LITTLE ROCK — The closest thing Arkansas has to real angels are two great steel machines with 20-foot propellers for wings, multipaned safety glass for eyes and a big blue belly for moving babies.
These angels are not of God but very much of man.
That would explain the enormous capital campaign forthcoming from the Arkansas Children’s Hospital Foundation to replace the hospital’s two helicopters — roughly $30 million — as well as the fact that little Billy Crain, 3, is bawling like he’s about to meet the Angel of Death.
He’s not.
Not riding with Death.
He’s just an asthmatic tyke with a bronchial infection who’s getting a very special lift to the hospital on the hospital’s flying intensive care unit, Angel One.
ANGEL ONE
Ten minutes before takeoff on an ordinary Tuesday last month, here’s what was happening with Billy.
In a single-bed hospital room inside White River Medical Center in Danville, little Billy, an Albuterol breathing mask spilling vapor from its vents every few seconds like its user is Godzilla or the Ghost of Christmas Future, is sitting up and crying inconsolably. His bronchial passageways are dilated largely by the aid of the steroid.
His mom and “Nanny” (Grandma) take turns squeezing him, and Papa is there, too. Soon he’ll watch his guardians stand down as a fleet-footed team of techs besiege him like he’s patient zero.
Back in Little Rock, the team hangs out in their navy blue jumpsuits in a fifth-floor lounge. They look like firefighters between calls. Daytime television plays on the big-screen. There’s a refrigerator and a stove. Several plastic containers half emptied of last night’s leftovers cool on a large lunch table.
Down another floor, pilot Darrell Long sits studying and checking weather in an officer’s room inside the Angel One Transport office.
Each year, Arkansas Children’s Hospital records several hundred thousand patient visits — last year, 337,785 — and far less than 1 percent arrive by Angel One.
By our measure, Billy is one of the blessed. (By his own estimation, man, he is doomed.)
The call came into dispatch about 2 p.m. Automatically, the nurse, Joe Hand, a respiratory technician named Chris Curtis and Long get pager alerts — yes, there’s still a place in the world for beepers.
In about 10 minutes, Hand, Curtis, Long, hospital staff photographer Kelley R. Cooper and this newspaper reporter are lifting straight up from the sixth-story helipad atop the hospital’s main building.
‘NO SMOKING IN AIRCRAFT’
If you’ve never hit the sky in a helicopter, you’re not missing much. It’s novel at first, rising straight up from the planet like a doddering circus balloon. But once directional the vehicle feels pretty much like an airplane. It’s loud, and from a few thousand feet the earth passes along at such a snail’s pace that the actual speed — nearly 200 miles per hour — is something believed, not perceived.
Outside the windows, the propellers whir by at a speed no greater than a ceiling fan. Can that be?
(At a constant 314 revolutions per minute, that’s only about twice the speed of a Hampton Bay.)
“Leaves are starting to change,” Long observes.
“This time of year,” Curtis says.
“Didn’t think we’d have much fall color, dry as it was,” Long says.
“Oh, I know.”
To the north is Petit Jean Mountain, as plainly the tallest thing in sight as Corliss Williamson in his sixth-grade class photo, while way over to the west there are the humps of the Ouachita range.
Inside the cabin, each of the four seats is stitched with Angel One crests. The rest of the signs are warnings like “No Smoking in Aircraft.” It’s posted in several places, including over the compressed oxygen tanks. There’s another prohibition against oiling any of the oxygen breathing apparatus. Beside each big bay door are signs labeled “Exit.”
It’s a wonder these weren’t included in our pre-flight briefing.
‘THE HAND THAT REACHES OUT’
If Angel One isn’t anything like a real angel, it fulfills at least one kindred mission — to deliver us from trouble, quickly.
The farthest flight within the state, Piggott, is only about an hour. Little Billy’s flight from Danville is under 20 minutes from liftoff to touchdown, during which he stops crying. He’s never more at ease than inside the bay, airborne. He even appears to nod off.
Up in the cab, Long is pointing out the basic instrumentation of a Sikorsky S-76C+, outfitted with Turbomeca Arriel 2S1 turboshafts — the point, Long says, is that the hospital runs elite transport aircraft when it could run suitable ones at half-price, and this piques and pleases him in equal parts.
Angel One Transport isn’t a helicopter ride, says hospital Chief Operating Office David Berry. It’s intended to be a mobile ICU. Very frequently, board-certified doctors and surgeons make the flight.
“We’re kind of being the hand that reaches out from Arkansas Children’s to help those other hospitals,” says Dr. Matt Jaeger. “You show up on their ER, and they’re always so happy and grateful that you’re there to help because they know these children need specialized care, and you have the training to give that.”
