As I rounded the front of the van a horrifying scene came into view…
“Quick! Quick! He’s dying!” a woman screamed, perched at the window, half in view.
Her shrills cries sparked a feeling in me that I had not experienced since Iraq. I tried to push past her shrieks and told someone to grab her and move her away so I and another guy that had shown up could get the injured man out. She was standing at the door rubbing the man’s face and screaming, over and over…”He’s dying! Ahhhhh……”
As soon as her body moved away, I could see the man and the side of the vehicle. The lower portion of the driver’s door had been ripped from its frame and twisted into an unrecognizable mass of crumpled metal, wires, and plastic.
“Sir! Sir!” I yelled, “Can you hear me?” as I checked for breathing and a pulse.
“Ahhhh….” he moaned in a whispered tone.
“Ahhh….”
Small trickles of blood formed around his eyes, nose and mouth, his face a horrifying pale yellow. His chest was crushed and distorted, resembling a jagged mountain under his glass and debris-covered t-shirt. His pulse was faint, his breathing labored and gasping. I began to assess for other injuries and saw that his left, upper arm was now in the shape of an “S”, and his left leg appeared to be crushed under the dashboard. I stepped back from the driver to get a better look inside the vehicle through the opening in the lower part of the door.
What happened next probably set me back 2 years in my attempt to deal with my PTSD. Somehow, in my haste to assess the driver for pulse and breathing, perhaps distracted by the woman screaming over and over, I had missed the most gruesome sight I have seen since my initial deployment to Iraq in 2003. Disguised in the detritus of electrical wires, and the remains of the steel door frame, was the lower half of the man’s femur. His lower leg, sheared off cleanly from the force of the impact was nowhere to be seen. His thigh muscle, shredded and lazily hanging to one side only slightly obscured my view of the end of his thigh bone, the cartilage shining and glistening, his skin slowly oozing a strange mix of bodily fluids. My stomach turned amidst the chaos of more people now screaming in the background and the sight of a man’s freshly eviscerated thigh bone jutting out from the interior of the van like an angry limb seeking sunlight in a heavily shaded wood.
By now, a soldier from the 82nd Airborne Division on his way to Jumpmaster School had identified himself as a combat medic. I told him to go grab his bag and break out the IV kit. He rushed back to his truck as I turned again towards the mangled extremity that hung lifelessly from the door. As people continued to pull away branches and chop at the tree blocking the passenger side door, I opened my emergency bag and removed my tourniquet. The black nylon felt reassuring in my hands. I had no gloves but I didn’t even think about that as I carefully navigated the sharp metal and wires that surround his leg like a dense thornbush. As I attempted to place the tourniquet over the stump of his leg, something strange occurred to me. Where was all the blood? Why was his femoral artery not spurting bright red life from him? Unsure of what to think I tried three times to place the tourniquet on his leg but was unable to reach far enough into the twisted metal to place it on flesh. With his entire lower leg missing, I could see at least six inches of exposed femur.
“Here…here!!!” yelled the young soldier as he reappeared with his combat lifesaver bag. I told the woman that had been standing near me as I assessed the patient to stand and hold his head as still as possible.
The soldier and I ran around the front of the van to the passenger side. The other witnesses had by this time chopped down the tree that had been blocking the passenger side door and the door was now open. I jumped in next to the injured man checking again for vital signs of breathing and pulse. The sound of sirens was now audible in the background as I looked into each of his eyes…nothing. Absolutely, fucking nothing. I knew then that this man would die. His crumpled chest, the trickles of blood from his eyes and nose, the massive trauma sustained to his leg, and now, not even the slightest reaction in his unequal pupils, indicative of massive head trauma. I turned and saw firemen and medics running around the front of the van and behind me to the passenger side door. I exited the vehicle as the overweight EMT tried to fit inside the crumpled cabin of the van. I explained everything that I had seen and done so far and he sat there and tried over and over to set an IV line in the injured man’s forearm. I said nothing as I walked away.
I gave a statement to the police officer at the scene and thanked the two or three people that stood out in my mind as ones who had assisted in trying to save the man. I spoke with the young soldier and we exchanged phone numbers. Still in shock, I slowly walked up the embankment, back to my car. The five-finger running sandals I was wearing wear soaking wet and covered in oil and other nasty fluids. I changed into a pair of fresh socks and sneakers and got back on the road.
I have no recollection of the rest of my trip that day or how I got to a hotel. I vaguely remember exiting the highway and renting a room in Savannah, Georgia because I was unable to stop the movie reel in my mind’s eye from completely overtaking me as I drove. That evening the nightmares began again. I had not had a nightmare in months. Like clockwork, I woke up in a sweat-filled pool at 1200 and 0300 hours breathing heavily with chest pains like I had experienced so many times before. A SEAL buddy of mine had turned me on to a meditation course he had used when he left the teams and it had worked for me in the past so I fired it up on my Ipod and began doing pushups and squat thrusts in my hotel room at3am while trying to meditate.
Two things I know to be true: that shit worked for me that night and PTSD never goes away, it just grows a scab on it. Sometimes that scab gets picked at, and sometimes, it gets ripped the fuck off. My PTSD scab got ripped the fuck off that day…
Main photo: Courtesy of Palmer Lab
COMMENTS