‘Cop Doc’ Honored by Arizona Group That Helps Police, Firefighters

Posted By Mike Padgett

Aug. 13, 2009

PHOENIX, Ariz. – A cappuccino and painkillers are what the wisecracking policeman wanted. They might ease the pain from a bullet that tore through his belly in a blazing gun battle in downtown Tempe.

At the shooting scene, with paramedics just minutes away, Sgt. John Schaper’s eyelids were getting heavier. He was bleeding internally. He could feel it. Pain was increasing. A sergeant yelled at him to keep his eyes open.

During the ambulance ride to Maricopa Medical Center, Schaper pulled off his oxygen mask. He asked another officer to tell the driver to slow down. A fast ambulance is good. Fast and safe is better.

Rescue workers wheeled Schaper into the emergency room, where he cranked up his friendly sarcasm. It sparked smiles on the faces of other officers nearby. They were there for him. He boosted their morale.

On the operating table, Schaper was losing blood as fast as Dr. Daniel Caruso and his medical team raced to save his life. A priest performed last rites.

Two years later, Caruso and his team faced another medical challenge that continues to make headlines. Phoenix Police Officer Jason Schechterle was rushed into the same emergency room. He was unconscious.

His patrol car exploded when a taxi, with a driver suffering a seizure, hit him from behind at about 100 mph. The fireball charred Schechterle’s head and hands. His ears and nose were nearly burned away.

Special award for the surgeon

Schaper was shot in 1999. Schechterle was burned in 2001. Both officers credit their survival to Caruso, who is head of the Arizona Burn Center at Maricopa Medical Center.

Caruso has been chosen to receive a special award, the Jason Schechterle Lifetime Achievement Award, for helping the two critically injured officers and many other public safety personnel in recent years.

The honor comes from the 100 Club of Arizona, a nonprofit group that helps public safety personnel and their families. Caruso will receive the award at the group’s annual dinner Sept. 26.

Since its formation in 1968, the 100 Club has raised more than $4 million to help Arizona public safety officers and firefighters injured in the line of duty.

Caruso also received a special honor from officers he treated – a custom badge that reads “Cop Doc.”

Jock turned doc

Caruso, 45, has an easy smile and kind eyes. Some say he can be abrupt, all business.

He grew up in Ionia, Mich., which is about halfway between Grand Rapids and Lansing. He never thought about entering medicine until high school, where he was a straight-A student. He was more interested in football.

But his participation in the sport was sidelined by a comment from Caruso’s 10th-grade science teacher. That short conversation, Caruso says, changed his life.

‘Temperament of a surgeon’

In class one day, Caruso was cutting up with his buddies. The science instructor told Caruso he will be staying after class.

“And I’m like, here we go again. The fallout’s going to be, I’m going to have to sit in the corner and take my time out. And he says to me, ‘You know Dan, you’re a smart guy. You’re really a smart guy. I know how well you do in math.’”

Caruso aced math and science. He says his science instructor “looks at me and says, ‘You’d make a really good physician.’

“And then ­– swear on a stack of bibles – he says, ‘You have the temperament of a surgeon.’ I don’t know if he knew some surgeons or his father was a surgeon. I have no idea. But I had watched all the TV shows – Emergency 51 was big back then. I knew all that stuff. Marcus Welby, my dad loved Marcus Welby. M*A*S*H was huge way back when. The surgeons on M*A*S*H, all the rest.”

Family encouragement

Caruso’s four grandparents immigrated to the United States from Sicily. His father and his maternal grandfather, when they heard that his science teacher was encouraging him to consider a medical career, led his family cheering squad.

His father was an industrial engineer. And his grandfather, who worked with his hands all his life, bought Caruso computers and anything else he needed for his studies.

Caruso earned a master’s degree from Wayne State University in Detroit where he also entered medical school. After graduation, he headed for Arizona in 1992 to do his internship and residency.

