How a "crash course" in medicine changed my life

A reckless cabbie sent this doctor on an unexpected trip to an Egyptian ED, where he developed a new outlook on life.

By Patrick E. Peterson, DO
Family Practitioner/Rochester Hills, MI

hen I set off for a medical student conference in Egypt four years ago, I anticipated an exciting adventure. Instead, I had a horrible experience that forever changed my view of the world.

Four other second-year medical students and I belonged to an organization that arranged for month-long rotation exchanges with med students from other countries. Two women and a man in my group hailed from Chicago, my friend Paul came from Michigan, and I was studying in Miami.

We arrived several days early to sightsee in Cairo, and were fascinated by the pyramids, the people, and the strong, aromatic coffee. One day, we decided to go to the Red Sea, which is almost legendary for its scuba diving.

We took a bus to the seaside town of Hurghada. On the way, we saw many cars that had been in accidents and abandoned on the side of the road, but we didn't give them much thought. We had a marvelous time diving and snorkeling, and our biggest concerns were sunburn and getting to Alexandria in time for the conference.

Unfortunately, when we were ready to leave, the Muslim holiday of Ramadan was about to start, and everyone in the country seemed to be traveling. The buses were full; our only hope was a taxi. Seeing the way the cabbies drove—racing down the middle of the road and swerving at the last moment to avoid crashes—made us leery. If we wanted to get back to Alexandria in time, though, we had no other option.

We found an empty taxi—a small, old Peugeot station wagon with no seat belts. The driver agreed to take us to Cairo, where we could board a train to Alexandria. While he strapped our luggage to the roof, the rest of us eyed the front passenger seat, by far the most comfortable-looking. Paul slipped into the seat when we weren't watching. He grinned at us as we folded ourselves into the two rows of seats behind. With a chuckle, Paul promised to grab the wheel if the situation grew perilous.

It was twilight, and we had a two-hour drive back to Cairo. Our spirits were high as we discussed our plans for the conference. Our driver kept the pace over 60 mph throughout the winding trip. We asked him to slow down, but he laughed at our concern. At one point, the car's back hatch fell open. The driver found this funny. We didn't.

After about 45 minutes, Paul called our attention to the road. We were rapidly approaching a curve, and our driver was trying to pass a truck. Suddenly, a tour bus rounded the curve, approaching us at about 40. Our driver sped up, and with nowhere to go, tried to veer to the left of the bus. Instead, we smashed into it head-on. It felt as if we'd hit a brick wall.

When I came to, I was trapped in the car, the seat on top of me. My back hurt terribly. I pushed the seat away and crawled out through the smashed window. Everything seemed distant and slow-moving. Sight and sound were distorted.

Our car was crunched into a ball of metal. The engine and front end were practically in the front seat. The two women had pulled themselves out of the car but were completely disoriented. Our companion from Chicago was a little bloodied, but seemed okay. I watched as he fixed his dislocated elbow.

Paul, however, was in critical condition. Lying on the left side of the car, he was covered in blood, with decerebrate posturing. He wasn't breathing, and he had a huge laceration on the right side of his face. As I got him breathing again, people tried to pull me away. I yelled that I was a doctor, and finally they left me alone. Eventually, Paul stopped decerebrating, and an ambulance came.

My relief turned to horror as I realized the ambulance had no equipment. The vehicle contained an oxygen bottle, but no valve, hose, or mask. We were loaded into the back and taken to the nearest hospital, in Suez. I assisted the local medical personnel, and Paul received a hasty blood transfusion. I was concerned about his airway, though the medical staff was intent on suturing his lacerated face. I called the US Embassy in Cairo and asked whether it could send a helicopter. No luck.

We loaded Paul into another ambulance for the 45-minute ride to Cairo. Again, the vehicle had no equipment. I kept Paul's airway open and assisted his breathing manually. Whenever I stopped to rest, he stopped breathing. Believe it or not, a truck sideswiped our ambulance and ripped off our side mirror just before we got to the hospital.

Paul was finally placed on a respirator and admitted to the ICU of Ain Shams University Hospital in Cairo. The others in our party arrived and were admitted several hours later. I slept on a gurney in the ED, as my injuries didn't require admission.

A few days later, the other students went home. One woman returned to Chicago with a neck injury. The next day, she had three bone-graft neck fusion operations after doctors found a vertebral fracture in two places. The neurosurgeon said it was a miracle she wasn't paralyzed.

I stayed with Paul, making arrangements for him to be cared for until his parents could get there. He was comatose, and hemiparetic on his left side. Five days later, his parents arrived and had him placed on a Medevac plane for home. I managed to make it to the medical conference for one day, but I didn't get much done.

Paul was diagnosed with a closed head injury and remained in a coma for a month. But he slowly recovered much of his functioning, including some motor function on his left side, through the help of the Neuroscience Center at Sparrow Hospital in Lansing, MI.

He never fully recovered, though. For almost three years, he tried valiantly to progress in his medical schoolwork, but finally was unable to continue. He's now in a master's program in computer science in Colorado, where he's doing well and seems to be happy. Paul still remembers telling us he'd grab the wheel if anything happened, but doesn't know why he didn't do it.

I was diagnosed with postconcussion syndrome. For a while, I couldn't remember much, including lectures I'd just heard. I managed to finish medical school and pass one part of the board exams, and I recently started a job in family medicine. All my travel mates, except for Paul, are also progressing in their careers.

Barely a day passes when I don't think about the accident. That night, I was pressed into medical service before my time, but I wouldn't have changed that. I'm just glad I knew how to help Paul. Fate, or something greater than ourselves, saved us that night.

The director of my residency program subsequently commented that I was sometimes overzealous in treating my patients. Maybe so, but I want people to be healthy and to enjoy what time they have left. As for me, I'm grateful for every minute I have.

 

Patrick Peterson. How a "crash course" in medicine changed my life. Medical Economics 2002;5:67.