Collateral Damage

Updated: Oct 18, 2017

This is about the night that a Very Bad Thing happened to Sara.


I am not Sara.


It was a nondescript night, any one of a thousand shifts. Cool, dark, a little breezy and quiet. Quiet is an ominous word, it does not infer the idea of peace that one might think. Not to us. It is the where the Very Bad Things live. Like the throbbing chords from the iconic movie Jaws, quiet is the subtle soundtrack that plays leading up to their arrival.


We do not care for that word, “quiet.” It is more the result of experience than superstition, you learn to know the sound of Very Bad Things coming when you do not hear it.


Driving aimlessly for a time, Vinny and I are enjoying the night air. The stereo on low, the steady hum of the tires on asphalt, idle conversation passing the time. The radio crackles, the assignment breaching the surface of the sea of white noise.


Respond to a local police station for an assault, no other information.


We exchange puzzled looks as I turn the truck in the right direction. Our small bank of radios had been completely quiet, nothing was going on in any of the surrounding towns. At least nothing they were talking about.


A short time later they come back again, the gruff voice has an odd catch in it. They want to know two things. The first is what our ETA is. Weird, considering that we are a non-transport paramedic unit and we had heard no ambulance dispatched. The second question was used to confirm that we had a woman on the truck. Vinny answered both questions and looked at me in silence. I frowned and drove a little faster, we did not have any small talk after that.


Ladies, if they are inviting you to an assault because of your gender – there is a reason.


There was an ambulance there, silent with lights flashing and doors closed. We step out with our equipment and meet the small assembly of police and firefighters waiting by the back doors. They are a little dazed, unsure how to frame the information correctly. They are glad to see us, they are glad to see me. There are no other women here.


“She just walked in and said, ‘please help me.’ I don’t know how …”


“We didn’t hear anything about this. One minute we were having coffee and the next she was at the door.”


“How could she walk like that? That far?”


“I don’t know what he did to her, we did not want to hurt her more.”


“This is a very bad thing.”


“We waited for you guys, we did not know what else to do for her.”


“Hey guys, just so you know, her husband’s a cop from the town next door. He’s going to meet you at the hospital. He doesn’t know much.”


“We didn’t want to say.”


We get what quick information we can and go into the back of the ambulance, where we meet Sara.[1]


She’s lying on the stretcher, covered in blankets. Her misshapen face is turned toward me where I sit on the bench seat. Bruised and battered beyond recognizable features, both eyes are swollen completely shut. Her hair is dark and matted with dirt and dried blood, you cannot tell what color or how long it really is. I realize she cannot see us, effectively blinded.


I force myself to smile, so she can hear that in my voice, and introduce us gently to her. Vinny slides into the Captain’s chair silently, so at first all she hears is my voice. She exhales, visibly relaxing a little as we start to take care of her. Blood-tinged tears slide down her face silently as she quietly speaks with us. I look down at her hands, she is holding them gingerly in front of her.


At least I think they are hands.


They were where the hands are supposed to be, one at the end of each arm. Except these look more like a cartoonist’s rendering of hands, and a bad one at that. Both of her hands are shattered, swollen to the size of melons up past the first knuckles of her fingers. They look like discolored balloons with puffy sausages sticking out of them. One of the stubs twitches, she can move them but it is excruciating. She lays there patiently, working with us as we get through the assessment. Even when it obviously hurts.


On the way to the hospital Sara begins to tell us, in pieces, about what happened to her. She went to a girlfriend’s house for some coffee and conversation. As she got in her car, that’s when he got her. He abducted her at knife-point, in her own car – ten minutes from her home.


The details overlapped as she talked, often in a monotone. It was as if she were rehearsing it so she could hold on to the details, she wanted to remember so she could tell the police as much information as she could. Vinny and I listened as we worked, letting her get the poison out as we tried to ease the pain of her broken body. How he would drive her to random empty locations, rape her and then beat her with The Club from her car. That explained the hands, the face. After the third time (she thinks), he pushed her out of the car alongside of an empty stretch of road and left. She lay still until he left. In a ditch. In the dark. She lay still for a long time.


