Almost Dead in the Water

His legs shredded by a boat propeller, Nate Winters nearly died on Lake Maitland in 2008. After losing his left leg and undergoing numerous surgeries to save his right foot, the teenager still held out hope of playing baseball again. This spring, Nate made his comeback as a pitcher for Winter Park High.

Nate Winters felt weird when he bobbed to the surface of Lake Maitland. As he oriented himself, something told him to raise his right leg. He was stunned to discover a toe dangling by a shred of skin. Not good, he thought to himself. What he saw next, when he tried to lift his left leg, was far more alarming. Protruding out of the water was his femur—the thigh bone—with chunks of flesh and muscle hanging from it. Only then did he notice the color of the water around him—blood red.

“I started screaming,” Nate recalls of that late afternoon on Aug. 5, 2008, only seconds after the then-15-year-old had been pitched from a boat being driven by his older brother, Zach. Instinctively, Nate began swimming toward the boat, whose occupants were unaware that the craft’s propeller blades had ravaged Nate’s lower body. Nate knew he wouldn’t be able to kick with his left leg. But he was surprised when he couldn’t generate push with the right one, either. “My Achilles tendon wasn’t attached,” he says, “so when I kicked, it just kind of fluttered in the water.”

When Nate reached the boat, Zach and Brian Yeager, one of Nate’s five buddies on board the Super Air Nautique, hoisted him onto the back platform. What they saw was almost too gruesome to comprehend. From mid-thigh to mid-calf, Nate’s left leg had gone through a blender. His left foot was unscathed, but it was barely attached by a mishmash of muscle and skin. His entire right side looked as if he’d been hacked with a machete. His right foot was split lengthwise down the middle, his Achilles was severed, and he had gashes on his thigh, buttocks, waist and rib cage.

Another friend called 911 while Zach fashioned a tourniquet from a ski rope, staunching the blood spurting from what remained of Nate’s left leg. Everyone on the boat, including Nate, feared he would bleed to death as the craft labored toward shore, its prop enmeshed with shreds of Nate’s bathing suit and fragments of his left leg. Zach cradled his brother and peppered him with inane questions, trying to keep him from losing consciousness.

“I remember laying on the boat and just, like, looking around,” says Nate. “It still looked really nice to me. I kind of thought this was the last time I was going to be around, so I was trying to take in the moment.”

Nineteen months and 18 days later, Nate Winters is taking in the moment again. Grinning widely, he hobbles off the pitcher’s mound at Winter Park High School’s baseball field and tips his cap to the 500 or so spectators who are giving him a standing ovation. The Wildcats lead 11-5 against highly regarded Lake Howell High, and Nate, Winter Park’s starting pitcher this night, works five and a third innings, giving up seven hits, two walks and five runs (two unearned). Of his 88 pitches, 55 are strikes. ESPN captures it all on film, to be presented later as an inspirational documentary: An athlete bounces back from the brink of death and resumes his quest to play professional baseball, but with a prosthetic left leg and a right one that required 11 surgeries to reconstruct.

Nate’s an easygoing kid, not one to draw attention to himself. But he revels in the moment. It’s cool, he says, that he and his teammates will

be on national TV. He has no problem with ESPN camera operators tailing him at home, at school or during the game—even between innings as he drops his pants in the dugout, removes his prosthesis and adjusts it. Through it all, he keeps his concentration.

“He’s always had that. He focuses when he has to do something and he does it,” says Nate’s mother, Dr. Rebecca Moroose, a hematologist who teaches at the University of Central Florida’s College of Medicine. “He doesn’t let his emotions or other things get in his way.”

Nate’s father, Dr. Tom Winters, a prominent orthopedic surgeon, says he’s “ecstatic” about his son’s sudden fame. “Doc” Winters is a fixture at Winter Park High baseball games and can typically be found in the concession stand, aiming his radar gun through a small window directly behind home plate, measuring the velocity of pitches. His interest in baseball goes beyond his son’s pitching; he’s the owner of the Brevard County Manatees baseball club, a minor league Class A-Advanced affiliate of the Milwaukee Brewers. 

Winters confidently predicts his son will excel next season and go on to play college baseball. Later, though, in a candid moment  at the Winters’ lakefront home in Winter Park, as he  sits just outside the family room where Nate spent so many painful hours in recovery, Winters tacitly acknowledges the odds against it. “At least now it’s a situation where if Nate never plays another game, he’s still going out on his own terms.”

