Patient Care, Rescue & Vehicle Extrication

Air Force Pararescue Team Saves Sick Baby 1,000 Miles Out at Sea

Issue 3 and Volume 42.

As the MC-130 Combat Shadow airplane flew over the distressed sailboat adrift in the middle of the Pacific Ocean, the aircrew dropped a series of smoke flares and four U.S. Air Force Pararescuemen readied themselves to jump.

As members of the world’s most specialized combat and civilian search and rescue team, the men had performed dozens of missions around the world, but this rescue was different. The voice on the radio wanting help hadn’t changed multiple times as it often did in war—meaning the caller had been tragically killed or injured—nor were pararescuemen (PJs) being inserted from a helo on a hoist line while taking fire; there weren’t any injured soldiers on the ground needing tourniquets, chest decompressions to relieve a tension pneumothorax or ketamine for the pain, but, despite this, the pucker factor on this mission was real and rising.

There was a critically ill baby girl on a crippled sailboat a thousand miles off the coast of Cabo San Lucas, Mexico. The weather was awful and seas were a mess. The last the team had heard was that Rebel Heart, the 36-foot sailboat on which the Kaufman family was sailing, was taking on water, and that Lyra, their youngest, had been ill for days with nausea, vomiting, and a fever, and was now growing lethargic and pale. The PJs didn’t need their paramedic school textbook to know this was a life-or-death emergency and all of their training and experience was about to be tested.

After dropping the smoke flares, the C-130 banked low on the horizon, turned and flew another pass to insert the team. With ocean rescues in unruly seas, it wasn’t uncommon to spot a boat or person once, only to have them disappear from sight forever among the rolling waves before rescuers could reach them. However, thanks to the aircrew dropping the flares near the boat and perpendicular to the wind line, they’d not only narrowed the last known location of the sailboat to a few dozen yards, they’d also inserted a smoky grid onto what was once a blank-slate, amorphous ocean.

“Sixty seconds,” hollered Seth to the PJs behind him.

Seth, a PJ with years of experience, was acting as a jumpmaster for this mission. His job was to prep all the gear prior to departure and safely manage the team out of the plane and into the mission site. This left the guys performing the mission to focus entirely on the task at hand: saving lives.

Thus began what PJs term the “mad minute” that precludes any parachuting mission to rescue personnel.

The Combat Rescue Officer, responsible for organizing and strategizing this recovery, confirmed that all the objectives were in place for this mission: right safety precautions, right personnel, right location, right resources, and right objective—save a baby.

Klay, the team leader, glanced at the inflatable Zodiac boat with an outboard motor and the resupply bundle filled with medical supplies, food and water. The Zodiac would be pushed out of the plane first. Next the PJs would parachute into the ocean and then, once they’d inflated the zodiac and were safely aboard, the aircrew would drop the resupply bundle for them to retrieve.

Tech Sergeant Nathan Schmidt, one of the PJs tasked with patient care for this mission, quickly reviewed pediatric medications and dosages while Miles, on his first jump mission as a PJ, reminded himself of the steps to parachute safely out of a plane—jump at two-second intervals, with arms out, feet up, and eyes on the horizon.

Although the PJs were well-trained in high-altitude, low opening (HALO) parachute jumps, Seth had ordered a static (square) jump that evening, due to the low cloud ceiling, low altitude they were jumping at, and the approaching darkness.

As they flew over the appointed spot, Seth pushed the canisters and the Zodiac off the cargo ramp and the Combat Rescue Officer, Klay, Nathan and Miles jumped in rapid succession, their parachutes blossoming in the air like silk, grey flowers. As the men floated down, the roar of the plane receded and for them there was just a quiet peace and the endless ocean, a calm, meditative moment, squeezed between the noise of the plane they’d just left and the chaos of the mission they were about to undertake.

As the team splashed into the churning ocean, transitioning from air to sea, a whole set of objectives and tasks presented themselves—swim out from under the parachute that could pull you under; make radio comms with the plane, and derig the Zodiac, inflate it and climb in. However, when they inflated the boat, it was upside down and the men struggled to right it.

“Push harder,” Klay yelled, as waves slammed the group, darkness fell, and aboard the Rebel Heart, little Lyra’s condition worsened.

A Family Affair

Both as people and parents, Eric and Charlotte Kaufman believed in the life-affirming importance of family, travel and adventure. This holy trinity of life and love crystallized in the sport of sailing where they could spend quality time as a family, experience new places, meet new people and explore cultures. The Kaufmans “collect memories, not material” mindset lead them to save money and buy the sailboat in 2005—which they named Rebel Heart—and they spent years planning and preparing for a sailing trip around the world with their daughters, Cora (3) and Lyra (1).

