Last week Dan Simonson shared the story about a 
rural practice CRNA friend named Kimmerle Miller-Leonard , involved in a serious car accident while on the way to an urgent C-section, who crawled out of her wrecked car, flagged down a passing car and continued onto the hospital to provide anesthesia. Although Dan’s story was compelling I was very interested in hearing the story from “Kim’s” perspective. Here is Kim’s story.
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I work in Rural America, at a small community hospital, 2 CRNAs contracted to provide 24/7 call alternating weeks. Some days I work from dawn to dusk, other days are spent checking my phone to make sure it works because “the hospital” has not called. We have an active OB department so epidurals and C/S and my favorite “ruptured ectopics” are always looming.
May 2, 2012 I got a 1:30a.m. call “urgent C/S” meaning get up and come in, no one is dying, so I get to drive the speed limit to the hospital 20 minutes away. It is very dark, I am greatfull for the absence of traffic, I can use my brights as I travel along the dark 2 lane highway. Dimming them when I approach on-coming traffic makes me anxious, more so tonight perhaps it is a premonition of what is coming.
About half way there I see a van on the side of the road with it’s emergency lights flashing, out of gas? pulled over to sleep off a “great night at the bar”? no sign off anyone waving arms trying to flag me down. I think to myself I will call 911 and tell them about the van so someone can check on them.
Suddenly I see a live horse in the left lane and “holy crap what is that enormous brown mound in my lane?”. As I hit the dead horse, killed just moments before by the van with the flashers on, I am going 55 with my cruise control on. The next eternity of rolling, sliding and flipping with the sound of glass shattering and metal bending and breaking in my ear, I have a calm thought of this is it, no way I am going to live through this, I was going too fast and there was too much damage happening around me. I wonder “when are my my airbags going to deploy?” They never do.
As I grasped my seat belt pinning me tightly in my seat I pray it will hold. Then I reach out to God, “I can’t die Joshua my son is not grown yet”. I am not afraid, just sad, I am not ready to die. I never considered if not killed, then horribly injured, I simply accepted people who have accidents like this, die.
Then the car is stopped and I am upright in the seat and I am not dead, I am not even hurt. As I pull my left ankle free of where it was jammed, my driver’s door is gone and my ankle is pinned under the door hinge. I realize THAT HURTS!! Ok so now what?! as I look around I think I need to call the hospital and tell them I have been in an accident. My phone is gone! my purse no longer next to me, is in the back seat. The car jack has tumbled to the floor on the passenger side from the hidden compartment in the back of my car with out giving me a head injury.
Getting out of the car is easy with no door next to me. My right arm is bleeding and dirty but functional!! I start out of the field where I landed 30 feet from the road and 50+ feet past the dead horse. I think that I need to get to the van and hopefully they will have a phone. As I hobble down the highway calling out, I realize it is still so dark, the live horse is guarding his dead friend.
The van has a phone and they are already talking to someone. I realize they are not English speaking. They hand me the phone to talk to the 911 operator who is frustrated. He wants an exact location. I attempt to tell him where on the dark 2 lane highway we are, he wants the name of near by side roads. I tell him I need to get to the hospital to do an anesthetic.
This is my anchor to sanity, I need to do my job, I need to get a ride. I need life to be normal. More importantly I need to convince this man that the horses are still in the road waiting to be hit again and the next person may not be as lucky as I was. He is vague about how long it will take to get help. I state that the driver of the van is covered in blood and screaming hysterically. There are 4 other people in the van, scared more then injured. He promises help as soon as he can send it.
Rural America has a limited budget. I call my husband and tell him to get up and come get me or deal with the accident if I can get a ride. My husband Charles Leonard is also a CRNA and has done his share if rural anesthesia. He agrees if I feel I can do it I should go to the hospital, people are depending on me.
There is a car coming. I wave my arms to get him to stop and slow down, the live horse moves off the road to allow him safe passage. He turns around and drives me to the hospital. As I use his phone to call the hospital, I realize we are going at a very fast speed, I tell him it’s OK slow down and to drive safe. My good Samaritan reply’s he is just trying to get me there as quick as possible for my C/S, he believed he was getting me to the hospital so I could have a C/S. I laugh it It feels good. It calms me and helps me focus.
As I run?? to the OR I am reminded that my left ankle is very sore and putting weight on it is best avoided. As I change to go to the OR, the ObGyn Dr hugs me, I am safe and she does not have to do the C/S under local without an anesthesia provider. Once in the OR I do my job. It is nice to just focus on what needs to be done, its like baking a cake first you do this then next comes that.
I am shaking and once again reaching out to my overworked guardian angel, “Help the SAB to go well”. The spinal falls in and works well. Baby does great. As as I drop off the patient to the PACU, the family Dr who assisted on the C/S arrives with ace, ankle brace and an order for an ankle x-ray and recommendation to see the ER doctor who is expecting me. He tells me they have just received a pregnant woman from the van to the ER and no one including her was seriously injuried.
My husband arrives to take me back to the scene to talk to the officer, who was on over time to “work the scene” he was the only one available to be there. Horse is off the road and his friend no where to be seen. It hits me how trully blessed and lucky I am as I watch them tow out the crumbled metal that used to be my car. “Not your time the tow driver says, people with cars that look like this go to heaven or trauma hospitals”.
Soon I am back at the hospital keeping my x-ray and ER appointments. It is broken in 2 spots, but not out of alignment. “Keep your weight off it and it will heal with out surgery” is the instruction from the orthopedic surgeon I work with.
My partner Terry Leaf CRNA arrives for his week on and quickly tells me he will work as long as I need him to. He lives 3 hours away, this will mean he lives at the hospital 24/7 until I can work again. I am lucky to have such a good partner. I would do it for him, that is how it is in rural hospitals. When asked by numerous people why did you go to the hospital and do the case. My response was who else was available to do it? I was not dead, I was able to go and do the case.
In the distant past I worked “crash hearts and life and death cases” anyone who has been there knows you just do your job, as well and as fast as you can, people need you. Siince the accident we have worked to get my husband hospital privileges as an emergency back up for me. Since I live 20 minutes away I can be Terry’s back up on my weeks off.
As I write this story for CRNA BIZ almost 3 weeks have passed. I am in love with my knee scooter. I worked 24 hours yesterday to allow to allow Terry to go home for a night. It has given me confidence that next Tuesday it will be business as usual as I start my week on.
The purple blob on the end of my left leg is looking like a foot again. The multiple bruises, cuts and sore spots are healing and I have a new car. It is a Subaru Outback “it has more airbags”. I will be forever grateful to my Subaru Forrester. It saved my life.
Kimmerle Miller-Leonard CRNA,MAE
