The Lifeline Pilot

The Lifeline Pilot

The ideas for many of my stories are triggered by a few words or sentences, as was this one. I was lucky enough to attend two classes, two years apart, given by the pilot in this story. It is based on a few details he provided, and from them, I had to weave a tale that is, more or less, his story. Although I had to make up some of it, the essence of the account stands. And, of course, his name has been changed. This story honors him and all those who suffer post traumatic stress disorder (PTSD). He is one of my heroes.

By David Barth, May 19, 2008

At a young age, Conrad Carpenter became a pilot of fixed wing aircraft. After graduating from college, he joined the Marines and received helicopter training. He flew many missions and became known as a can-do pilot who would accept missions that few other pilots would fly.

During his exciting military career, Conrad learned how to fly a chopper in all sorts of weather conditions. Often, Conrad was able to complete a mission when other pilots wouldn't go. The reason he was so successful is that Conrad studied weather so that he knew if he could navigate through it safely. When asked by a Marine "newbie" pilot for his secret to surviving, Conrad told him that it was knowing the weather so well that he knew when not to go. But military aviation isn't an easy life, and he lost many close friends who crashed or ditched.

When a friend didn't return from a flight, he felt a great sense of loss. He stopped making friends with the new guys who came into the squadron because he didn't want to suffer their loss if they met their demise.

After leaving the military he wanted to continue working in the aviation sector, and he landed a job flying air ambulance helicopters. Most of these missions involved picking up injured persons from automobile accidents and flying them to a hospital.

Conrad flew emergency medical technicians (EMTs) to accident sites so that they could load the worst of the injured on board and fly them back to the hospital. Sometimes they didn't pick up anyone if the accident had been so terrible that no one had survived. Naturally, Flight for Life helicopters don't load deceased persons.

Often, after landing at an accident site and shutting down the helicopter motor, Conrad got out and helped the EMTs get the worst of the injured out of the wreck, onto a gurney, and loaded into the helicopter for transport to the hospital's trauma center. By doing this, he was exposing himself to some gruesome, horrible injuries. Injuries that would make one think "that person can't possibly live," but sometimes they were just barely hanging on, and it was very important to fly them out, even if they couldn't possibly survive for another hour after arriving at the hospital.

If the injured person could be transported to the hospital before he expired, the medical staff could hook him up to life support machines to keep his body alive for another few hours. In the meantime a special team of surgeons and operating room technicians would be called in to prepare to harvest the organs.

Many people need transplants, and accident victims who expire at the hospital are often good donor subjects. While the victim is being kept alive on life support, the team arrives at the hospital, sometimes flying in from another city. Harvesting organs is such a specialized activity that specific training is required to perform the operations that can take more than six hours. Teams are organized to do only organ harvesting. The harvesting process takes almost all bones in the body for the marrow, the heart, lungs, liver, spleen, blood, blood vessels, intestines, kidneys, corneas, and even skin to cover burn areas on people who have suffered that type of injury.

What is left of an accident victim after the harvesting procedure is only the head and some skin from the upper part of the chest. The head is turned over to an undertaker who specializes in recreating the likeness of the victim's body, based on photographs provided by the family. He creates a fake body, dresses it, pads it, as necessary, and prepares it for placement into a casket. If there is little or no head trauma to the victim, the casket can be open for viewing, but it was always best that those attending the viewing don't know that only the head and some skin are all that remain of the original body.

Harvested organs are very important in saving the lives of people who are in need of a particular body part. If there is a genetic match between the person needing a part and that of the victim, the part might be given to that person. However, there is selection criteria that must be addressed before deciding who should receive a part. One criterion is that there must be a match to reduce the chance of rejection of the part by the recipient. Another is how long the person has been waiting for the organ. Often, an organ goes to the recipient with the greatest need. These are life-critical decisions that medical practitioners in the field of organ donation and transplant must make every day.

Conrad had a strong sense of empathy for the victims. He saw innocent people who were maimed, severely injured, or expired due to accidents that were not of their own making. He imagined the tragic sense loss that the surviving family members and friends of the victim would feel. He saw that in the flash of a moment, a strong, viable person's life would be crushed, ruined for ever after, and, inside, he was deeply saddened at the senselessness of it all.

