This is an excerpt from “Life Inside the Dead Man’s Curve: the chronicles of a public safety helicopter pilot” by Kevin McDonald.” Like many EMS providers, McDonald spent a career skirting the question about the worst call he’s ever run because this story is one he can’t tell without being overrun by emotion.
By Kevin McDonald
“Sometimes, the scars are on the inside.”
“What’s the worst call you’ve ever run?”
When I was still flying, I used to get this question a lot. Usually, I would figure out a way to avoid giving an answer by changing the subject. Occasionally, I would simply pretend that I hadn’t heard the question. Now that I’m retired, I think I can go ahead and answer it.
Of course, the predictable choice would be a call in which mayhem and carnage was the overriding theme. I certainly would have a number of those from which to pick. I still remember the day Dave Williams, the paramedic who flew with me on the night of my first call as a STAR Flight pilot, walked up behind me as we were preparing to leave the scene of a train-versus-pedestrian accident.
“Can you give me a hand here?” I heard him ask.
When I turned around, I was shocked to see Dave standing there awkwardly, and somewhat apologetically, with the vital signs monitor under one arm — and a severed leg under the other. After hesitating, just for a moment, I grabbed the monitor and loaded it into the aircraft. Then I took a disposable blanket from one of the cabin-mounted storage bins and handed it to Dave so he could wrap the leg before loading it into the back of the helicopter — next to the patient to whom it had formerly been attached.
There are many grotesque calls that have left indelible impressions on me — some that I wish I didn’t remember. Obviously, the multiple-fatality car wreck I ran with Dave and Ron Startzel on the night of my first shift at STAR Flight is one of those. There are others as well.
The first time I transported a burn patient to BAMC (Brooke Army Medical Center), in San Antonio, I dutifully followed my crew inside the hospital. After we were in the elevator, headed up to the burn center, I wondered if I should have waited outside. Once we were wheeling our patient into the ward filled with all the other patients, some of whom had suffered horribly excruciating, disfiguring burns, I knew I should have waited outside. I made close to a hundred more flights to BAMC after that day — I never set foot inside the burn center on any of them. I simply didn’t possess the intestinal fortitude to watch people agonize that way. It made me wonder — in awe, actually — how the people who cared for those patients had the emotional stamina to do it day after day.
After my experience at BAMC, I decided that burns had to be the worst form of trauma a person can suffer. Not that amputations weren’t devastating injuries as well. Just like those burn patients I saw, they’re not easy to forget — even though I witnessed some of them twenty years ago. I could fill an entire chapter recounting all the amputations I saw, but trust me, you wouldn’t want to read it.
There were also several decapitations I wish I could forget. I can think of one that occurred during a car-versus-motorcycle accident, one that was the consequence of a flying piece of scrap metal, and another that was the result of a shotgun blast to the face.
To be honest, the grisly sort of calls I’m describing took a serious toll on my psyche after a while. At the risk of sounding calloused, you almost have to file those kinds of macabre scenes in an abstract part of your memory, or you’ll succumb to the anxiety they produce. When I was still learning how to cope with it, I used to come home and tell my wife, Nancy, about the terrible things I’d seen at work, thinking it would be therapeutic to talk about it — it wasn’t. It certainly didn’t do anything to improve Nancy’s state of mind, and since it really didn’t help me to feel any better, I eventually just quit talking about it altogether.
As the years have passed, it’s becoming a little easier to discuss some of the things I saw, and maybe writing about it here has finally helped me to exorcise some demons. Nancy has been encouraging me to write this book for a long time, and I even sat down and tried to do it about ten years ago, but the story I needed to tell was still a work-in-progress. Besides, I just didn’t feel like reliving some of this stuff.
If this part of the book seems disjointed or out of place, I suppose it’s because I’m writing it more for my own emotional well-being than for the benefit of the reader. In fact, I’m guessing some of you would prefer that I had left this discussion out entirely. If that’s the case, I beg your indulgence. Perhaps I just decided to throw this chapter in here so I could get some things off my chest—which brings me back to answering the question at hand.
