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The Safety Story I Wish I Wasn't Writing


LETTER FROM CINCINNATI

THE SAFETY STORY I WISH I WASN'T WRITING

Answering the telephone, I heard a strange voice on the other end: "Hello, I'm a nurse in the emergency room at the Terre Haute Regional Hospital. Your parents have been in a car accident."

They had driven off that morning from Cincinnati, heading for the 50th reunion of an Illinois high-school class that my mother once taught. They never made it. About 10 miles east of Terre Haute, Ind., my father lost control of the car. It bounced off the left guardrail and plowed off the right side of the interstate. My father was all right, but my mother wasn't.

For the next few weeks, I would commute to hospitals in Terre Haute and, after she was transferred, Cincinnati more often than to the office. But the journeys kept intersecting. As BUSINESS WEEK's Detroit bureau chief, I have written story after story on the topic of auto safety. The dry facts and figures I had heard on seat belts, survival rates, and elderly drivers would come flooding back to me as I held the hand of a woman hooked up to a respirator and a jumble of tubes in an intensive-care bed, clinging to life.

KEY DIFFERENCE. My parents, both 76, both wearing their seat belts, had vastly different injuries. My father had only a few cuts and bumps. My mother suffered six broken ribs, a broken sternum, and, worst of all, a punctured small intestine. Why the difference? Mom had let her guard down. While trying to sleep, she had slipped her shoulder belt under her arm. And apparently she was wearing her lap belt high across her stomach, rather than low across her hips, where the pelvic bone could help absorb the sudden pressure. Wearing her belts undoubtedly saved her from instant death, but wearing them improperly cost her dearly.

As accidents go, the wreck wasn't that horrendous. I went with my father to collect a few items left in the car. I could tell from the twisted front axle that the Chevy Celebrity was totaled, yet the damage looked relatively mild. Not quite three weeks earlier, at a General Motors Corp. briefing, I had seen a demolished Oldsmobile that had been hit head-on by a drunk driver. Thanks to her belts and airbag, the Olds' driver walked away with little more than a cut nose.

My folks' Celebrity had no airbag. Would one have helped? Probably not. Airbags inflate and deflate in about one second. Had the airbag inflated when the car hit the guardrail, it would have been deflated and useless by the time the car ran off the road.

The fact that my parents were in a frontal-impact, single-car accident makes them something of a statistical aberration. Usually, such crashes involve teenagers, booze, and high speeds. Elderly drivers are more likely to be in a side-impact collision. For example, an elderly driver pulling out at an intersection may be rammed by a car that he didn't see coming or whose speed he misjudged.

But those stats didn't matter as much to me as pulse and blood-pressure numbers when I first visited mom in Cincinnati's Good Samaritan Hospital. She had just gone through surgery, and she looked awful. A tube through her nose was draining foamy bile from her stomach; another in her mouth led to a respirator. Other tubes fed her intravenously and drained excess fluids from her gut. Although mostly coherent, she was too weak to do more than lift a hand and point to letters as she spelled out messages.

My stomach queasy and my knees weak, I pulled up a chair and sat on its armrest as I prayed over her and searched for encouraging words to say. I reproved myself for finding it easier to look at a monitor's video screen displaying her vital signs than to look at my own mother's face. But this wasn't the mother I knew. My mom had left the family farm during the Depression to earn a college degree in math, raised four kids, and learned to swim after she was 50. This incapacitated patient before me seemed to have nothing in common with the woman of drive and determination who raised me.

But, as a doctor declared, had she been more passive, sitting around home and smoking, she would already be dead. However, she never smoked or drank, and swam regularly. Her body was much stronger than that of most 76-year-olds. She would need all of that physical strength and mental determination in the weeks ahead.

In that first operation, the doctors found that her punctured small intestine was leaking food-dissolving fluids. If they weren't drained off, those fluids would eat away at her other organs. As one doctor graphically explained, she was "septic."

If her other organs held up, there was hope that her abdominal problems might heal. But that was a big "if." In addition, she remained catabolic: Because her body needed more food than the IV tubes could carry to her, she was, in effect, eating into her muscle tissue to sustain herself. She had received two pints of blood and would need more over the coming days. My sister, brother-in-law, and I searched out a blood-donor office and gave. Meanwhile, prayer groups in Cincinnati and elsewhere added Clara Treece's name to their lists.

Our family maintained a vigil in the post-surgery waiting room, taking turns sleeping overnight there, next door to the chapel. We met other anxious families: the teenage daughters of another car-crash victim and a nine-year-old boy whose father, working on a road crew, had been hit by a car in a thunderstorm.

As mom's condition stabilized, I began to think she might survive, and I returned to Detroit briefly. I left too soon. A CAT scan found multiple abscesses in her intestines, and she was rushed back into surgery. She would be coherent and stable for 48 hours and then teetering for another 48 to 72 hours, I was told. The doctors gave her a 10% chance of survival. My wife and I packed our three-year-old son into the car and headed south on I-75. Three times we saw ambulances with lights flashing. I felt sick to my stomach each time.

AWKWARD SILENCE. After an additional half-week of waiting at the hospital and babysitting each other's children, the family met with the senior doctor on mom's case. He was encouraged by her strength so far, but noncommittal about the future. "What else could go wrong?" my twin brother asked. The doctor paused. Breaching the awkward silence, one of my sisters said: "Too many things to list, huh?"

I searched for good news. Surely, now that we had passed those 48- and 72-hour periods, we could begin to breathe easier? No, he said, her recovery was still on a critical, narrow path. She was so weak that they didn't want to risk any more operations, even though they knew she needed a tracheotomy soon, to get her off the respirator.

More crises followed. Despite their aversion to further operations, the doctors had to cut her open twice more in response to massive internal bleeding. They stapled her stomach shut just above the intestines and patched her open abdomen with a sheet of Gore-Tex, later replaced with a skin transplant from her thigh.

Ten weeks after the accident, mom left intensive care. She is improving and may soon leave the hospital for a nursing home. Her goal: to remove her IV tubes and eat again.

Back at work as an auto reporter, I've undergone an irrevocable conversion. As the carmakers unveiled their 1992 models this fall, I wasn't very impressed by higher horsepower or swoopy styling. I wanted to know whether the new cars offer driver- and passenger-side airbags, antilock brakes, adjustable shoulder-belt anchors, and other safety features.JAMES B. TREECE


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