Nate, however, has a history of defying the odds. As a freshman, he made Winter Park’s varsity roster thanks to his versatility and work ethic. In his role as middle reliever, he pitched more innings that season than anyone except the first two starters in the rotation. He was a backup catcher and utility infielder, as well.

Winter Park High’s baseball coach, Bob King, didn’t know what kind of player Nate would be when the team began workouts last January. Within days of the accident, if only to hold out hope, King had told Nate to plan on playing again. “Did I really know it could be done? I had no idea,” says King. “The biggest hurdle he faced, in my eyes, was going to be the frustration.”

During Winter Park’s first intrasquad game in early February, Nate tried to pitch using his everyday prosthetic leg. He fell flat on his face, literally. “We made light of it,” says King, but he knew Nate was shaken. “I think for him it was a realization that this is going to be really hard.”

Nate, a self-described perfectionist, says he was more angry than discouraged. “It was just pissing me off that I wasn’t able to do the stuff I used to do,” he says. “It was really getting to me.”

He thought about quitting. “My dad sat me down a good amount of times,” he says. “We got into fights over it.” Something within fought Nate, too: “I don’t think I could actually say, ‘Coach, I quit.’ I couldn’t say those words.”

Further sustaining Nate was a promise made by Stan Patterson, founder of Orlando-based Prosthetics & Orthotics Associates of Central Florida. During his first consultation with Nate, which came after another prosthetic maker had told the youngster he would never play baseball again, Patterson learned of Nate’s desire to return to the sport. Patterson’s response? “Let’s make it happen.”

A couple of weeks after the falling episode, Patterson completed work on Nate’s “baseball leg.” The limb, which cost roughly $20,000, features a specially designed carbon graphite foot and a knee joint that looks like the shock absorber on a mountain bike. The knee, which was developed to accommodate amputee snowboarders and surfers, rotates slightly and allows for about 30 to 35 degrees of bend when the prosthetic leg strikes the ground and Nate follows through on his delivery. The heel of his prosthetic foot is designed to act like an automobile strut and absorb the force of impact.

“You don’t want energy to be absorbed into the prosthesis and into the residual limb, because (a) that could really hurt his residual limb and (b) you lose all that forward progression,” Patterson explains. “When you land like a pitcher would normally do, you don’t land with your leg completely locked out. You want that knee to slightly flex.”

Once Patterson adjusted the baseball leg’s socket to alleviate a recurring slippage problem, Nate began to hit his stride. On March 15, he had what Coach King called “an A-plus” day throwing in a simulated game. Nine days later he started in a junior varsity game at Dr. Phillips High, throwing 30 pitches (a predetermined limit) without giving up a hit or a walk. (A designated hitter was used to fill Nate’s place in the batting order when he played in games.)

There was a moment of levity that afternoon when Nate called timeout because his knee had become loose. Patterson was summoned from among the spectators to supply an Allen wrench, which was delivered to the mound so Nate could tighten the artificial joint.

On April 12, Nate made his first varsity start, against Colonial High, going four and a third innings without giving up a hit. Walking through the dugout after he and his players had escorted Nate off the field, King shook his head in amazement, saying to no one in particular, “You can’t do any better than that.” Nate’s return attracted local media attention but went national with a story on AOL’s FanHouse website. With the arrival of ESPN 11 days later, Nate Winters became a certified phenomenon.

Media coverage of Nate’s saga has been narrowly focused on the comeback angle, an inspirational tale of a young athlete who lost a leg but not his desire to compete. Yet the medical story behind this “Miracle on the Mound” is every bit as compelling. “That boy was on the other side of this world,” says Dr. Wadih Macksoud, the orthopedic surgeon who repaired Nate’s right leg. “He was dead.”

After Nate fell from the boat that fateful day, he essentially had been drawn into the whirling propeller, ground up and spit out. It’s rare for surgeons to deal with such carnage. “If more than one limb is severed, the person usually dies before they can get to the hospital,” says Macksoud. “We never see them.”

