Crash Decision

There is a hollowness to the sound a car makes when it crashes.  The sound of screeching tires, of breaking glass are more forefront – but inside all of that there is also a deep transmuted, sub-sound.  As if inside the moment of impact, a hungry void swallowed the destructive forces, then spat it back at you, hitting you not in the ears, but inside the body.

It is difficult to shake from your chest.

One road connects the plains of northern Montana to Yellowstone, the Tetons, Flaming Gorge, Moab, Four Corners, south through the Apache National Forest.  Route 191 touches Canada and Mexico and between, it traverse hundreds of miles of the most remarkable landscapes this country has to offer.

Our trailer park wasn’t on one of those miles.  A strip of grass followed by a dirt parking lot separated our front door from the logging trucks headed north out of the mountains and skiers heading south to Big Sky.

The dozen or so trailers and double-wides were perpendicular to the road, ramshackle and worn.  Sleeping our first nights there, on the floor on camping mats, it was so cold that the moisture from our breath froze our hair to the back wall.

At the time we were just grateful for a place to call home.  In retrospect, it was a bit sketchy.  Actually, probably a lot sketchy.

The Benedictine monks “Chant” would accompany my 20 minute meditation.  Part of my launch sequence before my night shift in the Emergency Department.  I’d be pouring in the coffee shortly, but now I was still sitting; that was where my head was at.

I don’t recall any screech, but can’t forget the crash.  Maybe it hit so hard because I was meditating.  The deepness of it.  The hollowness with its ugly anger felt like a monster was out there swallowing comfort, normalcy, safety.  It sounded hungry.

I also don’t recall much between hearing the crash and  heading across the parking lot, the grass strip, and out to the road.  My partner was behind me, getting her car started so we’d have some light to work with, but other details simply disappeared into what was about to happen.

As I walked up onto the road, I saw mid-sized pickup just beginning to burn.  It was cattywampus across the road,  and from the fire light, I could see the driver.  The condition of the truck told enough of a story.  As I got closer, I figured the driver wasn’t much for this world.

I was within a couple yards of the truck when a looming figure just appeared – seemingly from nowhere.  I’d probably tunneled my vision to the driver of the truck and the fire that lit his battered face.  It was all pretty dramatic.  But this guy just appeared, wandering in the road, feet from my face, it was a jarring surprise.

He also was badly broken.

That was the jolt I needed to wake up some semblance of situational awareness.  I now spotted his truck in the far ditch.  The folks from the surrounding trailers were pouring out.  Traffic was confused, slowed, but at least drivers could see that the road was blocked given the odd angle of headlights and the fire.

My new ‘friend’ was wandering somewhat aimlessly in the street with a floppy arm, a freaky limp, and an awful looking face.  He was confused and need guidance to get him off he road before he got run over.  We laid him down on the grass..

Oddly, I don’t think I ever saw him again.  There were a lot of moving parts and it was a long time ago; bits of the recall are just mush.

I turned back to the truck, the fire, the other patient.

Years before, in firefighting school, a group of us worked with the Massachusetts state police arson investigators.  We torched a bunch of junk cars to demonstrate burn patterns: intentional torch jobs vs. accidental fires.  Of the 10+ cars we torched, my observation, they all burned exponentially fast.

At this point, likely less than 5 minutes had passed since the crash.

The truck was starting to burn with a bit more interest.  Entry through the passenger side door was possible with some of my neighbors helping.

Much of the engine had been transplanted into the cab, making the interior working space super tight.

Pulling the patient’s head back made an immediate improvement in his breathing.  Good.  I couldn’t assess anything below his nipple line.  Bad.  He had a strong pulse.  Good.  Fire.  Bad.

I wasn’t in any immediate danger, but I also wasn’t prepared to be doing this kind of work.  The engine in his lap, the driver’s side door caved into his left ribs and his seat jammed against the back wall of the cab, he was very stuck.  I didn’t see a lot of options except brute force.

I grabbed what I could of him and pulled – as awful as that was – hoping that somehow he would somehow come free of it all.

Never do that.  You can make a lot of problems a lot worse by yanking on a broken body.  Never do that except if the alternative would be so much worse.

He did respond to the pain, but he didn’t move.

Outta time and outta luck.  I bailed.

There was a moment, a bunch of us looking at that guy in the growing fire light, beyond the smashed windshield.  A moment in which I was pretty sure we were about to witness something awful.

Opposite our trailer park, across a small field was a semi-truck repair shop/private home.  That guy also heard the crash, woke up, and went into action.  He and a couple buddies arrived with 4 huge fire extinguishers from his shop, knocking the fire down in seconds, then standing by to knock down the flare-ups.

It really was an incredible moment.  We were going to get him out.  He wasn’t going to burn.

At this point, you’ve got to wonder: Where is the fire department? But it was still only 10-15 minutes into this thing. Gallatin Gateway Fire Rural Fire District, our fire company, was all volunteer.  Those folks were coming from home.

By the time they arrived, with the help of our neighbors, we’d not only extinguished the fire but also removed the passenger seat, giving us working room in the cab.

The local set of JAWs were broken so in the end it took nearly 2 hours to get the right equipment to the scene and cut this guy free.  The roof and back of the truck cab came off.  Then he was pulled back, up and out onto a long board.  All of which he survived.

Months later some of my colleagues told me my patient had returned to our Emergency Department; just as drunk as the day of his accident.  They’d outfitted him with one red cast, one green cast to remind him what leg he was allowed to put weight on; and a cast on his forearm.  The rest of the bits and pieces seemed to have healed relatively well.

In the long game, he needed a hospital to not die.  What eats me is that he probably wasn’t going to die in that truck of his initial injuries.  The hole in his lung and his other broken pieces were bad, but not immediately lethal.

I want to hold onto the miraculous timing that happened that night.  That the right people were in the exact right place and at the exact right time and when they showed up they engaged beautifully.  I wish I could remember all the efforts of all the other folks who showed up.

But that’s not how it works.

I see his face, lit by that unholy fire, and know the decision I made.  In that moment, I hoped his other injuries were fatal.  That my decision to bail out of the truck and let him burn would not have been the decisive one.

In this case, that is just not true.  He would have burned to death.

Most of us have some version of that face.  It may not be surrounded by such drama, but it feels the same.  Our brain’s storage system can’t seem to clear those memories.  They jump out at you, run around your brain for a bit and remind you.

It can occupy a lot of space in your head if you let it.  Worse, part of us feels like we have to pay homage to the memory by giving it all the time and space it needs. 

I don’t think that is right.

So I actively talk back to myself.  “Sure, give me a memory I didn’t want.  I’ll see that bet and raise you the cool part.  When things were really bad, a bunch of folks who didn’t know each other all cared enough to put themselves on the line for this guy.”

That is the greater truth.

That helps.

L. Jurgen Atema

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