Team-based medicine, freeway style
Citizen responders assess and comfort patients in the aftermath of a car accident.
As my wife and I were driving home to Seattle from Tacoma on Thanksgiving night, we were feeling relaxed and festive after a wonderful gathering at her brother's house. It was full of the traditional warmth that we all hope for in holiday family gatherings. We threw the football around in the street, watched a game on TV, and shared some incredible food.
Seattle is about an hour from Tacoma, and the traffic was dense but moving right along. We were cruising along at 60 mph, chatting amicably, with plenty of space between us and the rest of the cars moving along Interstate 5. It was dark and raining, just after 7 pm, and our 2006 Kia Sportage was humming along with the traffic.
Suddenly, I saw a flash of red as a truck flew across our right bow, and this baby was flying. It had to be going at least 80 mph. There wasn't time to say or do anything as it smashed into our vehicle with an ugly grind. I heard my wife, Pat, who had been looking down at her phone, exclaim “OH!” and it was game on.
Everything went white, and I just held on to the wheel for dear life, thinking “this could be it.” It was not an optimistic moment. There were relentless sounds of impact, of metal crunching, of sliding, grinding, and colliding. It went on for what seemed like forever, and the car seemed to lift up and take off into outer space. I just kept thinking, “hang on buddy, get through this, it's going to have to stop.”
As we both would later describe to each other, Pat and I felt so alone, so separated, as though we were in bubbles. I envisioned being an astronaut, launching into the stratosphere. Aside from the sickening sounds of the vehicle doing whatever it was doing, there was total silence. No yelling, no screaming, and just the sound of the collision. And then it stopped.
The first thing I heard next was Pat asking, “Jim! Are you okay?” I couldn't see her, as there was a weird foggy mist, perhaps smoke, in the car. The sound of Pat's voice was strong, and I knew she was okay. I was pretty sure I was too, and I said, “I think so!”
Then I realized that we were upside down, and the smoky haze made me worry that the car might be on fire. I struggled to figure out my body's orientation, and Pat said, “open the door, we need to get out. Can you open your door?” I couldn't seem to find the handle, and I was still having a hard time dealing with the concept of crawling around on the ceiling of our car. I was also having a hard time breathing with all of the stuff in the air, which I realized was the powder from the airbags. Pat got her door open, and when she pushed it out, fresh air came pouring into the car. I gulped it in, like someone thirsty gobbling in cold water from a mountain stream.
That helped orient me and get me moving. I turned around and was able to push my driver's side door open with my feet. I slid out on my back, and once I was out I stood and came to the conclusion that neither of us were badly hurt. Pat looked great, totally focused, and she took charge of getting us away from the car to make sure we were standing in a safe place. Our car had come to a stop ramming into the concrete median divider on the left side of the freeway, and it looked like the car had slid on the roof for some distance. Plastic debris was scattered all over the ground. It was still raining hard, but it felt good on my head and skin.
Suddenly, there were lots of people around us, talking to us, assessing us, and comforting us. It was a parade of faces, none of which I will ever forget. "I'm a Critical Care Nurse!" "I'm an EMT!" "I'm a combat medic!" "I'm an MD!" These people were all business, willing to rush out of their vehicles into the dark and downpour to make sure we were okay.
They looked as traumatized as us, maybe more, from watching the wreck. The combat medic was so memorable. He came at us out of the dark, sprinting toward us and commanding our attention. "Stand still and look at my chest!" he exclaimed as he used his phone to examine our pupils. "Neck side to side!" This dude took charge. They all did it in their own ways. The EMT firmly prohibited us from walking around the car to gawk, because I was still trying to get a good look at what happened. “Stay put on this side of the car,” he said. “You're safe here. Stay against the median divider.” The critical care nurse, huddled in the rain, stopped to hug Pat as she left.
Sometimes I think that as a medical, nursing, or emergency care provider, or maybe even just as a human, some things can be taught and learned. But there are some things that you either have, or you don't. And all of these people had it.
So did Pat, who moved us through the incident with focus, wide vision, and practicality. As I was thinking “gee, I wonder what the other side of the car looks like,” Pat was thinking about what stuff we needed to get out of the car, and how we would get home.
When the nurse stopped to hug Pat after the arrival of the police and firefighters, I thought “now that's nursing.” I also felt overwhelmed with appreciation for all that these citizen responders had done. I so wish we knew who they were, and I wish that we could all sit down together over a nice meal so that we could tell them how much it meant for us to crawl out of an upside-down car into the dark and the rain only to be greeted by these heroes. It was almost like they were welcoming us back from the chaos of the accident, and back to knowing that we were okay and safe. These people cared, and they personified the best that the medical world can offer.Jim Anderson, MPAS, PA-C, DFAAPA, is a physician assistant in Seattle.