Diane Dinsmore knew something was wrong with her 7-year-old daughter one day 20 Christmas mornings ago.
For one thing, Kerri wasn’t acting like a second-grader on Christmas.
“She was just listless,” Dinsmore remembers.
The day before, Dinsmore had taken Kerri to the local hospital near their home in Washingtonville, New York, about 50 miles northwest of New York City. Kerri had a splitting headache and had been vomiting.
Doctors sent the girl home, said she could have a migraine – like ones Dinsmore gets – or a stomach bug. Give her fluids, they said.
But moms know when something is not right.
What Dinsmore couldn’t know was that Kerri would slip into a coma that Christmas Day, that she would be hours, possibly minutes, from dying.
‘She’s probably going to die’
“By Christmas morning, we knew something was terribly wrong, so we brought her down to her pediatrician, Dr. Jacob Boris, in Orangeburg," almost 40 miles on winding roads from their new home, Dinsmore said. They had moved from Pearl River about 5 miles from the doctor's office but hadn't yet changed pediatricians.
Boris met them at his office, did a quick assessment and sent them to Nyack Hospital. He followed them there.
By 8 a.m. EST, they had driven the short distance to the hospital. Kerri was admitted to the pediatric floor where a nurse noticed her vital signs flagging.
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A CAT scan showed a large mass on Kerri’s brain.
She should be airlifted to what was then Columbia Presbyterian in New York City, they were told.
"When I asked Dr. Boris if Kerri was going to survive, he shook his head and said, 'I don't know,' " Dinsmore recalled.
But then a young neurosurgeon walked confidently down the hall: Dr. Jeffrey Oppenheim.
Oppenheim, who was on call that day, recalls what he saw on the CAT scan: “a big hemorrhage, bleeding in the area of the cerebellum due to the rupture of a tangle of blood vessels, a type of vascular malformation.”
The bleeding was putting intense pressure on Kerri’s brain. Her pupils weren't reacting to light, Oppenheim remembered, a bad sign. He spoke to the Dinsmores.
“I told Kerri’s parents: ‘Look, she is near death. She has to go to surgery right away. I don’t know that I can fix this. She’s probably going to die. But I will do what I can.’ ”
Oppenheim didn’t sugarcoat it: The staff at Nyack didn’t typically operate on children – those cases were usually sent elsewhere – but the bleeding in her brain made Kerri’s condition too dire to airlift her.
This was the kind of conversation Oppenheim dreaded.
“It’s deeply emotional and painful because you have to warn people the severity of the situation like this and to tell a parent that they may lose their child," he said. "That's the worst thing you can say to somebody.”
'It wasn't Kerri's time, yet'
Lose Kerri? On Christmas Day? The family couldn't process what they had heard.
“We were devastated, beside ourselves,” Dinsmore said. “(Karl Dinsmore,) my husband at the time, now my ex-husband, had a lot of trouble dealing with the fact that we might lose our little girl. A lot of the decisions really were left up to me and my parents who were there at the time.”
Oppenheim was about Diane Dinsmore's age. He was confident but completely candid.
What could they do? They had just met this young surgeon, who had prepared them for the worst.
But Diane Dinsmore's family had faith. Everybody just came together for Kerri, she said.
While they kept vigil at the hospital, other family members had stayed home with daughter Lauren, who is three years older than Kerri.
“I knew he wasn’t a pediatric neurosurgeon, and that was obviously a concern. But he seemed to be very confident, and he tried to allay our fears as much as he could,” Diane Dinsmore said.
“Ultimately, we just kind of put our faith in Dr. Oppenheim and in a higher power,” she said.
Save our little girl, they told Oppenheim. They then called their parish priest, who came to sit and pray with them.
Diane Dinsmore's parents sat in the waiting room, too.
Then they waited – for seven hours.
“We thought positively the entire time, that it wasn’t Kerri’s time, yet,” Diane Dinsmore said.
Back at home, Lauren refused to open any Christmas gifts until her little sister got home and could open her presents, too. Christmas would wait for Kerri, she said.
Details from that day of unspeakable worry have stayed with Diane Dinsmore all these years.
She remembers the small kindnesses of complete strangers: people who showed up to drop off a stuffed animal or a little trinket in Kerri’s room, a young girl who came in with a bag of figurines they used to put in McDonald’s Happy Meals.
“She didn't even say a word. She sat down and she put all these Happy Meal figurines on Kerri’s little table and then just left,” Diane says.
She still has a folder with all the names of the nurses who cared for Kerri.
Christmas joy, deferred
The surgery went well, but Oppenheim knew not to expect much when he made the rounds the next day.
"Given her neurological condition when this happened and how bad her brain stem compression was and her state going in, usually the way people come out of surgery might look a bit like the way they were going in,” Oppenheim said. “In her case, going in, she was near death.”
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But that’s not the way Oppenheim found Kerri the next day.
