A ground blizzard occurs when strong winds lift previously fallen snow, creating whiteout conditions even when no new snow is falling.
From the windows of the Historic Park Inn in Mason City, Iowa, it can look like ordinary blowing snow. On a snowmobile traveling 20 mph, however, the swirling snow can become a wall of white that limits visibility to just a few feet. Those were the conditions in northern Iowa in 1993, when Daniel J. Waters, DO, MA, FACS, was a cardiovascular surgeon in Mason City.
Dr. Waters arrived in northern Iowa after a winding path that began in New Jersey. His uncle, Rudolph C. Camishion, MD, was a surgeon who trained under John H. Gibbon Jr., MD, and later became chair of surgery at Cooper Hospital in Camden, New Jersey. Dr. Camishion’s connection to the early development of cardiopulmonary bypass made him an influential figure in his nephew’s life.
In Dr. Waters’ large Catholic Italian family, his uncle was both a heroic figure and an inspiration. Dr. Waters’ mother nurtured the idea that her son might become a physician. One of the books she routinely read to him as a child was Doctor Dan the Bandage Man, a Little Golden Book.
By high school, those seeds had sprouted, and Dr. Waters was determined to become a physician. At the time, however, New Jersey had no osteopathic medical school, and neighboring states largely favored in-state applicants.
Dr. Waters’ family was far from wealthy, so medical school seemed like an unattainable dream. Then a new osteopathic medical school opened in his home state. Although he was too young to join its inaugural class, he was accepted into the second class of 28 students.
Because the school was new, its students shared some laboratory experiences with allopathic medical students at Rutgers University. The experience reinforced Dr. Waters’ confidence that he could compete with peers pursuing an MD. He went on to complete an osteopathic general surgery residency in Des Moines, Iowa, including a pediatric surgery rotation in Oklahoma. There he met David W. Tuggle, MD, FACS, who later became known for his response to the 1995 Oklahoma City bombing.
Dr. Waters excelled during the rotation and considered pediatric surgery, but after returning to Des Moines, he rotated on the cardiovascular service, where several attending surgeons had trained at Cleveland Clinic. He was drawn to the precision, daring, and drama of heart surgery and ultimately completed cardiovascular surgery training at Cleveland Clinic.
Training was rigorous. Dr. Waters remembers falling asleep at the dinner table and once at a red light on the way home after a 36-hour call shift. His 2 years at Cleveland Clinic were exhausting and thrilling. He returned to Des Moines to join his mentors’ practice, then within a few years helped bring heart surgery to northern Iowa. In Mason City, he built a dedicated team and embraced the autonomy of practicing in a smaller community, referring to himself as a “blue-collar” surgeon.
On the day of the blizzard, three men set out on snowmobiles near Mason City. One rider, 31-year-old Ward Krenz, became separated from the others in the driving snow. Unable to see the open water ahead, he rode onto Clear Lake and plunged through the ice into the 32°F-water.
Krenz called for help before losing consciousness as ice began to reform over the water. His friends soon realized they had lost sight of him, but the blinding storm made it difficult to know where to search.
Battling the storm, the group reached a nearby bar and called 911. Rescue efforts began, and Krenz eventually was pulled from the lake and transported to the hospital, where his condition appeared dire.
The familiar maxim that a hypothermic patient is “not dead until warm and dead” reflects the potential for recovery after profound hypothermia, but in 1993 such resuscitation remained uncommon outside major centers. Dr. Waters knew the literature. In the emergency department, Krenz was in cardiac arrest with a core temperature of 23°C. Nearby was a portable heart-lung machine. Doing nothing offered no chance of survival, so Dr. Waters and the team attempted aggressive rewarming and resuscitation.
Dr. Waters cannulated the femoral artery and vein and initiated portable cardiopulmonary bypass to rewarm, oxygenate, and reperfuse Krenz. The published case report documented at least 78 minutes of cardiac asystole before bypass was established. As rewarming continued, Krenz’s cardiac rhythm returned, and he ultimately recovered without neurologic impairment. He later recalled waking and asking where his snowmobile was.
Dr. Waters and colleagues reported the case in The Annals of Thoracic Surgery in 1994. Years later, the remarkable recovery was featured by National Geographic and ABC News as an example of survival after prolonged ice-water submersion and cardiac arrest.
As the saying goes, still waters run deep, and the phrase suits Dr. Waters.
Over a career spanning 4 decades, he became known not only for cardiovascular surgery but also for his interest in narrative medicine and writing. He has written about medicine and surgery and authored a series of murder mysteries drawing on his knowledge of the Jersey Shore. Through surgery and storytelling, Dr. Waters has remained committed to serving others with skill and trust.
Disclaimer
The thoughts and opinions expressed in this article are solely those of the author and do not necessarily reflect those of the ACS.
Dr. Tyler Hughes is a retired rural surgeon who spent most of his career in McPherson, Kansas. In retirement, Dr. Hughes travels in search of stories about surgeons and the experiences that shaped their lives.