Sometimes he had to help the EMTs pick up body parts that were strewn over the road after a particularly bad accident. It wasn't a pretty sight, and Conrad began to suffer symptoms of traumatic stress disorder. At times he became irritable and difficult to be around. Fortunately, his wife was a nurse, and she understood what he was going though. She gave him the support that he needed. A wife who didn't understand Conrad's situation might have assumed he was permanently losing control over his emotions and might divorce him. Fortunately for Conrad, his wife stood by him through these difficult times.

Very early one morning, when Conrad was assigned flight duty, a call came in for him to fly to the site of a bad accident. He and the EMTs went into automatic mode. They knew what had to be done, and they did it efficiently and with precision. They were a well-honed team. They gathered at the helicopter pad with the tools of their trade, ready to go. Everyone got on board and Conrad started the engine. When the gauges indicated the machine was operating properly, Conrad lifted the bird off the pad, into the early morning darkness. He flew directly toward the site where the highway patrol had shut down the road and had identified a field that was clear of wires, trees, and other obstructions. Air Traffic Control blocked out the airspace for Conrad's flight route so that he wouldn't have to worry about other planes, but flight for life flights were usually at a lower altitude than most other aircraft fly.

All the way to the accident site, Conrad was in communication with the patrolmen on the ground, finding out where the best landing zone was located and the condition of the accident victims. If all of the injured expired before he got there, he wouldn't land, but return to the hospital. No use loading bodies into the helicopter. A coroner could move them using a road vehicle.

Enroute to the crash site, Conrad was told that it was a single-car accident and the two teenage girls who had been in the car were seriously injured. The car had left the road at high speed and smashed into a bridge abutment, destroying the car. The girls had not had their seatbelts on and had been thrown through the windshield. The resulting head injuries were bad, and they were losing a lot of blood. To survive, they needed help soon.

Conrad throttled the engine up to what the armed services call "full military power." He knew that this put extra stress on the engine and the rotors, but if he could save a life, it was worth it. He carefully monitored the engine instruments. If the turbine inlet temperature got too high, he would have to throttle the engine back to cool it down. No use losing the engine before he got to the accident scene. Besides, he didn't want to have to perform an autorotation to a forced landing in the dark if the engine gave out. It was tricky enough in daylight.

Then, on the horizon he spotted the flashing lights of the emergency vehicles and traffic backed up in both directions. A fire department crew was on scene to provide initial medical care and carefully get the injured girls onto backboards in preparation to move them to the helicopter. The chopper had enough lift to fly two victims if one of the EMTs who flew in with him stayed on the ground. That person would be driven back to the hospital by the police.

As he came over the designated landing area, he switched on the powerful search light beneath the nose. It provided bright illumination of the landing zone and, he hoped, showed any obstructions that might be in the way of the rotors. It looked clear, and he quickly set down in the field. The EMTs on board jumped out and ran to the crash scene. Conrad followed as soon as he got the rotors stopped and the engine shut down. It would be several minutes before the girls were loaded and they were ready to fly back.

At the crash site, Conrad saw the car. It wasn't against the concrete pillar because it had bounced back about five yards following the impact. He couldn't tell what make or model it was because the sheet metal had been completely deformed in the crash. He realized that it must have been traveling at a very high rate of speed. The specifics that included the speed of the car, if the brakes had been applied, and other data would be extracted from the black box that automobile manufactures have been placing in cars since the turn of the century. Not many drivers knew that the last few seconds of driving data was being stored into a small on-board computer, sort of like a miniature version of the black boxes (actually, they are orange) carried aboard commercial aircraft.

Then he saw the girls. They had been carefully placed on trauma boards and were receiving intravenous fluid to replace lost blood. Maintaining the volume of blood was critical to get oxygen to the brain and other organs. He saw blood on the concrete abutment where the girls had hit after being thrown violently through the windshield. And he smelled alcohol. The smell was strong. Perhaps the girls had been drinking or maybe they were transporting booze in the car. He would be interested in finding out if they were drunk when they crashed, and the accident report that he would receive the next day would provide the details.

Conrad gave a solemn thanks to each of the firemen who had helped at the scene, the girls were loaded aboard, he then climbed into the helicopter, fired it up, and lifted off. The EMTs who flew back to the hospital with him could talk to him through their headset microphones. On these flights they always kept him apprised of the condition of the victims. If a victim died enroute, he would throttle back to save gas.

The EMTs said the girls were still alive, just barely. They were doing everything they could to stabilize them. Conrad called the hospital and provided the details. At the hospital, two surgical teams were gearing up in two different operating suites, ready to receive the girls. The girls would each go to a separate suite so that the teams could operate on each of them, independently.

