“Unit 8-1 to central we’ve been involved in a Signal 350 (MVA) with injuries. Need help.”

These were the first coherent words I spoke into the police radio. Moments earlier I had been thrown  from the back of our ambulance into the front when we were struck head-on by an out-of-control car.  I landed across the front passenger seat with my head where legs would normally be.

As I write about the events of December 16, 1988,  that beautiful, cold, Friday morning seems remote yet still emotional and raw.  The story now comes out of me in rote fashion. I was a volunteer EMT, riding in the patient compartment as we took a 76 year old woman to the hospital after a motor vehicle crash. She was boarded and collared and I was unrestrained moving around the back of the ambulance as we began to climb a steep hill toward our destination hospital.  I remember my driver saying something about a car coming towards us. I remember seeing the car just before we hit (or maybe I don’t and just think I should).  Maybe I was knocked unconscious or just stunned.

Now the absurd, almost funny moments flash by….wiggling my fingers and toes and deciding it was safe to move because I wasn’t paralyzed. Making that broadcast on the police radio. Flipping myself over into a seated position on the floor and watching as my knee moved one way and my hip another. Wondering why a broken femur did not hurt more. Handing my partner a fire extinguisher because he had the sense to realize the engine was on fire. Instructing a good Samaritan to hold my broken leg straight while I slid/climbed out of the side door.  Visions of my  friends and colleagues standing over me while I babbled. The irony of being put back into an ambulance (now as a patient) just after one tried to kill me.

Fortunately I don’t remember the car. I should since I was lying only a short distance away when they used a front end loader to pull our ambulance off of it. I should remember the moans and screams that must have come from some of its five occupants. But fortunately I don’t.

While I  was young (2nd from left in picture) they were even younger. They were on their way back from the mall after some Christmas shopping. Two were pronounced dead at the trauma center but likely died at impact. The other three with multi-trauma.  My patient was ok, as was my partner.

This day would begin a series of firsts for me. First fracture. First narcotics. First surgery (and second and third and fourth). First Christmas in a hospital bed. First corneal abrasion. First urinary retention. First foley catheter. First seizure. First lumbar puncture. First deposition. First re-learning to walk. First feeling of mortality.

It is humbling to be a patient. There is a process of assimilation into this new role and it is not gentle. You go from independent to totally dependent.  You control almost nothing but crave any little amount of it. You live by other people’s schedules.

You also know that when the nurse is caring for you or the doctor is discussing things with you that there is a bond. That you are sharing something important.  You know these quiet one-on-one moments are intimate and sacred to you both.

It is, of course, hard to isolate what I learned from these events. We are the sum of our experiences not solely shaped by occasional epiphanies. But I do think this horrible experience brought some good to my practice of medicine. It gave me role models to live up to and keeps me aware of the sacred spaces into which I am invited. I know what was important to me as a patient and try to provide the same:

• Make them feel better (pain relief, a warm blanket, a few calm words).
• Communicate plans – what’s going on, what is going to happen.
• Smile – it says everything is going to be ok.
• Be present – patients know your time is precious, which is why complete attention is so important.

Writing is cathartic. This post is based on very personal material covering one of the worst and yet one of the proudest days of my life.

Though a great deal of time has passed I remain grateful to everyone that cared for me that day and through my recovery. I am also honored by my patients now who place the same confidence in me that I did in my caregivers back then.

David