The day after Darshi Wewalage's 40th birthday, she lay unconscious on an Auckland operating table with her unborn baby boy trapped inside her. Both hearts were minutes away from death.
"I remember there being a calmness in the room... we had to act quick or she and her baby would die," Auckland District Health Board consultant anaesthetist Dr Jack Hill told the Herald.
It was July 4 and Wewalage - who was 29 weeks' pregnant - had developed a rare and life-threatening pregnancy complication called HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome, affecting her ability to get oxygen to her and her baby's lungs.
The Auckland banker's condition worsened when doctors were unable to get a breathing tube through her mouth due to her swollen throat, Hill said.
Instead, close to 20 Auckland DHB staff - including surgeons, anaesthetists, junior doctors, nurses and orderlies - had less than five minutes to complete a task no one in the operating room had ever performed.
"It was a team effort, everyone played their part," Hill said.
Another anaesthetist had to make a cut across the Wewalage's throat and insert a breathing tube into her lungs.
It's called a emergency surgical cricothyrotomy and is only used in life-threatening situations when the patient's airway is blocked.
Hill, whose career spans more than 20 years, said it was a crisis procedure a doctor might only see "once in a life time, if that".
"As an anaesthetist, you train for it but you never think you will actually have to do it. It was an absolute last resort and no one knew if it would work," he said.
"But the patient would die otherwise so it had to be done."
Wewalage's husband Rukshan Don Wijesinghe and their 6-year-old daughter Hailey sat in the waiting room, anxiously awaiting their loved ones' fate.
Four days later, she had just finished her birthday dinner at the hospital and said goodbye to her husband who was returning to a pub where he works as head chef.
That's when doctors felt Wewalage's unborn baby was not moving.
Without being able to kiss her husband goodbye, Wewalage was rushed into surgery.
Hill said the crisis procedure they performed on Wewalage was so rare it only happens in 3.4 out of every 100,000 caesarean sections.
"It's a task we can only practise on artificial models."
Within seconds of the anaesthetist inserting a tube into her neck, the beep of the heart monitor returned to a steady pace and whole room let out a big sigh of relief, Hill said.
"It was an incredible moment."
But the medical team was "not out of the woods yet", Hill said.
Obstetrician and gynaecologist Sarah Corbett, who was not involved in Wewalage's surgery, said she had been working as a specialist at Middlemore Hospital and never seen the crisis procedure done before.
"That's really impressive they were able to pull it off and recognise she was getting into that state in time to make that decision," Corbett said.
Meanwhile, Wewalage was taken to the intensive care unit (ICU) to recover.
"I didn't get to see my baby for five days after he was born," she told the Herald.
"I was scared my husband and daughter with our newborn wouldn't be able to cope."
When the now mum-of-two finally got to look into her son Joel's eyes, she said it was magic.
"I can't describe it. He is so beautiful. Every morning he is the first one to wake and you always find him smiling.
"I am just so thankful to all the hospital staff involved. They were just so amazing."
The baby is now at home, healthy and happy.
Wewalage's husband Wijesinghe said he couldn't imagine life without his wife and newborn son.
"Words cannot describe it. I believe those doctors are gods and the nurses are angels."
