‘10 out of 10 sick’: How Lancaster General Hospital fought to save Ciara Dierking’s life
When an infection turned to sepsis, it took surgeons, nurses, therapists, chaplains, and countless others working together to save a young mother’s life.
Critical care nurse Rebecca Berry, BSN, RN, CCRN, knew Ciara Dierking was even sicker than she appeared the moment she rolled through Penn Medicine Lancaster General Hospital’s emergency department doors on Dec. 28, 2023.
Ciara, then 33, was struggling to breathe behind a pressurized oxygen mask. Later that day, Ciara’s husband David would be told his wife was “10 out of 10 sick.”
In those first moments, as Berry waited to transport her to the intensive care unit, she noticed alarms indicating the young mother was going into shock. Ciara’s blood pressure was beginning to fall. Her oxygen levels were slipping. The young mother was barely engaging with the people around her, expending nearly all of her energy simply trying to breathe.
“She was teetering on the edge of the cliff of cardiac arrest,” Berry said.
Berry called ahead to the ICU to make sure critical equipment would be waiting, requested a ventilator, and alerted staff that Ciara might need aggressive intervention immediately upon arrival. To stabilize her for transport, Berry urged the team to start medications to raise her declining blood pressure.
Ciara was on her way to a five-week fight that would require doctors to place her on life support, shock her flatlined heart, and amputate all four of her limbs.
Nearly three years later, Ciara is standing longer each month on prosthetic legs, and speaking publicly about what she survived. None of that, she says, would be possible without what happened over her 37 days at Lancaster General Hospital.
‘Weather the storm’
That Christmas, Ciara and David had driven with their children 10 hours from Rock Hill, SC, to Lancaster County to visit family. On Dec. 26, their 3-year-old son, Colton, was hospitalized at Lancaster General Hospital with what turned out to be COVID-19, strep, and abscesses in his neck. After a few days, he was transported to a nearby children’s hospital to undergo surgery to remove the abscesses, and made a speedy recovery.
But before Colton’s transfer, Ciara began feeling ill herself and went to the ED.
Within hours, Ciara, too, was diagnosed with strep. But her illness would take a very different course.
The strep bacteria had entered her bloodstream, triggering sepsis, a life-threatening condition in which the body’s immune response can damage its own tissues and organs. Toxins from the bacteria also caused streptococcal toxic shock syndrome, a rapidly progressing infection that sends the body into shock and causes organs to shut down.
When all traditional medical therapies were clearly failing, cardiothoracic surgeon Jeremy McGarvey, MD, placed her on ECMO—a machine that would take over the function of her heart and lungs. That proved to be a lifesaving measure when the toxic shock syndrome resulted in widespread tissue and muscle breakdown, and her heart stopped for about 20 minutes.
“If you looked at her EKG, it was a flat line,” McGarvey said.
‘A different level of coordination’
David and his mother-in-law, Brenda Smith, who had arrived from South Carolina just moments earlier, were pulled from the family waiting room.
In the hallway, they could hear defibrillator paddles being used before they’d even reached the door. Smith dropped to her knees and prayed. Lancaster General Health chaplain Krishana Suckau, ThD, BCC, got down on the floor beside her.
The ECMO machine kept blood moving through Ciara’s body even without a heartbeat. Dialysis cleared the potassium from her blood; slowly, her own heart found a rhythm again. By morning, there was a flutter, then something steadier.
“It was one of the first moments where I thought she might be able to pull through this,” David said.
What followed was 37 days of a kind of medicine David hadn't imagined existed—a rotating team of critical care doctors, cardiac and vascular surgeons, infectious disease specialists, renal doctors, respiratory therapists, nurses, and chaplains, all working in sync.
“When doctors would change shifts, someone who had been out over the weekend came into the room first thing in the morning and knew what had happened,” he said. “There was no catch-up time needed.”
David began sitting in on the ICU’s multidisciplinary rounds, joining the pharmacist, doctor, nurse, and nurse manager as they moved from room to room.
ICU nurse manager Aimee Anderson, MSN, RN, CCRN, made some compassionate compromises. She moved Ciara into one of two ICU rooms with a private nook to give David an area to work remotely and sleep. And she made an exception to an unwritten rule that children shouldn’t be in the ICU, so that the Dierkings’ kids could visit their mom.
Ciara’s survival wasn’t yet guaranteed, and as the days passed, staff members found themselves deeply invested in her recovery.
Braided hair and Bible verses
Amanda Harting, BSN, RN, E-AEC, Lancaster General Health’s ECMO coordinator, said the program implants and manages roughly 80 ECMO patients a year, but few captured the hearts of caregivers the way Ciara did. She was a young mother of two who had been healthy only days before her hospitalization.
As Ciara’s fight stretched from days into weeks, the staff saw pieces of themselves, their spouses, or their children in Ciara’s story. They found themselves rooting for her recovery and looking for ways to make her long hospitalization a little easier.
Patient care assistant Ashley Maynard braided Ciara’s hair some mornings, “trying to make her feel and look her best at the lowest time in life.”
“With Ciara, I just felt a connection because she's my age and we’re both moms,” she said.
