As It Happens

Man who fell off his bike saved by doctor who just happened to be out for a ride

Dr. Jesse Coenen didn’t expect to perform emergency surgery in the middle of the forest on his day off, but the man he operated on is glad he showed up when he did.

Dr. Jesse Coenen performed an emergency surgical procedure on a cyclist who was rapidly losing oxygen

Todd Van Guilder pictured at the Cuyuna Lakes Mountain Bike Trails in Minnesota. The avid mountain biker fell off his bike last month and received an emergency surgical procedure from a doctor who happened to be passing by. (Submitted by Todd Van Guilder)

Story Transcript

Dr. Jesse Coenen didn't expect to perform an emergency surgical procedure in the middle of the forest on his day off, but the man he operated on is glad he showed up when he did. 

Coenen, an emergency physician at the Hayward Area Memorial Hospital in Wisconsin, was riding the Cuyuna Lakes Mountain Bike Trails in Minnesota on Sept. 12 when he came across an unconscious man surrounded by paramedics desperately trying to intubate him.

The man had fallen off his bike and was losing oxygen fast. Coenen had to perform an emergency cricothyrotomy on site, feeding a tube through an incision in his throat to help him breathe. 

"My memory of the moment is a little bit blurry, and I think I lost track of time," Coenen told As It Happens host Carol Off. 

"But the fact that the scene has replayed itself over and over in my mind many times is evidence of the fact that it was a high-stress event."

A hard fall, then a bright light

It was a high-stress event for Todd Van Guilder, too. 

The corrections officer was camping and mountain biking with friends when he went over a rock garden and felt his bike swerve downhill toward a ravine. 

He decided to bail, leaping off his bike "in a Superman fashion" with his hands out in front of him. 

He hit the ground hard, landing on his chest and stomach.

"How I got away with no broken ribs or bruises or fractured ribs is beyond me, because when I landed, it wasn't like I was sliding into second base. It was a pretty good impact," he said. 

Dr. Jesse Coenen, kneeling in the centre, performs emergency surgery on Van Guilder with the aid of paramedics. (Submitted by Todd Van Guilder)

When he sat up, he saw a strange flickering light, like the flash of a camera. When he squeezed his eyes shut to make it stop, all he could see was white.

"It's hard to explain to somebody who's never experienced this," he said. "This was like the brightest white light that you could ever see. Not to, like, preach religion or anything to anybody, but when you stand at the gates of heaven or whatever, and you see the bright light, that's pretty much what it looked like."

When he opened his eyes again, he couldn't see. 

He could hear his friends scrambling to find help. One of them called 911, while the other blew frantically on an emergency whistle. 

Van Guilder started to slur his words. He became confused. He heard voices he didn't recognize, and felt people poking and probing at his body. 

He knows now those were first responders trying to help. But at the time, he says it felt like he was under attack, and he was desperately trying to flail and kick the people off of him. 

"They talk about somebody who's had trauma, where they go into that fight or flight mode? Well obviously, I was in fight mode," he said. 

But it didn't matter, because soon after, he lost consciousness. 

First time performing the procedure

Coenen says he was originally planning to steer clear of the scene, but a police officer asked if he and his friends could bring an oxygen tank to the team on-site. When they arrived, Van Guilder was lying face up, surrounded by about six paramedics. 

"After handing over the oxygen tank, I did not initially introduce myself as a physician. But after listening to the conversation and realizing that they were discussing medication dosing in preparation for intubation ... that's how I realized that my skill set could be helpful. That's when I joined the group," Coenen said.

Dr. Jesse Coenen, an emergency room doctor from Hayward, Wis., is pictured on his mountain bike, left, and at work, right. (Submitted by Jesse Coenen)

A paramedic had tried to intubate Van Guilder, but something was blocking the way, so Coenen stepped up to give it a shot.

"Unfortunately, his oxygen level got worse and it lowered to a point where I was concerned that he was at risk of having a cardiac arrest," he said. "That's when I realized that we were going to have to do whatever it took to get oxygen into his lungs."

There were no spare gloves on hand, so one of the paramedics gave him hers, which he turned inside out. Someone else handed him a scalpel and he got to work.

"This is a procedure that I have studied over and over and that I review on a regular basis and that I've performed on mannequins as well as animal models, but never on a live person," he said.

The surgery was a success. 

"Within moments, his oxygen level started to rise," Coenen said. "That's when I took a sigh of relief, I think."

I'm starting to realize the severity of ... what could have happened had that doctor not been there.- Todd Van Guilder

Paramedics carried the stabilized patient to the parking lot, where an air ambulance was waiting to take him to hospital.

Van Guilder is now recovering at home. Physically, he says he's feeling pretty good. But mentally is a different story.

"Initially it didn't sink in what happened, but now I'm starting to realize the severity of what all transpired that day — you know, the severity of what could have happened had that doctor not been there," he said.

He said he keeps thinking about his 16-year-old daughter and all the precious moments he would have missed if Coenen hadn't been in exactly the right place at the right time. 

Asked if he believed he saved Van Guilder's life that day, Coenen hesitated. 

"I don't have the answer to that question," he said. "I know that in the moment his trajectory was towards that of his heart stopping and possible death."

Written by Sheena Goodyear. Interview with Dr. Jesse Coenen produced by Sarah Jackson. 

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