New EMS Chopper Bears MED Prof’s Initials

N72EH.

That lettering on the tail of a new Sikorsky S-76 EMS helicopter may mean little to most people. But to Boston MedFlight pilot John Marden, the last two letters resonate, invoking the memory of Erwin Hirsch, a key figure in the origin of critical care transport in this region. A beloved trauma surgeon at Boston Medical Center and a professor at the School of Medicine, Hirsch died last year in a boating accident. He was 72 years old.

“Erwin was a pilot, too,” Marden says, standing beside the new chopper at Hanscom Air Force Base in Bedford, Mass. “He’d been a captain in the navy and was very in tune to the helicopter side of things. He was our buddy from the get-go. He supported this program 150 percent.”

Marden, who flew helicopter gunships during the Vietnam War, has been ferrying New England’s injured through the skies for 24 years. He joined Boston MedFlight soon after Hirsch helped launch it in 1985. It has since grown into a fleet of three helicopters, a jet, and three critical care ambulances, based out of Hanscom and Plymouth Airport, in Plymouth, Mass. Hirsch, a MedFlight board member, had been pushing for the new S-76, with its $11.5 million price tag, to replace an aging copter.

“It’s probably the most sophisticated EMS aircraft in New England,” says Charles Blathras, chief operations manager at Boston MedFlight. “It’s the only Sikorsky S-76 that is night-vision capable. It gives us options. We needed something that could carry a little more, a little bit farther, a little bit faster.”

The shiny gray and blue helicopter, which still has that new car smell, is a flying ICU and broadens Boston MedFlight’s ability to execute specialty missions, such as isolette transport, intraortic balloon pump, and trips that require extra equipment and personnel. Two patients, with a nurse and a paramedic, can be flown about 400 miles nonstop. The airborne suite also includes a blood pressure monitor, a defibrillator, a pacemaker management system, and a pharmacy equivalent to that of an emergency room. The interior light is tinged green so as not to interfere with the pilot’s night-vision goggles, which magnify light up to 6,000 times.

Terrain awareness technologies and greater automation enhance safety, but for helicopters, which cannot rise above the weather like jets, the mood of the skies is a crucial factor that can’t be avoided. As Blathras speaks, clouds grow thick and a drizzle peppers the runway. Several medical requests have come in, but thunderstorms are developing to the west. The ocean, mountains, even cranberry bogs can contribute to sudden weather changes.

“John can smell fog,” Blathras says. “And the old cliché is true: if you don’t like the weather in New England, just wait a minute.”

The S-76 is pushed into the hangar, where a maintenance crew is working on another helicopter. The Plymouth chopper already is in the air, heading to Beth Israel Deaconess Medical Center. The jet, which sees most of its action on the Cape and islands, remains still. Altogether, some 1,800 helicopter missions are flown each year, Blathras says, and it’s always the pilot’s call whether to go up — a decision made without knowing detailed patient information in advance.

“People aren’t thinking clearly when you tell them there’s a kid involved,” Blathras says. “That’s the only piece of information we don’t pass along until the pilot’s made a decision.”

Marden once unwittingly picked up a cousin who had sawed off his fingers. Another pilot learned after landing that the patient he had just whisked to an emergency room was his sister, who had suffered a heart attack.

With 29 deaths nationwide from accidents or crashes related to helicopter emergency medical services, Blathras says, 2008 marked the industry’s worst year. “Very few accidents are mechanical in nature. Most are the human factor — someone made the wrong decision or someone should have spoken up. If you have a significant accident in this industry, it’s really hard to recover as a program. The community’s confidence and trust in you is gone.”

After flying countless combat missions, Marden is not fazed by adrenaline-fueled flights where lives and limbs are at stake. He’s responded to as many as seven calls in one day and has landed on highways, ball fields, and backyards.

“Two days ago, we picked up a motorcycle accident victim, 22 years old, his leg held on by slivers, nothing left,” he says. “I don’t think they saved it. I landed on a garage rooftop in Salem. He had a head injury. Usually motorcycles don’t fare well. But at least you give them a chance.”

The independent nonprofit Boston MedFlight transports patients regardless of income and is financially supported by a consortium of Boston hospitals, including Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital, Children’s Hospital, Massachusetts General Hospital, and Tufts Medical Center.

“Boston MedFlight does phenomenal work,” BMC CEO Elaine Ullian said at a recent event to show off the new Sikorsky. “We wouldn’t expect anything less than that with our own Dr. Hirsch having a hand in its founding. There is no greater tribute to Dr. Hirsch than having his initials on this gorgeous, advanced, sophisticated helicopter devoted to critical care transport.”

Marden says he misses Hirsch’s intensity “about making sure we were getting everything we needed and that we were doing it the right way. He knew his stuff. He was hard on his people, demanded a lot. He pushed for perfection.”

Marden recalls Hirsch studying thick helicopter manuals for hours and then quizzing him while they flew.

“N72 Echo Hotel — it’s a nice number,” Marden says, glancing at the helicopter’s tail. “Every time I fly, he’s going to be riding with me.”

Caleb Daniloff can be reached at cdanilof@bu.edu.