Wednesday, September 22, 1999 - Denver, Colorado - He waits for you. He sits in a small room above the Swedish Medical Center and waits for your life to take a tragic turn, which it will do, someday - all of ours will - and when yours does, you will want him there, waiting.

He is Sean Becher, a helicopter flight nurse, and he is the important link between medical care on the scene and in the hospital. As you lay in possibly the worst situation of your life - with great fear that it may be the last one - he will appear out of the sky, in a whirlwind of noise and dust, and he will treat you, and then he will fly away, with you by his side.

Swedish is in the Denver suburb of Littleton, but Air Life takes calls throughout metropolitan Denver. Becher will sometimes fly four or five times during a twelve-hour shift, and sometimes not at all. Some days are filled with nothing more than paperwork and pacing, with volunteering in the ICU, and watching afternoon TV, and some days are filled with blood.


"Never approach a helicopter that is powering up or down," says six-foot, two-inch Sean Becher. "And don't look down, or you'll probably run right into the ship."

I get instructions on helicopter safety before I can ride with the Air Life crew. They tell me how to walk, how to sit, how to stay out of the way, and how a helicopter can mess with your stomach like nothing else.

Pilot Dave Richter, who pulled two students from Columbine High School earlier this year, describes, simply, how a helicopter works; "It beats the air into submission," he says. It can only do that so much though, so if we get a heavy patient, I may be left at the scene. "We'll get you back here somehow," says chief flight nurse, Dale Gunnink.

Gear: Night vision goggles, cold-weather survival gear, and everybody gets a helmet -- something the commercial airlines don't offer.

Medical: Monitors for EKG, blood pressure, respiration, pulse, and percentage of oxygen and CO2 in the blood. A defribrillator, intubators, I.V. equipment and "scene bags" filled with first aid supplies are checked at the start of each shift. "We have more equipment and capabilities than in many small hospitals' emergency rooms," Becher says.

The ship sits on one of two rooftop pads. Safety fences lay horizontal, like trampoline nets, and a lighting system is controlled by radio. A ramp leads to the service elevator and a stairwell with two doors, both locked on the insides, to keep people off the rooftop.

Downstairs are offices for nurses, pilots and administrators, a break room, sleeping quarters, showers, laundry and lockers. Air Life has a second helicopter (in Aurora) a ground ambulance, and two jets for long-distance transfers.

Some days are busy around here, and some days, like today, are not. We wait, and we get five calls, but none of them are a "go." So, we wait all day. Becher, Utterson and Richter get some paperwork done, but they may as well have stayed home today. It's days like this that you contemplate the high cost of health care, but it's days like the one in which Sean Becher rescued eight people, that you don't care at all.

When your life takes that tragic turn. When, in a mere second or so, your body meets an awesome foe, and you are reduced to a collection of maligned organs and bones, fluids and flesh, he will be waiting. His pager will sound, and he will walk to the rooftop, where a pilot will ready the helicopter (the "ship") and they will wait. Do you really need him? Paramedics are working that out, and they will page him again, to either tell him to stand down, or take off.

If you do really need him, he and a second nurse will pile into the ship, put their helmets on and strap themselves in, while the pilot gets the rotor turning. They will take off and head your way, the Bell 407 streaming along at up to 165 mph, cheating all the way; ignoring stop lights and traffic jams.

The ship will land, usually on a road the police have blockaded for it, but sometimes in a pasture, a yard or on a mountain. Perhaps the paramedics have successfully treated you, and all Becher needs to do is get you into a sterile room quickly. But likely, you had been too great a challenge for them.

Your body is merely a machine that supports your brain, with blood enriched with oxygen, and when you die, it will be because your body failed that support. At this time, everything else - broken bones, crushed organs - is secondary; you need juice to your bean.

You have two pumps; one for air and one for blood, and when either one of these fails - either one - you are in serious trouble. When your heart fails, paramedics can use a defibrillator to start it again, or CPR, which they can also use to keep it pumping. Your lungs may be crushed, obstructed or impaled, and not responsive to air provided by a manual bag, or oxygen through a mask. So, Becher will put a tube down your throat and into your lungs, and you will fight him, of course, and for your own good, he will sedate you.

From a pocket on his lower leg, he will pull a small case, containing sedatives, paralytics and narcotics. He will break the security seal, and remove a vial, from which he will take a drug that will knock you out.

Flight nurses Sean Becher and Chad Utterson, and pilot Dan Ritcher

Now you are a sack of organs, whose life he can sustain without your involuntary repulsion. He will take a stainless steel intubator, which is like a long, thin shoe horn with a flashlight, and slide it far down your throat. This guides a tube which brings oxygen to your lungs and brain. "We have standing orders to do many procedures which EMTs are not trained for," Becher says. "Basically, we're emergency physicians." If he has to cut an airway to get the tube in you, he will. He can perform a crycothyrotmy and advanced heart attack procedures, he can put central lines in your major vessels and insert a drainage tube into your chest.

Approaching the hospital, Becher contacts the emergency room and briefs them on your condition. The ship hits the pad and you are met by a nurse, a respiratory therapist, and an E.R. technician, who wheel you down the ramp to the elevator, which a security guard is holding for you. If necessary, Becher will stay with you, continuing treatment in the emergency room, but likely, he will put you in the capable hands of the Swedish staff, and return to his ship to prepare for another flight.

Sean Becher studied for four years to get his nursing degree, and worked for five years in intensive care units and emergency rooms before he could take some sixty hours of specialized classes (which he repeats every other year) to become a flight nurse. He loves being able to help people like this; being in charge of a situation and having the most advanced tools and skills possible. "I enjoy the autonomy up there," he says. He also enjoys the confidence he has in his ability, as he is constantly training, and constantly using and honing his skills. He enjoys the job in spite of the constant risk of flying in a craft that does not want to fly. Helicopters are beautiful, incredible machines, but they defy gravity only through aggression, and that makes for a constant struggle with fate. Two years ago, an Air Life helicopter hit a wire and crashed, and no one could save the pilot, two nurses and patient.

27-year old Becher worked in California and Tennessee, and moved out here, he says, because of the mountains. He enjoys their backdrop to his everyday life, he enjoys hiking on them, and he enjoys watching them float below him as he flies to a rescue among them, their golden aspens and white snowcaps painting a scene of seductive solitude.

It could have been Becher's mother, a nurse, who inspired him to this career, but he gives credit to the television program "911." "I watched that show, and I just knew I would somehow be in emergency care," he says. He was also attracted to the excitement of flight. "I could never do an office job," he says.

Sean Becher spends his life in preparation; studying, maintaining equipment, filing reports, and waiting - waiting for your turn. But it is all worth it, he says, every time he pulls a living, breathing patient out of that ship. Flight nurse Deb Hurlbut boils it all down to two words. "It's magic," she says. "I swear, every time I lift off, I think that."

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