Shark tattoos adorn each of Heidi Ernst’s calves. You can see them now as she sits at an Iowa clinic, gazing out the window. Around her neck are two silver necklaces: one clasps two dolphins, the other a shark. Her blue eyes twinkle like the ocean. The lines on her face reflect not her 74 years, but the fears she has faced.
“I’m so excited I can hardly talk,” she says to her neighbor, who drove her to this critical medical appointment in mid-September.
Ernst is a physical therapist, but today she is the patient. For the first time in 103 days, she will stand on two legs. One has been designed just for her.
On an early June day in 2023, the Caribbean Sea sparkled around Grand Bahama Island, about 100 miles east of the Florida coast. Sponges, squids and sharks meander the clear waters. Ernst perched at the back of the boat, ready for the team’s second dive of the day, this one in “Shark Junction”.
The Grand Bahama Scuba dive team decided to wait an extra hour before the second dive because a tour operator nearby had lured sharks to the surface to let visitors hand-feed them.
This luring practice is controversial, and Ernst didn’t approve of it. Human feedings train the sharks to come to the surface, disrupting their normal hunt. Regulations prohibit the practice off the coast of Florida, but no such restrictions have been placed on operations in Bahamian or other Caribbean waters.
Reef sharks grow up to 10ft long and are among the largest predators here. Ernst felt excited to catch sight of them, as she had countless times. With hundreds of dives under her belt, it was hard to imagine that she once feared this sport.
Even though she lived 1,000-plus miles from the ocean at her acreage in Marshalltown, Iowa, something about scuba diving had intrigued Ernst – and terrified her. One day in 2011 she thought: you can’t go through life avoiding the things that you fear. So she signed up for a class in the shallow recreation pool at the YMCA, and soon after, a colleague at a training in Florida pointed her in the direction of Grand Bahama Scuba.
That afternoon, she leaped into the water for her 524th dive. The dive rope attached to remnants of a shipwreck, and the sandy bottom in front of the wreckage contained a treasure: shark teeth. The sharks glided by and paid no mind to the divers.
Ernst buoyed up to the surface when they finished and, after all the others were back aboard, climbed the boat’s ladder. She ditched her diving mask, her oxygen tank, her buoyancy compensator and her fins, removing her wetsuit last, dropping it all on the deck.
She splashed back down into the water to relieve herself before the ride back to shore.
At 73, she felt triumphant in her sport, a mermaid. She had earned her gills.
But even a master could not have been prepared for what came next.
Ernst grabbed the top rung of the boat’s ladder to thrust her weight up to climb back aboard. Her right foot went forward. She began to take a step with her left foot when a monstrous pain hit.
There had been no signs of a menace lurking in the water. The shark came out of nowhere, emerging from the water, jaws open. It chomped down, sinking its teeth into Ernst’s left leg, shattering her bones instantly.
The scene she turned to see horrified her. A Caribbean reef shark, probably 5ft in length, had clenched its daggers into her calf and pulled Ernst’s entire foot into the depths of its mouth.
She balled her left hand into a fist and punched it. One of its teeth stabbed her middle finger.
A crew member delivered another blow, kicking its head. The assailant finally released her leg, and adrenaline helped Ernst scramble up the ladder.
To stop the blood loss, the divemaster wrapped a tourniquet around the gaping wound. His wife contacted land, asking them to ready an ambulance and call the hospital.
I know I’m going to lose this leg, Ernst thought. But I don’t want to die.
In death’s proximity, a vision overtook her. She felt herself floating above the boat, rising through the air. No wounds, no blood, no pain. The white puffy clouds painted the blue skies like the ornate ceiling of the Sistine chapel. Pure peace, but not for long.
Back in her body, she lay on the boat’s deck in excruciating pain. A bath of blood welled around her, the salt water still dripping off her body.
A young man cradled her head in his lap and prayed with her as the boat sped to shore. Ernst had stopped going to church for many years, but just a few months ago she had decided to return to services. Maybe it was in preparation for this.
