4:26 p.m. Just 47 minutes after the call to Stanford, the helicopter glides back over the bay, the Dumbarton Bridge visible through a haze in the distance. The aircraft approaches Palo Alto, passes over the Stanford Stadium, then begins to vibrate heavily as it prepares to meet the helipad.

The back door of the aircraft is opened, and hospital security officials swiftly offload the gurney into an elevator and down to the first floor. A greeting committee of some 15 doctors, nurses and technicians is waiting in the hall just outside the emergency department to welcome the little girl and wheel her into the trauma room.

4:47 p.m. The clinicians cut through her red T-shirt and remove the head brace to reveal the little girl’s slender frame and her shock of black hair. They gently poke and prod her to see if her limbs are working and ask simple questions to gauge her mental status. “Who is this?” asks emergency physician Phil Harter, MD, pointing to her mother. “Is it your daddy? Is it your uncle? Is it your mom? The girl just nods, then yells one of the few words she will utter during the ordeal: “Mama!”

Harter, an associate professor of surgery, orders a CT scan, which will help determine the extent of her injury, and Aeshna is rolled into the big machine next door.

An hour later, results in hand, he issues the diagnosis: Aeshna has a skull fracture and a concussion. She needs to be watched closely for possible bleeding, but no surgery is called for now. She has suffered significant head trauma, and it will take time to heal. He briefs the parents, as the girl’s father has arrived from his job in San Francisco. “Right now, we don’t think she’s at risk for bleeding, but that’s why we’re watching her,” he says. “There is no intervention other than to watch and see that she improves. And that takes time.”

Hammer, who takes over her care in the pediatric intensive care unit at Packard, says there is a depression of a few millimeters in her skull — not enough to put pressure on the brain. But the fracture occurred close to a major artery, a spot where clinicians sometimes see disastrous bleeding, he says. So she is lucky the fracture wasn’t too deep.

The concussion also knocked around her brain inside the skull, jarring the nerves. So she is very sleepy and “out of it” and is prone to vomiting. In the intensive care unit, she is awakened every hour during the night for “neuro checks” — a test in which nurses ask her to grab a hand or answer a question and check her eye movements and see if the pupils are normal. Her scores aren’t perfect, but they are OK. A CT scan the next day again shows no signs of bleeding.

“She was extremely lucky,” Hammer says. “To have this thing fall off the wall and cause a skull fracture and no worse injury, that’s good news…. It’s amazing how lucky some people are, given the circumstances.”

Though Aeshna hasn’t returned to normal, Hammer sees she has supportive parents and he feels comfortable enough to let her go home later that day. She leaves the hospital at 5:17 p.m.

The flight nurses are relieved: “It could have gone differently,” Gardner says. “She could have had a crushed head, blood everywhere. I’ve done CPR on patients on the helipad.”

Because the nurses operate independently, they feel ultimately responsible for the outcome. “It’s emotionally taxing,” Gardner says. “If that kid didn’t have a good outcome, we go home with that. You feel it’s all on you.”

Four days after the incident, Alameda County officials shut down the preschool because of multiple code violations. The loaded, 2-by-4-foot cabinet had shorn away from the wall because it had not been properly secured: It was attached only to sheet rock, not to studs in the wall, says Diane Hendry, a division chief in the Fremont Fire Department.

Back at home, Aeshna is slowly recovering in a process that could take months. She has to limit her activities so her brain does not become fatigued. That means no story books, no exciting games, limited TV watching and certainly no somersaults or headstands, as any further injury to the brain could cause long-term problems, such as cognitive difficulties or memory loss. That is a tough prescription.

“She has resumed activities and wants to do all things, but it’s hard to keep her tied down to bed,” her mother says. As a result of the accident, the family went to India for a few weeks to stay with relatives, who helped provide support and care, she says. She says she is optimistic about Aeshna’s prognosis, but she is nonetheless shaken by the experience.

“It looks like it’s going well, but you have this insecurity in the back of your mind until she has a full recovery,” Bhatt says. Like the accident itself, it’s all a matter of time.