Monday, April 16, 2012
Failure to Yield
by Kevin S. Baldwin
It had been a perfect Fall day: Clear, crisp, and sunny. Then there was one of those moments (like Kennedy's assassination or 9/11) where you never forget what you were doing. A student had asked me a question that I did not have the answer to, but knew where to find, and I was pulling a book off the shelf in my office, when the phone rang.
"Hi, you don't know me, but your wife asked me to call you: She has been in a bad accident outside of town. There were four people in the van. Paramedics will call you in a few minutes."
From his tone, I knew this wasn't a prank, so I waited. My mined raced: Had my wife picked up all three kids after school and headed out of town? The paramedics called and told me to go the local hospital, which I did. A few minutes later an ambulance pulled up and a friend of my wife (covered in blood and screaming in pain) and her daughter were carried in on body boards. Oh, that's right, they had talked about going shopping together. Thankfully, my older two kids were not involved, but where were my wife and four-and-a-half month old son? They had been life-flighted to a major hospital an hour away. I got in the car and drove.
When I arrived at the hospital, a helicopter was on the pad and a receptionist instructed me to wait for a minister in a room down the hall. Fearing the worst, my jaw dropped and my face fell. "Oh, don't worry, we do that for all the life-flight families," she assured me. After a few minutes, the clergyman came in and took me to the ER, where a team was huddled around my wife. She was conscious, but clearly shaken-up. We both have pretty dark senses' of humor so I said "If you wanted a new minivan you could've just asked." She looked back with total incomprehension, at which point I realized the severity of her concussion.
As she was turning into a driveway (to drop off the friend and daughter at their house), they were struck from behind by a large, loaded flat-bed wrecker. According to the guy who had first called me, the van flipped head-over-tail three times before coming to rest on its side in a ditch by the road.
The minister asked if I wanted to accompany my son to his CT scan. Up in radiology, they strapped him onto a table. His eyes were as big as saucers as the X-ray source and detectors began circling around the table. There were bruises on his head.
The impact had crushed the rear of the van and flattened the front seats into the full reclining position. The passenger seat had struck my son's pumpkin seat with enough force to break the handle and deform the base, causing him to be ejected from it. My wife had found him on the floor boards. As a result of the head trauma, both of them began vomiting before the emergency personnel arrived.
The little girl suffered a fractured cervical vertebra. A bit more speed and it could have damaged or severed her spinal cord, but she otherwise fared well perhaps because she was in the van's built-in childrens' seat. Her mom's right clavicle was broken and her pelvis was fractured on both sides. Between the head injury and the internal bleeding, she needed 7 units of blood. At one point, she stopped breathing and had to be intubated. Luckily, she made a full recovery.
Interpretation of the CT scan indicated my son had a bilateral subdural hematoma, meaning his brain was bleeding on both sides. Fortunately it stopped bleeding after a few hours. The next concern was pain and brain swelling, so he was given morphine and dexamethasone (a steroid) to manage each respectively. The first night, I stayed in the room with him and placed my t-shirt next to him so he would have something familiar in his new surroundings. He seemed to get better, and after a few days we went home.
My wife insisted on being released so she could be with our son. The ER team had been so focused on head injuries they had missed her broken left clavicle, which was diagnosed a few days later (note that this is certainly preferable to the reverse!). We were told that 85% of the time clavicles heal on their own. After 2 months, it had not healed, so surgery had to be done. Two plates and eight screws later, it was a single bone again. Interestingly, my wife's friend had to have the same surgery.
After a few days at home my son began vomiting again. They suspected that his brain was still swelling and resumed the "dex" drip. He continued to vomit and began to lose function as the brain swelling within the confines of the skull began to crush its own neurons. He was becoming more withdrawn and limp by the hour. They gave him a spinal tap and the cerebrospinal fluid dripped out surprising rapidly through a tiny needle. The pressure must have been quite high and I can't even imagine what the headache was like. Within minutes my little boy began behaving like his old self. It was one of the most astonishing transformations I've ever witnessed: "That's why we tap 'em!" exclaimed the pediatric neurologist triumphantly.
As we left the hospital for the second time, we were warned that the hematoma had been over the motor cortex and that there might be deficits. Many months later when he failed to talk, we began to worry. We enrolled him in an early intervention program (speech, play, and group therapy) and within a year he was caught up. That he was so young was probably a blessing. The brain was plastic enough to rewire itself. Now, he never stops talking. The only hint that something may have happened is that he stutters when he gets tired.
My wife still suffers from shoulder and hip pain, especially when the temperature and/or barometric pressure drops. We joke that she is better than the weather channel. She still visibly stiffens whenever a truck passes or a helicopter flies by, and her short-term memory is not what it used to be.
Perhaps the worst part of the whole experience was dealing with insurance companies who didn't want to pay for the helicopter ride because it was not pre-approved, questioned the justification for the spinal tap, and basically did whatever was possible to avoid doing what they said they would do when I enrolled with them. The highlight was getting served for unpaid medical bills that they had declined to do anything with. Before it was all over, we had racked up $40k in credit card debt and had to borrow money from family to get by. No wonder bankruptcies and medical issues are so frequently intertwined. After two years, and the help of a lawyer (who got 30%), we settled and got some compensation. Even today, 6 years out, we still get an occasional bill for something stemming from the accident! So much for the vaunted efficiency of the free market. An economist might celebrate the entire escapade because a lot of money changed hands, but that perspective offers us little comfort.
Still, we are lucky and grateful. The kindness, competence, and professionalism of all the medical personnel was incredible. Friends and family were very supportive. As bad as things seemed for us, they were tempered by our awareness of other situations in the pediatric intensive and intermediate care wards that helped put things in perspective. There was a kid who fell out of a two story window who was going to have some serious deficits. There was another kid in a semi-vegetative state, and a two-week-old with some serious genetic defects whose parents had never visited and the staff hoped would just quietly pass. The worst was probably was an Amish child whose buggy had been deliberately rammed by an angry driver (I can still evoke nausea and anger when thinking about that one).
Eventually, we found out that the truck driver had been on the phone when the accident happened. He was checking his load as he accelerated to pass the minivan and had missed that they were braking in preparation for their turn. As my ex-cop father-in-law observed, this was a very unusual kind of accident that should have been entirely avoidable (weather and visibility were not contributing factors). The driver was cited with "failure to yield."
I wonder if the supposed increases in productivity and convenience promised by cell phones are really worth it. Multitasking may work for computers, but it really seems to stretch human abilities. Having a cell phone for roadside emergencies is great, but talking or texting while driving is just too risky (About 10 years ago, I was sideswiped by a guy who was simply reaching for a dropped phone!). Now that I am sensitized to driving distractions, I routinely observe somebody with a delayed response, weaving, or simply not paying attention while on the phone. Some of them are just talking, others are trying eke out that last little bit of productivity, whether demanded by supervisors or their own ambitions. The concept of self-restraint seems to have vanished from our society. We are addicted to distractions, yet the phrase "with great power comes great responsibility" is perhaps most real and consequential when we are piloting two ton vehicles at 60 mph, a task that demands undivided attention. I am hard-pressed to think of anything short of a 911 call that would justify the use of a phone (or any other device) while driving. I'm pretty sure I don't have anything to say that's so important that it can't wait.
Posted by ksbaldwin at 12:10 AM | Permalink