Nate was beyond lucky. Had the propeller blade gouged his rib cage a half-inch deeper, it would have punctured his lung, resulting in certain death. The spinning blades narrowly missed his spinal column, as well; had they severed is spinal cord, Nate would have been a paraplegic—if he’d survived. Had he succumbed to panic and not swum to the boat . . . had the 911 call not been made so quickly . . . had his brother not applied the tourniquet . . . had the emergency services team not been so efficient . . . had the medevac helicopter not arrived so quickly . . . and had Nate not been rushed to Orlando Regional Medical Center’s Level One Trauma Center—one of seven in Florida—friends and family would have been visiting his grave instead of celebrating his baseball comeback.

By the time Nate arrived at the hospital—35 minutes after the 911 call—he had lost nearly 80 percent of his circulating blood. His hemoglobin count was 3.1—too low, in most cases, to sustain life. “After he was resuscitated, we were worried that there wasn’t enough blood running to keep his brain functioning,” says Macksoud. “I was concerned that when he woke up, would he still be Nate?” His mere survival, says Macksoud, “was like winning the lottery 10 times over.”

Joining Macksoud in the operating room was another orthopedic surgeon, Dr. Mark Munro. His task was to amputate the remains of Nate’s left leg and bind the residual limb. Macksoud had a more complicated challenge.

“One option was to amputate the [mangled right] foot, but we figured we could do better,” says Macksoud. He and Munro considered taking Nate’s intact left foot and transplanting it onto his right leg, but they determined “what we had left [of Nate’s right foot] was enough. We managed to reconnect the arteries and nerves and kept them alive.”

Nate would endure 10 more surgeries to repair the damage, including one every other day during the week immediately after the accident. “It was an ordeal for him,” says Macksoud. The left foot had been split lengthwise from the fourth toe. When Macksoud surgically merged the two parts, the result was a narrower, four-toed foot. “It was a gamble,” says Macksoud. “But he still had motion and sensation, so it was worth trying to go for it.”

Repairing Nate’s Achilles tendon was just as problematic, if not more so. Under the best circumstances, a ruptured Achilles is a difficult injury from which to fully recover. Macksoud had to remove a “large portion”—a little over an inch—of Nate’s Achilles and reattach what remained. The resulting tendon was stretched so tightly that Nate’s foot had to be secured with his toes pointing straight down, like a ballet dancer frozen en pointe.

His right foot and ankle were encased in a spring-tension apparatus designed to incrementally stretch the reconstructed Achilles. If you’ve had orthodontic work, imagine the same sensation as when your braces were tightened. Nate calls it torture, but that wasn’t the worst of his pain.

“When they took the bones out of my right foot [to merge it], that was awful,” says Nate. “I just woke up and started screaming. ‘Put some drugs in me—it hurts!’ I was like that for two or three days.”

Painful complications slowed the Achilles repair. “I had absolutely no skin [on the back of his ankle and calf], so I got an infection,” says Nate. “You could just see straight into my leg. My sural nerve was exposed. [Macksoud] would have to touch that nerve and that was the worst pain. For two weeks straight, he would have to do that every single day.”

In January 2009, after four months of homebound schooling by specialists from Orange County Public Schools, Nate returned to classes at Winter Park High. By early April, eight months after the accident, Nate’s foot had mended and his Achilles had lengthened to where he was flat-footed again. “All the little gambles we took worked,” says Macksoud. “It was like being on a winning streak.”

By all accounts, Nate’s grounded family life is the biggest contributor to his recovery. In the weeks after the accident, the Winters entertained a constant stream of friends and well-wishers whose ribbings and encouragement buoyed the convalescent. Some schoolmates even stuck around when Macksoud made his daily house calls, watching as the doctor worked on Nate’s right leg.

“I thought his parents would want to hide him for a while,” says Macksoud, noting that’s common for parents of children who suddenly have become disfigured. “But they didn’t. There was always a house full of friends. Nate would yell and curse [when Macksoud touched an exposed nerve or adjusted the tension on the Achilles-stretching device]. It was all in the open.”

On the day of the calamity on Lake Maitland, Zach was home on summer vacation after his sophomore year at Cornell University in Ithaca, N.Y. Nate had friends at the house, and they pressured him into a boat ride. But neither Nate nor any of his buddies was experienced at piloting a craft as powerful as the Super Air Nautique, a boat specifically built for wakeboarding, so Zach consented to take them out on the lake.