The hospital helipad came into sight, and Conrad prepared to set down as quickly as possible. Time was critical. Then, as he was nearing the pad, an EMT in back with the girls gave him the bad news. Both girls had expired about the same time. Conrad almost cried. So close to surgical care, but yet, so far. He felt responsible for the failure to get them to the hospital in time. There was no rush now. The girls would not be taken to the operating suites. Instead, they would be placed in temporary cold storage until a family member came to identify them and indicate to which mortuary they should be sent.

The next day, Conrad received the accident report from the highway patrol. The blood alcohol of both girls was double that which would make operating a motor vehicle illegal. Witnesses at a party the teenagers had attended said that the girls had arrived at the party in the car of one girl's mother. He said that even though she didn't yet have a license, her mother often gave her the use of the car to drive around town. Apparently, the girls had gotten drunk at the party, and then taken the car out for a high-speed joy ride at 1 A.M.

Conrad was crushed at the stupidity of it all. He had a daughter, and she had strict rules about drinking that amounted to: NO drinking. The mother of this girl had set her daughter up to die. Conrad was so upset that he asked the flight operations manager for four days off. The manager was sympathetic to Conrad's situation. Besides, a distraught pilot shouldn't be flying. The flight surgeon concurred with the time off request.

When Conrad returned to work, he was still upset with the carnage he'd seen and the senseless loss of life. The manager saw this, and told Conrad that he wouldn't be flying on this day, but to wait around the office for awhile.

About an hour later, the manager told Conrad to go to a certain room in the hospital. Conrad didn't know what it was all about, but he shrugged and walked into the room where he saw the flight surgeon, a woman physician who monitored the physical and mental state of the pilots to ensure that they didn't fly when they were ill. This was an accident prevention activity.

Then he saw a disheveled woman sitting in the corner of the room. Her hair wasn't combed and her eyes were red. The flight surgeon introduced Conrad to the mother of the girl who had been driving the car at the time of the accident.

Inside Conrad, it was as if an atom bomb had detonated. He exploded in fury, speaking loudly at the mother at how she had, in effect, murdered her daughter and the other girl. Didn't she know enough to teach her daughter not to drink? And what in the world was she thinking by letting her daughter drive the car without a license? Conrad vented. And he vented. He released the stresses of four years of horrible accidents on the mother. He tried to place the 800 pound gorilla that was on his back onto hers, but it was no use. He would have to live with all of the tragedies he'd seen and the deaths he had experienced. He couldn't unload them or erase them from his mind. The mother put her head into her hands and cried. She had been told this pilot needed to vent, but it was difficult for her to take. After all, she had lost her only child, and she knew it was her fault.

Within a few weeks, Conrad quit that job. He took a long sabbatical to try to get his head straight. The flight surgeon, the doctors, and the psychologists realized that he was suffering from the same post traumatic stress disorder that many war veterans have. As the medical profession studied the disorder and learned more about it, they realized that it is a disease that will never entirely leave a person's mind. The nightmares might become less frequent. The flashbacks might subside somewhat, but they will always be hiding in the dark recesses of a person's psyche, ready to reveal themselves at any time, especially when that person nods off to sleep.

After six months being unemployed, Conrad wanted - and needed - to go back to work. His flying credentials were impeccable. His leadership ability was well known. He was hired as a flight operations manager at another hospital with a flight for life helicopter. He wouldn't have to fly - only manage those who did.

Well, that isn't quite true. The reality of his position as manager was that if a pilot were ill or unable to fly, it was Conrad's duty to take the flight. So, Conrad tried to fill in, but he just couldn't enjoy flying emergency airlift sorties. In fact, he loathed them because flying them was like taking a time machine back to horrible, disgusting times that he had experienced before. The times that had given him the trauma disorder. He quit that job and changed to a more pleasurable flying career: teaching people to fly. He enjoyed helping people learn, and he was good at instructing.

As time went by, his teaching ability became well known, and he was asked by a major, nationwide aviation organization to give flight instructors weekend refresher courses. People who attend his classes range from pilots who have recently become flight instructors to high-time, senior airline pilots. Conrad is not afraid to tell these instructors of his experiences, but when he does, people sitting in the front row see tears well up in his eyes as he tells how he wishes he could have saved every victim who was loaded onto his helicopter.