An extraordinary medical journey unfolds as devastating trauma—a 17-year-old girl's shotgun blast to the face—is transformed into renewed hope through groundbreaking facial reconstruction.

Dr. Long welcomes special guests Dr. Eric Dierks, an oral maxillofacial and ENT surgeon, and Dr. Larry Over, a prosthodontist specializing in maxillofacial prosthetics. Together, they unravel the remarkable case of a patient, whose face was catastrophically damaged by a shotgun injury that destroyed her nose, eyes, and significant portions of her facial structure.

The conversation takes us through the progressive stages of reconstruction, beginning with the initial life-saving surgeries performed by Dr. Bryce Potter and team, who created a new structural foundation using bone from the patient's leg. Two years later, when the patient was still facing profound disfigurement that caused public whispers and stares, Dr. Dierks stepped in to prepare her for a prosthetic solution.

What follows is a fascinating deep dive into both the surgical and artistic elements of facial prosthetics. Dr. Dierks describes creating a nasal airway that allowed her to breathe normally for the first time in years, while Dr. Over reveals the meticulous process of crafting a silicone facial prosthesis—from creating impressions and wax prototypes to custom-matching skin tones and placing artificial eyes with perfect symmetry.

Perhaps most compelling is hearing how this medical intervention transformed not just the patient's appearance but her entire life. The magnetically-retained prosthesis allowed her to blend into society as simply a blind person rather than someone with a visible disfigurement. She later established a long-term relationship and built a fulfilling life that would have seemed impossible in the aftermath of her injury.

This episode exemplifies the podcast's core mission: showcasing how collaborative expertise, innovative thinking, and patient-centered care can create outcomes that once seemed impossible. Listen now to discover how saving time saves lives, and how dedicated medical professionals can transform a flatline situation into a lifeline of hope.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

What happens when a 17-year-old girl arrives at the trauma center with her face destroyed by a shotgun blast? In this episode, we explore an extraordinary case that demonstrates why specialized expertise and immediate intervention make all the difference between life and death.

The shotgun injury created catastrophic damage, essentially removing the girl's face from the eyebrows down to the nose. Most trauma centers would have classified this as non-survivable. But Dr. Long assembled a team with unique qualifications—Dr. Bryce Potter, an oral-maxillofacial surgeon, and Dr. Mark Buehler, a microsurgery specialist—who approached this challenge with revolutionary thinking.

Instead of following the conventional staged approach to reconstruction, the team performed complete repair during the initial admission. Their philosophy? "A patient is never healthier than when they first present to the ER." By establishing an airway through tracheostomy, multiple specialists worked concurrently rather than sequentially, drastically reducing time to definitive care.

The cornerstone of the reconstruction was a "free flap"—living tissue transferred from the patient's leg that included fibula bone, soleus muscle, and skin. This complex microsurgery required connecting tiny blood vessels to maintain circulation to the transplanted tissue. When unexpected complications arose with blood flow during the procedure, the team's adaptability proved crucial.

The outcome was remarkable. Despite catastrophic facial trauma, the patient regained the ability to eat and speak. She went on to live a functional life for twenty years before additional cosmetic procedures, even having two children during that time.

Listen now to understand the extraordinary measures that transform seemingly hopeless situations into stories of survival and recovery. Because when the need is greatest, saving time truly saves lives.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

Caution: Graphic Medical Content. Listener Discretion Advised

A shotgun blast to the face at close range should've been fatal. Everything between her eyebrows and upper teeth was gone—eyes, nose, mid-face—yet somehow, a 17-year-old girl survived. This is the first episode in a three-part series exploring one of the most remarkable and complex facial trauma cases in medical history.

The secret to her survival? An extraordinary collaboration between specialists who weren't afraid to challenge conventional medical wisdom. Dr. Bill Long and Dr. Bryce Potter take us through this remarkable case where quick-thinking EMTs, who stuffed her facial cavity with sterile dressings to staunch the bleeding, innovative airway management, and revolutionary reconstruction techniques came together to save and rebuild a life.