Five years in Arizona, and he was off for a year at University of California-Davis in Sacramento, Calif., for a fellowship in trauma and critical care. He returned to Arizona in 1998 for family reasons. Caruso has been medical director of the Arizona Burn Center for the past 10 years. Recently, he was named Chief of Burn Services at Maricopa Medical Center where he also is chairman of surgery.

Immersed in career

Caruso says his life has been in two time frames. His first eight years or so were as an attending surgeon at the hospital’s Burn Center, where his career was his primary focus.

“The problem with that part of my life, I left my ex-wife and my son behind. People would say, ‘God, it’s so stressful, how do you do this.’ I said, ‘This is easy for me. I love being here.’ It shows because I spend 110, 120, 130 hours a week here. My record was 146 hours in the hospital in one week. That’s crazy.”

He was engrossed in his work. After surgeries, he would change ventilators, fluids and drips, tasks generally performed by other staff. His conscientious nature and his dedication to patients and their families were taking their toll on him and his family.

“Problem is, you can only do so much. Obviously that had a lot of issues in my marriage. I have one son that, really until my divorce almost, I really didn’t know all that well.”

He says it was his divorce and his own health issues that forced him to rethink his priorities.

“It kind of almost closes a chapter for me, which was work, work, work, and it really beat my health up quite a bit. But the work, I really enjoy. I really have not found it stressful.”

Caruso has since rekindled his relationship with his son, and he has remarried. He now has four stepchildren.

Doctor’s two cancers, knee surgery

In recent years, as Caruso has transitioned into administration at the burn center, about 60 percent of his time is focused on paper work and planning the burn center’s future. He also has had his own medical challenges. He had thyroid cancer, which led to radiation therapy.

He has had several operations on his right knee. He says his knee is “kind of shot from playing football and power lifting and stuff.” He expects to have a knee replacement someday.

During treatment on his knee, Caruso’s doctors discovered he had kidney cancer. It was a silent tumor, meaning no pain or other symptoms. The tumor was removed. Caruso didn’t need any chemotherapy or radiation treatment. So far, so good. Cured. For luck, he raps the wood table in his office.

Downtown gun battle

During his career, Caruso – like the other doctors at the medical center – has treated an unknown number of patients. Two that stand out for Caruso are Schaper and Schechterle, because of the medical challenges they presented.

Schaper was on patrol just after midnight in late March 1999 in downtown Tempe. He was part of the downtown mountain bike squad. He met up with two other officers – Chuck Bridges and Steve Smith – just west of Mill Avenue and Sixth Street. They had arrested a man for trespassing. They were holding him for other officers to take to jail.

As Schaper and Bridges talked, and Smith finished paper work with the trespassing suspect, a pickup pulled up. The driver got out and walked toward the officers. When he was within about 10 feet, he pulled out a handgun and started shooting at the officers. It was a .32-caliber pistol firing brass-jacketed rounds.

Schaper isn’t sure who was hit first. One bullet hit the protective vest under Bridges’ left armpit. It punched through all the layers of Bridges’ vest and broke his skin, but stopped. The impact knocked him down and left him with a massive bruise.

Schaper was hit on his left side, just under his vest. As he fell, another bullet entered his pocket and flew out his zipper, missing him.

Schaper landed on all fours. A bullet ricocheted off the sidewalk in front of his face. Schaper had his gun out but his vision – because of pain and blood loss – was blurring. He was unable to aim his weapon. He tried to scoot behind a nearby electrical box.

Bridges and Smith were firing at the shooter. Smith had stepped in front of the trespassing suspect to shield him. One of the shooter’s bullets whizzed past Smith’s head. He was not injured.

Schaper says the shooter was hit several times by Bridges and Smith. “He was dead before he hit the ground. But he got off six rounds.”

Dozens of bystanders uninjured

More than 20 bullets were fired in about five seconds by the two officers and the pickup driver. The gunfight was across the street from a restaurant where several dozen people were standing outside. Schaper said no one was hit by stray bullets.

