As I say each year during our Children's Hospital fund-raising campaign, Children's performs miracles every day. But when a teen-aged shooting victim was brought into the emergency room last spring, there didn't seem to be a miracle big enough to save her. However, thanks to courageous work by two surgeons and outstanding cooperation from paramedics and emergency room staff, the miracle became reality, and that teen-aged girl is alive today. My associate, Deborah Schwartz, has the story of Tanessa Starnes:

It was June 2, 1987, a cloudless Tuesday. Shaw Junior High School had let out about a half hour earlier. Tanessa Starnes, a 14-year-old eighth grader, was walking down Rhode Island Avenue NW with some friends on her way to be tutored. The group was in front of Seaton Elementary School when three young men on motor scooters rode past.

One of the young men pulled out a handgun and fired once into the group, for no apparent reason. The shot struck Tanessa in the chest. The bullet ripped into her heart and ricocheted into one of her lungs, puncturing it four or five times.

When the D.C. Fire Department's Medic One arrived, Tanessa lay motionless on her back behind a police barricade. Paramedic John Proper found no heartbeat, and Tanessa was barely breathing.

Proper and fellow paramedics Van Coppedge and Donna Beverly performed cardiopulmonary resuscitation. They immobilized Tanessa. Then they put her in the ambulance, and could have taken her to any nearby hospital. But Proper says his gut feeling was: Head for Children's Hospital.

On the way, one of the paramedics in the back shouted to Proper, who was driving, that Tanessa had a pulse. Proper replied, "You've got to be crazy."

"People like that don't come back, even though I was praying for her," Proper said. "It's fate. If God wants them, He'll take them."

Even so, "I had a positive attitude. She had a chance. She had been breathing and she was viable."

Medic One radioed ahead to Children's Hospital, to describe the nature of Tanessa's injury. When the ambulance arrived 15 minutes after the shooting, the emergency room was crowded with waiting medical staff.

The next few minutes were crucial. Dr. Kurt Newman, a pediatric surgeon, rushed from surgery in another part of the hospital and began operating on Tanessa while she was still in the emergency room. He didn't have time to have her anesthetized.

"The first thing I did when I got down there was to organize the team," said Dr. Newman. "Just go around the room. It was like you were playing football or something.

"Even if everybody knows what they're supposed to do, {you tell them}: 'You're going to do this, you're going to do this,' and so on. That focuses everybody in on what they're going to do and also establishes that somebody's in charge, and then everybody can relax because they know what they have to do.

"And then I also got the instruments ready to open her chest. Just that scenario of a gunshot and no blood pressure. That means her best chance is going to be to open her chest.

"Then they bring her in. They're pumping on her chest. We put her on the gurney and here's where time is of the essence."

Any anesthetic would have slowed her down, Dr. Newman said. Besides, Tanessa started going downhill again at that point. Her heart was not beating and she had lost her pulse.

"Essentially, she's dead. Her heart's not going. She's not getting oxygen," said Dr. Newman. "But she's in a situation where she's dead or comatose or unconscious. You don't know how much {she's feeling}. And that's one of the things that I didn't think about right away. I didn't focus in on what her mental state is."

So Dr. Newman opened her chest without anesthesia, separated her ribs with his hands and started searching the lungs for the site of the wound.

"The instruments aren't always perfect, what you're used to in the operating room where you have a nurse give you what you need. So your best instruments in that situation are your fingers. You just kind of pull the ribs apart," Dr. Newman said.

At this point, doctors and nurses were pumping blood into Tanessa as fast as she was losing it. Paramedic Proper was helping with suctioning. Meanwhile, an anesthesiologist was giving Tanessa oxygen.

Very soon, Dr. Newman discovered at least one hole in her heart. He knew he had to get the heart started again. Using his hands, Dr. Newman started compressing the heart. Every time he squeezed, blood spurted in two directions, indicating that the bullet had made two holes.

Dr. Newman plugged the holes with his fingers. Tanessa was barely hanging on. Dr. Newman knew that more help was needed.

Cardiovascular surgeon Frank Midgley, also in surgery at the time, was called down to assist. Dr. Midgley sewed up the two holes in Tanessa's heart. Then he returned to his first operation.

Tanessa was now stable. But she still needed repairs on her lung. Dr. Newman did not close up her chest cavity. He administered antiseptic, draped her and moved her to a regular operating room to sew up her lung.

Once he had done that, and Tanessa remained stable, he had a chance to think about the long-term effects of her injury.

"So {after surgery} I came out to talk to her father. It was very emotional. The father asked me point blank, 'Was she ever going to wake up and was she going to be Tanessa again?' " said Dr. Newman.

"That was a guestion that I didn't know the answer to. I didn't want to take away his optimism about it. But there were a lot of things that made me very nervous." The chief worry was that Tanessa had been without oxygen long enough to cause brain damage.

To everybody's surprise, Tanessa started to show signs of brain activity just hours after surgery had been completed. By the next day, she began to regain consciousness.

"Even after a regular heart operation, you don't see people turn around that quickly, let alone with a wound to the heart, CPR, open chest down in the emergency room," said Dr. Newman.

"Even if you had good expectations that she was going to recover, she outmatched all of that."

Ten days after Medic One had rushed Tanessa Starnes to Children's, she walked out. Within six weeks, she was able to go to Kings Dominion with a church group.

"For me, it's been a tremendously positive experience. It's the ultimate, being involved with a child, a family like this and to have her come through and have the hospital and everybody involved {to be} so caring," Dr. Newman said.

"It's amazing the effect this type of patient and case had on the hospital. Everybody was into it. Because everybody felt like they contributed."

"I don't doubt, I never will doubt that there is a God. I was given a miracle," said William Starnes, Tanessa's father.

The Tanessa miracle is not yet complete. The bullet remains lodged in her body, in her lower back, in a nonthreatening place, just under the skin. It will be removed during her Christmas vacation.

That will be routine surgery. The surgery on the afternoon of June 2 was anything but.


Make a check or money order payable to Children's Hospital and mail it to Bob Levey, The Washington Post, Washington, D.C., 20071.