance Flosenzier turned toward the screaming children and saw blood coloring the ocean. He and another man sprinted into the surf and found the 7.4-ft., 200-lb. shark about to roll away, its jaw on Jessie’s arm. Vance, who trains for triathlons, grabbed the shark by its sandpapery tail and tried to pull, but it would not budge. He yanked again, and Jessie fell away, his arm ripping, as the shark clamped down. Aware that two girls were still farther out in the water, Vance walked backward, pulling the shark along the sandy bottom of the shallow sea toward shore. With Jessie’s arm only partly swallowed, the shark tried to wiggle free from Vance’s barehanded grasp. But Vance, at 6 ft. 1 in. and 200 lbs., held on and dragged it to shore where his wife Diana and others had laid Jessie on the sand.

“Shark! My brother’s been bitten by a shark!” a boy yelled as he ran down the beach. Tourists Trina Casagrande and Susanne Werton of St. Louis, Mo., thought it was a prank and kept walking. Then they saw the chaos and the crowd gathered around the unmoving body of a boy, the red muscle of his thigh exposed and looking like a “bite [had been taken] out of a drumstick.” The women could not see much blood. Most of it had drained from the boy into the Gulf. Jessie’s lips were whiter than his face and body. His eyes were open, but rolled back.

“We have to get him covered up,” Werton told her friend. All they could find were a sheet and beach towels. Werton took over CPR compressions from Vance as Diana blew air into Jessie’s mouth. Werton counted to five, then pushed five times, then counted again as Diana blew. His chest rose, so they knew they were getting air into him.

The shark attack had severed Jessie’s arm 4 in. below the shoulder. Vance tied towels into tourniquets and used T shirts to cover the bone sticking out from the stump, slowing the loss of what little blood was left in the boy’s body. Breathless but calm, Vance used his cell phone to call the 911 dispatcher, “The right arm and right leg are gone… Completely gone. He’s lost a lot of blood… He wasn’t breathing, and he didn’t have a pulse a minute ago… We need a life helicopter out here or something like that.”

Before they landed, the crew of the chopper from Baptist Hospital saw the shark on the beach, its gray body against the white sand. Once the chopper touched down, they discovered that Jessie had basically been drained of blood, the worst situation in a trauma. In such situations, fewer than 1% of victims survive. No medication can help the heart. “There is nothing left to pump,” says Greg Smith, an emergency-room physician who had hopped onto the helicopter when he heard there had been a shark attack. “You’ve basically run the pump dry.” The medics could well have declared Jessie dead. But Smith and paramedic Chris Warnock had kept the chopper’s engines running for a “scoop and run” and with Jessie’s uncle, they carried the boy to the chopper. “He was kind of like a rag doll,” Smith says. Inside, the medics continued CPR and inserted a breathing tube. They had been on the ground less than 6 min. As they closed the door, they asked about the arm. Smith says, “No one knew where it was.”

The shark was still thrashing on the beach. Jared Klein, a National Park Service ranger, wondered whether the arm was in the water or in the shark’s mouth. At a paramedic’s suggestion, he took his expandable baton and pried apart the bull shark’s jaws. There it was. But, says Klein, “the arm was too far in the mouth to remove it,” particularly with the shark still in violent convulsion. He asked the crowd to step back and shot the shark four times in the head. Then he opened its mouth with the baton, while Tony Thomas, a lifeguard and volunteer firefighter, his own arm wrapped in a towel for protection, reached in with hemostats and extracted the limb. He covered it with a towel and packed it in ice to be rushed to a waiting ambulance.

