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Archive for January 3rd, 2010

UC101 Revision

1: Accident

Daniel Cho was on his way home from tae kwon do practice when he heard the unmistakeable collision of steel on steel and shattering glass. Dammit, he thought, this is supposed to be my night off. He dropped his gym bag and bolted towards the sound of the collision.

Pulling his cell phone out of his pocket, he dialed 911. “This is Daniel Cho. Reporting a multicar accident at 17th and M, send emergency units.” Without waiting for a confirmation, he disconnected the call and reached into his back pocket for the latex gloves he kept there just in case.

The accident was a bad one, a three car pileup. As Daniel pulled on the gloves, he could see in the glare of the streetlights what had happened. A heavy Mercedes town car had been barreling down M and ran the light, t-boning a minivan into the pickup truck going the other way. The whole cluster had veered sideways and now blocked off M street in both directions, along with part of 17th. It would be at least half an hour before the ambulance and fire truck got here, if then. Daniel had sat in the back of that ambulance waiting to get to wrecks like this, knew what that wait was like.

Well, now he didn’t have to wait. Why do I even have nights off, he wondered as he approached the nearest car, the Mercedes.

Before he even got the door open he could see that the driver was beyond help. The bastard who caused all this carnage hadn’t been wearing a seatbelt, and the force of the crash had propelled him onto the steering wheel with enough force to break off the wheel itself and ram the steering column through his ribcage. The car predated airbags, so there was really nothing to do. The blood was everywhere in the cabin, even dripping from the ceiling. It looked almost black in the artificial illumination. But what Daniel noticed most was the man’s eyes. They were angry, focused on the road ahead of him, as if determined to continue on their way. That’s odd, Daniel thought. They usually look surprised.

Daniel shook it off and moved to the next vehicle, the minivan. It was sandwiched between the other two cars, and Daniel couldn’t seen much past the shattered windshield. He didn’t hear anything, or sense any movement. Come back to this. He moved on to the pickup truck.

The pickup driver was belted in and conscious, trying to claw his way past the deployed airbag. Daniel opened the passenger door and leaned in to help. “It’s okay,” he said, “I’m going to help get you out of there.” The man was still dazed, but complied with Daniel’s efforts to slide him out of the truck cab.

Daniel quickly palpated the man, looking for hidden injuries. He had several minor cuts from broken glass and would have the dual black eye raccoon mask from the airbag, but fundamentally he seemed okay. No broken bones and his spine looked normal. Daniel guided him to the sidewalk and propped him into a seated position against a building. “Just sit here, and try to stay awake until we can get you to a hospital and check for any head injuries,” Daniel said. The man nodded.

Now Daniel had the hard work to do. He went back to the pickup and crawled through the cab. The now shattered driver side window was matched up with the pylon on the minivan. He couldn’t reach into the minivan, but he could get a better look inside it.

The front seat was just the driver, a woman in her late twenties. She was also slumped over a deployed airbag, and had both blood and tiny cubes of safety glass in her hair. He didn’t see any major bleeds, so she could probably hold on for a bit while he figured out how to get her out. He looked into the back seat and froze. Daniel had seen a lot of horrific things in his career. This was one of them.

Behind the driver was an infant, maybe a year old, maybe less in a car seat. He was covered in blood and broken glass but seemed to be breathing. Thankfully, he was also unconscious. He didn’t have to see what was next to him.

The passenger side of the back seat held a bag of meat that used to be a little boy, maybe six or so. He was dead center for the front end of the Mercedes and took the brunt of the kinetic energy transfer. Every bone was broken, several jutting out through his flesh and clothing, red smeared white shards in all directions. Bits of gray brain matter where dripping from the ceiling, and what the seat belt held in place was crammed into his brother’s car seat.

So three possible survivors, two dead on arrival, Daniel thought. As these kinds of crashes went, that actually wasn’t bad, but the next few minutes would prove critical. And he needed some help.

He backed out of the pickup and looked around. Daniel could hear now the distant wail of the ambulance siren. He couldn’t wait. If the mother and her baby were going to live, they needed to get out of that car as soon as possible. He saw a burly man in a Redskins t-shirt. Daniel jogged up to him.

“Hey!” Daniel said. “Ever been a hero?”

The man started waving his hands in front of him and backpedaling. Daniel reached out and caught him by the forearm. “It’s okay,” he said. “I’m a doctor. I just need an extra pair of hands and a strong back. You in?”

The man gulped audibly and nodded. “I ain’t never done anything like this,” he said. “I was just on my way home.”

“That’s okay,” Daniel said. “I do this all the time. I’ll tell you what to do. Come on.”