According to the accident report by the Maitland Police Department, Nate was on his feet in the area of the boat’s walk-through windscreen when Zach made a left turn. “The victim lost his footing and slipped, falling head first out of the right side of the boat,” the report says. No citations were issued, although the report notes that “the operator of the vessel could be held at fault” because he “should have taken the initiative to instruct the victim to sit down or to slow down before making the turn.”

Nevertheless, the Winters, in early May, were prepared to file a personal injury lawsuit against Orlando-based Southeast Correct Craft, the maker of Air Nautique boats, claiming design flaws were to blame for Nate having been flung from the boat and that the company was negligent by not equipping its craft with propeller guards.

The accident left Zach dealing with feelings of guilt for months, even though Nate, when he regained consciousness after the amputation, told him “don’t worry about it” and reassured his brother that the incident wasn’t his fault.

“I was just scared that he was going to die,” Zach says. “I had been driving the boat . . . I was just, you know, ‘It’s my fault.’ ”

Nate’s magnanimity toward Zach was a great relief to their parents. “He has an extremely mature coping mechanism for a teenager,” says Rebecca. “When he woke up in the intensive care unit, he started telling jokes. That’s an extremely mature way to deal with anything this tragic. The fact he called his friends and said, ‘I’m going to be a [peg-legged] pirate for Halloween.’ Things like that. And he said that wonderful thing to his brother.”

For his 17th birthday, on Nov. 29, Nate got a tattoo etched in script on his left bicep: Take It Easy. Beneath that motto is the date: 08-05-08. His parents weren’t pleased when they found out. “My dad s— a brick,” recalls Nate, with a smirk. Tom Winters can laugh about it now, too—“I told him I was going to take his leg off and beat him with it”—having come to appreciate the tattoo’s deeper meaning.

No three words could be more descriptive of his son’s personality, or provide a better clue to the character attributes that have enabled Nate to thrive after being maimed. Through the entire ordeal, Nate matter-of-factly accepted his fate. Indeed, this is a kid with a sense of humor so keen that as he lay dying on the boat, he nodded toward his crotch and asked his brother, “Zach, are my balls still there?” If they hadn’t been, he quipped the next day in the intensive care unit, “I would have jumped back in” the lake.
 
Nate’s pitching leg is stashed atop his locker as he sits in the dressing room behind the dugout at Winter Park High’s baseball field, discussing the chronology of his emotions as he came to grips with his disfigurement. “I was just kind of like, ‘It happened. Oh well, deal with it,’ ” he says. “I was like that for a good two weeks. Then I got out of the hospital and I started getting down . . . but I had so many people coming by that it kind  of took me out of it. And I started playing guitar and I just really didn’t care anymore. I had something else to do and to focus on.”

Nate had been a casual guitar player. He always grabbed the instrument when he was bored or wanted to avoid some task. But while laid up at home, he began to practice with a vengeance—“sometimes 10 hours a day, until my fingers bled,” he says. One day, a classmate, Clark Galloway, brought his guitar to the Winters’ house for a jam session and was so impressed with Nate’s riffs that he asked him to join his band. Fusing reggae and rock, Innercoastal has gained a reputation as a promising warm-up band at bars and clubs throughout Central Florida. Occasionally, the band plays at the pub Tom Winters owns across from ORMC, Legends Sports Bar & Grill.

Nate plays lead and bass guitar, and occasionally keyboard. He’s dev-oted to the band, but recently he shaved his beard and has forsaken his Bob Marley T-shirts in favor of those emblazoned with Major League Baseball team logos.

By any measurement, Nate’s junior year of high school wasn’t so much a turning point in his young life as a confirmation of his character. He was elected president of the WPHS Class of 2011 and will serve an uncontested second term as a senior. He has performed well enough academically that he hopes to attend an Ivy League university.

This summer, King and Patterson will review videotapes of Nate’s pitching performances, breaking them down in slow motion for clues as to how his “baseball leg” can be improved. Nate already is training with next season in mind. “I want to get into good shape,” he says. “I’m sure I can gain five miles an hour on my fastball just by getting stronger.”

King, however, says Nate’s contributions won’t be measured by a radar gun. “I really think next year he could become a very important part of the team, a key pitcher and an emotional leader,” predicts King. “You’re not going to mess with a guy who’s been through what he has.”