Paramedics and other officers arrived. Schaper struggled to stay awake. He wanted to close his eyes.

“I was talking,” he says. “In fact one of the new sergeants, because I kept wanting to close my eyes, one of the new sergeants was yelling at me, ‘Keep talking, open your eyes, open your eyes,’ and I made some smart-ass comment about life sucks when you get shot before your first cappuccino, and told her to bring one to the hospital.”

‘If we wreck, I’m toast’

In the ambulance, Schaper was worried about the driver’s speed. He pulled off his oxygen mask and told another officer to tell the driver to slow down.

“You hear about ambulances rushing cops (to medical treatment) and they lose control and roll it,” Schaper says. “I’ve heard of it happening, overzealous ambulance drivers.

“So I tell them to slow down. I said, ‘I got one shot at this and if we wreck, I’m toast,’ or something like that. They’re like, ‘No, we’re almost there, we’re almost there.’”

‘Let’s get this going’

At the hospital, Schaper took out his contacts. He signed paper work. He asked for painkillers. That’s when he met Caruso.

“I’m saying the bullet’s over here, it went in over here. And I’m telling him the pain I had. And everybody’s moving fast around me. And I asked for anything to put me out. I kept telling them, let’s get this going, let’s get this going.”

Caruso pushed on Schaper’s abdomen, then his flanks. “He was really tender, although he’s a pretty tough guy, very tough guy,” Caruso says.

He says the bullet entered an area of Schaper’s abdomen where there “are some very big structures,” referring to major organs and arteries.

When a bullet enters the body, it may hit several organs or arteries as it tumbles.

Caruso, as he started operating, saw no blood. Until he lifted Schaper’s bowel out of his abdomen.

‘There was blood everywhere’

“When I did that, there was blood everywhere in the space behind the abdomen, and that’s where your vena cava and your aorta travel,” Caruso says.

He discovered that Schaper’s vena cava, the major vessel that returns blood from the legs to the heart, had been nicked several times by the bullet.

The bullet also caused nerve damage and pierced or nicked the appendix, small bowel and ureter to the kidney.

“So he’s bleeding to death, slowly but surely. And he will bleed to death if that’s not taken care of. And there are massive bleeds.”

‘Nearly lost him’

Caruso says the bleeding flowed like a geyser. “We lost, I don’t know, 50 units of blood on the table. And John nearly coded a couple of times on the table. Nearly lost him completely.

“And he ended up having three holes in his vena cava, and one of the holes was underneath where the aorta splits off. The aorta is on top of the cava, and where it splits off into both legs, down by the pelvis. It’s a very, very difficult area, to get to the veins underneath. And it was bleeding so fast and so profusely. I mean I spent forever trying to sew this up. Staple and sew.”

Schaper’s core temperature began dropping. He was losing blood as fast as it was replaced.

‘He’s going to die here’

“And the nurse told me I swore so much that she goes, ‘I felt like I was in the room with an old sailor.’ I don’t even remember, but I do remember this – I had probably only been in practice here like six or nine months out of my fellowship.

“And scared to death. Because at one point, I do remember screaming out loud, top of my lungs, ‘This SOB has probably got a beautiful wife, two kids, couple dogs, a nice white picket fence in front of his damn house, and he’s going to die here on this table and I can’t stop it.’

“And everybody was, I remember everyone kind of looking at me. I just wanted it to end. I couldn’t fix this guy. But every time I looked up at anesthesia, they’re like, ‘Blood pressure’s great. We’re giving blood. He’s doing fine.’

“I don’t know what they were doing up there (referring to anesthesia) to keep him alive, and it went on it felt like for eternity.”

Schaper’s operation lasted several hours. Caruso had kept his fingers clamped on Schaper’s vena cava for so long, a nurse had to pry his fingers free.

