::Warning – This post contains graphic imagery and a situation that may not be suitable for all readers. It is however Safe for Work. Consider yourself warned.::
Late September 1995 was a perfect Indian Summer in the Midwest, warm temperatures, bright sunshine and everything was green and beautiful. It was a perfect Saturday afternoon made for playing frisbee with a dog, or fishing, or anything that would get you outside to enjoy the best part of the year.
Agnes was driving home from a visit with her mother in the next town over. The radio was on, the windows were down and other than her dark green 1986 Oldsmobile, no traffic on the highway. Her 13 year old son, Jeffrey, having been up most of the previous night playing video games, had drifted off to sleep in the passenger seat clutching his GameBoy.
They were about twenty minutes from home, heading into a wide valley between two of the rolling hills of north-central Missouri when Agnes noticed a bright reflection off the glass of a large black Ford Bronco approaching them from the top of the next hill. The driver of the Bronco seemed be having trouble keeping the truck under control as it picked up speed on the incline. The right tires briefly slipped onto the gravel shoulder kicking up a rooster tail of dust. The driver seemed to get it together, and then swerved into the center of the two-lane roadway.
Agnes grew concerned that the driver was either drunk or otherwise incapacitated, so she slowed down and pulled to the right shoulder. She continued driving forward slowly while the truck continued to weave back and forth, growing ever closer. Agnes stopped the car on the shoulder and flashed her headlights in an effort to get the driver’s attention.
Unfortunately, the driver of the Ford Bronco, David, was asleep at the wheel. His allergies had been bothering him something fierce with all the recent rain and warm weather keeping the pollen and mold counts high. He had taken some Benadryl and was hoping to make the trip from St. Joseph to Macon without using an entire box of tissues. The effect of the medication, and the warm temperatures induced a ‘highway hypnosis’ that he was powerless to resist.
The Bronco, traveling around 70 miles per hour crossed the center line and in a perhaps one-in-a-million shot slammed head-on into the parked Oldsmobile.
I was on emergency service call that day, meaning that I was in uniform, but at home carrying a pager/radio. When the call came in to the dispatcher, he sent the warning tones out over the airwaves that activated the pager.
I recognized the tone for my pager (each person’s pager responded to different tone frequencies, mine was a perfect descending 4th) and was already walking out the door to my pickup when the tone for my supervisor, John, went out and the dispatcher’s voice crackled over the radio. “Units 2 and 5 10-21 Emergency.” The ten code meant ‘report to base’ and ’emergency’ meant ‘turn on the lights and sirens on your personal vehicle and get here 10 seconds ago.’
John and I lived less than 2 blocks from each other, which in turn was approximately 12 blocks from the station. We arrived almost simultaneously. Bryan, the dispatcher, met us at the door with the call sheet containing the location and any other available details, and a set of gloves for each of us. Our procedures dictated that we put on our gloves and other protective gear before we entered the ambulance. In emergency situations it is quite easy to forget to stop and glove up once you arrive and get caught up in the scene.
“There’s a 10-50 J2 J3 on Highway 36 between Marceline and Macon. Macon County is already en route,” Bryan informed us. A 10-50 is an automobile accident and J-codes were used to classify the severity of injury. J1 was no-injuries, J2 meant injuries reported, J3 meant multiple patients. The neighboring county had an ambulance closer to the scene than we were and was responding, but as the location was within our county, we would run the show upon arrival.
That Ford ambulance had an 8-cylinder 450 engine that I once personally drove at 140 miles per hour with plenty of room left between the accelerator and the floorboard. John drove to the scene this particular day.
We were about 8 minutes from the scene when Macon County arrived. The Highway Patrolman who had responded contacted us, and stated that this was a 10-50 possible J4.
We arrived to what can only be adequately described as a ‘clusterfuck.’ There were police vehicles and two of Macon County’s ambulances, our own fire squad who had followed us, Marceline’s volunteer fire squad, and probably every single civilian with a police scanner parked haphazardly in our way.
John and I hopped out of the ambulance, grabbed our bags and hurried to what had once been a dark green Oldsmobile. The hood of the car had crumpled and was now situated where the windshield should have been. The roof of the car was flattened almost level with the headrests of the front seat. Engine parts were strewn about the highway, parting streams of antifreeze and various other fluids leaking from the inner workings of the car.
It’s strange how quickly a bit of training and only a small amount of experience can make your brain begin to work in a different way. I looked at the smoking wreckage and my brain immediately began processing things like: Head on collision means we should first check for head and chest injuries caused by the windshield and steering wheel, then seatbelt injuries to the neck and shoulders and then extremity damage caused by the transmission being forced up into the floor or the engine block entering the cabin…
The fire crew was getting the hydraulic snips, often called the ‘Jaws of Life’ assembled, and one of Macon County’s medics was hanging halfway out of the passenger window trying to assess the status of the patients inside. We couldn’t get the doors to open, and it was going to take some time for Jaws to grant access to the passengers.
I was much smaller than I am now, and was able to easily drag myself into the backseat of the ruined car through the driver’s window. John handed my bag to me through the window and I began to yell out instructions to those standing outside.