When she was able to she stood up. She pulled up her pants, and said that’s when she first noticed that her hands wouldn’t do what she wanted them to do. Still, she pulled them up as best as she could and began walking. She recognized where she was and headed directly for the police station, a mile and a half away. Holding her tattered clothes on, she walked in as her eyes were swelling shut, and asked for help.


It was an awful story to listen to, brutal and vicious, a Very Bad Thing had happened to Sara.


I am not Sara.


The ride to the hospital was without any issues, Vinny and I cared for her as gently as we could. She worked with us, trying her best to assist in her own care. At one point she wiggled her misshapen digits and winced. She asked me wryly, “So Doc, what do you think? Will I ever play the violin again?” I shrugged and said, almost reflexively, “Could you play it before?” She said, “Nope!” Grinning I answered, “Well then I’d say you’re in good shape!” She managed a small laugh, and I knew that this remarkable woman would not be beaten by the Very Bad Thing.


Given enough time, Sara would heal.


As we arrived at the hospital, I looked out the back window. In the middle of a small cluster of police officers stood a younger man in plain clothes, face tense and worried. There was no doubt this was her husband. I can’t stop him, I wouldn’t, but I need to warn him.


I jump out early and explain to him quickly that she looks very bad, but that she is awake and talking and making sense. I warn him that she cannot see at the moment, and why. He asks me the question that I have no defense to, no way to mitigate. “Was she raped?” Even if I had considered any other answer, I would not have been able to say it. I could feel my face twisting, my brow furrowing and my eyes starting to burn. Our eyes met and he saw my answer, I never said anything. He broke. I watched it happen, in the span of a heartbeat I watched the Very Bad Thing get him and tear his life apart.


See, the Very Bad Thing is the key to our line of work. Very Bad Things are out there, they lurk in the shadows of carelessness, bad decisions and sometimes plain bad luck. They circle the young and the elderly, waiting for that lapse of attention or that overlooked detail. Some of their favorite hunting grounds are the wrong place at the wrong time. They prey easily on the foolish and the unlucky, and they do not discriminate – ever.

Good providers acknowledge Very Bad Things, even respect them. We cannot stop them, we cannot avoid them, and it is a waste of energy to try. Even if you avoid one Very Bad Thing, another one is waiting right around the corner. No, our job is to deal with the aftermath. We try and repair the damage, mitigate the pain, pick up the pieces left behind in the wake of a Very Bad Thing. We cannot stop them from happening, but we may help someone survive it.


What we rarely get to do however, is see the Very Bad Thing happen. More often than not we come just after. Even if we got there fast enough to see the blue haze from the gunfire, or the trees are still swaying from the impact of the car, or last bit of foam is bubbling up from the grandmother’s mouth, it is still after. The moment of the Very Bad Thing is private. It is personal, it is where the reality of mortality and fear is. Even for the most experienced provider, it is the seeing of the event that is traumatic, not the aftermath. The aftermath is easy, it’s second nature.

I did not see the Very Bad Thing that happened to Sara, all I could do is care for her wounds. But I saw the one that got her husband. In that locked stare, those few seconds, I watched it get him. I saw him break, his reason cracking and his cop’s stare fill with anguish. I watched the Very Bad Thing laugh as the layers of practiced control slipped from his face, his heart breaking for his wife. In my head it sounded like glass shattering. That one non-verbal exchange was so nakedly human and raw, that it has remained with me the rest of my career as the most pain I have ever witnessed in a single person. He ripped his eyes from me and looked to the ambulance doors.


I could not actually say anything else, as they were taking her out. I grabbed his arm and out loud gave a helpful reminder that she could not see well at the moment. He took a deep breath, stepped forward and touched her arm. With tears streaming down his face he said in a full, strong voice, “I’m here Sara, it will be alright. I’m here with you.” His voice never matched his eyes, I imagine it would be a long time before that could happen again. We went in to the trauma area.


I never saw either of them again. I was told she required significant microsurgery to repair her hands, but that they had been able to do it and she would regain function. I doubt she’ll take up the violin though.


Sara was the victim of a serial rapist who abducted her in front her friend’s house, in her own car, ten minutes from home.


I am not Sara.


But I could have been.


There was one thing she said, about walking to her car, right before he grabbed her.


“It was so quiet.”




[1] Even “Sara” is not Sara. Patient’s name changed for privacy reasons.

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