“She woke up almost like nothing happened,” he said. “It’s just extraordinary.”
Kerri's family, prepared for the worst, got the best.
"She was awake and talking and looking great," Oppenheim said. "To go from the deepest possible low to the greatest high, that was extraordinary. That was really part of the reason why I haven't forgotten it."
Kerri Dinsmore, now 27, doesn't remember much about that hospital stay that started Christmas Day and stretched until she was released New Year's Eve 1998.
She does remember having to learn to walk again, the only significant side effect to her ordeal.
“I remember the nurses and the doctors at Nyack and how caring and how special they tried to make me feel after Christmas," she said. "When I woke up, I didn’t really know what was going on.
"I didn’t know if Christmas had passed already," she said. "And they tried to take all the scariness away and make it feel normal for me.”
She also remembers the staff searching for – and finding – her pink stuffed elephant, Ellie, which had been mislaid when she switched rooms. She had had Ellie since birth and brought the elephant with her to the hospital.
She still has the stuffed animal, she said with a laugh.
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When Kerri came home on New Year's Eve, Christmas came to the Dinsmores. They opened presents and took a photo, date stamped 12-31-98, in which a beaming Diane Dinsmore is flanked by her two adorable girls.
Other photos, too, show 7-year-old Kerri lying in bed at the hospital wearing a floppy hat, a smiling surgeon at her bedside.
Diane Dinsmore calls what happened at Nyack Hospital "a Christmas miracle" and Kerri "our miracle girl."
“It very well could have gone the other way, and we were just thankful that our Kerri was in one piece and that her eyes were open," Diane Dinsmore said. "She had a funny little wrap around her head, but she was our Kerri and she was still with us.”
The case made a bit of a believer out of Oppenheim.
“I’m not even Christian. I’m Jewish,” he said. “But I like to think of it as a bit of a Christmas miracle."
At the very least, he said it was "a Herculean effort, in a desperate moment, to take care of somebody who needed care and then doing it really well."
Consider this: "It was on Christmas Day and the hospital staff was obviously out, but people rushed in and took care of this girl," Oppenheim said. "And it was really a team effort in the hospital to do that, to care for somebody who we normally, at Nyack Hospital, we don't normally take care of 7-year-olds.
"That's not something that the anesthesiologists do and the operating room nurses do," he said.
Not until years later at State University of New York Cortland, after Kerri Dinsmore decided that teaching wasn't for her, did she settle on a career path that had its roots in Christmas 1998.
“One of my friends, who was my best friend while I was going through my whole brain hemorrhage thing, reminded me of my admiration and how I always talked about the nurses at Nyack Hospital and how I had wanted to do that when I was little,” she said.
Now Kerri Dinsmore is a nurse, engaged to marry her high school sweetheart in June. She said she hears her mother's words when she approaches patients, how important it is to give family members information and keep them involved.
"I try to remember that, especially dealing with pediatrics and remembering that they’re more scared than the adults would be and talking through that and being compassionate," Kerri Dinsmore said.
How did Kerri survive?
Oppenheim said her age played a role in that miracle. Someone older than 40 likely wouldn't recover from that level of compression on the brain.
"You’re left with permanent deficits if you live," he said. "But this girl woke up like nothing had happened.
"The resilience of the young is wonderful, the capacity to heal," Oppenheim said. "But it really was a bit of a miracle that this girl not only woke up and didn't die but came back and has lived a normal life and is fine. I mean it was really exceptional."
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The surgeon knows how close the scenario was to ending differently.
"That hemorrhage was, I think, a matter of minutes or hours away from her being irreversibly brain dead," he said. "It doesn't get closer than that, and you would never want to be that close. Nobody would. That's terrifying."
"In an adult, it would be irreversible. But in this girl, on Christmas Day, that was reversible," Oppenheim said.
'I honestly owe my life to him'
The family’s medical episodes weren’t over.
Three years later, Kerri had a similar, but not as serious, brain hemorrhage, the result of another cavernoma, a cluster of abnormal blood vessels. Since Oppenheim had monitored her and seen this coming, he suggested the family take her to a pediatric neurosurgeon at Columbia Presbyterian, who performed non-emergency surgery to clear the problem.
Since the fifth grade, Kerri has had no similar episodes. She now lives in Hastings-on-Hudson.
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Oppenheim, who went on to serve as mayor of Montebello, New York, for nine years, remains the family's go-to neurosurgeon.
Ten years ago, an MRI for an unrelated ailment showed Diane Dinsmore had a similar cavernoma. Oppenheim scrubbed in on the surgery at St. Luke’s-Roosevelt Hospital in Manhattan.
“We’ve been seeing him forever," Kerri Dinsmore said. "I honestly owe my life to him."
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Diane Dinsmore, remarried and living in Fishkill, New York, puts it differently.
“He’s part of our family,” she said. “He’s a very important part of our family.”
Follow Peter D. Kramer on Twitter: @PeterKramer