Watch video Oregon Health & Science University Telemedicine Network. In the last few years, all Portland’s major hospital systems have developed such networks, giving doctors at smaller or rural hospitals access to specialists clustered in the city. Using audio, video and computer technology, telemedicine consultations are the next best thing, doctors say, to having a specialist in the same room. Problem was, the emergency physicians in Astoria that evening weren’t familiar with the technology. Maskell consulted the old-fashioned way, calling Jennifer Needle, an OHSU pediatric critical care specialist. She described MaLea’s symptoms and discussed inserting a breathing tube. Meanwhile, McPherson headed toward the hospital. Trained in telemedicine, she’d been waiting for her first opportunity to use it. She rolled a cart loaded with audio- and camera-equipped computers into MaLea’s room and fired up the gear. Needle’s face appeared on a screen. From a computer station at OHSU’s Doernbecher Children’s Hospital, Needle aimed a camera at MaLea and zoomed in. In the 30 to 45 minutes since she’d consulted by phone, the baby’s rash had spread and she labored to breathe. “I had a gut intuition,” Needle says. “This kid’s gonna get really sick before she gets better … I knew that they had to fly.” ***A Life Flight helicopter touched down in Columbia Memorial’s parking lot around 8 p.m. Graber and the Life Flight crew tending MaLea climbed aboard. Sedated, MaLea lay quiet. An intraosseous line, used in emergencies, snaked into a bone below her knee, delivering medicine directly to the marrow. A ventilator helped her breathe. The helicopter lifted off and Graber figured they’d be in Portland in 45 minutes. Twenty minutes later, the chopper made a U-turn. Weather had worsened and they had to land. Graber’s heart sank. MaLea, her mom and those working to save the girl with slate blue eyes and dark, flyaway hair landed back at Columbia Memorial. Vomiting, MaLea had displacing her breathing tube and it had to be replaced before heading, again, for Portland. By the time an ambulance delivered them to Warrenton-Astoria Regional Airport to board a fixed-wing plane, which could handle the weather, darkness had fallen. MaLea’s blood-pressure was deteriorating. Every moment mattered. Needle was in the middle of her shift when the girl arrived at OHSU between 12:30 and 1 a.m. The splotchy rash she saw via Webcam had turned solid. MaLea was purple from head to toe. ***At OHSU, Graber found worried friends and family, including MaLea’s father, Luke Fox of Albany. She settled in to wait. When Needle talked to the family, she didn’t sugarcoat the message: “She didn’t think MaLea was gonna make it through the night,” Graber says. “I kind of already knew that but nobody had said those words.” Around 4 a.m., blood work indicated antibiotics and other medicines were working. So were MaLea’s kidneys. Her blood pressure improved. And as the sedatives wore off, she opened her eyes.
MaLea Fox turned 8 months old and got her first tooth during her weeks at Doernbecher Children’s Hospital.*** One day this week, Graber leaned over MaLea’s crib at Doernbecher and stroked her daughter’s head. Surrounded by stuffed animals and with a pacifier planted in her mouth, MaLea glanced toward her mother and batted her long, lush eyelashes. A pink afghan covered her tiny legs and bandages wrapped her forearms. Her most severe wounds are in her buttocks and right arm. In the month since Neisseria meningitidis bacteria, which causes the blood infection meningococcemia, turned their world upside down, MaLea has endured regular surgeries to remove damaged skin and to clean wounds. She faces skin-graft surgeries. Doctors aren’t sure whether she’ll require amputations, a frequent repercussion of the infection. She suffered no neurological damage. Graber sleeps in her daughter’s hospital room, reading to her and admiring the baby’s first tooth, which appeared about a week into her stay. MaLea’s smile returned last week. Graber expects to spend at least another month at OHSU before MaLea transfers to The Children’s Hospital at Legacy Emanuel, for rehabilitation. She never took her girls for granted, she says. But watching one fight for her life changed the young mother’s perspective . “I can’t look at them the same way,” she says, one hand on MaLea. “She’s my little hero.”
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