Trauma and Growth: My First Mass Casualty

I stumbled upon this picture the other day and ugh, it made me smile. So young. Innocently taken earlier that day.  This is a story that I rarely, if ever, share.  It’ll likely be hard to read for some, however it speaks towards an important aspect of life – trauma and our ability to grow from it.

It really does feel like a lifetime ago yet it with one glance at the picture above I can remember every moment of it. The feelings, words, emotions, sights, and smells. The panic. Most of all, I remember her big brown eyes staring at me in pain as she took her last breaths.

And to be brutally honest, I felt relief.

Let me start at the beginning…

Once upon a time, in a land far, far away…

It was my first military deployment in a foreign country most people have never heard of and I was all of twenty one years old. Wide eyed and bushy tailed on a grand adventure!

It was a beautiful sunny day and we were heading out on a vehicle patrol for a reason I frankly can’t remember.  It was refreshing as all get out to finally spring free from our main camp.

So I stuffed a backpack with extras which seemed necessary to me for some unknown reason. In went garbage bags, supplemental first aid kits, bottles of water, snacks, extra note pad, warm clothing, ranger blanket, and glow sticks.  In hindsight, I think I would have made a damn good boy scout.

Oh how the gents gave me a few good jabs for bringing so much! Typical girl…blah blah blah.  It was just a simple vehicle patrol out to a site and back. Easy peasy. No need for so much. All in good fun though, we were a great team and I didn’t mind the joking around.

The incident

The day was uneventful until we began our route back. The roads along the coast were narrow, curvy, and bordering on steep cliffs to the one side. One particular truck driving well in front of us, with its heavy 50+ passenger load, lost its brakes and went over the cliff.

Just. Like. That.

People were scattered everywhere.  I remember thinking that it looked like a movie scene but still not processing what was going on as we approached.  Where did all these people come from? Why is everyone lying down?!

In a split second realization set in and it became painfully clear.

There were four of us, multiple wounded, no medics, help was hours away, and all we had was a satellite phone with crappy reception and my handy backpack of extras.

This was a mass casualty.

“Mass Casualty Incident: An incident which generates more patients at one time than locally available resources can manage using routine procedures. It requires exceptional emergency arrangements and additional or extraordinary assistance.” ~ WHO

One little girl with big impact

The girl’s parents were there. At least I think they were her parents. They spoke no English and I wasn’t able to speak their language.  They frantically waved me over to come care for her.

The girl was young and her injuries, mostly internal from impact, were substantial.

First aid begun.

At a certain point however, there was nothing left I knew to do to help. It was frustrating AF. I was thinking if these poor people only knew that I worked with radios. I was someone who had no clue beyond basic first aid and a little common sense. Her parents watched and pleaded with me to do more, over and over again like I’m sure any parent would. And what did first aid teach you about internal injuries?! Nada. Zilch. FML. What I needed in that itty bitty first aid kit was a magic wand, or a surgeon maybe.  Medics were still hours away. It was disheartening to say the least.

She was literally dying before my eyes and there was nothing else to do but let it happen. Maybe pray. Which I did by the way, even though I’m not religious by any means. I held her hand, smiled as a means of comfort, and sang a lullaby. A f*$king lullaby, sigh, a ridiculous thing to do but I had no idea what else to do.  The boys didn’t either when they came over to check before moving on the help others.  She was wavering in and out of consciousness, crying from abdominal pain.  So I sat there singing softly and thinking in my oh-so-wise twenty one year old mind that this just sucks. It seemed like time was frozen, the chaos faded away, and it was just her and I. A beautiful but scared brown eyed little girl on her way out of this world.

When her hand gently let go with that last moment, I took a long deep breath and went to help the other injured.

The rest is a bit of a blur, keeping in mind it was almost twenty years ago.  There was triage, the call over the satellite phone for a med evac, the boys going down the cliff to help bring up the injured and eventually, field ambulances arriving.

What are the odds

I was told later that of the fifty local nationals on the truck only two people (including the girl I was with) succumbed to injuries. Really wish it was none but the reality is that we were pretty lucky it wasn’t more than two.

Speaking of luck, there was a one critically injured man with a skull fracture exposing the brain. The hole was the size of an iphone, in my mind it was the size of a damn tablet. The only thing we had to help clean out the dirt ridden wound was the bottled water, so that’s what I did. You just do what you can do ya know? It was so incredibly surreal. Pretty sure we arranged a medevac by chopper for him, but again, it’s a haze. I have no clue anymore. Surprisingly (and thankfully), he survived and we visited him days later in the field hospital.

Lessons of trauma

You might think I’m insane for saying so, but this experience was a gift. It was a gift because we were there to help and it could have been much worse. A gift because it enabled me to develop stronger coping skills, gave self-confidence in my ability to react in stressful situations, and forced an exploration of self and spirituality.

It was a moment of personal and professional growth that set the tone for how I’d react and adapt to similar situations in the future.

Looking back there are a few lessons that learned that day:

• Feel all the feels in whatever way feels best (so long as it’s not destructive to yourself or others): We came back from that patrol exhausted and in silence. We did talk about it later and that made a difference. It was acceptable to cry and normal to be angry but I was neither. Instead I journaled the heck out of the event. The moment was acknowledged and I was able to feel all the feels through writing. All that energy and emotion also made for an epic workout the next day…and then it was done.  Fait accompli.
• Boy scouts are smart cookies: We used absolutely everything that I had stashed in the backpack earlier that morning. The bottled water to clean wounds, the notepad by writing injuries to help triage patients for the medics, extra food, and obviously everything in the extra first aid kits. Now a days I hike with a day pack that even MacGyver would be impressed with. Emergency everything. Extra everything. I don’t mind the added weight in exchange for peace of mind.
• Reflection of reactions: Take the time to reflect on which coping skills you want to keep, want to chuck, and/or want to build on. What serves and doesn’t serve? Bursting out in anger…not so much useful. That energy and emotion has to go somewhere though so if it’s running or writing or peer support or therapy or cleaning (my go to) – roll with it. It’s amazing how clean my house gets during a rough week. That’s productive. 😉 Reflection tends take honesty though, a boat load of humble pie, and sometimes exposes an uncomfortable vulnerability. Ugh. That said, it is usually always worth it.

It’s ok to be ok.

With so many mental help campaigns on the go lately, we are all starting to understand and respect that it’s ok to not be ok. It is part of our beautiful humanity to experience challenges and to be challenged from them. It is ok to not be ok. Definitely.

On the flip side, as long as you’ve processed the event and you’re not bottling up your experiences for a dark rainy day…it’s ok to be ok too.  With so many friends and coworkers experiencing post-traumatic stress disorder (PTSD) – that one took me a while to figure out.  I usually run into the misconception that if you’ve experienced trauma and you must have PTSD. Umm, no. We experience/process/feel/cope/heal differently which is part of the beauty.  It is how we perceive the event and there are so many factors that come into play with that…well, a person with a much higher education than mine should explain it. That said, no one is unique in their experience/process/feelings/coping/healing. We are diverse but never alone.

Life is still good

This experience doesn’t weigh me down and it doesn’t even make me sad to tell you the truth. Not that I don’t care mind you, a child literally died in my arms, of course I care. Its just that I’ve had time to process and came to terms with it. Mostly I’m thankful. What I learned served well in the years to come and I’m appreciative for this damn good life of mine.

The final thoughts swirling around in my head are that I think that trauma and tragedy are as much a part of life as the shining sun, that healthy coping skills are some of the most important gifts to teach/discover, and we’re really just all in this big mess called life together.