Job’s Sin

Dr. Jobson, a cardiovascular surgeon, and wife come upon an auto accident while driving to visit their children at Harvard. Pages 7-8. While at the restaurant that night, Eli said, “Liz, I’ve had a couple of amazing days lately. Let’s get away this weekend and surprise the kids by driving to Cambridge and taking them out to dinner.” Overjoyed by Eli’s spontaneity, especially the invitation to be with her beloved kids, both of whom were in Boston, along with the possibility of driving by her parents' house to say ‘Hi,’ she jumped at the idea and began thinking about what to wear. She thought, “Just 4 more days until Friday. Eli is not on call Memorial Day weekend. This will be a 4-day vacation, out of range of the hospital.” Liz was ecstatic knowing she would be with her most favorite people in the world this weekend. At 0600 Friday morning, Eli asked, “Liz, are you ready? We want to beat the holiday traffic leaving for the mountains.” Liz yelled down the hall, “I’m coming! You just throw a couple pairs of jeans, some shirts, and underwear into a suitcase, and you’re ready to walk out the door. You don’t realize what it takes for a woman to get ready. I’ll be downstairs in 5 minutes. Grab some snacks and start the car.” Both Eli and Liz, each being detailed planners, from making grocery lists to organizing piles of clothes on laundry day, were a bit giddy with their impulsive adventure. Neither the kids nor Liz’s parents were aware of the mini-family reunion that began with the garage door opening and Eli behind the wheel of Liz’s 2025 Z4 BMW convertible with the top down. Feeling the sun’s warmth on their faces, the warm breeze blowing through their hair, and seeing the clear, deep, rich blue sky overhead, they chose to get off I-90 and take scenic Route US 20 from New York to Massachusetts. Thirty miles from Boston, going around a tight turn, Eli hit the brakes. Over the embankment in front of them, both Liz and Eli saw a cloud of dust coming from an overturned 2013 Chevy Malibu 50 feet off the road. “Liz, call 911 while I go over the hill to check out the car. Stay up here, and I’ll yell back to you my assessment for emergency medical services (EMS). We may need more than one ambulance.” Both jumped out of the car. No one else was around. Eli rushed over the hill, stumbling at times over loose rocks. He got to the car and could see two adults in the front and an infant restrained in the back. Looking inside the driver’s side window, Eli saw the broken steering wheel impaled into the adult male’s chest. Pulse check: none. He went to the passenger’s side. The woman was not conscious. Her head was resting on her chest. She had difficulty breathing and obvious bilateral leg fractures from the dashboard crushed against her lap, pinning her inside the car. She had a thready right radial pulse and intermittent, rapid, shallow breathing. With extensive facial fractures and blood drooling down both sides of her chin, Eli took his shirt off and wiped the blood from her mouth, providing a momentary opening of her oral airway. Eli realized her facial trauma would block her breathing again. Looking to the back of her mouth, Eli saw a clot which he removed with his shirt; he knew this was temporary. It bought a few precious moments for Eli to assess the infant in the back. He glanced over the woman’s seat to look at the infant, who was about 18 months old. Blood was coming from her mouth, and there was no sign of life. The back side doors were crushed and could not be opened. Eli reached over the woman’s right shoulder to check the child’s right brachial pulse, there was none. The lifeless child now appeared blue in the face. Eli got out of the car and yelled to Liz, who was waiting at the top of the hill, “The driver and child are dead, but the passenger is barely alive. We need two ambulances with the Jaws of Life and a helicopter.” Eli returned to the passenger side of the car. Her major impact was from hitting the dashboard with her head, and her trapped legs were crushed by the dashboard. He could not remove her from the car. Eli re-assessed her mouth and airway again. He could see that the blood in her oral cavity came from her extensively lacerated tongue. Without moving her head due to concern over a possible cervical fracture, he yelled out to Liz, “Bring me your ink pen.” Liz rushed back to her car, grabbed the pen, ran, and slipping down the hill toward the car, she reached Eli, and handed to him her ink pen. Eli knew he had to get below the bleeding tongue for air to get into the woman’s lungs. He took apart the pen and forcefully jammed the hollow tube into the woman’s throat just below her Adam’s apple. No blood came out, so he blew into the open end of the pen, providing air into the woman’s lungs. He repeated this process 3 times, noting expansion of her lungs each time he breathed into the pen. Next, Eli took off his belt and placed it as a tourniquet around the woman’s proximal right leg above the knee to stop the bleeding. Her left leg had a sharp piece of metal from the dashboard impaled into it below the knee. Eli stuck his head out of the car and told Liz, “Quickly, get your scarf!” Liz grabbed the scarf Eli gave her when they were dating and rushed down the hill, scarf in hand, Eli tied a tight knot just above the wound entrance. Hemorrhaging from both leg wounds stopped. EMS arrived from a Boston suburb, and a helicopter landed on the highway above. Paramedics went to work, with two assessing the driver and infant and two relieving Eli. Two large IVs were placed in the woman. The Jaws of Life were used to remove the car roof to get to the dashboard; the woman’s neck was stabilized with a collar, and a tracheostomy tube was placed in the opening Eli created in her throat. EMS thanked Eli and Liz for their heroic work, took their phone numbers, and said they would be in touch should they need any further information. The Jobsons stayed around until the helicopter took off with the mystery woman and her uncertain future. With the situation under control, the Jobsons—bloodied from the horrific situation—climbed into their pristine BMW, turned around, and headed back to Syracuse. During the drive back home, Liz looked at her shirtless hero with blood-covered pants, who was lost in his own thoughts. She recapped the recent hour in her mind. She had never seen a horrific auto accident with mangled bodies and death. Then she stared at her car’s driver, who went into the valley of the shadow of death and emerged on the other side. She was proud—deeply proud—of the man who skillfully triaged a tragic accident and probably saved a woman’s life. Eli just looked straight ahead, driving the speed limit and replaying in his mind each step in the triage process. As best he could tell, he did everything right. He was satisfied with what he had done. The family in Boston never knew of the family reunion that might have been.