It had been a long two years for Beth Callahan.
As a physician assistant in the intensive care unit at Lahey Hospital & Medical Center, she’d rise each morning, strap on an N95 mask, and care for COVID-19 patients. She’d monitor the oxygen coursing through intubation tubes and into the stiffened lungs of her sickest patients. She’d prop up iPads so that worried family members could see their loved ones. Then she’d come home to Arlington to help raise her 8-year-old twins.
Eventually, it became too much. Like so many health care workers across the nation burned out by the grind of the pandemic, Callahan, 42, quit her job of almost a decade in late January. Days later, she, her husband, and their twins set off for Puerto Rico, eager for a reprieve amid the mountains and palm trees.
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But in a cruel twist, Callahan now lies intubated in a San Juan hospital intensive care unit after she slipped atop a cliff during an excursion on the island last Wednesday.
The day began with a hike through the El Yunque National Rainforest to a series of waterfalls with pools at the bottom of each. At the first waterfall, Callahan and her family slid down a natural rockslide into the clear, cool water.
Up above, another group was preparing to jump off a 50-foot cliff that towered over the pool below. Callahan’s guide and husband hiked up and followed suit. Then she decided to give the plunge a go.

Once atop the cliff, though, Callahan grew hesitant. She attempted to leap a couple of times before backing down. On her third attempt, with the group below cheering her on, she lost her footing and tumbled down the cliff into the pool. Somewhere along the descent, she hit her head and was knocked unconscious.
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“The horrible irony of it all, after everything that she went through the past two years, is too much,” said her sister, Sarah Hart, who learned the details of what happened from a woman who witnessed the fall.
It’s not clear if Callahan would have made it to the hospital at all if another health care worker seeking refuge from pandemic pandemonium had not been hiking the same rainforest trail.
Kris Knopp, a 42-year-old emergency room physician at a hospital just outside Chicago, had also jetted off to Puerto Rico to decompress after the crush of the Omicron surge. That day on the hike, he’d jumped off a cliff into the pool below, and then dried off and begun the muddy trek back to the van at the start of the trail when a man appeared and alerted his guide that a woman had just slipped off a waterfall.
A fellow hiker ran toward the trailhead in hopes of finding cell service within the remote rainforest to call an ambulance to the parking lot and medics to the scene.
Knopp, meanwhile, said he quickly jogged back to the nearby pools and found an impromptu group — among them a surgical resident and two nurse anesthetists also on the trail — stabilizing Callahan with twine to a wooden slat. Her breathing was shallow and erratic, a telltale sign of neurological damage.
Knopp asked that the twins be escorted away from the falls, unsure of how much longer Callahan might survive.
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“It was frustrating because there are some things you could intervene upon in the field — say, a broken leg. But you could tell within a few seconds that she needed a neurosurgeon,” Knopp said.
The closest one was some 30 miles away in San Juan. And to get there, the group needed to carry Callahan to an ambulance at the start of the trail, roughly a mile and a half away. They attempted to transport her on the makeshift spine board, but the task seemed too risky. So they waited for the medics to arrive. When that team emerged from the forest roughly an hour after Callahan’s fall, the group then began to carry her along the undulating path and over footbridges cutting across the river that feeds the waterfalls.
Knopp parted ways with Callahan in the parking lot. He spent the final few days of his vacation wondering if she had survived the journey to the hospital. Then, while waiting for his flight home, Knopp ran into the man who had rescued Callahan from the water. The hiker shared a GoFundMe that Hart, Callahan’s sister, had put together to help with medical expenses.

He immediately e-mailed Hart, expressing his joy that Callahan was still alive.
When they later connected by phone, he asked her straight: “How much do you want to know?”
“Just tell me everything you know. I can handle it. Tell me it all so I can be closer to my sister,” she responded. So he did.
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As of Tuesday afternoon, Callahan remained stable, but in a coma, her sister said. Her husband, Daniel, her high school sweetheart from their days in Shrewsbury, hoped to get her on a medical flight to Beth Israel Deaconess Medical Center in the coming days so that she can be closer to home and in a hospital of colleagues and friends connected to Lahey.
But intensive care units in Suffolk County remain 85 percent full, with COVID-19 patients filling 19 percent of those beds, according to federal data. The family worked all day Tuesday to secure a bed for Callahan.
Then, finally, just after 9 p.m., a staffer at Beth Israel rang Callahan’s husband in Puerto Rico with some rare good news. They had an open bed.
Back in Massachusetts, her sister was elated. “The gift of Beth, at home in her home hospital,” she said.
Hanna Krueger can be reached at hanna.krueger@globe.com. Follow her @hannaskrueger.