To those who don’t boat, the prospect of sailing with a family across the ocean can seem unnecessarily rare and risky but, within the sailing community, it’s quite common and is routinely a very safe endeavor. Eric and Charlotte Kaufman were well-prepared for their trip. Eric had earned his Coast Guard Boat Captain’s License and piloted commercial vessels. They’d lived on Rebel Heart for the last seven years and spent thousands of days sailing, including the last two years exploring Mexico’s Pacific Coast, Sea of Cortez and Baja peninsula.


Seth performs a last-minute gear adjustment for Tech Sergeant
Nathan Schmidt prior to parachuting into the Pacific Ocean.
Photo courtesy 129th Rescue Wing

The Kaufmans planned to sail 3,000 miles to the Marquesas Islands, a volcanic string of islands clustered in the South Pacific, and eventually make their way to New Zealand. When they departed La Cruz, Mexico, a tiny fishing village near Puerto Vallarta on March 20, 2014, the waters were calm but, as they entered the Inter Tropical Convergence Zone two weeks later—an infamous spot near the equator where Northern and Southern trade winds converge—the weather turned. A dangerous combination of rain, wind and waves tore solar panels off Rebel Heart and cracked the hull (the water tight body of a boat) deck joint, causing leaks. Eric estimated the boat was taking on 60–70 gallons of water a day, an amount easily disposed of by hand or bilge pump, but the water had also infiltrated his battery compartment and the electronics were beginning to fail.

Making matters worse, Lyra was sick. She’d had salmonella before their trip but the Kaufmans had delayed their departure until she was feeling better and cleared to travel by her pediatrician in Mexico. Lyra was healthy and happy during the first 10 days of the trip, cooing and playing with her big sister Cora, but then she’d come down with a fever, poor appetite and a rash that wasn’t responding to the antibiotics that Charlotte and Eric administered.

With Lyra’s worsening condition, Eric contacted the Coast Guard for a medical consult but, before they could respond, the Kaufman’s satellite phone began saying, “SIM card error … SIM card error.”

Unbeknownst to the Kaufmans, their satellite phone company had mailed new SIM cards to all their subscribers and deactivated the old SIM cards. Since the Kaufmans were at sea, they neither received their new SIM card, nor were they alerted that their current phone would be deactivated. With radio communications down and satellite phone inoperable, the Kaufmans had one final option—their emergency position indicating radio beacon (EPIRB).

Fearing for the well-being of his daughter and family, Eric strapped the EPIRB—which relays your position quickly and accurately to a worldwide network of search and rescue
satellites—to the deck of Rebel Heart in full view of the sky. If he pushed the “help” button, it would mean the end of their trip and possibly his family becoming homeless. Eric knew that when help arrived, there was a good chance that they’d have to sink Rebel Heart because an unmanned boat in the open ocean is a navigational hazard. It was a process known as scuttling and was every captain’s worst nightmare. However, Eric also knew that pushing the help button would mean saving his daughter’s life.

Without a second thought, he broke the seal and pushed the button. As he did, four LED strobe lights suddenly began flashing and broadcasting their extraterrestrial glow out to a stormy sea.


Three-year-old Cora Kaufman rides on the back of her
“big teddy bear,” Tech Sergeant Schmidt, as pararescuers
transfer her from her family’s sailboat to an
inflatable boat. Photo courtesy Eric Kaufman

Swift, Silent & Specialized

When the Kaufmans activated their EPIRB the morning of April 3, 2014, they summoned the most elite search and rescue team in the world. Rescuing people at sea usually fell upon the broad and capable shoulders of the U.S. Coast Guard. However, for this mission, the Coast Guard didn’t have aircraft resources that could range so far out to sea. This Rebel Heart rescue required a team that could deploy rapidly, perform a long-range mission, refuel if needed, and had medically-trained operators that could administer ALS interventions, and work effectively in air, land and sea environments. This left the Coast Guard with one option—pararescue.

Pararescuemen are U.S. Air Force special operators responsible for the recovery and medical treatment of personnel in combat and humanitarian environments. Like Navy SEALs, PJs undergo some of the most rigorous training in the U.S. military. However, with the proliferation of books, movies and television shows about Navy SEALs, PJs have stayed relatively quiet in the media, upholding their oath of being silent professionals. This reticence has helped the PJs maintain focus and team cohesion, but it has also hurt recruitment: many people don’t apply to become a PJ because they don’t know they exist.

The pararescue indoctrination class, held at Lackland Air Force Base in Texas, has an 80% attrition rate. Following “Indoc,” PJs attend a series of separate schools, such as combat dive school, Army airborne school, military freefall parachuting, SERE (survival, evasion, resistance and escape) and become nationally registered paramedics. Once a PJ graduates from the “pipeline,” they’re assigned to active duty or a reserve team, or they have the option to work for one of four Air National Guard teams in New York, Alaska, Kentucky or California that have pararescue programs.