By the time the chopper landed at the hospital, Jessie had gone without blood–and thus oxygen–for 30 min. The medics put him on a gurney and took him down in an elevator four floors to Trauma Room 9, continuing CPR all the way. As doctors, nurses, aides and technicians hunched over the lifeless boy, nurse Dawn Colbert inserted an IV into his arm and began a rapid infusion of O-negative blood, the universal-donor type. Within 15 minutes, Colbert pumped nearly 1.5 liters of warmed blood into Jessie, about half the normal volume for an 80-lb. boy. Jessie began to bleed. But his heart still wasn’t beating on its own. Twice the team stopped CPR, waiting for Jessie’s heart to pump on its own. No pulse. Nurse Sandi Miller, who was keeping watch for the arrival of the arm, prayed under her breath as the team continued CPR, then paused for a third time. One doctor felt a faint carotid pulse, another felt a femoral pulse. The blood began to flow on its own. Outside, the ambulance had pulled up. “As soon as his limb came through the door, we got a heartbeat,” Miller says.

Having stabilized Jessie, Dr. Jack Tyson summoned colleagues to close up the wound. Joining Tyson in the E.R. were orthopedic surgeon Juliet De Campos and microvascular surgeon Ian Rogers. The doctors were surprised by the neat tears in the muscles and tissues. “My God,” Rogers told the others. “This is replantable!” In 16 years of reattaching arms, it was the cleanest cut Rogers had ever seen. “You never get a shark bite like that,” says De Campos. Still, the doctors debated for nearly an hour before Rogers made the call to proceed.

One bone, three nerves, one artery, three veins and three muscle groups had to be reattached if Jessie was to recover with some semblance of normal use of his arm. While De Campos prepared the stump, Rogers marked the corresponding veins, arteries and nerves with sutures on the severed arm. First, De Campos shortened the arm even more, taking away about an inch of bone so that the stump would hold a plate to keep the limb in place. She clamped the bones together–two screws in the stump, two at the overlap and two more in the arm.

That done, Rogers connected the muscle tissue. Wearing magnifying goggles, he began reattaching major nerve endings, which are just slightly thicker than an eyelash. Next, veins and arteries were reconnected. Rogers had to take some veins from Jessie’s leg to replace damaged vessels in the arm. Finally, Rogers released the clamps and blood began to flow back into the arm, which he describes as “absolutely white” and very cold. Arteries and veins starved for blood for so long went into spasms as new liquid began to flow. Antispasmodics were administered, and team members massaged the arm.

Five minutes, 10, 15. No response in the arm. “We were nursing this for about 30 minutes,” Rogers says. “Then, all of a sudden, all the little cuts in his forearm started to bleed, and we could hear pulses in the arteries.” The trickiest part, the doctors say, was stitching the skin back. “It was like putting a jigsaw puzzle together,” says De Campos. After 12 hours in surgery, they wheeled him into the recovery room. They could only wait and see if he would survive.

Dave and Claire Arbogast found out about the attack when Vance called them from the rangers’ station. It’s the second time an Arbogast child has knocked on death’s door. In 1994 Dustin spent more than a week in a coma after a car wreck. Now 17 and recovered, he is the family’s living hope for Jessie’s recovery. Friends who know Jessie talk about a tough kid, one who can hold his own in debates with grownups about the sun and stars, but who is happy to shoot squirt guns and swing from oak trees. When he got a finger stuck in a hole in the school bus two years ago, he remained calm as firefighters cut away the bus to free him.

Last Thursday, 13 days after the attack, Jessie’s parents put him in a wheelchair and rolled him around the intensive-care unit, IVs dangling behind them. Jessie responds to pain stimuli, and his eyes are open. But his parents are not sure he can see them. At his bedside, they talk to him about Digimon cartoons and other things he enjoys. The parents were there when De Campos moved Jessie’s reattached arm to make him more comfortable, and the boy moved it back. They were there when he wiggled his hand. “They continue to view every small step as a very positive sign of hope,” says Sister Jean Rhoads of Sacred Heart Children’s Hospital, where the boy has been transferred. Rogers, Jessie’s surgeon, says the boy will probably not regain full use of his arm. And his right thigh lost half of its mass during the attack, so he will probably require a brace to walk–if he can walk. Or if he ever wakes up to tell his part of a tale of a boy and a shark on the wrong side of each other.

–With reporting by Alice Jackson Baughn/Ocean Springs and Michael Peltier/Pensacola

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