by Bill Case
WVU Alumni Magazine
Summer 2006 Issue
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| Sago Survivor Randal McCloy Jr., Center, with two of his WVU doctors: Julian Bailes M.D., chair of the Department of Neurosurgery in the School of Medicine, and Larry Roberts, M.D., director of the Jon Michael Moore Trauma Center. |
The Sago Mine explosion on January 2, 2006, focused the world’s attention on a tiny West Virginia community for a few days early this year. Thirteen miners were trapped deep underground; rescuers were delayed for hours by dangerous gases that filled the mine after the blast. As the hours passed, hundreds of friends, family members, public officials, and reporters gathered on the surface.
When rescuers reached the miners, all but one were dead. Many of the victims survived for long hours after the accident and wrote heartfelt notes to their wives, families and children before succumbing to the gas.
The sole survivor, Randal McCloy, was treated at WVU Hospitals for three weeks, and then spent another month in HealthSouth MountainView Rehabilitation Hospital on the WVU campus. He’s currently recovering at home with his family and participating in an ongoing outpatient rehab program.
It was 3 a.m. on January 4 when an ambulance carrying injured miner Randal McCloy pulled up to the Emergency Department at WVU’s Ruby Memorial Hospital. Larry Roberts, M.D., director of the Jon Michael Moore Trauma Center, was waiting.
“We were placed on alert earlier in the evening for up to a dozen patients,” he said later. Like millions around the world, Dr. Roberts and his trauma team had heard the false reports on television that all the Sago miners survived the accident. They put well-prepared emergency plans into effect, and were ready. But shortly before McCloy arrived at WVU, the awful truth was known — he was the only survivor of the 13 men who had been trapped deep underground in air poisoned by carbon monoxide for more than 40 hours.
McCloy was barely alive when rescuers reached him. “He was dehydrated, had a collapsed lung, and was suffering the results of oxygen deprivation to his brain and hours of immobility of his muscles,” Roberts said. “It was the heroic action of the mine rescue teams that made the difference between life and death.”
The rescuers carried him hundreds of yards to a medical team — still more than a mile underground — which had been established to provide first aid to survivors. Then he was transported to the surface on a mining vehicle, transferred to an ambulance, and driven to St. Joseph’s Hospital in Buckhannon.
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| Occupational therapist Amanda Acord, ’02, left, and physical therapist Tracy Rice, ’98, challenge Randy during a session at MountainView. |
There, emergency doctors stabilized him and prepared him for transport to WVU, inserting a breathing tube and administering sedatives. Upon arrival at WVU, he was unconscious, but already beginning to improve.
“The carbon monoxide was already nearly gone from his bloodstream by the time he arrived here,” Roberts said. “But his other injuries were our primary concern. We had to reinflate his lung and treat the damage to his heart, kidneys, and liver before we could assess if the oxygen deprivation had resulted in any brain injury.”
McCloy was placed on dialysis while a team of doctors tried to coax his vital organs back to work.
For nearly 36 hours, his life hung in the balance. Fortunately for him, WVU has developed a team of trauma professionals whose expertise crosses every area of medicine.
“When people hear the words ‘trauma center’ they think it is just another name for an emergency department,” Roberts said. “In fact, a trauma center doesn’t have a physical location — it’s people. The emergency department is where patients enter the hospital, but trauma care starts at the scene of an accident and continues until a patient is discharged from rehabilitation, sometimes months or years later.”
WVU’s Jon Michael Moore Trauma Center was established in the 1980s with assistance from U.S. Senator Robert C. Byrd, and named in memory of the senator’s grandson, who died in an automobile accident. It includes dozens of physicians — and well over a hundred specialized nurses and other professionals scattered throughout West Virginia University Hospitals.
Over the course of his first few days in the hospital, McCloy made tremendous progress as his organs, one by one, began to respond to treatment. Dozens of experts participated in the diagnosis and treatment.
One was Julian Bailes, M.D., a neurosurgeon who has treated hundreds of patients with traumatic brain injuries. In McCloy’s case, however, what Dr. Bailes was concerned about was not a physical injury, but the effects on thousands of brain cells that were starved of oxygen in the hours following the explosion.
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| Sago Survivor Randal McCloy Jr. |
“Randy’s brain scans showed that he had considerable damage to the white matter of the brain — the system that allows one part of the brain to exchange signals with another. But what was encouraging was that the gray matter — the part of the brain that actually holds memories and develops thought — appeared to be relatively undamaged.”