The 129th Rescue Wing, part of the 131st Rescue Squadron of the California Air National Guard, is unique because, along with performing the federal mission of combat search and rescues around the world, they also support the state of California with emergencies ranging from wildfires, flooding, earthquakes and lost hikers.

The 129th Rescue Wing, based at Moffet Airfield in Silicon Valley, had three specific strengths that made it the perfect agency for the Rebel Heart mission: the MC-130 Combat Shadow, which could operate in low visibility, perform long-range missions and handle single or multi-ship refueling; an HH-60 Pave Hawk helicopter, versatile for both day and night ops; and lastly, the 129th had the “Guardian Angel” PJs who had “anytime-
anywhere” lifesaving expertise.

Within hours of the Coast Guard calling the 129th Rescue Wing, the pararescue team had flown 2,500 miles from their base at Moffett Airfield, entered Mexico’s airspace, and located Rebel Heart, a tiny blip, bobbing in agitated seas.


A Combat Rescue Officer of the U.S. Air Force 129th Air Rescue
Wing holds 1-year-old Lyra Kaufman during her rescue.
Photo courtesy Eric Kaufman

Courage & Compassion

Summoning all their strength, the PJs righted the Zodiac boat that evening and sped to the Rebel Heart to find Eric Kaufman on deck waiting for them.

“Lyra is downstairs,” he said, pointing nervously.

Miles and Nathan grabbed their cardiac monitor, pediatric advanced life support kit and airway/breathing bag and hurried downstairs. Below deck, they found Cora and Charlotte holding Lyra, who appeared pale and lethargic.

The PJs set down their gear and immediately went to work. As Nathan began taking a set of vital signs and checking Lyra’s capillary refill time, Miles tried to assess her mental status.

“Hey Lyra,” he said, checking to see if her eyes were tracking him, “Lyra, like the young girl from The Golden Compass!”

Lyra’s gaze didn’t track him, but Charlotte and Cora’s eyes lit up. Lyra had, in fact, been named after the character in Philip Pullman’s beloved fantasy-adventure story and the book was a Kaufman family favorite.

Cora, in particular, was fascinated with the PJs. In her young eyes,
they were superheroes who’d just fallen from the sky, knew her favorite book and were now saving the life of her little sister.

When Miles and Nathan finished their assessment, they quickly discussed their findings and then contacted their medical control with a proposed treatment plan—continue to monitor Lyra’s airway, breathing and circulation; administer fluid for her low blood pressure and delayed capillary refill; increase the dose of her antibiotics and keep her fever down. The team would monitor Lyra for the next 12 hours and then decide whether to evacuate her on the Pave Hawk helicopter, which the 129th Rescue Wing had staged in Cabo San Lucas, or transfer her to the USS Vandegrift, a Navy warship that was two and a half days away but sailing toward them.

With the turbulent sea and Rebel Heart listing in the waves, both Miles and Nathan quickly became seasick. They had medication for the seasickness but the pills also made them drowsy. “That others may live” was the motto that all PJs lived by and to them, it meant sacrificing their needs and comforts—and, perhaps their lives—in the service of others.

If Miles and Nathan took the medication for seasickness and became drowsy, they knew they possibly might make an error computing Lyra’s medication dose or miss a subtle shift in her mental status, which could compromise her care. So they withheld medication for themselves in order to be 100% mentally present for Lyra, pushing through the discomfort while passing the puke bucket back and forth.


Tech Seargant Smith and a Combat Rescue Officer help transport
the Kaufman family to the USS Vandegrift. Photo courtesy U.S. Navy

As Miles and Nathan tended to Lyra, Klay and the Combat Rescue Officer helped Eric with the boat, pumping out water, along with assessing and treating the cracks in the hull as if she was a patient.

Miles says he and Nathan based their treatment of Lyra upon five key pillars of treating a pediatric patient: “Always start with very thorough patient assessment because that is your foundation of your care. Pay special attention to the parents who have an intuitive sense of what’s normal and what’s not for their children. Take vitals often so you can see where your patient is trending. Don’t forget that kids compensate well then can drop off quickly, and don’t be afraid to form a bond with your patient or the family.”

Putting these theories into practice, within hours of the team arriving and administering care, Lyra’s condition improved and it was decided to evacuate the Kaufmans onto the USS Vandegrift, rather than perform a risky hoist rescue on a helicopter so far out at sea.

This evacuation plan, or exfil, meant that the PJs would now spend 2.5 days with the Kaufmans on Rebel Heart, a situation far different than their normal swoop-and-scoop rescues. The Rebel Heart, sized to fit two adults and two small children, had been packed to the gills with everything a family would need to sail 3,000 miles across the ocean, now housed six adults, two kids and all the PJs gear and food. To deal with the cramped quarters, the team quickly set a sleep and meal schedule for everyone onboard.

