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Second, Cappuccino instructed Lengel to drive to Millard Fillmore Gates Circle Hospital. Normally a player injured in a Bills game would be taken to Buffalo General, about a mile closer, but Cappuccino knew that Gates has magnetic resonance imaging (MRI) technicians on duty 24 hours a day. This is rare, and with Gates's in-house CT scanning capability it would enable swift diagnosis of Everett's injury. The hospital also is the only one in Buffalo with a neurosurgical intensive care unit, under the direction of Dr. Kevin Gibbons, 47.
Everett arrived at the hospital about 35 minutes after the hit. X-rays and CT scans showed a fracture dislocation of Everett's cervical vertebrae at the C3/C4 level, meaning that one vertebra had slipped out of alignment and was compressing against its adjacent vertebra and the spinal cord in the neck. An MRI showed that Everett's spinal cord was 70% to 75% compromised, or pinched, by the dislocation.
Cappuccino and Gibbons, assisted by senior neurosurgical resident Ken Snyder, worked to reduce the dislocation. A halo device was screwed into Everett's skull, and while he remained awake, manual pressure and traction weights were used to realign the vertebrae and remove pressure from the pinched spinal cord. Next would come 4 1/2 hours of surgery to stabilize Everett's vertebrae and further decompress the spinal cord. Both the reduction and the stabilization surgery are common practices in spinal cord injuries and clearly were vital elements of Everett's care.
BEFORE EVERETT had been put under anesthesia for the operation, Cappuccino had placed a call to Everett's mother. Patricia had begun her day under the impression that she could watch her son's game on cable television. When she found that the game was not carried locally, she and her husband, Herchel Dugas, went to Mulligan's sports bar in Humble. "We were late because I spent so much time trying to get the game on TV at home," says Patricia. "When I walked in the door at Mulligan's, it wasn't 15 seconds before I saw Kevin running down the field and boom! And then Kevin wasn't getting up, and I was just standing there in front of the TV. It was so noisy everywhere, but I couldn't hear a thing. I felt like I was in a movie. And he wasn't getting up."
Patricia remembered that she kept a number for a member of the team's training staff. From the bar she punched it in, identified herself and left a message. Bills director of player programs Paul Lancaster called back shortly and told her Kevin had been taken to the hospital. It would be 90 minutes before Cappuccino phoned Patricia from the surgical suite at Gates. She can't recall his exact words, but snippets are burned into her soul: Your son is paralyzed right now.... We're taking him into surgery.... Afterward I want to do something called cold therapy. "She was upset," says Cappuccino. "She cried."
It had been a trying summer for Patricia. In August her youngest daughter, Davia, had fallen into a diabetic coma and spent two weeks in intensive care in Galveston. Now her oldest child was in a hospital, 1,500 miles away, paralyzed. Cappuccino held a cellphone to Everett's ear so he could speak with the woman he calls his Moms. Patricia heard a weak voice on the other end. "Don't worry about me," Kevin told her. "I love you."
"That was my baby," says Patricia, tears rolling down her cheeks as she retells the story three months later. "He's always been so strong, and he sounded so weak." The next morning Patricia would be on a plane to Buffalo with Moore, at the Bills' expense. The surgery went smoothly and was finished at roughly 9:30 on Sunday night. Soon, however, another dilemma presented itself.
Last June the hospital had purchased an Alsius CoolGard 3000 thermal regulation system, which uses a catheter of cooled saline inserted through the patient's femoral vein into the inferior vena cava, cooling the blood as it flows past the catheter and regulating core body temperature. The machine, which has been helpful in treating strokes and other brain injuries, had not yet been used at the hospital on a spinal cord patient, but Cappuccino felt strongly that induced hypothermia—at a significantly lower temperature and in a more controlled environment than is possible with IV cold saline in the ambulance—could help Everett.
There was contentious debate at the hospital. At least two doctors, including Gibbons, did not want to induce hypothermia, which can have dangerous side effects such as heart arrhythmia, blood clotting problems, pneumonia and organ failure. "Dr. Cappuccino was pushing the cooling, and it became a dynamic issue," says Snyder, 35. "He had been saying all along, 'We should do the cooling. We should do it.'"
Only when Everett started developing a low fever did Gibbons and others assent. Still, Cappuccino, who bore the ultimate responsibility because Everett was his patient, took stock of his position. A native of New York City who counts two other doctors among his six siblings and whose father was a research biochemist, Cappuccino is married to a surgeon, Helen Hess Cappuccino, with whom he has six children. His life's work and his life experience weighed into the decisions he made that day.