The Worst Call I Ever Ran
Unfortunately, even though it happened over two decades ago, I still can’t forget the details — those peripheral details I mentioned earlier. They’re the kind of details you notice only if you’re standing around with nothing else to do while everyone around you is busy working.
I hadn’t been at STAR Flight for all that long, so I was still in the process of learning how to deal with the human-tragedy aspect of the job. We flew to one of the surrounding counties directly east of Austin that night. When we landed behind a well-kept little ranch house, several emergency vehicles were already parked on the other side of the home, in the front yard. It was one of those picture-perfect nights — when the weather is balmy, and it feels good just to be outside. I remember this because after we had shut down, I decided to stay by the helicopter instead of going inside with the medical crew.
Like I said, I hadn’t been at STAR Flight very long, and at that early stage in my career, I would normally have followed my crew into the house; but the weather that night was too perfect to waste, so I found a comfortable spot in the grass and just sat, soaking it in. We’d been dispatched to the house because someone inside had dialed 911 and informed the call-taker he was feeling chest pain. After we’d been there for about forty-five minutes, I remember thinking to myself, This seems to be taking longer than usual.
I decided to go inside and see why it was taking so long to bring the patient out of the house. As I entered the kitchen through the back door, the first person I encountered turned out to be the patient’s wife, who looked to be in her late seventies or early eighties. I asked her if she could tell me where to find my medical crew, but she just gave me a blank stare. Then I heard voices coming from the other end of the house, so I headed off to see if my crew needed any help.
I left the kitchen, then walked across a large living room and down a hallway. As I reached a bedroom door at the end of the long hallway, I found them administering CPR to a man who looked to be around the same age as the woman at the door. They had moved him out of his bed and onto the floor because, in order for the chest compressions to be effective, they needed to have a hard surface under the patient.
My medic was sweating profusely as he pumped the man’s chest, and my nurse was on the phone with the ER doctor at the hospital. There were also a couple of ground medics there. One was busy preparing medications, and the other was confirming the dosages and taking notes for the official paperwork that would need to be filled out following the inevitable “pronouncement” from the ER doctor. I’d seen this drill enough to know they would continue performing CPR until there was no longer any hope, but based on the man’s age, I also knew the ultimate outcome was fairly predictable.
Meanwhile, the woman who had met me at the door was all alone, so I decided to go back down the hall and check on her.
“Ma’am, are you okay?” I asked her.
Again, just as she’d done when I first entered the house, she looked right through me and didn’t say a word. She kept wandering aimlessly, back and forth across the kitchen, and wouldn’t even acknowledge my presence.
At first, I thought she was in a state of panic, but I finally realized she wasn’t panicked at all. Instead, I’d been trying to converse with someone who was afflicted with Alzheimer’s disease (or some other form of dementia), and I just hadn’t been attentive enough to recognize it. Not only was she not panicked over her husband’s situation — she was completely unaware of it.
I finally decided I was probably making her nervous, so I decided to leave her and walked back into the living room. As I looked around — because I had nothing else to do — I noticed some family photographs on the mantle above the fireplace.
There was one, in particular, that caught my attention, and I moved in for a closer look. Inside the aging wooden frame, I saw a strapping young first lieutenant in a World War II, Army Air Corps dress uniform. He was wearing a Tenth Air Force patch on his left shoulder — and a striking young blonde on his right shoulder. In the frame right next to that one, there was another photo. That same gorgeous blonde was locked arm in arm with a now-somewhat-older captain as they ducked beneath a shower of rice on their way out of a wedding chapel. The several rows of ribbons the young pilot was wearing beneath the wings on his uniform weren’t in the first photo, but in this one, they were almost as conspicuous as the huge smile he was wearing on his face.
It was easy to deduce that the first picture had been taken before he was sent overseas, and the second was taken after his return. There must have been thousands of photos like these, all across America, taken during and after the Second World War — each of them telling a similar, yet uniquely personal story.
