For some people, going back to work after a weekend off takes some motivation and an extra cup of coffee. For Roger Paulson, the morning of Monday, March 27 couldn’t come soon enough—his first full day back on the job as a mechanic at Dan Porter Motors in Dickinson.
Roger considers himself “The Miracle Man”, and for good reason. On January 10, 2017, Roger suffered a ruptured abdominal aortic aneurysm (AAA) – and lived.
Sharp, stabbing pains prompted Roger and his wife of 37 years Heidi to come to the Emergency Department at CHI St. Alexius Health Dickinson late that afternoon. With Roger presenting typical symptoms of kidney stones, Physician Assistant DesiRae Dinius and hospital staff started doing tests.
When Roger started to code, he was quickly resuscitated by nurse Jordan Mork and the emergency team.
Emergency Physician Dr. Michael Cassidy was consulted and ordered a CT scan. Because Dr. Cassidy was qualified to read CT scans, he was able to recognized ruptured AAA as soon as it appeared on the screen.
Heidi remembers Dr. Cassidy spinning around in his chair and saying to her, “We need to fly him out, right now.”
According to a study by Stanford University School of Medicine, an AAA is one of the most fatal surgical emergencies, with an overall mortality rate of 90%. The aorta is the largest blood-carrying vessel in the body, and a rupture fills any surrounding body cavity with blood, which is nearly always fatal.
Roger remembers, “I was conscious up to the point when I heard them say ‘he’s hemorrhaging.’ I knew that wasn’t good. I literally put myself in my happy place which is Lake Tschida.”
Staff tried to keep Roger in stable condition as transport was arranged. Preston Huber, CRNA, was working on Roger’s airway and blood pressure.
“We tried to find the perfect balance of getting his blood pressure up, but not too high as that pushes more blood out of the tear (caused by the rupture).”
The weather was poor that evening – the medical helicopter was not able to fly due to winds. He would have to travel by ambulance to Bismarck in order to have the vascular surgery needed to save his life.
The first Dickinson Ambulance crew to respond included three crew members: Terry Hartman, Misty Peck and Katie Schwartz. The severity of Roger’s case and the hazardous roads were added stressors.
Schwartz said, “He looked ash-y when we started out, but by the time we got to Bismarck his color was looking better. We got his blood pressure under control. I told Terry to try to drive a little faster and that we might make it.”
Heidi recalls not fully knowing how severe the odds were in the moment. “Ignorance is bliss, because I didn’t know. We [Heidi and their daughter and son in-law] left in such a hurry that I got to Bismarck before Roger.”
When the ambulance arrived at Sanford Health in Bismarck, the surgery team met them at the door and rushed Roger into surgery, three hours after he presented at Dickinson’s ED.
By 7:00am the next morning, Roger was awake and talking to staff.
Susan Price, Director of Emergency Services at CHI St. Alexius Dickinson, said her staff was somber when Roger left on the ambulance. They feared a tragic outcome.
When they learned that Roger had successfully come through surgery, they were elated.
Price told the Paulsons at a visit in March, “You touched a lot of my staff’s hearts.”
Heidi replied, “You touched ours!”
Roger will undergo annual scans to check for any newly developed aneurisms or tears in his current aortic repair. Due to the genetic nature of aneurisms, Roger’s siblings have undergone medical imaging scans to check for any aneurisms of concerning size.
He stresses that his years of smoking were a risk factor. “Nicotine is terrible, whether you smoke or chew or even vape. It hardens your vascular system and makes it more likely you could have an aneurism.”
The Paulsons are grateful for all of the medical professionals who played part in Roger’s survival, from the emergency, hospital, and ambulance staff in Dickinson to the surgical, ICU, and rehab teams in Bismarck. Above all, they know that God had a hand in saving Roger’s life.
Heidi explains, “I take it on faith. There’s no particular reason why it happened, no particular reason why he came through the way he did. He had guardian angels. He had God on his side from day one.”
Roger smiles, “I used to smell the roses before, because I was always upbeat, but now I smell the roses EVERY day, because I could be dead.”
-Story and photos by Stephanie Fong