They went back to the minivan and looked at the shattered safety glass of the windshield. Daniel hopped up on the hood and checked around the edges until he found what he was looking for, a two inch section where the seam had separated with the crumpling of the pylon. He worked his fingers into it and started pulling. Once he got about a foot free, he waved Redskins over. “Grab this and pull as hard as you can,” Daniel said.

They both pulled, and the windshield peeled away from the metal like a giant band aid. Once it was free, they cast it aside and Daniel was able to get a closer look at the mother.

It was worse than he’d hoped. The airbag was mostly deflated and it was clear that the woman’s maternal instincts worked against her. Her right arm was flattened, smashed as she tried to reach back and protect her children at the moment of impact. Right now the bleeding was contained by the pressure, but they’d have to apply a tourniquet before pulling her out. She also had a large gash on the side of her head Daniel hadn’t seen before, and it was bleeding badly. Great, Daniel thought, shouldn’t move her, but can’t afford not to if that head wound is as bad as it looks.

He looked back at Redskins. “Give me your belt,” he said. As the man started to stammer, he added, “I need to use it as a tourniquet or she’s going to bleed out through her arm when we move her. Come on, now!”

The man quickly pulled it belt out and handed it over. “Good, Daniel said. “Now I’m going to need some kind of stick or rod to tighten it. See what you can find.”

Redskins ran off on his quest. Daniel threaded the belt under the woman’s arm and tied it off at the deltoid, making sure he had a grip on her brachial artery. Redskins ran up with a tire iron. “Got this from the pickup” he said.

Daniel grabbed it and slid it through the belt before spinning it to tighten the bind, then tied it down with the other end of the belt. It wasn’t the best field tourniquet he’d ever applied, but it would hold. She might even be able to keep the arm if they got her in surgery fast enough.

“Okay,” Daniel said. “We’re going to have to move her now. Get up here.”

Redskins climbed up on the hood and looked into the cabin. He gagged. “I never seen so much blood,” he said.

“You’re doing great,” Daniel said. “I couldn’t do this without you.” He tried to slide over as much as he could to give the big man room to get a hold, but the Mercedes had crumpled in most of that half of the minivan. “We need to make sure we grab her by the torso, not the arms, and we need to make sure we cradle her head. Her head wound has me worried, so I want to make sure we don’t jostle her any more than we have to.”

Redskins started shaking his head. “You sure you don’t want someone more—”

“You’re doing fine,” Daniel said. “And I need someone strong. You’re strong.”

Redskins nodded. He was psyching himself up, Daniel could see it. He was amazed what people could rise to when given the opportunity. He’d seen it before.

“Okay,” Daniel said. “Let’s do this.” He reached in and took hold of the woman under the tourniquet, guiding Redskins to the other side. He also unlatched her seatbelt and pulled it free. “On three, we’re going to lift her out, and keep her head steady.”

He guided Redskins’s hand to the side of her head and showed him how to brace it.

“On three, he said. “One, two, three.”

Daniel and Redskins pulled and started easing her out. As soon as her arm cleared the wreckage, her eyes snapped oven and she screamed.

Redskins dropped his side and part jumped, part fell off the hood to the pavement. The woman kept screaming, a high keening wail. Daniel reached round and grabbed under her other arm, bracing her head with his own while she screamed into his ear. He pulled slow and steady until he had her out of the car and on the hood. Only then did he notice how her lower leg flopped to the side. Her leg was broken, probably both the tibia and fibula, snapped when the Mercedes crumpled the cabin.

Nothing for it now, he needed to get her stabilized. He pulled her off the minivan and laid her down in the road, trying to make sure at the very least he didn’t make things worse. Her screaming died down to a whimper, then sobbing. She reached up with her good arm and grabbed Daniel’s shirt.

“Russell,” she rasped, “Elijah…”

Must be the kids’s names, Daniel thought. “Everything’s going to be fine,” he told her. “I’m a doctor.” Daniel checked her head wound. it was starting to clot, for once something not as bad as it looked. As Daniel pulled back, he saw that the woman had passed out again. He’d rather her stay conscious until they got an MRI on her head, but frankly, what he still has to do would probably be easier with her out.

Redskins was still sitting on the concrete, shirt stained now with the woman’s blood. He had a blank stare, and Daniel knew he was done. Courageous as he may have been, everyone had their limits, and Daniel knew the signs all too well. He had to get the kid alone.

Without another word, Daniel vaulted up on to the minivan’s hood and pulled himself into the cabin. He reached down and felt for the latch to release the driver seat back, and pulled it forward, trying to get as clear a shot as he could to the baby. Again he shuddered when he saw what was left of the little boy on the passenger side. He felt bile rise in his throat and choked it down. Not now, he thought. Plenty of time to freak out later. Crawling over the driver seat, he got a closer look at the baby and felt gently for injuries. He was still out cold, but otherwise he seemed okay. His brother had absorbed all the punishment for him, shielded the baby from the worst of the impact. Daniel wondered if the kid would ever know that as he grew up.