As Roberts’ team helped restore McCloy’s physical health, Bailes, working with other WVU doctors, began to develop a plan to protect his remaining brain function and, hopefully, restore his ability to think and act. Carbon monoxide poisoning experts across the country saw the story on television and called to offer advice and assistance.
WVU doctors and the outside experts agreed that McCloy needed a high-pressure oxygen treatment to purge any remaining carbon monoxide from his body. “We decided after 36 hours that he was stable enough for a hyperbaric oxygen treatment,” Bailes recalls. “But no chamber in West Virginia has the specialized equipment that can accommodate a comatose patient on a ventilator.”
McCloy was transferred to Allegheny General Hospital in Pittsburgh for three hyperbaric “dives,” then returned to WVU two days later for continuing care.
For nearly three more weeks, he remained in the WVU Hospitals Surgical Intensive Care Unit. There, he had the 24-hour-a-day care of a team of highly trained nurses — and regular care from a medical team that included medical intensivists, neurosurgeons, cardiologists, neurologists, kidney specialists, and pharmacists. He also began, slowly, a regimen of physical and occupational therapy.
Slowly, he began to emerge from his coma. His wife, Anna, who rarely left his bedside, was the first to notice the signs of returning awareness.
“The doctors did not believe me,” she says. “But I knew that Randy could hear me and was trying to answer.”
Soon it was obvious to all his doctors and nurses that his brain was starting to work. He looked toward people who spoke to him, tried to follow verbal commands, and swallowed food placed in his mouth.
“These are small things to most people, but very important for a person who has been in a coma for more than two weeks,” Bailes said.
Day by day, as his physical condition continued to improve, his mental abilities began to return. Nearly three weeks after the accident, he no longer needed kidney dialysis or a breathing tube, and Roberts released him from the hospital.
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| Exercise physiologist Erica Tuckwiller, '04, coaches Randal during water exercises at HealthSouth MountainView Regional Rehabilitation Hospital on the WVU campus. |
For another two months, McCloy was subjected to an ever-more difficult regimen of therapy at HealthSouth Mountain View Rehabilitation Hospital, just a few hundred yards away on the WVU campus. His primary physician there, rehabilitation specialist Russell Biundo, M.D., of the WVU School of Medicine, described his progress as nothing short of miraculous.
McCloy arrived at the rehab hospital unable to speak, unable to move without assistance, and unable to focus his eyes on people or objects.
“Everything came back a little at a time, but there was progress every day,” Dr. Biundo recalls. “When he tried to talk at first he just made sounds — he babbled. Then he began to express his needs — but he was very confused, and sometimes very angry. Finally he started to communicate, to smile, to laugh, and even made jokes — and then we knew we had Randy back.”
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| The McCloy family prepares to leave for home. With Randy are his wife, Anna, his brother-in-law, Rick McGee, and son, Randal McCloy III. |
A large team of nurses and therapists worked with him, some concentrating on physical tasks — like standing and walking — and others working on his abilities to understand, think, and communicate.
“They worked him day and night,” Biundo said. “He’s still weak on one side, and his vision is not back to normal. But he’s amazing. You have a person who was lying in bed, in a coma — and now he’s walking out. I have never seen this sort of progress in this short a time, and I work with brain injuries every day.”
On the day he left the rehab hospital, McCloy brought with him a new road sign, courtesy of West Virginia Governor Joe Manchin III: “Miracle Road” now leads the way to the McCloy’s Taylor County home.
A month after he returned home, McCloy could participate in conversations with family and friends, and his mobility and range of motion improved. He was attempting ever-more challenging tasks in therapy — climbing steps, performing increasingly complex manual functions, regaining his balance, and sharpening his reading, language, and comprehension.
“When Randy was rescued, everyone called it a miracle, but we weren’t sure of our miracle,” said Anna McCloy. “But thanks to our miracle team of doctors and the entire staff of West Virginia University Hospitals, this man is well enough to begin his road to recovery, and it is truly a miracle.”
“Everywhere we turned, we found WVU grads focused on Randy’s care and recovery,” Anna said. “From Governor and Mrs. Manchin, to our nurses and doctors and finally to Randy’s therapists, without WVU alums, I don’t know if the results would have been the same.”