Anderson and nurse Victoria Mollitor, BSN, RN, CCRN, decorated Ciara’s room for an early Valentine’s Day in mid-January and, when Ciara’s sister visited, Mollitor organized a spa day for them with lotion and face masks. With Ciara unable to speak at times due to a breathing tube in her throat, nurses learned to read her lips. One time, nurses interpreted that Ciara wanted a fan moved in her room by deciphering the direction of her eye movement.
After once helping draw a difficult blood sample from Ciara, respiratory therapist Kristen Knowles, RRT-ACCS began stopping by her room on her own time. In talking with David, Knowles learned she shared the family’s Christian faith, putting her at ease to read Ciara passages of Scripture and play worship music at her bedside through the weeks Ciara couldn’t speak or track what was happening around her.
“I just wanted to be there for her,” Knowles said. “We’re sisters in Christ … to me it was special.”
Chaplains also visited the family 16 times during Ciara's stay.
“We talk about it as a ministry of presence or accompaniment,” Suckau said, “walking alongside people when there are no words.”
But even as staff tended to her, Ciara’s body was already losing a separate fight, one unfolding quietly in her arms and legs.
Life over limb
To keep Ciara’s heart and brain alive through septic and toxic shock, doctors had maxed her out on vasopressors—blood pressure medications that work by narrowing blood vessels, squeezing what circulation she had left toward her vital organs. ECMO carried a similar risk. Both treatments were saving her life. Both also came at a cost: less blood reaching her hands and feet.
“It's literally a situation that’s life over limb,” McGarvey said. “You may have an intact brain and heart, but it’s going to come potentially as a consequence that your limbs will die off.”
McGarvey called in vascular surgeon John Affuso, MD, and hand surgeon Adam Griska, MD, to assess the extent of tissue death in her arms and legs. Hoping to preserve as much future function as possible, they waited until they could distinguish dead tissue from living tissue before performing staged amputations of her legs and arms.
Mollitor wheeled Ciara to one of those surgeries herself.
“I looked at her, knowing she was still fighting,” Mollitor wrote in a paper for her Doctor of Nursing Practice program. “Still a mother. Still a person with hope, love, and faith, even in the face of this unimaginable loss.”
The hallway
On Feb. 2, 2024, Ciara was transferred via medical flight to a hospital closer to the family’s home that also specialized in limb loss, as Ciara required additional amputations.
Lancaster General Hospital nurses, clinicians, therapists, chaplains, and other staff lined the hallway to see Ciara off, cheering a patient many had come to know deeply.
“I did not realize how many people were out in the hall until we turned the corner,” David said. “That was very special.”
Ciara doesn't remember that moment, or most of her time at Lancaster General Hospital. Heavy sedation and the trauma of those weeks left gaps in her memory. She came back in October 2025 to meet the people who could help fill them in.
The reunion occurred in the same ICU room where she had been treated.
“Going back, meeting everybody, hearing all the stories, it helped make sense of the timeline in my mind,” she said.
She posed for photos with staff and listened to Mollitor read from the doctoral paper she had written about treating Ciara. For the team, Ciara’s return visit provided something caregivers rarely receive in health care: the opportunity to see a patient’s long-term outcome.
“It made me realize, ‘Wow, we did this. We saved her. She’s doing well. She’s alive,’” Mollitor said. “It really helped the whole team know that our hard work paid off.”
For Ciara, making the most of that life has been its own kind of fight.
Finding purpose after survival
During Ciara’s hospitalization, David created a Facebook page to keep family and friends updated on her condition. What began as a way to communicate through a crisis has since grown into a community of more than 49,000 followers, including staff members who cared for her during those 37 days in Lancaster.
The updates document a journey that is still unfolding. There, Ciara has shared that she is still learning how to live in the body she has now. She has spent the years since her illness cycling through surgeries, physical therapy, and prosthetic procedures to improve her mobility.
In 2026, she underwent osseointegration, a limb reconstruction technique that provides greater comfort and freedom of movement. She recently reached a milestone of taking some of her first supported steps on prosthetic legs.
At home in South Carolina, Ciara relies on a part-time caregiver and an all-terrain wheelchair to keep up with her boys, who are now 8 and 6, inside the house and out. The boys have grown into their mother’s care team in small ways. They do their own laundry now and look after their own rooms.
“Sometimes I can talk the boys into being my hands for a few minutes,” Ciara said, “and I’m so grateful for those moments.”
Ciara has also become something she never expected to be: a public speaker. She has spoken about her journey and how it has impacted both her identity as a mother, and her faith, at women’s retreats, church banquets, and, earlier this year, to a room of nearly 400 teenage girls.
“I hope we can give people encouragement that no matter what happens in their life, with God's grace, you can make it through anything,” Ciara said.
When Ciara arrived at Lancaster General Hospital in 2023, she was wearing a sweatshirt that read “Always Grateful.” The phrase has since become the foundation of an apparel line she and David created to raise money for her medical expenses, while reflecting the family’s outlook on faith and recovery.
None of it looks like the life Ciara expected to be living at 36. Some of it, she’ll say plainly, is still really hard. But nearly three years after a nurse looked at her and understood, before almost anyone else did, how close she was to dying, she is still here, still telling the story of the 37 days that made the rest of her life possible.