Driving east out of Gettysburg on a country blacktop, the gray Bronco ahead of us passed through a rural crossroad just as a small pickup truck tried to take a left turn. The Bronco swerved, but slammed into the pickup on the passenger side. We immediately slowed to a crawl as we passed the scene. The Bronco’s driver looked fine, but we couldn’t see the driver of the pickup. I pulled over on the shoulder and got out to investigate.
The right side of the truck was smashed in, and the side window was shattered. The driver was partly out of the truck. His head hung forward over the edge of the the passenger-side window, the front of his neck crushed on the shattered windowsill. He was unconscious and starting to turn a dusky blue. His chest slowly heaved against a blocked windpipe.
A young man ran out of a house at the crossroad. “Get an ambulance out here,” I shouted against the wind. “Tell them a man is dying.”
I looked down again at the driver hanging from the windowsill. There were six empty beer bottles on the floor of the truck. I could smell the beer through the window. I knew I had to move him, to open his airway. I had no idea what neck injuries he had sustained. He could easily end up a quadriplegic. But I thought: he’ll be dead by the time the ambulance gets here if I don’t move him and try to do something to help him.
An image flashed before my mind. I could see the courtroom and the driver of the truck sitting in a wheelchair. I could see his attorney pointing at me and thundering at the jury: “This young doctor, with still a year left in his residency training, took it upon himself to play God. He took it upon himself to move this gravely injured man, condemning him forever to this wheelchair . . .” I imagined the millions of dollars in award money. And all the years of hard work lost. I’d be paying him off for the rest of my life. Amy touched my shoulder. “What are you going to do?”
The automatic response from long hours in the emergency room kicked in. I pulled off my overcoat and rolled up my sleeves. The trick would be to keep enough traction straight up on his bead while I moved his torso, so that his probable broken neck and spinal-cord injury wouldn’t be made worse. Amy came around the driver’s side, climbed half in and grabbed his belt and shirt collar. Together we lifted him off the windowsill.
He was still out cold, limp as a rag doll. His throat was crushed and blood from the jugular vein was running down my arms. He still couldn’t breathe. He was deep blue-magenta now, his pulse was rapid and thready. The stench of alcohol turned my stomach, but I positioned his jaw and tried to blow air down into his lungs. It wouldn’t go.
Amy had brought some supplies from my car. I opened an oversize intravenous needle and groped on the man’s neck. My hands were numb, covered with freezing blood and bits of broken glass. Hyoid bone–God, I can’t even feel the thyroid cartilage, it’s gone . . . OK, the thyroid gland is about there, cricoid rings are here . . . we’ll go in right here . . .
It was a lucky first shot. Pink air sprayed through the IV needle. I placed a second needle next to the first. The air began whistling through it. Almost immediately, the driver’s face turned bright red. After a minute, his pulse slowed down and his eyes moved slightly. I stood up, took a step back and looked down. He was going to make it. He was going to live. A siren wailed in the distance. I turned and saw Amy holding my overcoat. I was shivering and my arms were turning white with cold.
The ambulance captain looked around and bellowed, “What the hell . . . who did this?”, as his team scurried over to the man lying in the truck.
“I did,” I replied. He took down my name and address for his reports. I had just destroyed my career. I would never be able to finish my residency with a massive lawsuit pending. My life was over.
The truckdriver was strapped onto a backboard, his neck in a stiff collar. The ambulance crew had controlled the bleeding and started intravenous fluid. He was slowly waking up. As they loaded him into the ambulance, I saw him move his feet. Maybe my future wasn’t lost.
A police sergeant called me from Pennsylvania three weeks later. Six days after successful throat-reconstruction surgery, the driver had signed out, against medical advice, from the hospital because he couldn’t get a drink on the ward. He was being arraigned on drunk-driving charges.
A few days later, I went into the office of one of my senior professors, to tell the story. He peered over his half glasses and his eyes narrowed. “Well, you did the right thing medically of course. But, James, do you know what you put at risk by doing that?” he said sternly. “What was I supposed to do?” I asked.
“Drive on, “he replied. “There is an army of lawyers out there who would stand in line to get a case like that. If that driver had turned out to be a quadriplegic, you might never have practiced medicine again. You were a very lucky young man.”
The day I graduated from medical school, I took an oath to serve the sick and the injured. I remember truly believing I would be able to do just that. But I have found out it isn’t so simple. I understand now what a foolish thing I did that day. Despite my oath, I know what I would do on that cold roadside near Gettysburg today. I would drive on.
