A Pencil in His Heart

By MICHAEL D. LEMONICK

What happened to Nathan King on his 12th birthday last month could be classified as a parent's worst nightmare--except that few parents could even imagine such a freakish accident. Bursting with exuberance, the Helena, Mont., boy bounced a football off the wall of his room, dove onto his bed to retrieve it and somehow drove a No. 2 pencil through his chest and right into his heart. "I kind of felt it go in," he says, "but it didn't hurt, so I looked down. Then I started yelling, 'Mom! Mom! Mom, I'm gonna die!'"

And but for his level-headed mom, that's just what would have happened. Many parents would have instinctively tried to pull the wooden stiletto from Nathan's chest. But Lorri Earley, a trained nurse, saw the pencil throbbing rhythmically in her son's chest and knew where it had probably lodged. She knew that pulling it out could unleash a torrent of red that would bleed the boy dry in a matter of minutes. "There was no way we'd touch it," she told TIME.

So while Lorri dialed 911, she kept one hand cupped over the pink rubber eraser to prevent the panicky Nathan from yanking it. "There was nothing you could do," recalls Mike Earley, Nathan's stepfather. "Adrenaline all the way up to your eyeballs, and all you can do is hold his hand, let him know you're there."

A CAT scan at a local hospital confirmed Lorri's battlefield diagnosis. Not only had the pencil pierced Nathan's heart, but it had penetrated a valve. He would need open-heart surgery--which meant Nathan had to be airlifted to the nearest cardiac surgeon and heart-lung machine, in Great Falls, 100 miles away.

It was nearly three hours before Nathan finally made it to the operating table. A team led by Dr. Brett Williams--summoned from his own 45th-birthday celebration--put the right side of Nathan's heart into cardiac arrest, diverted his blood supply to the heart-lung machine and began repairing the damage. "There was absolutely no blood anywhere. It looked to be an immaculate perforation," Williams told TIME.

That's not all: If the pencil had taken a slightly different trajectory, it could have destroyed far more of the heart's blood-pumping machinery. And it just missed an artery in Nathan's chest that could have bled enough to send the boy into shock. "As it was," says Williams, "there couldn't have been more than a thimbleful of blood in the pericardium [the membrane surrounding the heart]. He needed no transfusion, which is fairly unusual for a child undergoing heart surgery."

Without such complications, the operation was straightforward. "We were at fairly close quarters, trying not to disturb the pencil and aggravate the injury," says Williams. But there was no infection, no contamination from pencil lead--and no permanent damage. Indeed, by last Saturday, less than three weeks after his open-heart surgery, Nathan was itching to get out of the house. "I want to go back to school," he told TIME. And parents who used to warn kids of the dangers posed to eyes by various sharp objects now have, for the foreseeable future, a new and even more frightening cautionary tale to tell.

--Reported by Patrick Dawson/Helena

With reporting by Patrick Dawson/Helena