‘There was so much blood’

“He bled and we gave blood and I threw stitches and we held and we clamped and I put stitches in places I had no idea where I was throwing (stitches). There was so much blood, and he just couldn’t stop it. ‘Cause what had happened was, the bullet tumbled in through the vessel, tore a hole, tumbled up, tore another hole, and tore a third hole on the back side of these tubes, of these vessels.

“So you had to roll him over and try and sew them. And it’s bleeding profusely from three areas. And I’ve got clamps and I’ve got control everywhere I could.

“And it went on and on and on. And that without a doubt was my defining moment in my career. I’m nine months out of fellowship. I just started as an attending (surgeon). All I’m thinking about is this guy dying in the line of duty.

Surgeon paced the room

“And I’m starting to think about, it’s because of my inadequacies that I can’t get this guy fixed. I remember I had my residents just put a whole bunch of pressure on it and I paced around the room for about three minutes.

“And I looked over at anesthesia again and they’re like, ‘Dan, he’s doing fine.’

“It was almost like I started over again after several hours of being there, flipped those vessels over, sewed them again, we held pressure, and I pulled it off after like five minutes, and it had stopped.

“So we cleaned everything up, looked at everything, threw couple more stitches where it was kind of oozing, packed it all up. We actually left his abdomen open. He had been there so long, we just put a plastic drape over it so his bowels were hanging up right here.”

Sent to intensive care

Medical workers raced Schaper to the intensive care unit on another floor. Caruso ordered one of the residents to sit with Schaper with a pack of sponges and a clamp.

“And I said, ‘If this guy starts to bleed, you pull open this drape, you know where the bleeding is, you stick those pads on there and you clamp that thing, and then you call me.’”

A couple days later, the surgeons returned Schaper’s bowels – still resting on his chest – to his abdomen and stitched him closed.

Fear was gone

“I will tell you, from that moment on, never again did I fear a thing in surgery,” Caruso says. “I still had young innocent folks die on me, but never again did I have that nervousness, that fear, that I couldn’t tackle anything.”

Schaper was in a drug-induced coma for a few days. He remembers waking up on life support equipment. He said his abdomen, after his intestines were replaced, was extended “like a nine-month pregnant woman.”

Schaper said there was discussion about giving him a permanent colostomy. That idea was rejected when his bowels began working again, as did his kidney and his spleen.

More sarcasm

Schaper says that while he was recovering, he caught Caruso’s attention, pointed to his own distended abdomen, with the staples and stitches, and asked, “Is this going to leave a mark?”

He said Caruso began laughing, “and he looks and he goes, ‘You really are a smart ass.’ He turns to a nurse and says something to the effect of, ‘He’s going to live. I think he’s going to make this one.’”

Caruso describes Schaper’s injuries as “one of the more difficult and demanding technical cases you’ll ever face, and I got lucky. There’s no doubt.

“It was a very defining moment in my life, which was, I don’t think I’m always alone in that room.”

Schaper, 43, because of the nature of his injuries, retired in 2000. He was on the Tempe force for 14 years. Before that, he was in law enforcement in Texas for two years. He now helps his wife in her computer business.

For their actions, Bridges and Smith later received the police department’s Medal of Valor.

And why did the shooting begin in the first place? Because the man died at the scene, police were unable to determine the cause of his actions.

Another challenging patient

Two years later, on the night of March 26, 2001, Caruso found himself facing another medical emergency that would push the limits of his medical skills.

It was late. Caruso is a night owl, not much of a morning person. He was at home on his computer, about ready to go to bed, when one of his trauma surgeons called him.

“He says, ‘We got this cop here and he’s burned severely. And with your relationship with the police’ – because I’d already taken care of several police officers, and I was the burn guy on for that month as well – he goes, ‘you might want to come in and see this because this guy’s head is completely burned to a crisp,’ was the exact phrasing.”

Someone burned completely on the head is unlikely to survive. That kind of injury is likely to cause the victim’s throat to swell closed, causing suffocation.