“Please don’t let me die,” she pleaded.
Emergency crews rushed Ernst to a local hospital to stabilize her broken fibula. The next day, they flew her to Fort Lauderdale and an ambulance sped her to Ryder trauma center at Jackson Memorial in Miami.
The doctors there had to figure out what to do.
In the course of 10 days, Ernst’s medical team would transfuse nine units of blood, roughly a pint each, to account for all that she had lost (an average adult holds 10 units). A day after the attack, the trauma team did not yet know the totality of the blood loss. They worried more about a correlated problem: the open wound had left Ernst vulnerable to the salt water’s flesh-eating bacteria.
The severed nerves, arteries and veins meant no blood could flow to her left foot. It turned black. Ever since the attack, the extremity had sagged and had no feeling, a type of paralysis known as drop foot. Reattachment looked bleak. There was no guarantee that the surgeon could bring the nerves and blood vessels back to life, and even a healed wound, the team believed, promised tremendous pain.
Instead, the surgeon recommended an amputation.
The doctors detached Ernst’s left foot and all but a few inches of that calf, cutting away the threat of continued infection. They reattached the flesh and the nerves at the bottom of the appendage.
For some amputees, the first time viewing their severed limb can be devastating. But as a physical therapist, Ernst knew what it would look like right after surgery, how it would heal, how it would need to shrink down before working with a prosthetist.
When she gained consciousness after the surgery, Ernst wondered what remained under all the dressing now wrapped around her residual limb. Unspooling the bandaging, she was not filled with shock, anger or sadness. If this was the cost of her life being spared, she would accept it.
It helped that the surgeon had been able to salvage one thing below that knee: her shark tattoo.
Though her body felt unmovable, she had witnessed strong will after debilitation before. Her husband, Bill Ernst, once a burly firefighter, could barely walk 10ft after a massive stroke in 2013. With the help of physical therapy, he regained several more years of independence before his death in 2019 after additional strokes and cancer. If he could do it, so can I, she told herself as the hospital’s team wheeled her to physical therapy.
A hospital psychologist told her she probably still hovered in survival mode, but that one day, her trauma might get sparked like a wildfire and envelop her in its flames. A couple of times in the hospital, Ernst relived the attack while awake, but that has yet to recur. No nightmares have jolted her from her slumber. She has not wallowed. After brief self-pity, she stopped the waves of negativity from crushing her by building a levee in her mind: You’re going to have a prosthesis that will allow you to do anything you’d like.
Ernst relied on humor to get her through. When her friend drove her the 20-plus-hour journey from the trauma center back to Iowa, she insisted she be photographed outside of an Ihop restaurant. After all, she would be hopping to get around.
Several national and local news outlets reported the attack. People she didn’t know wanted to help her, including one resident at the Iowa Veterans Home who saved up all his Bingo winnings for her. People who had seen her story talked to her like they knew her, and random people asked questions, like a boy at the Y who wanted to know whether it hurt. To help answer the questions she knew lie behind people’s stares – or worse, their lack of eye contact – she purchased a blue sock to cover her appendage. It had a picture of a shark, jaws agape, with bold lettering: “A SHARK DID IT.”
She now propped her stump up on a hardware bucket so she could still drive with her right foot, used parallel handlebars for balancing in the shower, and developed a routine to propel herself on to her zero-turn riding lawn mower.
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On 7 August, when Ernst turned 74, she posted on Facebook: “The best thing about my birthday is that I had one!”
For 103 days, Ernst has put all her effort into gratitude for life’s offerings. But on this September day, her positivity requires no effort, no stoicism. She can barely control her giddiness.
In a small room at the Hanger Clinic in Ames, about 45 minutes from Ernst’s home, the sun shines through the blinds as her clinician, Maggie Siebel, brings in the prized possession.
A couple of weeks ago, another clinician had circled an iPad around her amputated leg. The scan was used to 3D-print a leg socket that serves as a starting point. Siebel can melt it down and make adjustments right in the same building. Ernst gets to try it out.