Berry and Jaeger point out that, unlike New York or even Texas, Arkansas has comparatively few critical care specialists for children and only one children’s hospital. Angel One Transport isn’t a competitive advantage for the hospital so that it can outperform a competing children’s hospital, it’s simply a necessity in a state where so much of the population lives far away in the corners (Benton and Washington counties, Texarkana and Jonesboro).
Little Billy is pretty much the worst demographic for Angel One staff — he’s too wise to be unafraid, too young to think it’s way cool. Besides, the big blue bird is idling a half-mile away on its pad when the tactical team arrives bearing luggage full of syringes, tubes and tools. His danger is clear and present, and non-negotiable.
He cries, “I want my mommy” and “I want Nanny” although they sit on each side of him. Everyone’s encouraging him to believe he’s OK, but there’s another voice coming from inside his own consciousness. Don’t believe the hype, it says. We know what they’re not telling us.
It’s so convincing.
This ride will eat us alive.
‘IT SAVED MY SON’S LIFE’
His mother, Lacey, is preternaturally calm. “I’m right here,” she says, signing release forms, her back to him. To her great relief, there’s a seat on Angel One for her, too, so she won’t even be separated from the boy they all call “Bubba” for so much as an hour.
Shannon Williams of Rogers wasn’t so lucky. Last year when her son, Justice, took a flight, she got bumped because a television news crew was filming a segment.
Though just a year old, Justice’s moment-to-moment well-being and comfort had been mom-managed. For the first time, he was completely out of sight, out of earshot- someone else’s charge.
“I was able to walk out onto the helicopter pad and be with him when they loaded him, and kiss him goodbye, but when he was lifting off, I just, I felt — because I was so involved in his care — in that moment, for a short time, I felt like I had lost control.”
Justice, now 2 1/2, spent several weeks at Children’s Hospital while doctors ran tests to determine what had caused his blood sugar to crash so precipitously he nearly slipped into a coma.The family could see the Angel One helipads from their window, and each time one took flight Williams wondered what other family is going through what she did.
“To me, that service is vital. The cost — I know it’s tremendous, but it saved my son’s life. And maybe with children with worse conditions, if that service wasn’t there, what would happen? I know children would die. That may be kind of harsh to say, but it is life and death.”
‘WE’LL GET THEM THAT FLYING ICU’
“You get to go up in a bird!” Billy’s Pa-pa says.
It doesn’t work.
Billy knows he’s not getting a bird.
“Pa-pa’s been in a bird. ‘Course, that’s not been for …” and here he cocks his Vietnam Veteran ball cap to the ceiling and rolls his eyes for the nurse’s amusement. “Forty years?”
For all of his distress, Billy doesn’t realize this isn’t his first helicopter ride. Angel One met him on his birthday, July 7, 2009. He was born nine weeks premature, just 4 pounds and already having trouble breathing.
About half of all transports are newborns, and most of those are preemies. Consider that a 6-ton, $12 million machine and as many as four people — a doctor, nurse, respiratory tech and pilot — are mobilized for the benefit of a 4-, 3- or 2-pound thing, well, pound for pound, these guys have it better than the Queen of England. (Last we saw her,she had to parachute out of her helicopter to arrive at the Olympics.)
“There are people that do look at this as a bit of an extravagance, and in some cases that’s probably true,” says Berry, but he’s not backing away, and neither is hospital foundation director Fred Scarborough.
“All I can say to you is, if there are three components we’re looking at [in this bid process], and they are good, cheap and fast, we’re going to go with good and fast.”
In other words, while the rest of the world is asking how can we do more with less, Scarborough, Berry and Company are hoping to do the most with more. More expense. More delivery. More care.
“We’ve set this up this way intentionally,” Berry says. “That baby in Harrison, that infant in Fayetteville, that critically injured adolescent in Texarkana — we’ll get them that flying ICU on that helipad at that local hospital so that we can start that critical care, that expert care, and get them into surgery or whatever’s needed here at Children’s Hospital.”
‘BACK TO BEING’ BILLY
Little Billy spent four nights at Children’s Hospital. His earlier diagnosis — bronchitis — was corrected in the pediatric intensive care unit to pneumonia. Last week he had another X-ray scheduled.
“He’s back to being himself, playing with his truck. Riding his bicycle,” says Lacey Crain.
Outside?
Yes, outside. He’s a boy, not a bubble boy.
Sometimes he plays so hard he gets sick to his stomach, Mom says. Ironically, “that’s how you know he’s sick” — when he’s not playing so hard he makes himself sick.
With proper diet and a little luck, that condition will persist undiagnosed.
Originally published in the Arkansas Democrat-Gazette 11 Nov. 2012.
