Ashley Callie is a human being - so are you

During the week that Ashley Callie was in a coma, I felt a sense of pressure, and a sense of her struggle. As each day passed and she remained in a coma, while we busied ourselves with our various concerns, I could not help but feel a strong sense of perspective...on what life is really about. And every time I saw impatient drivers overtake on Glenhove road, I'd wince. When will people get it? Your chance of getting seriously injured - in your life - is by far the highest when you get into your car. It's not a game. The steering wheel is the wheel of your own life, and you hold it in your hands.

What I remember was some spokesman speaking on behalf of the actress and being confident that she would pull through because she is 'a fighter'. It might sound like I am saying this in retrospect, but in fact, right then (he was speaking immediately after the accident), I remember thinking: "Where's the gravitas? She has serious head injuries, is in critical condition and this guy is sounding upbeat..." I believe it is appropriate for us to be modest sometimes, and humble, and try to face reality for what it is. Even if we have a positive attitude, we are not necessarily in control are we? Because it is possible to die. It is possible to die.

Did it matter that she must inevitably cease, completely. All this must go on without her. Did she resent it? Or did it not become consoling to believe that death ended absolutely? It is possible to die. It is possible to die. - Virginia Woolf in The Hours

Angelica Bell: What happens when we die?
Virginia Woolf: What happens? [pause]
Virginia Woolf: We return to the place that we came from.
Angelica Bell: I don't remember where I came from.
Virginia Woolf: Nor do I.

I saw Ashley Callie once at a mall last year in Bloemfontein. I was trying to take pictures of another soap star (Dezi, in 7de Laan). I noticed this long haired brunette and wondered who she was. I don't watch soapies, so I didn't know who she was. She gave me a few quizzical glances since I was coming in from the side taking photos (while everyone else was queuing for autographs).

It occurred to me when she was in hospital asleep/unconscious that her life actually ended for her at the moment of impact. Her body then fought for survival and lost that fight for survival because of the terrible damage sustained during the collision. This Sunday I saw pictures of the two car wrecks involved. The Renault is on its roof, and it is hard to imagine anyone survived in that crumbled mangle of red metal. Her small Smart is in a much better state, but she was hit on the driver's side and from the front.

[It now turns out that last sentence is incorrect in that it suggests another car collided with hers, when in fact it's been widely reported today - 20/02/2008 - that Callie ran a red light causing the accident. I must say I thought it was likely to have been the Renault - filled with youngsters and probably the guy driving was showing off, but this wasn't the case. Also, Callie had no medical aid, and hence had to be treated at a general hospital. All a pretty grim unfolding of events. One minute you're at a party, the next, you're fighting a losing battle to stay alive...]

My point is that we get mixed up with our hopes and wishes and wants, and it becomes a sort of 'expectancy'. Then we are shocked when we face the limits to life. There are limits, and once we can accept them, we can move on to enjoying and appreciating everything else.

To view a moving slideshow on Ashley Callie, go here.

French vs British Doctors: Scoop and Run or Treat on the Scene

The inquest into Princess Diana's untimely death presents an interesting question: for these sort of highly traumatic injuries, which is the best strategy? British doctors advocate a scoop and run approach, but it took 35 minutes to extricate Diana from the crash. Inside the ambulance Diana was reported to have been semi-conscious; she shouted out, pulled out her drip and had to be otherwise restrained. One presumes she was somehow conscious of her injuries and perhaps panicked, fearing she had been attacked or a target of assassination.

French Connection

But the French crews kept her in one place until 1:40am before transporting her to the hospital. In the entire period she suffered 2 cardiac arrests, and doctors performed heart massage.

Jean-Marc Martino was reported also to have instructed the ambulance to 'drive slowly'. The vehicle also remained stationery without any activity for around 5 minutes outside the hospital entrance. During this period, the Princess' blood pressure dropped to critical levels.

I am personally an advocate of the 'scoop and run' approach. I was a victim of a car accident and it is a nightmare being 'exposed' and in a non 'safe zone' under those circumstances. Highways and roads are just very nasty, alien, unsafe places to be, and efforts should be made to always evacuate from these bleak locations. Doing everything possible to get the patient to a place where all the necessary facilities exist should be the goal. Applying a minimum set of stabilising procedures (for example stemming the flow of blood, applying stabilising medications)is also recommended.

One Size Cannot Fit All

But I think it is a mistake to apply a 'blanket' approach. Under some scenarios, certainly, a patient can and must be treated in situ. For these cases, the ambulances must necessarily be thoroughly equipped to deal with the maximum of eventualities.

In the case of Princess Diana, a rapid scoop and run with in-transit treatment may have made all the difference. It is easier to make these assessments in retrospect, but if we can learn the valuable lessons there are to learn from them, many more lives can be saved.

This post was based in part on an article published recently in The Times (SA)