“OK, so what we’re gonna do is stand and step down in this,” Siebel says, holding the leg.
Ernst pushes her bulbous appendage, wrapped in a gel layer, through the narrow hole – like squeezing into the tightest pair of leather pants.
Siebel examines the fit. It needs a couple of adjustments. “And then we’ll walk for real.”
When Siebel and her resident Hunter Shaull exit, Ernst pulls fabric from her purse to show the neighbor who has driven her here. The cloth will be added to the socket, giving the mechanical-looking object a touch of personality. She has selected a bright blue material, emblazoned with Caribbean reef sharks.
Siebel carries in the improved leg. It’s time to walk.
After she pulls the prosthesis on, Ernst clutches metal handrails to stand up. Since amputation, Ernst has been hopping on her right leg with a walker, balancing her foot in the center of her body. Now she must adjust her gait for two legs.
“I’m not going to be running, yet,” Ernst jokes.
“We always say, ‘You didn’t learn to walk in a day when you were a baby, and it’s kind of the same thing,” Siebel replies.
“Actually – I hate running,” Ernst says, laughing. “So I have an excuse now.”
“You totally do,” Siebel responds.
Between several adjustment rounds, Shaull shows Ernst an inexpensive swimming fin that straps onto her amputated leg, an idea she loves. During the last trial walk, Ernst experiences a strange sensation.
“I feel my Achilles tendon,” she says. The one that is no longer there.
There’s science to explain this: even though the tendon is gone, the nerve ending isn’t and walking with the prosthesis makes it fire off. There’s also something beyond science: a reminder to Ernst that her body works miracles.
Only a day has passed after the prosthesis fitting when Ernst books a November flight to the Bahamas. She’s finally in for smooth waters. Knowing she will have two legs, she will be able to walk down to the dock for one more dive trip before the late December air chills the water.
But a new obstacle comes out of nowhere.
On the date her leg is supposed to be ready, scheduled about two weeks after her fitting, it’s not. Then more time passes, so one October day she calls to inquire about the holdup.
The prosthetist tells her that preauthorization from Medicare has been denied. The agency will not cover the cost of the leg. Most 74-year-old amputees don’t need a leg that high-tech, the agency has rationalized.
But most 74-year-olds are not scuba-diving, acreage-owning, physical therapy-providing people like Heidi Ernst.
For the first time since the attack, tears stream down her face from the cruelty. She imagines the people in the Medicare office scoffing at her claim, seeing her only as a number. How could they deny a prosthetic leg for someone who’s been hopping around on one leg for almost five months?
The clinicians assure her they will fight back. Instead of letting the anger wash over her, she opts for patience – a virtue on which she now relies.
Since the attack, she sometimes wonders: Why did this shark attack me when shark attacks are rare? Am I being punished? But then she remembers her life was saved. She has been spared for some greater purpose.
She hasn’t yet fully figured out why. Then one day in late October she gets the call. After more than three weeks of fighting Medicare: victory.
She squeezes the leg on once more at the clinic – it needs a few adjustments. That’s kind of the theme of Ernst’s life now.
Something like this would swallow many people whole. But Ernst remains fearless, and she never takes life too seriously. She has named her new leg “Chomp”.
In November 2023, she once again climbed aboard a boat, sailed out to sea and dived with her friends at Grand Bahama Scuba. And, yes, with the sharks.
Though diving felt healing, something else bothered her. On the boat, she’d needed assistance getting around. Negative thoughts intruded, to the point where she needed a day to herself.
She recovered by doing what only an amputee could.
She kicked herself in the behind with her prosthetic leg and told herself to get a grip. Instead of thinking about all that she couldn’t do, she thought about all that she could. That, well, was quite a lot.
Emily Barske Wood is an Iowa journalist who reports and edits human interest stories, especially those related to inclusion. She works part-time for the Des Moines Business Record and for NPR’s Public Editor team. She is completing her MFA in narrative nonfiction through the University of Georgia
