MICHIGAN CITY | Word arrived about 4 p.m. Friday. A boy was trapped under the weight of Mount Baldy, a behemoth sand dune at the Indiana Dunes National Lakeshore.
The boy was vacationing with his family and stepped into a sinkhole.
Nearly 2 miles away, the emergency room staff at Franciscan St. Anthony Health hospital in Michigan City was in a holding pattern on the case.
"At that point, it was 'possibly somebody buried,'" Dr. Justin Hepker said.
Hepker, a new doctor, was on duty that day in the emergency room.
"It was my third shift here," he said. "I literally graduated residency and had been a full-time doctor for two weeks."
He and the rest of the team waited.
"It became hour after hour of waiting," he said.
After digging more than three hours, rescuers pulled 6-year-old Nathan Woessner from under 11 feet of sand. Five minutes later, he arrived in the Michigan City emergency room. His eyes were open.
"He was not responding very much," Hepker said.
First responders had stabilized the Sterling, Ill., boy's spine and administered oxygen, but he was still in bad shape.
"He was very sick when he hit our ER," Hepker said. "He was very cold, just being that deep under the ground. He was in shock."
Doctors think he may have been saved by an air pocket in the dune.
Still, his airway was filled with sand, blocking Hepker's first attempt at inserting a breathing tube. Nathan was dehydrated, so a hole was drilled into his leg bone to administer fluids via an intraosseous IV. The procedure, although it may sound gruesome, is common practice, efficient and less painful than a peripheral IV, Hepker said.
Sand was everywhere — in clothes, on the floor.
As staff worked to stabilize the boy, Hepker said his adrenaline took over and trauma care procedures kicked in.
"There's no textbook way to prepare for a burial (victim)," he said.
Hepker's rotation at Advocate Christ Medical Center in Oak Lawn — the nation's fourth-busiest trauma center — helped prepare him.
"As an ER doctor, you go back to the basics," he said. "Not panic. Not go off course. That's what we're trained for — to stay calm."
In a short amount of time, Nathan was ready for transfer to the University of Chicago Medicine Comer Children's Hospital.
"We put the airway in, got fluids going," Hepker said. "The decision to transfer was made before he got to the ER. We have a lot of capabilities, but at the end of the day, he needs specialists."
Hepker said the teamwork to stabilize the boy and have him airlifted to Chicago was amazing. Only 47 minutes lapsed from the time Nathan was pulled from the dune until he was loaded in the helicopter.
"It was just an awesome effort," Hepker said.
Hepker remains close to the boy's family, getting daily updates on his condition.
Nathan remains in critical condition, receiving daily saltwater flushes on his lungs. Doctors hope that with rehabilitation, he can attend school in the fall and return to a normal life.