After a brutal shark attack, doctors on vacation intervene

Emergencies can happen anytime, anywhere, and sometimes medical professionals find themselves in situations where they are the only ones who can help. Is there a doctor in the house? is a Medscape Medical News series that tells these stories.

Ryan Forbes, MD: I live on the beach in Orange Beach, Alabama. I've lived in Hawaii, the Caymans, and other beaches for years. I've seen lots of sharks, but I've never experienced a shark attack. Not yet.

Mohammad Ali, MD: Ryan and I have been friends for 20 years. Every year my family goes to 30A in Florida (a popular highway resort) to celebrate my wife's birthday and the Forbesses always meet us there. This year we were a group of about 18 people.

Friday was beautiful and we decided to make it a beach day. We had nine kids with us. By the time we rounded them up and got there, it was lunchtime and there was no place to sit. We almost turned around and went to the pool. But my wife finally found a place for an umbrella.

Forbes: We were in the water boogie boarding. I was with my 8-year-old son and Mo was with his daughter, the same age. Suddenly we noticed a lot of excitement to our left. My first thought was: someone saw a shark, not an attack. They are so rare. But seeing one would scare people.

We grabbed our children and ran out of the water. As we approached the shore, I looked back to the left. And I saw it: blood. Waves of blood.

We dropped the kids off and ran along the beach.

Ali: There was mass panic. People were screaming and running out of the water. Others were running in and grabbing their children. Everyone just looked desperate.

We saw two men pulling the poor girl out of the water. It was unreal. Most of her right leg was severed, her femur was visible and snow white; it didn't look real. I kept telling myself I was in a dream and was waking up now.

A young paramedic who was there had put a tourniquet on her leg, but she was still bleeding, so I compressed the femoral artery as hard as I could, something I know very well.

Forbes: People later asked me what we used for a tourniquet. I said, “Mo's big hands.” I teased him because most doctors go golfing or fishing; Mo lives in the gym. He just held pressure.

The girl's left hand was also severed at the wrist. Two nurses were on site and helped to put tourniquets on her arm.

Lulu (the girl's name) was 15 years old. She was in and out of consciousness. At one point her face turned pale, so we tried to lift her limbs to keep the blood flowing to her heart. With such a large amount of blood loss, I thought she might go into cardiovascular shock and we would have to start CPR. But she had a pulse and she was breathing.

Ali: The beach was very crowded and there were a lot of people gathered. Everyone was emotional, shocked and really upset. But they gave us space to work.

Forbes: People were handing us things – towels, a ratchet strap that we could use as a tourniquet. There was even an anesthesiologist there who said, “If you need an airway, let me know.” It was like we had a trauma team.

Ali: Lulu's mother was having lunch with friends. When she saw all the commotion, she ran to the beach to look for her daughter. It was heartbreaking to hear her screams when she saw Lulu. But I was able to block it out because all we had to focus on was minimizing the blood loss.

Forbes: Another girl came over and said, “That's my sister.” Lulu has a twin sister. So she sat there holding Lulu's hand and was with her the whole time.

As we waited for the paramedics, the seconds felt like hours. It felt like it took forever. Eventually they arrived and we were able to put the correct tourniquets on her, get her on board and off the beach.

After that, the beach was closed. We packed up all our stuff and got on the little tram that was supposed to take us back to the house. The lady who was driving asked us, “Have you all heard about the shark attack?” My wife said, “Yes, we were there.” And she said, “No, there was one an hour and a half ago.”

Ali: What we didn't know was that there had been two more attacks that day. Around the same time, a friend of Lulu's was bitten and suffered a flesh wound on her heel. And before that, about 6.5 kilometers away, there was a serious injury: a woman in her 40s lost her hand and forearm and was bitten on the pelvis.

Forbes: At this point my wife leaned back to me and said, “You know we're never going to the beach again, right? We're never always go to the beach.”

If we had known about these attacks, we definitely would not have gone into the water.

Ali: My wife has never been a fan of going into the water. The night before, we had been debating whether we should take our daughters into the ocean because she was afraid of sharks. I had given her this condescending speech about waist-deep water and the statistical probability of ever witnessing a shark attack. I was in trouble.

Forbes: We didn't know if Lulu was going to make it. I worked as a family doctor in Oklahoma, so I've seen a lot of injuries – people on oil rigs and stuff. But I'd never seen anything like this kind of trauma and blood loss.

Later that day, I called my office manager to try to reach her and tell her what had happened. She was in Pensacola having dinner across the street from Sacred Heart Hospital where they had taken Lulu. She went to the emergency room to find out Lulu's condition – she was alive.

My office manager was able to go upstairs and talk to Lulu's mom. Then she called and we talked to her mom on the phone. She just said, “Thank you for helping my daughter.” It was an emotional moment.

Ali: It was a huge relief. We had no idea how it would turn out. Even if Lulu survived, would she be neurologically healthy? But thank God she was. We were so relieved when her mother said it looked good. We still didn't know for sure. But at least she was alive and seemed to be functioning.

Forbes: A few days later, my wife and I went to visit her in the hospital. Her mother and grandmother were there. They hugged us. We talked to Mo on FaceTime because he was back in Jackson. It was really amazing.

What are the odds? The odds of a shark attack are about 1 in 12 million. And two trauma-trained doctors, a nurse, another nurse, and an anesthesiologist were less than 20 yards away when it happened? That's crazy when you think about it.

Ali: And we almost weren't there. We could have turned back.

Forbes: Humans are at the top of the food chain. Or at least we think so. But water is not our element. We have no chance against a 3.6 meter long bull shark. But Lulu is here. It's unbelievable.

Her mother told me that when Lulu woke up, she just said, “I did it!” This girl is meant to be here. She's a strong girl with a great personality. She has these new prosthetics now that allow her to move with her mind; it's like Star Wars. She says she wants to be a doctor one day. So she's probably going to cure cancer.

Forbess is a family medicine physician at Orange Beach Family Medicine in Orange Beach, Alabama. Ali is an interventional radiologist at Baptist Memorial Health in Jackson, Mississippi.

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Read more in the series:

“Blood everywhere”: Nurses cope with serious crisis during flight

“Just be prepared”: Doctor finds overdose victim in an alley

Doctors on vacation struggle to resuscitate a drowned child

Read the entire series here.