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Extreme Emergency Surgery: An Amputation Under a Train

By on 08/13/2015

It was the middle of a hot summer night when two Einstein physicians rushed to a scene out of a movie: a man under a train with his leg pinned between the track and the train wheels; firefighters, police and medics surrounding him; emergency floodlights illuminating the dark scene. While it may have been the most unorthodox operating room for Dr. Melissa Kohn and Dr. Megan Stobart-Gallagher, who crawled under the train to amputate the man’s foot, it wasn’t, as it turns out, the most dramatic emergency for either one.

Dr. Melissa Kohn

Dr. Melissa Kohn

Dr. Melissa Kohn was volunteering in the medical tent at the 2013 Boston Marathon when the backpack bombs exploded. The tent was near the finish line, where the bombs went off, and she ran outside to witness the bloody aftermath. She worked intensely as casualties were rushed into the tent: “I put on tourniquets, cleared airways, helped do triage.”  She also treated one of the victims who later died.  When things calmed down, Dr. Kohn returned home on Amtrak—in the same bloodied clothes she wore in the tent. “I didn’t have a change of clothes with me,” she said. “I did get stopped by the Amtrak dog because I smelled like explosives.”

Dr. Megan Stobart-Gallagher was working on May 12, when four injured Philadelphia police officers were rushed into the ER along with the suspect who’d struck them with a car, and was himself shot and critically wounded.

Dr. Megan Stobart-Gallagher

Dr. Megan Stobart-Gallagher

“I tended to the most critical one, then I ran into the corridor and saw Mayor Nutter and Police Commissioner (Charles) Ramsey.” And that, she thought, was enough drama for the day. It was a Monday, the busiest day of the week in the emergency department to begin with, filled with patients who waited until the weekend was over to get medical help. And just as Dr. Stobart-Gallagher’s shift was winding down, word came that casualties were on their way from the Amtrak train derailment which killed eight people and injured numerous others. She worked 16 hours straight.

The two doctors who received so much media attention for performing the train track amputation don’t think they did anything heroic or altogether different from what they do every day. “It all felt very surreal, like out of a movie scene, when I first got there,” Dr. Stobart- Gallagher said. “But once I saw the patient, it was just time to go to work. I feel like I did what I was trained to do. With the type of various trauma we see at Einstein every day, it didn’t seem that dramatic.”

“That’s our job day in and day out: to save lives.”

It’s true that she never “got to climb under a train before,” Dr. Kohn said, recalling that the heat was overwhelming.  The weather was steamy and the heat under the train was suffocating.  Both women began sweating when they first went under to assess the patient, and were grateful for the water bottles and fans the Fire Department provided.

“We never had a situation like that before, either of us, but that’s part of what our training has prepared us for,” Dr. Kohn said. “You just knew what needed to be done. We were happy we had a skill set that was able to help the patient.

“That’s our job day in and day out: to save lives.”

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