“While Lyra was doing better, we also recognized that Eric and Charlotte were still going through a lot and might have to lose their boat, which was their home,” explains Miles. “So we made sure to give them some alone time below deck to discuss the situation and we entertained the girls by reading to them, playing peek-a-boo, and telling jokes.”

Despite the differences in their age and size, Cora and Nathan—a hulking hairy guy—immediately developed a bond.

“You look like a bear!” Cora exclaimed when she spotted Nathan’s hairy forearms and legs.

The rest of the team howled with laughter. Nathan was known as Sasquatch around the locker room of the 131st Rescue Sqaudron and they loved that this little 3-year-old was now ribbing him for the same reason.

The compassion and care that Nathan and the others showed their children touched Eric and Charlotte. “He’s not dealing with a tough Marine that’s hurt in Afghanistan,” Eric later said of Nathan. “These are little kids that are scared. There’s not a lot of people that you feel comfortable handing your small children to, and this is somebody who for three days could sit there and listen to my kids’ jokes and could feign interest in all the things that they were interested in and could make them feel better and make them feel safe.”

With Lyra feeling better and the Rebel Heart stabilized, the PJs and the Kaufmans waited to intercept with the USS Vandegrift. Boarding the warship would require the Kaufmans and PJs to jump from the Rebel Heart onto a rigid hull inflatable boat (RHIB) in stormy seas, which would then be hoisted up to the Navy frigate. Despite the momentary calm, the most dangerous part of the mission still awaited.


Tech Sergeant Schmidt immortalized the rescue mission and
his special bond with Cora by getting a tattoo of a little girl
riding a bear, riding a seahorse. Photos courtesy
Ed Drew (left) and Eric Kaufman (right)

Exfil

The USS Vandegrift reached Rebel Heart early Sunday morning, April 6, and the team waited until sunrise to transfer them.

“The seas were rough,” recalls Klay, “even the USS Vandegrift, over 450-feet, was listing!”

Due to this danger of transferring the girls from the sailboat to the RHIB, it was decided that the PJs would carry Cora and Lyra in baby carriers on their backs as they made the perilous jump.

Charlotte handed Lyra to the Combat Rescue Officer, a father of three, whom she knew would take good care of her youngest and then jumped first. The Combat Rescue Officer and Lyra jumped second.

Naturally, Cora wanted to ride on the back of her big teddy bear, Nathan. Donning a baby carrier decorated with seahorses, Nathan put Cora on his back and then, timing the sway and surge of the two boats, jumped safely into the RHIB.

Then, with his family safely aboard the RHIB, Eric was informed by the Navy that he had to scuttle Rebel Heart. Eric nodded, then knelt down and opened the seacocks and cut the hoses. As water slowly filled the hull of Rebel Heart, Eric jumped onto the RHIB and they motored toward the USS Vandegrift.

Eric couldn’t bring himself to watch Rebel Heart sink beneath the surface so he focused on Cora, still riding in the seahorse carrier on Nathan’s back and singing above the roar of the waves.

“On the ride from Rebel Heart to the Vandegrift, Cora sang her lungs out,” Charlotte recalls, “It was a song about traveling on a bear, riding on a seahorse, on the ocean. It was a bizarrely beautiful moment in a tremendously stressful day.”

The PJs traveled with the Kaufmans back to San Diego on the USS Vandegrift where they went above and beyond the call of duty to also accompany the Kaufman’s to Lyra’s primary care doctor. With the Kaufmans safely home, the rescue was officially over but the Rebel Heart mission would remain special for everyone involved.

In May 2014, the team and other airmen from the 129th Rescue Wing were photographed with President Barack Obama, who stopped by Moffett Airfield to thank them for saving the Kaufmans and to congratulate the 129th Rescue Wing for saving a total of 1,007 people since its inception—the wing’s total is now 1,015 saved lives.

Since the rescue, the Kaufmans have stayed in touch with the PJs who came to their aid and say they will always be indebted to them. “They will remain seared in our hearts forever,” Charlotte says. “We will never ever forget them. What amazing men!”

Gone, But Not Forgotten

After the Rebel Heart mission, Tech Sergeant Schmidt immortalized the mission and his special bond with Cora by getting a tattoo of a little girl riding a bear, riding a seahorse. But just a few months later, on Oct. 11, 2015, he was tragically killed in an off-duty skydiving accident in Hollister, Calif. In the wake of Nathan’s death, his heroism, humor, generosity and kindness were remembered by not just those in the Air Force but by everyone who’d ever met him. “I just saw a really special person that truly cared about other people,” Eric Kaufman said.

He is greatly missed.