What makes this story particularly fascinating is the counterintuitive approach to facial reconstruction. The maxilla, or upper jaw, was completely free-floating, no longer anchored to the base of her skull. In contrast, the mandible (lower jaw) remained attached. This meant the team had to begin by using the intact, still-connected lower jaw as the starting foundation to anchor and rebuild the entire face. The early placement of a tracheostomy, performed with a small incision in her neck to protect her airway, was a decision that faced significant criticism from other specialists. Yet, it proved transformative by allowing unrestricted access to the facial area for complex repairs and preventing her from drowning in her own blood.

This case also involved a unique collaboration between the trauma team and Oral and Maxillofacial Surgeons, as correctly aligning the mandibular and maxillary teeth was crucial to stabilizing the unstable maxilla. This was a pivotal step, as at the time, few plastic surgeons or ENT specialists had the training to perform this type of alignment. The old adage, "you can't sterilize the oral cavity," was a major challenge due to the high risk of infection in the open, bacteria-laden wounds.

The patient’s journey spans decades, from initial survival through multiple debridements to clear dead tissue and free flap reconstruction using the non-weight-bearing fibula bone from her lower leg. This graft was used to stabilize the critical upper mid-face bony structures and eventually rebuild the entire mid-face. This procedure, which involved an orthopedic and microvascular surgeon, required the detached flap to be brought to a new location and reconnected to the patient's artery and vein. The trauma team was also able to stabilize her blood pressure with transfusions, a crucial initial step to manage shock and prepare her for the long road of reconstruction. Her journey also included eventual prosthetic facial restoration using titanium plates and screws and magnets. Her two destroyed eyes were enucleated, and her case contributed to technological advances in 3D modeling that continue to benefit patients today. Most remarkably, she not only survived but went on to marry and have children, demonstrating the profound human impact of these medical innovations.

This episode illuminates how breakthrough medical approaches often emerge at the intersection of specialties when practitioners value patient outcomes over rigid adherence to established protocols. This is the first of three episodes on this incredible case, so stay tuned for the next two parts.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

A police officer is shot point-blank in the face during a routine traffic stop, the .38 caliber bullet severing his internal carotid artery at the base of his skull. Most wouldn't survive this catastrophic injury, but at Emanuel Hospital—a place Dr. Bryce Potter describes as "a hard place to die"—something remarkable happens.

Dr. Bill Long is joined by Dr. Bryce Potter, an oral and maxillofacial surgeon, as they take us through the harrowing case, revealing how innovative thinking saved this officer's life. When trauma surgeon Dr. John Zelko found himself literally holding back torrential bleeding with his finger, he made the crucial decision to call for help—an act that Dr. Long emphasizes is vital but sometimes prevented by ego in medical settings.

The solution? Dr. Potter improvised with bone wax and a muscle flap to permanently seal an un-repairable artery. Meanwhile, the team implemented their groundbreaking massive transfusion protocol, replacing the officer's entire blood volume multiple times during surgery using four specialized trauma nurses simultaneously administering blood components.

What truly sets this team apart is their philosophy of immediate intervention. "The patient is never more healthy than when they first present," Dr. Potter explains, challenging the standard practice of delaying facial fracture repairs. Their approach of immediate tracheostomy and fracture reduction not only stopped bleeding but dramatically shortened hospital stays and improved outcomes.

The police officer not only survived but eventually returned to active duty, despite the inevitable stroke. He had a permanent left hemiplegia resulting from the right carotid artery transection, and he underwent months of intensive rehabilitation. He is now confined to a wheelchair but is able to communicate orally with his devoted wife and family. His wife has worked out the logistics of transporting him in a vehicle to wherever they need and want to go. This case exemplifies how medical innovation comes not just from technology but from the willingness to challenge established protocols based on observed outcomes.

