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Tom DeLancy’s first semester as principal at Mountain View Elementary School was rewarding. He addressed curriculum and discipline problems that were neglected under the previous administration, and the faculty was enthusiastic about the school’s steady progress under his leadership. Mountain View is 25 miles from the central office and is the northernmost school in the district. The majority of the 1,500 people living in this isolated, tightly knit community support their families by farming or working in blue-collar jobs. Friday night high school football games always sell out despite consecutive seasons in which the team has failed to win as many games as it has lost. Each game is the topic of discussion and arguments at the community’s coffee shop on Saturday morning during football season. The school’s faculty is composed of 18 regular education and two special education teachers. Two federally funded teachers and an aide are assigned to help students improve reading and mathematics scores on standardized tests. As Tom developed safety plans for the school, one of his concerns was its isolation. A volunteer fire department was 10 miles away, but staff hours at that facility were irregular since the firemen worked at other jobs during the day. County sheriff’s deputies patrolled local highways but spent most of their time in more densely populated areas. Tom took most of the semester to get to know the faculty and community. Most parents welcomed his insistence on improved learning and attendance, but teachers continued to complain about a lack of support for homework and other academic matters. The PTA president suggested that training the faculty and staff in CPR would be an excellent way to enhance safety and build community relations. Tom agreed and arranged for a half-day session on one of the system’s professional development days before Christmas. Teachers were receptive to the idea, and only a few complained about needing the time to compile grades and attend to other classroom matters. CPR training, provided at no cost by emergency medical technicians who worked for the largest hospital in the county, was excellent. Two teachers were absent, but the rest of the faculty enjoyed the training and the opportunity to interact with each other. Three parents took time off from work to join the session. At Tom’s suggestion, Mrs. Bennett, the school secretary, noted the name of each teacher who earned CPR certification for future reference. The Christmas holidays passed quickly and the second semester began. During the second week of classes, Tom was working in his office to complete the written portion of a teacher’s evaluation when Mrs. Staley, a first grade teacher, rushed in. She carried a student in her arms. “There’s something wrong!” she said with a trembling voice. “What should I do?” “What happened?” DeLancy asked, standing to move around the desk. “I don’t know! Steven got out of his chair to come to my desk. He took three or four steps and fainted!” “Take him to the health clinic!” Tom accompanied Mrs. Staley to the clinic and watched as she laid Steven on a bed. “Now what?” she asked. “Let’s put him on the floor; it’s a flat surface.” Mrs. Staley helped the principal move Steven gently to the carpet. She stood and took a step back, her body trembling. “I don’t think he’s breathing,” she said. “I’m not sure if he is or not, but you go back to class. Take care of the other children.” As Mrs. Staley left the room, Mrs. Bennett appeared in the doorway. “Is there anything I can do?” DeLancy knew that he needed help. “Yes. Call Mrs. Roberts on the intercom. She was great during CPR training. Ask her to take her class to the library and come to the health room. Don’t tell her what the problem is; there’s no point in upsetting everyone.” She nodded. “Anything else?” “Call 911. Tell them we have an emergency. Call Steven’s parents, too. Tell them he fainted in class and we’re trying to get him to a hospital. Ask them to come to school right away! And keep the lines clear. Take the phone off the hook when you’re not making a call. We don’t need to have our line tied up right now.” She returned to her office. DeLancy began to administer CPR to Steven, who was unresponsive. Within minutes Mrs. Roberts joined Tom in the clinic. “Can I help?” “Yes! Steven’s a first grader in Mrs. Staley’s room. He fainted in class and I’ve been giving him CPR for about three minutes,” DeLancy replied, glancing at his watch.” “Mrs. Bennett is calling 911 and trying to reach Steven’s parents.” Mrs. Roberts nodded and settled onto the floor next to Steven, ready to begin chest compressions. “I’ll take over here,” she said. “Why don’t you check on 911?” Teachers were bringing their classes to the cafeteria for lunch. Curious about the commotion, several left their students unattended and strolled toward the health room. One of the school’s custodians appeared, and DeLancy directed him to bring three portable chalkboards to serve as a barrier between the cafeteria and health room. Mrs. Bennett told DeLancy that the hospital was dispatching a rescue helicopter, but she had been unable to reach Steven’s parents. He sent her to find Mr. Sanders, a third grade teacher, to ask him to wait outside the building to guide rescuers to the school as soon as the helicopter landed. DeLancy returned to the health room to find Mrs. Roberts continuing to administer CPR to Steven. He helped with chest compressions and breathing, but there was no change in Steven’s condition. Ten minutes later the sound of a helicopter’s main rotor announced the medical team’s arrival. Two paramedics rushed into the building, evaluated Steven, placed him on a gurney, and rushed him to the waiting aircraft. They promised to call DeLancy as soon as they reached the hospital and a physician examined Steven. Mrs. Bennett told DeLancy that she had found Steven’s parents and they were on their way to school. They arrived in time to board the helicopter with their son. As soon as the aircraft left, Tom called the superintendent’s office to tell him about the morning’s events. The superintendent asked to be kept informed as the situation developed. DeLancy received a call an hour later from the emergency medical technician who had promised to contact him. Steven died on the way to the hospital. “How could that happen? What went wrong?” DeLancy asked, incredulous. “His parents told us that Steven took some of his grandmother’s heart medication during the holidays. He had his stomach pumped in the emergency room and the nurse who inserted an air tube into his throat used one that was too big. The tube cut his throat and scar tissue from the cut formed around the top of his airway. Today was the day that the tissue sealed the opening. There was nothing any of us could do. I’m sorry.”