"There was a very good chance he could have been an organ donor," Dr. Andrew Sumner says of 4-year-old Quantae Johnson, the "Little Miracle Man" who survived a bullet in the head.
"This is a very lucky kid," says Sumner, an emergency room physician at Johns Hopkins Hospital.
Lucky because the bullet from a teen-ager's gun dodged critical areas of the brain.
L Lucky because he was shot just two blocks from the hospital.
Lucky because it wasn't Quantae Johnson's time to die.
"What saved him?" Sumner muses.
Hospital personnel played supporting roles in an extraordinary drama in which the right things happened and split-second decisions were made in the space of a crucial 90 minutes.
Neither the bullet nor its fragments did massive damage, and the slug itself came to rest at the back of the skull.
Yesterday, surgeons at Hopkins removed the bullet from Quantae's head, 10 days after the East Baltimore child was struck by errant gunfire.
Dr. Benjamin Carson, director of pediatric neurosurgeryextracted the large-caliber slug in an anticlimactic postscript to the remarkable recovery of the boy the hospital staff calls the Little Miracle Man.
Quantae, who is in stable condition today, is expected to be hospitalized two more weeks.
"Quantae's prognosis is excellent, and he is expected to recover and develop like a normal 4-year-old," says Carson.
The child was shot at 11:15 p.m. on Saturday, Sept. 7, while standing in the dining room of his grandmother's house in the 600 block of N. Castle St.
The bullet, which passed through an open window, apparently was meant for a 17-year-old next door, whose argument with another neighborhood teen earlier in the day precipitated the shooting.
Censeria Skipper, a friend of the family, heard gunfire that night as she happened to drive by.
"Part of me said, 'Get the hell out of here,' " recalls Skipper. "But then I saw people running from the house."
Skipper stopped her car at curbside, motor running, just as a woman rushed outside cradling a child in her arms.
DASH TO HOSPITAL
"Oh my God, my baby's been shot!" cried Diane Pittman, the grandmother. She climbed into the car, which streaked toward the hospital.
"I drove like a bat out of hell," says Skipper.
She knew the emergency room entrance. Skipper, a nursing student at Community College of Baltimore, works at Hopkins hospital as a clerk in the neurology department, where head injuries are treated.
En route to the hospital, Skipper tried to calm the grandmother, assess the child's breathing and keep him awake.
"Quantae, Quantae, can you hear me?" she shouted.
"Yes," he said.
Skipper raced ahead in her blood-splattered Pontiac, ignoring two red lights and thinking: God put me here to save his life.
She reached the hospital in less than two minutes.
"We need help!" Skipper cried.
A departing ambulance stopped, and a paramedic carried Quantae down a 50-foot corridor and into the Pediatric Trauma Room, bypassing the walk-in entrance and triage areas.
The child arrived so quickly that emergency room personnel were momentarily unaware of his presence. An X-ray technician saw Quantae and the paramedic in the hall and alerted the staff.
Nurse Donna Carroll rushed to meet the wounded child in the critical-care room.
It was 11.20 p.m., barely five minutes after the shooting.
EMERGENCY ROOM CARE
Carroll placed Quantae on the table, observed his shallow breathing, grabbed an ambu bag -- a device that helps patients in respiratory distress -- and began to ventilate him. She noted the small bullet hole in his forehead, and the ridge of tissue around it. Though the wound was no longer bleeding, Carroll feared the worst.
"Most kids with a bullet to the brain don't make it," she says. "A child shouldn't have these problems."
It had been a typically hectic night in the Hopkins ER: a pedestrian hit by a car, a near-drowning victim and a cardiac-arrest case, among others.
Sumner, the attending physician, was in the adjacent critical-care room when Quantae arrived. The child's eyes were closed and his respiration was sluggish -- about six times a minute, one-third the normal rate.
"In my mind he was ready for cardiac arrest," the doctor says.
Sumner was preparing to insert an endotracheal tube into the child's mouth, to aid his breathing, when a pediatric trauma team from the Hopkins Children's Center hurried into the room to assist.
Dr. Rob Greenberg, a pediatrician-anesthesiologist, and Karen Crothers, a pediatric nurse, had rushed downstairs from the Pediatric Intensive Care Unit. Running time: two minutes.
Quantae, now semi-conscious, was whimpering and struggling against the placement of the one-foot, curved air tube down his windpipe. Crothers took his blood pressure and found it stable, and Greenberg anesthetized the child so the air tube could be inserted more easily.
THE NEED TO BREATHE