“We see a lot of head burns, face burns, but you never see a whole head – front, back, sides – burned down to the shoulders,” Caruso says. “People don’t survive something like that.”

‘That’s not Jason’

The accident occurred just after 11 p.m. One critical factor favoring Schechterle’s survival is the Phoenix firefighting crew that happened to be at the same intersection. The firefighters were returning from a call when Schechterle’s car was rear ended by the taxi driver who, according to press accounts, suffered a seizure.

The rescuers struggled to pull Schechterle from his cruiser. Black smoke rolled from inside the car. His door was jammed. Someone cut Schechterle’s seat belt. He was pulled through the driver’s window. Paramedics inserted a breathing tube in his throat.

He was rushed to the hospital. Other officers began filing into the waiting room.

One officer who had heard about the accident was at the hospital when Schechterle was wheeled in, unconscious. He looked at Schechterle’s charred face “and said, ‘That’s not Jason,’ because he was so disfigured, so black, so charred, that he couldn’t even recognize him,” Caruso says.

Last rites

Medical workers around Schechterle were running on adrenaline. A priest was called. He performed last rites.

“So when I drove in, he was still on the CAT scanner because his car had been hit at 100 mph and blown up so he was in trauma as well,” Caruso says. “So they were working him up to make sure he didn’t have any internal injuries, and they’re scanning his head, scanning his head, scanning abdomen, pelvis and all the rest.”

Caruso tapped a knuckle against Schechterle’s left cheek. It looked like charred leather. It sounded like wood.

“It was that tight, that leathered, that deep already. And it had only been two hours from the injury. You know from doing this type of burn care that he’s got what we call fourth-degree burns. That they’re not only through all layers of skin into the fat, they’re actually down to his muscle and his skull.”

‘Package him up’

Schechterle’s hands were burned deeply, but Caruso thought they could be saved. His other burns were on his arms, on his trunk and the front of his thighs. His protective vest helped reduce more serious burns.

The scan showed the officer didn’t have any internal injuries. His vital signs were stable.

“I said package him up and take him to the operating room because I’m going to take off all this burn,” Caruso says. “I made a decision to immediately excise, remove, all that burned tissue.”

He had never seen burn injuries like this. The burned skin was so tight and the burns were so deep that the officer was going to get infected very quickly.

In burn care, the critical factor that will improve survival is early excision of the burn wound. If the tissue is dead, it must come off.

Caruso says the officer’s age – he was 28 – his top physical condition and the breathing tube inserted by the firefighters were three reasons why he survived.

“I can put a feeding tube in him. A 50 percent burn on a guy who’s 20 years old, and 90 percent of those patients survive. So let’s get to work on him.”

‘Come in here and help’

Schechterle was wheeled into the operating room. It was about 1 a.m. The decision was made to put him into a drug-induced coma, probably for months. Caruso called his burn center partner, Dr. Kevin Foster.

“I woke him up and I said, ‘I don’t think I’ve ever called you in, in the middle of the night for a burn operation. But I said, you got to come in here and help me with this because you’ve never seen the like, and I’m not exactly sure if I’m doing the right thing but I think this is what we should be doing.”

Caruso, Foster and Dr. Clifford Smith, chief resident, spent about seven hours removing all the burned skin, from his neck to his face to the top of his head. They exposed parts of his skull up front, and part of his nose. They took the skin off his eyelids because all of it was destroyed.

“We’re taking it off. And this is my famous saying that I have said it in public and I’ve said to Jason – I looked over at Dr. Foster to my right and I said, ‘What are we doing to this guy? This guy is going to live and I’m not so sure we should be doing this.’

“But Dr. Foster has actually done a lot of study on ethics and so forth, it’s kind of one of his specialties, and he said, ‘It’s not for us to choose. And maybe we can really do something good for him, long term.’”