Reaching around the car seat, he unbuckled the seat belt holding it in place and lifted the whole assembly. Then he realized he couldn’t back out and hold the kid at the same time. “Hey back there!” he called. “Can you pull me out?”

Daniel felt two strong hands grab his ankles and pull him back. He held the car seat as high as he could while he felt the tiny cubes of shattered safety glass digging into his thighs through his jeans. “Whoa!” Daniel said. “Careful.”

Suddenly he was free of the van and back into the harsh glare emergency flares. He turned and handed the carseat with the baby not to Redskins, but to a uniformed police officer. “Thank you, patrolman…” Daniel checked the officer’s nametag. “Fitsimmons. Appreciate the assist.”

The cop nodded and put the baby down next to his mother, who was still out. Daniel clambered down from the minivan and stretched. His muscles were stiff from tension.

Fitsimmons turned to him. “Sir, could I see some ID?”

Daniel nodded and dug out his wallet. “Sure. It’s okay, I’m a paramedic with the 33rd.”

Redskins, still seated in the middle of the road, seemed to wake up at this. “Paramedic? You said you was a doctor!”

“I am,” Daniel said. “Sort of.”

Fitsimmons continued rifling through Daniel’s wallet. “None of this says you’re a doctor.”

Redskins popped up. “I swear, that’s what he said. I never woulda touched that woman if he hadn’t said he was a doctor. I swear, that’s what he said.”

Without handing back Daniel’s wallet, Fitsimmons turned to Redskins. “ID, sir?”

Redskins had his drivers license ready and handed it over. “Randall Schlotsky, your honor.”

“I’m not a judge,” Fitsimmons said.

“Sorry, your honor. Anyways, this guy said he was a doctor, and that’s why I thought it was okay to move that woman.”

“Oh for Christ’s sake,” Daniel said. “I am a doctor. Or I was. I have an M.D.”

Handing Schlotsky’s drivers license back to him, Fitsimmons turned back to Daniel. The ambulance sirens were louder now, much closer. “You’re an M.D., but you work as a paramedic.” It wasn’t exactly a question.

“I just moved here from San Francisco a few months ago,” Daniel said. “I don’t have a medical license in the District.” He conveniently left out that he had no intention of getting another medical license.

“Um hmm,” Fitsimmons said, handing back Daniel’s wallet. “Sir, I’m going to have to ask you not to leave the scene.”

The ambulance finally broke through the last of the traffic and pulled up. It wasn’t from Daniel’s station, and he didn’t know the paramedics who jumped out.

“I have no intention of leaving the scene,” Daniel told Fitsimmons. “I was the first responder here, I called it into 911, and I saved that woman’s life.” He strode past the cop and addressed the paramedics. “We’ve got a probable concussion to that man,” he said, pointing at the pickup driver, “and concussion and crush injuries to the woman. Aside from minor abrasions, the infant seems fine, and we have two DOAs. A young boy in the van, and the driver of the Mercedes.”

Fitsimmons, walking around the scene, said, “Did you say the driver of the Mercedes was DOA?”

Daniel walked over. “Of course he is. What, you can’t see him through all the blood?”

“I see the blood,” Fitsimmons said. “Just not the driver.”

“Dammit,” Daniel said, almost to the Mercedes, “he’s right…

“There.” Daniel stood silent for a moment. The driver was gone.

“What the fuck?” Daniel started running, looping around the car. There was a faint blood trail for a few steps, but then nothing. But the man had been impaled. Even if someone had pulled him out of the wreckage, there should have been blood everywhere. He started scanning around at the buildings adjacent to the intersection.

And then, despite the heat of the Washington DC summer day, Daniel saw something that made his blood run cold. Walking down a back alley was the Mercedes driver, absently rubbing the still gaping hole in his chest. His clothes were still soaked with blood and gore, but he wasn’t spurting or dripping, and the size of the wound seemed to be smaller than it had been before. The man glanced over at Daniel, grinned, and disappeared behind a Dumpster.

Daniel sprinted into the alley and tried to follow the man, but saw nothing behind the Dumpster but a graffiti scrawled brick wall. He had no idea where the man had gone.

Daniel felt someone walk up behind him and spun around to see Officer Fitsimmons. “Did you see that?” Daniel asked. “Did you see him?”

Fitsimmons took a firm grip on Daniel’s arm. “Sir,” I’m going to have to ask you to come with me.”

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