Mike Lesher, the paramedic who first carried Gardell to the ambulance, heads back to the station. The CPR has gone on for more than an hour; typically rescuers give up after less than half that time. “If he survives,” Lesher remarks, “it will be a miracle.”
A moment later, the aircraft lifts off. Rose watches through the window, tears stinging her eyes; she has missed her little one again.
Dr. Frank Maffei is preparing for his evening rounds in the pediatric intensive care unit at Geisinger Medical Center’s Janet Weis Children’s Hospital in Danville, some 15 miles from Lewisburg. He gets a call from the ER downstairs: toddler on his way via Life Flight, full cardiac arrest. Worse: CPR ongoing for more than an hour, to no avail. Not promising.
Still, Dr. Maffei and his colleagues leap into action. Upon Gardell’s arrival, they run a breathing tube down the boy’s throat, and four residents line up on his left side to continue CPR: two minutes of chest compressions, move to the back of the line. It’s critical to get Gardell warmed up, so even as the limp little body jiggles and jolts under the force of the chest compressions, other doctors and nurses carefully insert an IV and two catheters to send warm fluids into his body, which is at only 77 degrees.
A resident turns to Dr. Maffei. “At what point are we going to stop?”
“We’ll stop if we warm him to 90 degrees and he’s still unresponsive,” Dr. Maffei says.
“What about a pH?”
The resident is referring to the acidity of the blood, which spikes when a person stops breathing; a pH lower than 6.8 is considered incompatible with life.
Objectively, he knows that it’s all over. Yet he can’t shake some strange, subjective notion that Gardell is still in there.
Dr. Maffei hears himself answer, “6.5.” It’s an outrageous threshold. A few minutes later, the pH comes back at 6.54. No heartbeat, no breathing, and a low pH: The boy is dead.
Dr. Maffei has been doing this work for 25 years. Objectively, he knows that it’s all over. Yet he can’t shake some strange, subjective notion that Gardell is still in there. “Keep going,” he says.
Now it’s after 8 p.m., and Gardell remains unresponsive. The doctors move him to the operating room and prepare to put him on a heart bypass machine. They’ve gotten his temperature up to 83 degrees, but the machine will allow them to warm his blood externally and recirculate it, speeding the process. A surgeon stands scrubbed and ready to cut into the little boy’s chest.
“Let’s just do one more pulse check,” Dr. Maffei says, laying his fingertips against Gardell’s femoral artery. To his amazement, there is a pulse. His colleague Dr. Rich Lambert checks the brachial artery—there is a strong pulse there. Excited, they stand in the OR, monitoring Gardell’s pulse for more than an hour, then transfer him to pediatric intensive care.
Dr. Maffei steps out into the waiting area to meet Rose. “Gardell’s alive,” he says. “However, we have to understand that he’s alive after essentially being dead for an hour and 41 minutes.” He needs to manage her expectations: Gardell’s oxygen-starved brain will probably be forever damaged. It’s anyone’s guess as to when—or whether—he will wake up and what function he’ll have when he does.
Now it’s the wee hours of the morning. Doyle Martin has gotten in from the highways, and he and Rose are sitting over Gardell’s bed. “Gardell,” Doyle says as he always does when he reaches home, “I came back from trucking to play with you. Do you want to play?”
And to the eternal astonishment of all, the boy opens his eyes and turns his head toward his father—the boy who, eight hours ago, was dead.
Gardell stays in the hospital two more days, under light sedation. He’s kept at a cool 90 degrees to prevent his brain tissue from swelling. He begins opening his eyes more frequently, obviously aware of his surroundings. The breathing tube is removed. He’s weaned off the sedation. On the fourth day, a Sunday, he returns home. Within a week, he’s playing with his siblings. “You would never know anything happened,” Rose says.
So how did a little boy who, by every objective measure, was dead for nearly two hours come back to life unscathed? To the Martins and many others, Gardell’s survival was simply a miracle. Rose points out that his pulse returned just as local church groups were meeting to pray on his behalf. Physiologically, the key to Gardell’s survival was the fact that he nearly drowned in ice water. “Hypothermia imparts a degree of protection from the detrimental effects of low blood flow and low oxygen,” Dr. Maffei says.
Read More: Frozen Back to Life: How Hypothermia Can Help Cheat Death
The severe cold stopped Gardell’s heart, but it also saved his brain, just as you might put an amputated finger on ice until you can reattach it. At a higher temperature, Gardell’s brain cells would surely have died for lack of oxygen; as it was, they could wait—at least for an ho