Several fingers amputated

During that first 24 hours, all of the burned skin was removed. Over time, more surgeons joined the medical team. Tendons on Schechterle’s hands were exposed when the skin was removed. His hands were inserted into slits in his abdomen to keep them covered. Eventually, skin was grafted onto his hands. Several of his fingers and a thumb were amputated. To get his eyelids to close, “they were doing operation after operation on his face,” Caruso said.

To encourage the regrowth of blood vessels from the officer’s skull into the grafts, a plastic surgeon used a tool to incise the skull to make it bleed, “and that helps regrow tissue and then you can cover it” with grafts, Caruso says.

The grafts took many operations over many months. Cadaver skin and grafts of a product called Integra – made of shark cartilage and bovine collagen, covered with a layer of silicon – were used to replace Schechterle’s burned skin.

Eventually, the silicon layer on the Integra is peeled off and replaced with grafts of Schechterle’s undamaged skin from other parts of his body.

Returned to police duty

Today, after more than 50 surgeries – with more likely as he ages –­ Schechterle considers himself lucky. He was allowed to come out of his coma nearly three months after his cruiser exploded.

That’s his first memory after the accident. He doesn’t remember the impact or the fire because he was rolling – with lights and siren on – to a dead body call. He had stopped at the red light at the intersection of 20th Street and Thomas Road, checking traffic right, left and straight head.

Because he was headed for an emergency, his focus was forward, not behind him. If he had glanced in his rearview mirror, he might have seen the taxi headed for his bumper like a missile.

“I never saw the vehicle, didn’t feel the impact, nothing,” he says.

According to press accounts, the taxi driver had suffered an epileptic seizure. He later was convicted of assault and sent to prison. His passenger received broken ribs.

In November 2002, about 20 months after the accident, Schechterle returned to duty. First, he worked in police public affairs. He was transferred in March 2004 to homicide division, where he worked until August 2006. That’s when he decided to take disability retirement.

Launched new career

Schechterle, 36, has since started a business, Quality Transport Services of Arizona. His non-emergency ambulance company, with 20 employees, has 17 vehicles that take patients in wheelchairs or on stretchers to medical appointments, nursing homes, hospices or assisted living facilities.

His company makes about 100 trips a day, mostly in metro Phoenix. The drivers also have taken clients to San Diego, Las Vegas and Albuquerque.

Schechterle has relearned how to play golf. He wears fingerless weightlifting gloves. He has a two handicap, using clubs with oversized grips.

Schechterle was a lineman with Arizona Public Service when he decided to become a Phoenix policeman. He’d thought about police work for many years, mostly because he has an older brother on the force.

He made the decision to quit APS and enter the police academy when a Phoenix policeman was fatally shot March 26, 1999. The officer’s death made him decide to become a policeman. He soon went to the city of Phoenix and submitted an application to enter the police academy.

Misses police work

Schechterle’s accident occurred March 26, 2001, two years to the day after the shooting incident that led him to decide to become a policeman.

“That incident for some reason was kind of the moment of clarity, if you will,” Schechterle says. “It made me realize that I needed to be doing that job.”

He adds that he will always miss police work. “Not once did I have a bad day at work. It’s one of those jobs, you know, you’re outside every day. You never know what the next call’s going to bring.”

Doctor’s heroes

Caruso says Schaper and Schechterle are only two of many police officers and firefighters he and his staff have treated over many years.

“Getting back to the award, I feel very honored to receive this award from who I consider my heroes,” Caruso says. “I’ve always had a real love and respect for the police. They’re laying their lives down out there. And I see what happens to them. I’ve taken care of several of the severely burned firefighters, and some of the burned police officers.”

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Aug 13th, 2009

One Comment to '‘Cop Doc’ Honored by Arizona Group That Helps Police, Firefighters'

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  1. This is an awesome story a a true testimonial to the heroism practiced by Dr. Caruso and other surgeons at Maricopa Medical Center every day.

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