Agnes had been screaming non-stop since we arrived. I was positioned behind her and trying to calm her down. She didn’t have any obvious head or neck injuries and was freely moving her arms around but the force of the collision had propelled her downward into the floorboard and the seatbelt had locked holding her into place and keeping her from changing position. I couldn’t see them, but between shrieks of pain she informed me that her legs were broken. I was hyper focused and picking up on little details one at a time. Things were moving in slow motion for me. Get the cervical support collar positioned, calm her down, ask her if had pain anywhere besides her legs, is that blood on her arm?
I had been in the car all of about 6 seconds.
The medic who still had his legs dangling out the passenger window motioned to me and said, “I need some help here.” I hadn’t yet noticed that he was attempting to perform CPR on a slightly overweight teenager who was laying in the seat out of my view. I leaned my body over the seat back to gain access and realized that the boy was trapped behind the woman. I yelled out the door for an ETA on Jaws and then made the decision that I would have to move the woman to get to the boy.
I had to position myself so that my shoulder was pushing Agnes forward, toward the steering wheel, my back was pressed against the flattened roof and my feet were wedged in the backseat giving me some leverage. I was able to reach the boy better from my position and continued CPR, using my left hand to hold and operate a bag mask and my right to do chest compressions. Agnes was still shrieking from the pain of her broken legs, and randomly pressing back against my shoulder in an effort to free herself from the car.
At some point, the firefighters threw a blanket into the car for me to protect ourselves from flying glass and shrapnel. The sound of Jaws wrenching the sheet metal and the screams and instructions being called out around me got drowned out as I was under that dark blanket staring at the lifeless body of a boy the same age as my brother. I knew from the start that he was dead. It was obvious from the visible injuries that he was killed instantly. Missouri’s law stated that once a medic began performing CPR, they could not stop without a doctor’s direct order. Our county’s policy was that once began, CPR would not stop until the patient reached the hospital and doctors took over. None of that mattered, as stopping would have meant that I would have to explain to that woman why we were not working harder to help her son. Not that she had stopped screaming long enough to ask how her son was doing. Intense pain makes you blind to everything around you.
The fire crew got the door off the car and John entered with the backboard and straps to extricate Agnes. He looked me in the eye and asked, “Are you all right?”
“I’ll be better when you get us out of here.”
Agnes had compound tibula/fibula fractures of both legs, exposing bone and muscle tissue. She was loaded into a Macon County ambulance and rushed to the hospital. John reappeared at the door with another backboard for the boy. We couldn’t get him positioned correctly without moving him, and as the three of us coordinated the effort to move him, the extent of his injuries became more apparent. Virtually every bone in his upper body had been broken. His shoulders did not move at the same time as the rest of his torso. In my flashbacks to this day, I picture him as being like one of those old action figures that was held together by an elastic cord. Once the cord got old and stretched out, the limbs would dangle loosely and the waist would separate from the chest.
John pulled him from the car, and moved away with the stretcher. It got quiet for the first time and I realized that the radio was playing softly. The Goo Goo Dolls, “Name.” He was being loaded into our ambulance when I finally crawled out of that backseat. I had been in the car for over 20 minutes.
As John lifted the stretcher onto the back of the rig, I heard the clatter of something dropping onto the roadway. I bent over and picked up a GameBoy. The screen showed an all too appropriate “Game Over.”
I drove back to the hospital, lights flashing and sirens wailing, but not exceeding the speed limit. John and I both knew that there was no hope that we would be able to resuscitate Jeffrey. John was following our trauma code procedures, continuing CPR and administering cardiac drugs, but there was no question in our minds that it was a lost cause. By slowing down we were giving the hospital a little extra time to stabilize Agnes before we rolled in.
We were at the hospital for a long time, filling out our call reports and assisting the hospital staff. Agnes stopped screaming soon after she received some pain medication, and I overheard her description of the accident to the police. She did not yet know that her son was lying in the next room. My favorite nurse was cleaning him up before they told her. I helped her wash the blood off his face and borrowed John’s comb to straighten his hair.
We got back to the station and began cleaning and restocking the rig. A routine that I had now performed hundreds of times. I don’t remember doing it.
John’s wife, the District Coordinator (boss), was waiting for us in the office. We walked in and John gave her a short run down of the scene. I was pretty numb by this point… running on pure adrenaline and instinct for an extended period of time has a way of draining you. For all of the problems that I had with John and his wife over the years that I was a medic, I will never forget the most important thing he ever said to me that day.
“This is it. This is as bad as it gets. I had my doubts when you started here that you were cut out to do this job. You are only 20 years old, and I just didn’t think you had the stomach for it. But I was wrong. It doesn’t get any worse than a kid who was doing nothing more than taking a nap getting killed while riding with his mom. The real test will be tonight, when you get home and things quiet down. If you don’t have a nervous breakdown and think you can get up and work again tomorrow, there will never be anything else in your life that is this hard.”
I went home that night and I cried for hours. I sat in the bathtub sobbing and shaking and snotting all over myself.
When I got up the next morning, I was able to go to work. And I went on other calls that were disturbing and stressful, some of which I’m sure I’ll write about here as they made definite impressions on me.
When I’m asked on job applications how well I perform under stressful situations, I write that there isn’t anything in the office that is as life and death as my job as a medic, so they could throw anything they like in my direction.
I think about that accident often. Usually when I’m feeling particularly stressed, or on the rare occasion when I feel like my self-esteem needs a bit of a boost.
Because John was right. There has never been anything else in my life as hard as that beautiful September day.