Join us to discover how these pioneering trauma techniques continue to influence trauma care of critically injured patients and why, sometimes, the most important medical tool is simply refusing to give up on a patient others might consider beyond saving.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

In this compelling episode of Flatline to Lifeline, Dr. Bill Long welcomes his longtime colleague Dr. Bryce Potter, a remarkable specialist with dual MD and DMD degrees, to explore how specialized training and innovative systems change patient outcomes.

Dr. Potter represents a rare breed of medical professionals - at the time of his practice, he was one of only twelve people in the United States with his particular combination of training. This unique background allowed him to handle complex head and neck trauma cases that would typically require multiple specialists working in sequence. Together, Drs. Long and Potter revolutionized trauma care by breaking down the territorial barriers between medical specialties to create a truly patient-centered approach.

The heart of this episode examines a fascinating case study of a 70-year-old man who survived a self-inflicted gunshot wound to the head. The bullet became lodged in his frontal sinus, creating a complex medical challenge that required innovative thinking and surgical expertise. The doctors discuss the critical decision-making process that took place, including the consideration of multiple surgical approaches and the necessity of having a "Plan B" when initial strategies prove impossible.

Most striking is their candid conversation about the psychological aspects of trauma medicine - how physicians respond differently to extreme stress, the dangers of perseveration and task fixation, and why some doctors struggle to adapt when faced with unexpected complications. This rare glimpse into the mindset of elite trauma specialists reveals why adaptability may be the most crucial skill in trauma care of critically injured patients and life-threatening emergency surgery.

Whether you're a medical professional seeking insights into trauma care or simply fascinated by remarkable human stories, this episode offers profound lessons about the systems and approaches that make unexpected survival outcomes possible.

Listen now to hear the full story of this amazing recovery. If you found this episode helpful, please subscribe to our show and leave us a review. To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Special Guest Bio:

Dr. Bryce Potter, MD, DMD, is a board-certified surgeon in both Oral Surgery and ENT (Ear, Nose, and Throat). He earned his dental degree from the University of Oregon Dental School and also received his medical degree and completed his ENT residency at the University of Washington School of Medicine. He gained extensive trauma experience at Harborview Medical Center in Seattle and co-founded Head and Neck Surgical Associates in Portland, Oregon.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

When a motorcycle police officer collided with an SUV at 50 mph, his survival chances seemed slim. With fixed, dilated pupils—a classic sign of severe brain trauma—the clock was ticking. In this riveting exploration of emergency neurosurgery, Dr. Bill Long and special guest Dr. Jeff Chen, former director of trauma neurosurgery at Emanuel Hospital, take us through the life-saving measures that turned catastrophe into recovery.

The episode opens a window into the specialized world of neurotrauma, where minutes matter and millimeters make the difference. The officer suffered severe blunt force trauma to the frontal lobes of his brain. Dr. Chen, who helped develop the pupillometer—a device that measures pupil reactivity to assess brain pressure—explains how this technology revolutionized rapid neurological assessment.

The critical turning point in the operating room was a bifrontal craniectomy, a life-saving procedure where the frontal bone of his skull was temporarily removed. This allowed the officer's severely contused and swollen brain to expand outside the skull, relieving dangerous intracranial pressure. The exposed brain was carefully covered with commercially available cadaver dura until the swelling decreased, a testament to the cutting-edge techniques used in modern neurotrauma.

What makes this case particularly fascinating is the officer's post-surgical journey. As he gradually regained consciousness, an unexpected complication emerged—he couldn't distinguish his wife from her identical twin sister. This symptom, stemming from frontal lobe damage, provides a poignant reminder of how brain injuries affect our most fundamental connections to the world around us. Yet through dedicated rehabilitation, his brain slowly recovered. The removed frontal bone was eventually put back in its normal place and secured with titanium plates and screws, and the officer returned to police work (though never again on a motorcycle).

