A Night at the Trauma Center

14 Dec 1998, 6:15 PM to 15 Dec 1998, 10:00 AM.

I had just been told by EMS that Damien had been airlifted to the trauma center. Paula had run an errand and I had no way to contact her. My son Merrill, had been stopped by the high school principal, Sam Champion, and told of the accident. Mr. Champion had visited the crash site and was returning home. Merrill and his aunt, Melody McGowan, stopped by the driver ed school and told me they were on the way to the hospital. I remained at the driver ed school until all of the students had been picked up by their parents.

It took me 45 minutes to travel to the hospital. When I entered the emergency area, I noticed that the entry point to the ER was secured by several armed guards. They were there to protect gunshot victims from being attacked by their pursuers: and other such scenarios. I identified myself and was led into a small room containing a small gurney. Damien was laying on the gurney with his eyes closed. I saw a trickle of blood, originating in his right ear,  running down his cheek. I immediately thought "Crud, that is not good." An orderly came in and asked me to leave. They were taking Damien to the operating room and I could wait in a specific waiting area. I left the ER, met Merrill and Melody and went to the surgical waiting area.

There were many Boerne High School students in the TCU waiting area. Three days prior to Damien's accident, the quarterback for the high school football team had been in an accident on IH10. The student had suffered major injuries and was currently in a coma. The doctors had called in the family and discussed the patient. After much soul searching, the parents had decided to remove their son from life support. Two hours later the doctors had checked with the nurse and she replied, "His breathing is labored but he is still here." The doctors said to place him back on life support. Therefore, all the visitors in the room were waiting word about the football player. This story does have a happy ending. The young man was able to be released from the hospital and start a physical therapy regimen. He was able to be graduated from the high school that June.

On our way to the second waiting room, we met one of our driver ed students on the stairs. We had had several discussions about his behavior during the classroom and driving portions of the class. Tonight, he was going to the vigil for the quarterback. When our eyes met, he looked guilty and glanced away. Paula had parked her Bronco in the main parking lot. When she made arrangements to leave the next morning, she found that the left rear side window was shattered.

All the driver ed students knew her car. Yes, I am associating the guilty look (he was ashen) with the broken window. I doubt that he intended to break the window. I imagine that as he walked by the car, he slapped it rather hard and his class ring was enough to cause the glass to shatter. Paula was a bit appalled to find this after the night she had been through. With all the concerns with Damien, now we had to take time to have the window replaced.

The waiting area was packed with family members waiting to hear about their loved ones. We found a corner of the room and stood waiting to hear any news. Paula arrived. She had returned to the school, was told of the events, and came directly to the hospital. Soon Office Smith, who had given a talk on the legal aspects of driving and how to interact with the police to the students that afternoon, arrived with his wife. They had visited Kevin at the military hospital. Kevin was still comatose. Officer Smith was not optimistic about Kevin's recovery. They were very interested in Damien's situation. As we discussed the accident with the Smiths, the phone rang. The person answering the phone turned and asked if there was a family member for Courtland Brown present. I took the call and a female voice said that Courtland was in a surgical room and we should move to the associated waiting area. We said good bye to the Smiths and Melody. Both had to leave and care for family.

We arrived at the new waiting area by 8:10 PM. We were the only people in the room. The cardiologist came into the room and discussed Damien's surgery. He was going in to repair the thoracic aorta. He was very positive and mentioned that this was a procedure he did on a regular basis. As the doctor left, Paula's sister, Sandra, and her husband, Randall, entered the room. They had driven their motor home down from Austin and had parked it on the hospital grounds. Paula began giving them the details of what we knew thus far. As the evening progressed, several people arrived: Paula's parents were there for about 3 hours; Mathew Smith and his father, Kelly, spent the night with us. Mathew and Damien had gone to Sunday school and youth activities at Manor Baptist Church. Mathew, Damien and I had often gone to Port Aransas to fish and enjoy the coast. Mathew was Damien's best friend.

Around 11:00 PM, the phone rang and I answered it. A nurse told me that Damien's surgery was completed and it had gone well. The doctor would explain things to us shortly. Dr. Winchester was an Air Force Captain on an assignment at the trauma center. He mentioned that he had been with Damien in the ER. He had asked Damien questions and Damien had answered them. He had also assisted with the repair of the aorta. Dr. Carnahan, the cardiologist, came and discussed the procedure. He said that the aorta was separated about 2 cm, but that there was enough surrounding tissue to prevent major blood loss. The procedure was successful and he was very pleased. Before he closed the incision, he lowered the stomach, part of the GI tract, and the liver to stitch the 15 cm tear in the diaphragm. While they were speaking with us, Dr. Winchester's pager buzzed. He was told that there was a problem in the operating room with Damien's brain pressure - it was elevated to 90 centimeters of mercury (cm of Hg) (normal is 1 to 20 cm of Hg). Dr. Winchester ran from the room while the intercom broadcast the need for personnel to return to the operating room.

We did a lot of pacing while we waited. Mathew was very quiet during all of this. We heard nothing more until about 5:00 am. A representative came and explained that they had removed a skull plate above the right frontal lobe. The right side of the frontal lobe was badly bruised so they removed a "golf ball" size portion of the right frontal lobe and replaced the skull plate. The theory was that the space left after the tissue removal would be enough to allow the brain to expand if it continued to swell. Unfortunately, that did not prove to be the case. After the brain surgery was completed, they opened the abdominal cavity, removed the spleen, rearranged the stomach and liver, stitched a tear in the liver and closed the incision. By 9:30 am, they had moved Damien to the Trauma ICU and we were told that we could visit Damien briefly.

Damien was attached to a multitude of monitors and was breathing with a respirator. The nurse was busy getting things arranged. She was friendly but busy. We stayed in the room for 30 minutes and then had to leave. Paula went to the motor home to rest and freshen up. I returned home.

o    When I got home, I sat on the sofa and turned on the TV. A Robin Williams movie [What Dreams May Come] was on so I watched it. I love that movie and its surrealism; I like the story; the presentation; the colors. When the movie ended, I walked into the kitchen and just started weeping. I was crying uncontrollably like a heart-broken third grader. I thought this is stupid but still could not stop. It went on for probably a minute or two but is seemed like I wept forever.

o    Finally, I stopped, washed my face, changed clothes and returned to the hospital.

Paula's uncle was a very religious man. He had personal devotions twice a day and attended church whenever they had services. He had visited us in the hospital two days after Damien's hospitalization. One morning before we left for the hospital, the uncle called. He express sympathy and encouraged me to not be angry with God. He did not see me, but at his suggestion I smiled. I answered, "Why should I be angry with God? God was not driving the Ford, Heather was."

Damien spent 5 months in the ICU. He experienced kidney failure; a major hematoma over the left frontal lobe; and being colonized with MRSA (methicillin-resistant Staphylococcus aureus).

When he left ICU to go to a physical therapy hospital, he was still on a respirator and had a Lumbar Peritoneal Shunt to control the intracranial brain pressure.

Before the crash we were fans of the TV program ER. I watched it religiously. Not anymore. After seeing Damien in the ICU, I decided that trauma is not entertainment. Even today we do not watch Doctor/Hospital (drama or comedy) programs.