On the opposite side of the room from the fireplace, there stood a bookcase. It was filled with more photos, and there were also several portraits, including one I knew I’d seen before. It was a reproduction of a very famous half-finished portrait — a portrait of President Franklin Delano Roosevelt. The portrait is unfinished because FDR, who was on a retreat to his summer White House in Warm Springs, Georgia, died before the artist could finish painting it. The remaining pictures were obviously family photographs, and from the dates on the photos and the ages of the people in them, I guessed I was looking at three generations of people who could trace their lineage back to those faded black-and-white images on the mantle.
There were also several framed citations in the bookcase, which accounted for some of the ribbons the young captain was sporting in his wedding photo. I knew I was snooping, but I couldn’t help myself. I had always been a big history buff, and as I’ve already mentioned — I had nothing else to do. I started reading the citations and couldn’t stop until I’d read every last word. They were quite compelling. Having flown C-47s with the Tenth Air Force, the young pilot had earned two Distinguished Flying Crosses and a Purple Heart while serving in the China Burma India Theater.
“Flying the hump” is what they called it. It was a massive airlift that lasted from 1942 through the end of the war, in 1945. It involved hundreds of planes, mostly C-47s, flying supplies from India to the Allied forces fighting the Japanese in China. These combat-resupply missions over the Himalayan Mountains were grueling and extremely hazardous. More than six hundred planes were lost, and more than a thousand crew members died in the effort.
Suddenly, I was overwhelmed with emotion. The man dying in the house that night — the man dying in the bedroom just down the hall from where I was standing — was an American hero. Because they were busy doing their jobs, however, not one of the people who were working in vain to prolong his life had any clue about his life — they had no idea who he was. What was truly tragic, though, was that the beautiful young bride in the wedding photo had no idea either. She and her husband were the quintessential couple from America’s greatest generation; but at that particular instant, because I had no assigned task, I seemed to be the only person who realized that a national treasure was slipping away in the next room.
I can’t begin to explain why that moment is so prominently magnified in my memory. I guess this just happened to be one of those situations to which I alluded earlier. It was one of those times when watching from the sidelines is actually harder than being on the field. It was hard for me to look at those photographs of a young, energetic man and his beautiful young bride — and accept that they were the same two people in the house that night. I guess the fact that the dying man had been a military aviator, and a decorated one at that, made it even harder for me.
Still, having witnessed so many grisly scenes during my years as a STAR Flight pilot, it’s simply not rational to think this could have been the one that affected me the most. So, why is it so difficult for me to talk about it? It’s been more than two decades now, and I’ve never been able to articulate this story to another human being without losing my composure in the process. I’ve struggled with this so much over the years that I’ve simply quit telling the story because I’m not comfortable letting people see this chink in my emotional armor.
I’m a veteran, a hot-shot naval aviator. Crying is not supposed to be part of my genetic makeup. None of those gruesome calls that actually involved dismemberment and mutilation affected me this way. Those scenes may not be pleasant to remember, but I certainly don’t break down in tears when I talk about them. How can this possibly be the worst call I ever ran? Surely there’s some rational explanation for it.
This is the paragraph where my journalism professors taught me that I’m supposed to cap off this chapter with a poignant answer to my own question. The only problem with that is, I really don’t know why this call was worse than all the others.
It just was. It always has been ... it still is.
---
Reprinted from Life Inside the Dead Man’s Curve: The chronicles of a public safety helicopter pilot
By Kevin McDonald
© Dog Ear Publishing
Available on Amazon and wherever books are sold.
About the author
Having received a journalism degree from the University of Texas at Austin, Kevin McDonald was commissioned into the United States Navy as an ensign in 1982. Two years later, he graduated at the top of his Navy flight school class and spent the next eight years flying as a naval aviator, logging most of his time in helicopters. In 1992, during the drawdown that followed the First Gulf War, he left the Navy and became a public-safety pilot for Travis County STAR Flight in Austin, Texas. As a native Texan, Kevin was a perfect fit for STAR Flight; and his literary background made him the perfect person to document the tragedy and triumph he would witness from the cockpit of his helicopter. By the time his career ended in 2012, he had flown more missions, logged more hours, and completed more rescues than any pilot in the history of the program. Now retired, he lives in Austin with his wife, Nancy, who was by his side for most of his thirty-five-year flying career.