The conversation goes beyond this single case to address wider issues in trauma care: the dangers of medical silos, the crucial role of specialized nurses in neurotrauma monitoring, and why maintaining hope is as vital as any surgical procedure. As Dr. Long puts it, "You take hope away from somebody and you have crippled them."

Have you ever wondered how the brain recovers from a catastrophic injury or what life-saving measures are taken in those critical first moments? Join us for an intimate look at modern trauma, surgical critical care, and the remarkable resilience of the human brain.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Special Guest Bio: Dr. Jefferson W. Chen, MD, PhD

Dr. Jeff Chen is a board-certified neurosurgeon with a focus on neurological trauma and critical care. He holds an MD and PhD from Johns Hopkins University and is a fellow of the American College of Surgeons (FACS) and the American College of Critical Care Medicine (FCCM).

A leader in the field, Dr. Chen was formerly the Director of Trauma Neurosurgery at Emanuel Hospital and is known for his work in multimodal brain monitoring. He also played a key role in the development of the pupillometer, a device that has become a staple in neuro-ICUs worldwide. His research interests include the molecular mechanisms of brain injury and the flow of fluids through the brain.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

Every second counts when a young boxing champion collapses unconscious in the ring. With his brain hemorrhaging and pressure building inside his skull, his life hangs by a thread. This is the story of a race against time, innovative medical thinking, and the power of teamwork in trauma care.

Dr. Long takes us deep inside the intricate architecture of the human brain and its protective systems. We learn how the scalp, skull, dura, and meninges form layers of protection, but also create confined spaces where even small amounts of bleeding—as little as a shot glass worth—can trigger catastrophic pressure increases. When this happens, the brain has nowhere to go except through the small opening at its base, a life-threatening condition called brain stem herniation.

The young boxer's journey from ringside collapse to complete recovery showcases revolutionary approaches to trauma care. Rather than following conventional protocols, the trauma team performed resuscitation measures directly in the CAT scanner—saving precious minutes. Most dramatically, surgeons kept the patient's skull open for five days, allowing his swollen brain room to expand while they monitored intracranial pressure with exquisite precision.

Beyond the medical details, this episode reveals the challenging human dynamics of trauma care. Dr. Long shares how he learned to bring together specialists with different training backgrounds to function as a cohesive team. He explains why doctors respond differently under extreme pressure and the most adaptive approach to navigating trauma care.

The boxer's story ends with a complete recovery—college graduation, marriage, children—though wisely, he never returned to the ring. This remarkable outcome demonstrates why Dr. Long's guiding principle remains: when the need is greatest for the patient, saving time saves lives.

Listen now to hear the full story of this remarkable recovery. If you found this episode helpful, please subscribe to our show and leave us a review.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Follow us on X @DrLongPodcast

Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025

In this poignant and insightful episode, Dr. Bill Long and host Will welcome special guests, producer Lindsey Kealey and organizational guru Esther McDonald, for a candid roundtable discussion as Season Four of Flatline to Lifeline begins. Moving beyond immediate shock trauma, this conversation delves into the vital role of patient advocacy when facing life-threatening medical scenarios.

Lindsey shares her deeply personal and current journey navigating her husband's rare and aggressive leukemia, revealing how the knowledge gained from producing the podcast has unexpectedly equipped her to understand complex medical terminology and advocate effectively with oncologists. Esther recounts her own experience with her husband's stage four pancreatic cancer diagnosis, highlighting the emotional impact and the critical need to seek second opinions and fight for necessary treatment.

Dr. Long emphasizes the profound importance of human connection and bedside manner, drawing on Hippocratic principles to illustrate how a doctor's empathetic presence and clear communication can build trust and positively impact patient outcomes. The team explores practical strategies for patients and their advocates, from the power of simply asking questions and taking notes (even recording conversations with permission) to the often-overlooked value of expressing gratitude to medical staff. This episode underscores that while the medical journey can be isolating and overwhelming, an informed and empathetic advocate can make all the difference.

To learn more about these life-saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

Follow us on X @DrLongPodcast

Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025